Điều trị viêm khớp dạng thấp theo quan điểm y học cổ truyền

Dieu trj viem kh6p

theo quan diem y hoc

Viem khdp dang thap la bdnh ly td midn man

tinh cua khdp xdong, dac trdng bdi sdng dau

nhieu khdp nho, doi xdng vdi ton thUOng cO

ban la d mang hoat dich ciia khdp, gdy tdn thUOng

XUdng va sun khdp ngay cang tram trgng va hau qua

cud'i Cling la dinh khdp, bie'n dang khdp gay tan phe

cho ngddi bdnh. Vidm khdp dang tha'p gap d mgi noi

tren the' gidi, tai Viet Nam, viem khdp dang tha'p

chie'm khoang 0,5% trong cgng dong vk lk benh ly

chie'm tren 20% sd benh nhan mac benh khdp phai

nam dieu trj tai benh vien. Benh thudng gap d nfl

gidi, ty Id nii'nam khoang 3/1. Tuoi hay gap nhat la

tuoi trung nien (30 - 60 tuoi).

Cho de'n nay, nguyen nhkn gay benh trong viem

khdp dang thap vdn con nhieu dieu chfla sang to.

Hku het gia thuyet cho rkng viem khdp dang thap

la benh ly tfl mien dich vdi nhieu ye'u to' tham gia:

Virus, vi khuan thfldng gap, ye'u to' co dia thudn lgi

(nfl, CO mang khang nguyen HLADR4), ye'u to mdi

trfldng, di truyen... lam khdi phat benh.

Cac trieu chimg nhfl sflng, ndng, dau, co the cd do

xukt hien d nhieu khdp nhd ngoai bien, co tinh chd't

ddi xflng hai ben la nhflng tridu chflng lam sang

dien hinh, hay gap trong viem khdp dang thap. Cac

khdp hay gap la khdp co tay, cac khdp ban ngon

tay, khdp ngdn gan, khdp khuyu, khdp gdi, khdp co

chan, khdp ban ngon chan, Khdp vai, khdp hkng la

cac khdp it gap va thifdng khi bdnh da dien bie'n

nhieu nam, Sflng dau cac khdp kieu viem, didn bie'n

thfldng keo dai tren 6 tuan va nhieu ddt tki phat la

cac chi didm tin cay cua benh viem khdp dang thap.

Ngoai ra, cflng khdp budi sang cung thfldng gap

trong cac dgt tie'n trien cua benh. Toan than bdnh

nhan viem khdp dang thap thfldng bi anh hfldng

nghiem trgng. Gay sut, thieu mau, chan an la nhuiig

dd'u hidu phu hgp vdi dien bid'n man tinh cua bdnh.

Cac trieu chiifng ngoai khdp nhfl hat dfldi da (rat die

hidu trong viem khdp dang thap nhflng it gap tai

Viet Nam), viem gdn, day chdng va phan mem canh

khdp ciing cd the gap. Mgt sd trfldng hdp ton thuong

ngi tang nhd mang tim, mang phoi, nao thfldng rat

nang ckn chan doan sdm va dieu tri tich cflc.

Muc tieu trong quan ly dilu tri viem khdp dang

thd'p la dat dfltfc sfl lui bdnh hoan toan, nghia la sif

vang mat ciia cac ye'u to: trieu chflng sflng dau khdp

va mo quanh khdp (qua quan sat va tham kham),

cuiig khdp budi sang, met moi chan an, hinh anh ton

thfltfng tren phim X quang tid'n trien gifla cac lan thdm

kham, khong giam cac chi so tren can lam sang ddc

hieu lien quan benh. Ne'u sfl lui benh hoan toan khflng

dat dflgc do bdnh da d giai doan trd thi muc tieu quan

ly benh la kiem soat sd boat dgng cua benh, giam dau,

duy tri chflc nang van dpng khdp trong ckc hoat dgng

X quang xUdng ban tay benh nhkn viem khdp dang thdp

f - Than minh: benh nhdn nam

d tfl the nfla ngfla, cd goi dd phia

Iflng de tranh cho phan ctf the ben

liet chju Iflc qua mflc,

- Ben liet: khdp vai, xfltfng ba

vai dflgc dfla ra trflde, tay duoi 90°

vdi than, khdp khuyu dudi, ckng tay

xoay ngfla, cd tay, cac ngon tay duoi

va dang, Chan liet d tfl the' khdp

hang dudi va khdp gdi htfi gd'p,

- Ben lanh: tay va chan lanh d

vj tri nghi ngtfi tren than hoac tren

22

go'i dd phia sau Iflng, de trd giup

gifl than minh d tfl the' nfla ngfla.

^ Nhdng diim cdn luu y

- Khdng de benh nhdn nkm

qua lau d mgt tfl the', benh nhan

ckn dfltfc thay ddi cac tfl the' ndm

thfldng xuyen tfl 2 - 4 gid mpt ldn

de phong ngifa cac bie'n chiing thfl

phat va ckc tdn thfldng thfl ca'p.

- Can than trgng khi de benh

nhdn nkm ngda, khong de benh

nhan d vi the' nda ndm nfla ngoi,

vi d vi the' nay, nguy cd loet viing

cung cut va tinh trang co cflng c6

the tang len.

- De giup ngfldi bdnh nkm d

cac tfl the ndi trdn, can c6 m§t

sd gdi nha't dinh de ke Ad, vat

lieu lam gdi cd the la bflng, miit.

Cac gia dinh khong cd dilu ki^n

cd the sfl dung chan man, qudn

ao cu, cd rom khd, sach,., di ISni

gdi ke dd cho cdc phkn cd the cua

bgnh nhan. ^

THUOC & SCfC KHOE sd 502 (15.6.2014)