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Yang Ya Meng
Rheumatology
About me
Graduated from Anhui Medical University in 2005, working in the Department of General Medicine at the Second People's Hospital of Anhui Province, specializing in the diagnosis and treatment of common and prevalent internal medicine diseases.
Proficient in diseases
Conventional diagnosis and treatment of systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, and gouty arthritis, as well as regular diagnosis and treatment of prolonged unexplained fever.
Voices
How is ankylosing spondylitis treated?
The treatment of ankylosing spondylitis mainly consists of three types: The first is anti-inflammatory pain relief, primarily using non-steroidal pain relief medications, such as sustained-release diclofenac sodium tablets. The second is the selection of disease control medications, mainly involving drugs like sulfasalazine tablets. For ankylosing spondylitis, the most effective and economically expensive treatment is biological agents therapy. We commonly use drugs such as tumor necrosis factor antagonists. Patients with ankylosing spondylitis during acute pain periods are advised not to engage in intense exercise. However, during remission periods, appropriate functional exercises are recommended to prevent the adhesion and stiffness of spinal joints.
What to do if systemic lupus erythematosus causes a fever?
Patients with systemic lupus erythematosus (SLE) who develop a fever first need to discern whether the fever is due to immune-related fever caused by the activity of the disease or an infectious fever due to weakened immunity from long-term use of steroids and immunosuppressants. If the fever is caused by lupus activity, then it is necessary to increase the dosage of corticosteroids in treatment. If the fever is due to an infection, a full course of anti-infection treatment is needed. The anti-infection regimen may even need to include treatments with antibacterial, antifungal, and antiviral medications. (Please follow professional medical advice for medication use, and do not self-medicate.)
How is rheumatoid arthritis treated?
The treatment of rheumatoid arthritis mainly falls into three categories: The first category includes anti-inflammatory and pain-relief medications, which are further divided into non-steroidal pain-relief drugs and low-dose corticosteroids. For rheumatoid arthritis, the most crucial treatment involves the choice of the second category: slow-acting drugs. Common drugs used in treating the key aspects of rheumatoid arthritis include immunosuppressants such as methotrexate and leflunomide. If the patient does not respond well to the above two conventional treatments, a third option that can be considered is treatment with biological agents. Commonly used biological agents include tumor necrosis factor antagonists. Before using biological agents, it is necessary to strictly rule out hepatitis, tuberculosis, and neoplastic diseases. (Please use medication under the guidance of a doctor)
What should be paid attention to in the diet for rheumatic fever?
For patients with rheumatism, the general dietary rule is to follow a light diet, reduce spicy and greasy foods, and avoid foods that are too warm and dry. Specifically, vegetables like celery, coriander, leeks, seaweed, and shiitake mushrooms should be reduced in consumption because they may cause photosensitivity and worsen rheumatism. At the same time, meats such as lamb, dog meat, and beef are considered too warming and nourishing, and may also trigger the worsening of rheumatism, so their consumption should also be minimized. Similarly, seafood like shrimp, crab, and sea cucumber, which are high in protein, might cause allergic reactions in patients with rheumatism, so their intake should be minimized as well.
Symptoms of allergic purpura
Allergic purpura, which we generally divide into four types. The first type is the mildest, often primarily characterized by purpuric rash-like skin manifestations. The second type we call allergic purpura arthritis type, where patients, in addition to the typical rash, also experience joint pain symptoms. The third type we refer to as the renal type of allergic purpura, where patients often present primarily with hematuria and proteinuria, and urine tests typically indicate positive urinary protein. The fourth type we call the abdominal type of allergic purpura, where patients suffer from nausea, vomiting, abdominal pain, and diarrhea as their main clinical manifestations.
Do you need to be hospitalized for allergic purpura?
Whether patients with allergic purpura need to be hospitalized mainly depends on the severity of their condition. For mild cases of allergic purpura, also known as purely dermal allergic purpura, where the main clinical manifestation is a rash primarily on the lower limbs, outpatient treatment is sufficient. However, if the patient has gastrointestinal or renal types of allergic purpura, hospitalization is required. The gastrointestinal type of allergic purpura involves significant symptoms such as abdominal pain and diarrhea, while the renal type is characterized by symptoms like edema and significant proteinuria. If allergic purpura affects internal organs, the digestive tract, or kidneys, hospital treatment is necessary.
Can people with rheumatic fever eat fish?
Patients with rheumatic fever can eat freshwater fish, but should try to eat less fish without scales and sea fish. For patients with rheumatic fever, the general dietary rule is to eat a light diet and reduce consumption of spicy, warming, oily, and rich foods. Foods such as celery, coriander, leeks, seaweed, mushrooms, beef, mutton, dog meat, and longan should be minimized. Seafood, such as shrimp and crab, which are high in protein, should also be consumed less. In addition to dietary considerations, patients with rheumatic fever should also avoid getting cold and pay attention to rest.
How is rheumatoid arthritis diagnosed?
Rheumatoid arthritis examinations include blood tests and imaging studies. The blood tests include complete blood count, erythrocyte sedimentation rate, rheumatoid factor, C-reactive protein, anti-streptococcal antibodies, ANA, anti-CCP antibodies, and anti-AKA antibodies. Imaging studies involve X-ray examinations of the hand joints. If the patient has significant increases in erythrocyte sedimentation rate and C-reactive protein, positive CCP and AKA antibodies, and the X-rays show bone destruction, then rheumatoid arthritis can be considered as a diagnosis.
Can systemic lupus erythematosus be cured?
Systemic lupus erythematosus is difficult to cure completely as it is a chronic disease that requires long-term, lifelong medication. The most basic drugs used to treat systemic lupus erythematosus are corticosteroids. Hydroxychloroquine is also a basic treatment for systemic lupus erythematosus, but it is necessary to rule out contraindications such as retinal problems before use. Some patients with systemic lupus erythematosus, if they also have kidney or lung involvement, may need to consider treatment with immunosuppressants after using corticosteroids. Commonly used immunosuppressants include mycophenolate mofetil and cyclophosphamide. (Medication should be taken under the guidance of a physician.)
How to control ankylosing spondylitis
The treatment of ankylosing spondylitis mainly consists of three parts: The first part is the use of non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets; the second is the choice of disease control medications, which may include sulfasalazine or methotrexate tablets, especially for patients with peripheral joint pain, immunosuppressive drugs can be chosen. The most effective for ankylosing spondylitis are biologics, but before using biologics, it is necessary to exclude hepatitis, tuberculosis, and cancerous diseases, and the cost of biologics is relatively high. (Please use medications under the guidance of a professional physician and do not self-medicate.)