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Ankylosing Spondylitis

　　Ankylosing spondylitis is a chronic progressive immune disease that mainly damages the axial joints and can affect peripheral joints, internal organs, and other tissues to varying degrees. The disease is more common in adolescents aged 15 to 30, and the incidence is relatively low after the age of 30 or before the age of 8. Male patients are more than female patients, with a ratio of about 5:1.

　　The incidence of ankylosing spondylitis is high, and it can recur for a long time. Most cases are difficult to be cured completely. The prevalence rate of the disease in China is 0.3%, with a hidden onset, a long course, and late-stage spinal ankylosis, joint deformities, leading to varying degrees of disability, and affecting the patient's work, labor ability, and quality of life. Most patients complain mainly of long-term lumbar and leg pain, and they seek medical treatment from various aspects and symptomatic treatment without improvement and gradually worsen, and finally they are diagnosed after further examination. The initial onset site is often at the knee and hip joints, and the patients have difficulty squatting, bending over, and walking, and the pain worsens at night. Ankylosing spondylitis should be strengthened in cold prevention and warmth preservation, try not to contact cold water, avoid invasion of wind and cold, and never be exposed to wind and cold or rain and dampness. Timely addition or subtraction of clothes, keep the home environment dry, and try to avoid living in damp houses.

　　This disease should be treated with a comprehensive approach, mainly medication and assisted by exercise, to achieve the purpose of controlling inflammation, alleviating symptoms, and preventing acute attacks of spinal and joint ankylosis. A single medication cannot 'subdue' this stubborn disease, and it is necessary to follow the combined medication approach used in the treatment of malignant tumors. Medical sports are an effective measure for preventing, slowing down, and improving the function of ankylosing spondylitis deformities, and it is necessary to persist in deep breathing, chest expansion, and exercises for the neck and lumbar areas.

Table of Contents: 1. What are the causes of ankylosing spondylitis
2. What complications can ankylosing spondylitis lead to
3. What are the typical symptoms of ankylosing spondylitis
4. How to prevent ankylosing spondylitis
5. What laboratory tests are needed for ankylosing spondylitis
6. Dietary taboos for patients with ankylosing spondylitis
7. Conventional methods of Western medicine for the treatment of ankylosing spondylitis

1. What are the causes of ankylosing spondylitis

　　Although ankylosing spondylitis is a relatively common disease, not many people are aware of it. In the early stages of the disease, there may be no clinical symptoms at all, and some people may only experience mild fatigue, weight loss, or low fever. So, what are the causes of the disease?

　　1. Infection:

　　Recent studies suggest that the onset of ankylosing spondylitis may be related to infection. Some researchers have found that many male patients with ankylosing spondylitis also have prostatitis; the incidence of ulcerative colitis and regional enteritis in some patients is higher than that of the general population. In addition, the detection rate of Klebsiella pneumoniae in the feces of patients with ankylosing spondylitis is 79%, while that of the control group is less than 30%.

　　2. Genetic factors:

　　90% of ankylosing spondylitis patients have genetic factors. Reports have shown that the risk of disease in first-degree relatives of ankylosing spondylitis patients is 20 to 40 times higher than that of the general population; a survey in China shows that the prevalence rate of first-degree relatives is 24.2%, 120 times higher than that of the general population. Therefore, ankylosing spondylitis is a disease closely related to genetics. People with a family history should be particularly vigilant about the early symptoms of ankylosing spondylitis.

　　3. Autoimmunity:

　　Researchers have found that 60% of ankylosing spondylitis patients have elevated serum complement levels, and most cases have IgA rheumatoid factor, with significantly increased levels of serum C4 and IgA. These phenomena suggest that the immune mechanism may be involved in the pathogenesis of ankylosing spondylitis.

2. What complications are easy to cause ankylosing spondylitis?

　　If ankylosing spondylitis patients do not receive timely treatment, it can lead to many complications. The following is an introduction to common complications:

　　1. Ear lesions:

　　The most common ear disease in ankylosing spondylitis patients is otitis media, and patients with ankylosing spondylitis are more prone to otitis media than normal people. Moreover, in patients with chronic otitis media due to ankylosing spondylitis, the number of joint diseases outside the joints is significantly higher than that in patients without chronic otitis media.

　　2. Ocular lesions:

　　Long-term follow-up surveys by experts have found that nearly one-tenth of ankylosing spondylitis patients may experience conjunctivitis, iritis, uveitis, or other lesions during the course of the disease, which may cause concurrent or spontaneous hyphema in the anterior chamber of the eye. Iritis is prone to recurrence, and the incidence rate increases with the duration of the disease, but it is not related to the severity of spondylitis. It is common in patients with peripheral joint diseases, and a few may occur before spondylitis. Eye diseases are often self-limiting and may require corticosteroid treatment. Improper treatment can lead to glaucoma or blindness.

　　3. Neurological lesions:

　　During the course of ankylosing spondylitis, patients may develop spinal cord compression due to spinal stiffness and osteoporosis, such as severe pain caused by discitis, or马尾综合征 leading to radicular pain in the lower limbs or buttocks, loss of sensation in the sacral nerve distribution area, weakened Achilles reflex, and motor dysfunction of the bladder and rectum.

3. What are the typical symptoms of ankylosing spondylitis?

　　Ankylosing spondylitis often develops stealthily, with patients gradually experiencing pain and stiffness in the lower back or sacroiliac area, or both. They may wake up in the middle of the night with pain, find it difficult to turn over, and notice stiffness in the lower back when getting up in the morning or after sitting for a long time, which subsides with activity. Some patients may feel dull pain in the buttocks or severe pain in the sacroiliac area, which occasionally radiates to the periphery. Coughing, sneezing, or sudden twisting of the waist can worsen the pain. In the early stages of the disease, pain is usually on one side and intermittent, but after several months, it often becomes bilateral and persistent. As the condition progresses, the pain may spread from the lumbar spine to the thoracic and cervical spine, leading to corresponding pain, limited movement, or spinal deformity in the affected areas.

4. How to prevent ankylosing spondylitis

5. What laboratory tests are needed for ankylosing spondylitis

　　Ankylosing spondylitis is a seronegative spondyloarthropathy that mainly invades the axial joints and is disabling. In recent years, with the development of imaging technology, especially CT and MRI, it has provided important guidance for the diagnosis of ankylosing spondylitis.

　　X-ray films are still the most commonly used means for the early diagnosis of ankylosing spondylitis, but their abnormal signs often appear late, and X-ray films are affected by the morphological structure of the sacroiliac joint, which has a great limitation in early diagnosis. In addition, the overlap of bony structures, feces, and intestinal gas shadows affects the observation of the lesion, as well as technical factors and reading experience, etc. The routine X-ray has a large diagnostic error for grade II and below sacroiliac arthritis, and it is not easy to achieve early diagnosis.

6. Dietary taboos for patients with ankylosing spondylitis

　　Patients with ankylosing spondylitis are often tortured by pain and have been long-term companions with medication. During an attack, they are not interested in food, so it is advisable to eat light; on the one hand, it can maintain a good appetite, and on the other hand, it can maintain a good function of the spleen and stomach to enhance the ability to resist diseases.

　　The following are the appropriate food choices for patients with this disease:

　　1. Nutritious foods: Such as beef, mutton, chicken, etc. It can also be cooked with Astragalus, prepared rehmannia, angelica, goji, and other herbs with meat and other foods to make soup, which can supplement protein.

　　2. Beans: Soybeans, black beans, and yellow beans, which are rich in plant proteins and trace elements, promote the metabolism of muscles, bones, joints, and tendons, and help repair damage. They can assist in the treatment of rheumatic bone pain with a heavy dampness pattern, and are effective for body沉重, joint stiffness, tendons and veins cramps, or numbness, joint swelling and pain in rheumatism. Black beans can treat rheumatic pain. Roast black beans to half-burnt and add yellow wine to treat joint pain effectively. Caution should be exercised for those with gastritis.

　　3. Fruits: Lychee, olive, grape, jujube, apple, longan, goji, and lotus seeds.

　　4. Fruits: Chestnuts can tonify the kidneys, strengthen the tendons and bones, and are extremely beneficial for tendons, meridians, rheumatic arthralgia, or weakness of the waist and knees.

　　Traditional Chinese medicine believes that ankylosing spondylitis is caused by kidney deficiency leading to damage to the tendons, muscles, and joints. It can be taken raw or cooked. Mashed chestnuts can be applied to the affected area to treat tenderness and swelling of the tendons and bones. Mashed fresh chestnut leaves can also be applied externally to reduce inflammation of the joints, muscles, and skin.

　　Plum has the effects of moistening the throat, quenching thirst, and stopping diarrhea, which is beneficial for patients with ankylosing spondylitis. For those with rheumatic bone pain, lumbar pain, and joint pain, plum wine can be used to wipe the affected area to relieve pain. Chinese dates also have significant effects on rheumatic pain. Chinese dates are sour and sweet, sweet to condense yin, and sour to enter the liver. Nourishing the liver helps alleviate pain in joints and tendons. Mulberries and cherries can also treat rheumatism. Walnut kernels have the functions of nourishing the liver and kidney, benefiting the brain and spleen, and strengthening the tendons and bones. Two to three walnuts can be eaten daily. Pine nuts also have the functions of nourishing the liver and kidney, benefiting the brain and spleen, and strengthening the tendons and bones. Three to five grams can be eaten daily.

7. Conventional methods for the treatment of ankylosing spondylitis in Western medicine

　　Traditional Chinese medicine dialectics classify ankylosing spondylitis into three types, and the following are the symptoms and treatment prescriptions for each type:

　　Treat with tonifying the liver and kidney, clearing heat and detoxifying, resolving dampness and unblocking the meridians. Prescriptions: Rhizoma Anemarrhenae, Phellodendri Chinense, Radix Achyranthis Bidentata, Herba Taraxaci, Fructus Meliae, Fructus Melo, Rhizoma Coptidis, Rhizoma Ophiopogonis, Caulis Lonicerae, Radix Sophorae Flavescentis, Caulis Sinomenii, Rhizoma Ophiopogonis, Herba Portulacae.

　　Treat with tonifying the kidney and reinforcing the Du Meridian, dispelling cold and unblocking the meridians. Prescriptions: Rhizoma Cibotii, Fructus Corni, Herba Dipsaci, Radix Morindae Officinalis, Herba Epimedii, Cortex Eucommiae, Scolopendra, Caulis Sinomenii, Herba Lycopi, Rhizoma Ophiopogonis.

　　Treat with tonifying the liver and kidney, resolving phlegm and removing blood stasis to unblock the meridians. Prescriptions: Rhizoma Cibotii, Fructus Corni, Radix Paeoniae Alba, Caulis Sinomenii, Semen Sinapis Alba, Rhizoma Curcumae, Rhizoma Belamcandae, Scolopendra, Bombyx Batryticus, Bombyx Mori, Scutellariae Radix.

　　The above traditional Chinese medicine prescriptions are for reference only, and patients should use them after辨证.

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