关节痛的诊断和治疗

Diagnosis and Treatment of Arthralgia

关节痛是临床常见病症之一,若诊断不及时、病程迁延过久可引起关节囊增生与肥厚、软骨及骨质破坏、关节间隙变窄及骨质增生等,使患者活动受限。关节痛的病因较为复杂,诊断需结合患者病史、体格检查及实验室检查等进行综合分析:首先,判断关节痛是功能性还是器质性;其次,确定关节痛性质;再次,明确关节痛的病因。关节痛的治疗可分为针对病因的治疗和对症治疗:针对病因的治疗包括关节制动、脱位关节复位、广谱抗生素控制感染、早期功能锻炼和积极治疗原发病等;对症治疗包括止痛药物治疗和中医中药辨证治疗。

Arthralgia,a common clinical symptom,can lead to joint capsule hyperplasia and hypertrophy,cartilage and bone damage,joint space narrowing,bone hyperplasia and so on to limit patients′activity if diagnosis is not done timely or disease course delayed too long.The etiology of arthralgia is complex.Its diagnosis must be made based on comprehensive analysis of patients′history,physical examination and laboratory tests.Whether arthralgia is functional or organic should be judged first,its nature determined next,then its causes.Arthralgia treatments can be divided into etiotropic and symptomatic.The former includes joint immobilization,embolia,infection control by broad-spectrum antibiotics,early function exercises,active treatment of primary diseases and so on;The latter includes pain medication therapy and TCM differential treatment.