There are only more than 6,000 rheumatic diseases doctors in China, and more than half of them are not standardized in treatment.

　　In the impression of many people, "rheumatism" is a disease that causes discomfort when it is windy and rainy. However, rheumatic immune diseases are not so clinically — — It contains more than 200 kinds of diseases, such as rheumatoid arthritis, ankylosing spondylitis, lupus erythematosus and gout.

　　Zeng Xiaofeng, chairman of Rheumatology Branch of Chinese Medical Association and director of Rheumatology Immunology Department of Peking Union Medical College Hospital, admitted that the public’s awareness rate of the disease is low, the rate of medical treatment is low, and the treatment rate is low. In the face of more than 200 kinds of rheumatic diseases, early diagnosis and treatment are very important.

　　There are only more than 6,000 specialists in China.

　　At present, there are more than 200 million patients with rheumatic immune diseases in China, but there are only more than 6,000 clinical specialists. Zeng Xiaofeng said: "With the improvement of people’s health awareness and the progress of diagnosis and treatment technology, the rate of patients with rheumatism has become higher and higher in recent years, but ‘ Lack of medical care ’ The problem is still the biggest dilemma facing the rheumatology community. " However, the establishment of hospital departments has no advantage for the development of disciplines: among the 2427 tertiary hospitals in China, only 770 have established independent rheumatology immunology departments. In Zeng Xiaofeng’s view, rheumatism patients can be effectively relieved only by early diagnosis and treatment in professional departments and standardized treatment.

　　With the strong support of National Health Commission, the consultation letters for the guidelines for the construction and management of rheumatology immunology department in general hospitals (Trial) and the basic standards of rheumatology immunology department in general hospitals (Trial) have been issued one after another, and more and more hospitals will set up rheumatology immunology departments. Through active promotion, the "one city, one department and one center" plan has also achieved fruitful results. At present, the number of hospitals with rheumatology and immunology departments has nearly tripled compared with 2015.

　　"We will set up independent departments in 1,657 tertiary hospitals, train more than 10,000 specialists, and strive to make patients get professional treatment without leaving the county." Zeng Xiaofeng said.

　　More than half of patients have irregular treatment.

　　Liu Yi, director of the Department of Rheumatology and Immunology, west china hospital, said that rheumatoid arthritis, the most common rheumatic disease, is a chronic and inflammatory autoimmune systemic disease. The patient’s immune system mistakenly attacks its normal tissues as a threat, triggering a series of inflammatory reactions. If the disease is not effectively controlled, it will eventually lose its function and lead to disability.

　　Wang Ling, executive vice president of the Red Cross Society of Zaozhuang City, Shandong Province, introduced that the latest research results of the first nationwide multi-center, forward-looking direct reporting project of wind-related diseases in China show that the patients with wind-related diseases in China have the following characteristics:

　　First, the patient population is huge and the degree of disease awareness is not enough. There are about 5 million patients with wind-related diseases in China, and there are generally "three lows" with low awareness rate, low medical treatment rate and low treatment rate. Second, the disability rate is high. The disability rate of patients with similar wind customs is 50% in two years and 70% in three years. Third, the standardized treatment rate is low, with less than 44% of patients receiving standardized treatment and the remission rate of only 17.7%.

　　The reason is inseparable from "lack of doctors and medicines", and it has a lot to do with patients’ lack of understanding of diseases and poor treatment compliance. Liu Yi believes: "Rheumatism often requires lifelong medication, but many patients are too anxious. After taking the medicine for a few days, they feel ineffective and change the medicine at will, or even give up formal treatment, which not only fails to cure, but also delays the opportunity for formal treatment."

　　Another reason is that the average annual overall economic burden of patients exceeds 150,000 yuan, which is much higher than other common chronic diseases. Zeng Xiaofeng called on the state to include relevant effective drugs in medical insurance as soon as possible to benefit more patients.

　　"Rheumatoid immune diseases can occur in the whole life cycle, and early diagnosis and treatment are more important for children." Li Caifeng, director of the Department of Rheumatology and Immunology of Beijing Children’s Hospital, said: "Children’s Rheumatology and Immunology Department ‘ Lack of medical care and medicine ’ The situation is more severe than that of adults, and only dozens of hospitals across the country have set up children’s rheumatology immunology specialties. " Li Caifeng called on the whole society to pay more attention to children’s rheumatic immune diseases, strengthen the training of doctors and the research and development of innovative drugs, so that children patients can get appropriate treatment as soon as possible.

　　Early diagnosis, early treatment and early attainment are the most important factors of rheumatic diseases.

　　"The earliest symptoms of wind-like customs are joint symptoms, including swelling, pain, limited activity and morning stiffness." Su Yin, chief physician of the Department of Rheumatology and Immunology, Peking University People’s Hospital, suggested that the metacarpophalangeal joints between the palms and fingers, as well as the wrist joints, are all parts that are prone to early wind-like diseases; Some large parts may also be affected. When patients have more than one joint swelling, they need to see a doctor.

　　"If the pain symptoms last for more than 6 weeks, the patient is likely to suffer from wind-like illness." Professor Tian Xinping from Department of Rheumatology and Immunology, Peking Union Medical College Hospital suggested. Although the early stage of the similar wind pass was hidden, there were also clues to be found. For example, morning stiffness is a typical symptom, but not all morning stiffness is related to wind-like customs. When patients get up in the morning, their joints will appear stiff, which is called morning stiffness. "If it is only for a while, the activity will be improved, which is not a kind of performance; If the morning is stiff for more than 30 minutes, or even one morning, this is a typical wind-like performance. "

　　"The" Guidelines for the Diagnosis and Treatment of Rheumatoid Arthritis in China "proposes to ‘ Standard treatment ’ Control the development of the disease as soon as possible. There is a lot of evidence that if patients reach the standard early, they will benefit greatly after recovery. " Zhang Xiao, director of the Rheumatology Department of Guangdong Provincial People’s Hospital, pointed out that the previous related biological agents reduced the patient’s compliance because of the need for injection treatment; Now there is an innovative oral targeted synthetic anti-rheumatic drug, which provides a better possibility for standard treatment. However, many patients are still not relieved after taking the medicine, and in fact they are not up to standard. It is suggested that patients should stick to a treatment plan for 3 months and be evaluated by doctors. If the curative effect is not good, they should consider changing the plan until the treatment is effective.