陈永大夫的个人网站 sgcy88888888.haodf.com

本站已经通过实名认证,所有内容由陈永大夫本人发表

当前位置: 上海华东医院 > 陈永 > 文章列表 >强直性脊柱炎问答

医学科普

强直性脊柱炎问答

发表者:陈永 人已读

Questions and Answers about Ankylosing Spondylitis

强直性脊柱炎问答复旦大学附属华东医院免疫风湿科陈永

This publication contains general information about ankylosing spondylitis (AS). It describes what ankylosing spondylitis is, its causes, and treatment options. Highlights of current research are also included. At the end is a list of key words to help you understand the terms used in this publication. If you have further questions, you may wish to discuss them with your health care provider.

本文包含了强直性脊柱炎一般信息。描述了什么是强直性脊柱炎,其原因以及治疗方案。点明了当前研究的热点。文末的关键词帮您深入了解该文。如果你有更多疑问,请与你的医生进行询问。

What Is Ankylosing Spondylitis?

什么是强直性脊柱炎

Ankylosing spondylitis is a form of progressive arthritis due to chronic inflammation of the joints in the spine. Its name comes from the Greek words “ankylos,” meaning stiffening of a joint, and “spondylo,” meaning vertebra. Spondylitis refers to inflammation of the spine or one or more of the adjacent structures of the vertebrae.

强直性脊柱炎Ankylosing spondylitis是一种进行性的由于脊柱关节慢性炎症导致的疾病。它的命名来源于希腊语“ankylos”意思是关节僵直。spondylo,意思是脊柱骨。所以强直性脊柱炎是脊柱关节及其邻近结构的炎症反应。

·Who Has Ankylosing Spondylitis?

·谁得了强直性脊柱炎?

·What Causes Ankylosing Spondylitis?

·强直性脊柱炎的原因?

·How Is Ankylosing Spondylitis Diagnosed?

·僵直性脊柱炎如何诊断?

·What Type of Doctor Diagnoses and Treats Ankylosing Spondylitis?

·什么样的医生可以诊断和治疗强直性脊柱炎?

·Can Ankylosing Spondylitis Be Cured?

·强直性脊柱炎可以治愈吗?

·What Medications Are Used to Treat Ankylosing Spondylitis?

·强直性脊柱炎用什么药?

·Will Diet and Exercise Help?

·饮食和运动有帮助吗?

·When Might Surgery Be Necessary, and How Can It Help?

·什么时候需要手术?手术有什么作用?

·What Are Some Things I Can Do to Help Myself?

·我自己能做什么帮助我自己?

·What Is the Prognosis for People With Ankylosing Spondylitis?

·强直性脊柱炎预后怎么样?

·What Research Is Being Conducted on Ankylosing Spondylitis?

·强直性脊柱炎目前进行什么样的研究

·Where Can I Find More Information About Ankylosing Spondylitis?

·那里可以找到强直性脊柱炎的相关信息?

·

Ankylosing spondylitis belongs to a group of disorders called seronegative spondyloarthropathies. Seronegative means an individual has tested negative for an autoantibody called rheumatoid factor. The spondyloarthropathies are a family of similar diseases that usually cause joint and spine inflammation. Other well-established syndromes in this group include psoriatic arthritis, the arthritis of inflammatory bowel disease, chronic reactive arthritis, and enthesitis-related idiopathic juvenile arthritis.

强直性脊柱炎是一组血清阴性脊柱关节病。血清阴性意为个体的类风湿因子RF检查是阴性。脊柱关节炎是一组以脊柱炎症疾病为表现的疾病家族。其他常用的此类综合症命名包括银屑病关节炎,炎症肠病性关节炎,慢性反应性关节炎,肌腱起止点相关的特发性幼年性关节炎

Although these disorders have similarities, they also have features that distinguish them from one another. The hallmark of ankylosing spondylitis is “sacroiliitis,” or inflammation of the sacroiliac (SI) joints, where the spine joins the pelvis.

尽管这些疾病有相似之处,但也有相互区别的临床特点。强直性脊柱炎的特点是“骶髂关节炎”,几脊柱关节和盆骨的交会处。

In some people, ankylosing spondylitis can affect joints outside of the spine, like the shoulders, ribs, hips, knees, and feet. It can also affect entheses, which are sites where the tendons and ligaments attach to the bones. It is possible that it can affect other organs, such as the eyes, bowel, and—more rarely—the heart and lungs.

在一些患者中,强直性脊柱炎可以累及除脊柱外的其他关节,包括肩关节、肋骨、髋关节、膝关节、足部关节。亦可累及肌腱,即肌腱端(肌腱附着于骨头处)。强直性脊柱炎亦可累及其他脏器,例如眼睛、肠道,较少情况下累及心肺。

Although many people with ankylosing spondylitis have mild episodes of back pain that come and go, others have severe, ongoing pain accompanied by loss of flexibility of the spine. In the most severe cases, long-term inflammation leads to calcification that causes two or more bones of the spine to fuse. Fusion can also stiffen the rib cage, resulting in restricted lung capacity and function.

尽管许多强直性脊柱炎患者可以反反复复的轻度的腰背部疼痛,但有些患者则表现为严重的持续的脊柱疼痛且活动性受到限制。在最严重的病例,患者由于长期的炎症导致了两处或多处关节钙化融合。这种骨关节融合发生在肋骨可导致肺限制性呼吸功能障碍。

Who Has Ankylosing Spondylitis?

谁可以得强直性脊柱炎

Ankylosing spondylitis typically begins in adolescents and young adults, but affects people for the rest of their lives. Men are more likely to develop ankylosing spondylitis than are women.

强直性脊柱炎 常发生于年轻的成年人,但是任何年纪均可发病。男性比女性更为常见。

What Causes Ankylosing Spondylitis?

是什么原因导致了强直性脊柱炎?

The cause of ankylosing spondylitis is unknown, but it is likely that both genes and factors in the environment play a role. The main gene associated with susceptibility to ankylosing spondylitis is called HLA-B27. But while most people with ankylosing spondylitis have this genetic marker, only a small percentage of people with the gene develop the disease.

强直性脊柱炎的病因尚不明确,但似乎与基因及环境因素密切相关。与之最为密切的基因称为HLA-B27该基因表型在强直性脊柱炎非常常见,但正常人亦可见到,且仅小部分该基因阳性发展为强直性脊柱炎。

How Is Ankylosing Spondylitis Diagnosed?

强直性脊柱炎如何诊断

A diagnosis of ankylosing spondylitis is based largely on the findings of a medical history and physical exam. Radiologic tests and lab tests may be used to help confirm a diagnosis, but both have some limitations.

诊断强直性脊柱炎主要依据患者病史及临床检查。影像学检查及实验室检查可帮助确诊,但有局限之处。

Medical History病史

The medical history involves answering questions, such as the following:

病史包括如下问题:

·How long have you had pain?

·您疼痛多久?

·Where specifically is the pain in your back or neck? Are other joints affected?

·痛处,后背?颈椎?或其他关节?

·Is back pain better with exercise and worse after inactivity, such as when you first get up in the morning?

·活动后关节疼痛好转还是加重?早晨起来怎么样?

·Do you have other problems, such as eye problems or fatigue?

·有无其他问题,如眼部疾病或疲劳?

·Does anyone in your family have back problems or arthritis?

·家族中有无类似疾病或关节炎

·Have you recently suffered from a gastrointestinal illness?

·最近胃肠道有无疾病?

·Do you have any skin rashes such as psoriasis?

·有无皮疹?或牛皮癣?

From your answers to these questions, your doctor can begin to get an idea of the diagnosis.

你对这些问题的回答可帮助你的医师进行诊断。

Physical Exam体格检查

During the physical exam, the doctor will look for signs and symptoms that are consistent with ankylosing spondylitis. These include pain along the spine and/or in the pelvis, sacroiliac joints, heels, and chest. Your doctor may ask you to move and bend in different directions to check the flexibility of your spine and to breathe deeply to check for any problems with chest expansion, which could be caused by inflammation in the joints where the ribs attach to the spine.

体格检查时,医师会寻找强直相关的临床症状和体征,包括脊柱或骨盆的疼痛、腰骶部痛、足跟痛、胸骨疼痛等。你的医师会让你活动、下弯等不同方向的运动来检查脊柱的活动度。进行深呼吸以观察胸廓呼吸动度。因为在肋骨与脊柱联合的关节由于炎症时会影响胸廓活动度。

Radiologic Tests放射学检查

X rays and magnetic resonance imaging (MRI) may be used in making or confirming a diagnosis of ankylosing spondylitis, but these tests have limitations. X rays may show changes in the spine and sacroiliac joints that indicate ankylosing spondylitis; however, it may take years of inflammation to cause damage that is visible on x rays. MRI may allow for earlier diagnosis, because it can show damage to soft tissues and bone before it can be seen on an x ray. Both tests may also be used to monitor the progression of ankylosing spondylitis.

X光片及MRI检查可以帮助确诊有无强直性脊柱炎,但所有的检查都尤其局限性。X线显示的脊柱和骶髂关节的改变可提示强直的存在,但是可能关节的炎症在数年后才能在X线检查上体现出来。MRI可以帮助更早诊断,因为MRI可以比X线更早期地看到软组织及骨骼的损害。两种检查都可以用于对强直的进展情况进行监测。

Lab Tests实验室检查

The main blood test for ankylosing spondylitis is one to check for the HLA-B27 gene, which is present in the majority of Caucasians with ankylosing spondylitis. However, this test also has limitations. The gene is found in much lower percentages of African Americans with ankylosing spondylitis, and in ankylosing spondylitis patients from some Mediterranean countries. Also, the gene is found in many people who do not have ankylosing spondylitis, and will never get it. Still, when the gene is found in people who have symptoms of ankylosing spondylitis and/or x-ray evidence of ankylosing spondylitis, this finding helps support the ankylosing spondylitis diagnosis.

HLA-B27基因是强直诊断的主要血液检查,绝大多数白种人强直患者改基因阳性。但该检查有其局限性。例如在美国黑人、地中海国家的强直患者中,该基因阳性的概率下降。并且很多正常人亦可阳性,且永远不会进展为强直。所以,当临床怀疑强直性脊柱炎,有X线证据时,HLA-B27基因阳性可帮助诊断。

What Type of Doctor Diagnoses and Treats Ankylosing Spondylitis?

哪个类型的医师可以诊断和治疗强直?

The diagnosis of ankylosing spondylitis is often made by a rheumatologist, a doctor specially trained to diagnose and treat arthritis and related conditions of the musculoskeletal system. However, because ankylosing spondylitis can affect different parts of the body, a person with the disorder may need to see several different types of doctors for treatment. In addition to a rheumatologist, there are many different specialists who treat ankylosing spondylitis. These may include:

强直常常由风湿科医师或经过专门的关节、肌肉骨骼系统疾病培训的医师进行诊断。但是,由于强直可累计人体的不同部位,所以一个患者如果有相关累及可能需要看不同科室的医师。对于一个风湿科医师而言,常需要联合各个科室专家进行对强直的治疗,包括:

·An ophthalmologist, who treats eye disease.

·眼科医师

·gastroenterologist, who treats bowel disease.

·消化科医师

·physiatrist, a medical doctor who specializes in physical medicine and rehabilitation.

·康复科医师

·physical therapist or rehabilitation specialist, who supervises stretching and exercise regimens.

Often, it is helpful to the doctors and the patient for one doctor to manage the complete treatment plan.

物理治疗师或康复专家可指导患者进行运动计划。这对于帮助风湿科医师或者处理一个复杂的强直患者非常有价值。

Can Ankylosing Spondylitis Be Cured?

强直性脊柱炎是否可以治愈?

There is no cure for ankylosing spondylitis, but some treatments relieve symptoms of the disorder and may possibly prevent its progression. In most cases, treatment involves a combination of medication, exercise, and self-help measures. In some cases, surgery may be used to repair some of the joint damage caused by the disease.

目前尚无法治愈强直性脊柱炎。治疗可以缓解症状、延缓疾病进程。对于绝大多数患者而言,治疗包括药物、运动及自我监测。对于一些患者,可能需要手术来进行疾病导致的关节损害。

What Medications Are Used to Treat Ankylosing Spondylitis?

有什么药物治疗强直性脊柱炎?

Several classes of medications are used to treat ankylosing spondylitis. Because there are many medication options, it’s important to work with your doctor to find the safest and most effective treatment plan for you. A treatment plan for ankylosing spondylitis will likely include one or more of the following:1

强直性脊柱炎有多种药物可供选择,关键是要配合好医师,找到最安全最有效的治疗。强直性脊柱炎可能会用到如下一种或多种药物;

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)非甾体消炎药

These drugs relieve pain and inflammation, and are commonly used to treat ankylosing spondylitis. Aspirin, ibuprofen, and naproxen are examples of NSAIDs. All NSAIDs work similarly by blocking substances called prostaglandins that contribute to inflammation and pain. However, each NSAID is a different chemical, and each has a slightly different effect on the body.2

这类药物可以缓解疼痛和炎症,是强直性脊柱炎的常用药物。包括阿司匹林,布洛芬和萘普生等。所有的非甾体消炎药作用机制相似:阻断前列腺素这一物质,从而发挥消炎止痛作用。但是每一种非甾体消炎药都是一个不同的化学物质,对机体也有少许不同的副作用。


1 All medicines can have side effects. Some medicines and side effects are mentioned in this publication. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.

所有的药物都会有副作用。不同患者表现的副作用不尽相同。你可以阅读药品说明书,遇到问题可咨询医务人员或药师。

2 Warning: Side effects of NSAIDs include stomach problems; skin rashes; high blood pressure; fluid retention; and liver, kidney, and heart problems. The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious. Many other drugs cannot be taken when a patient is being treated with NSAIDs, because NSAIDs alter the way the body uses or eliminates these other drugs. Check with your health care provider or pharmacist before you take NSAIDs. NSAIDs should only be used at the lowest dose possible for the shortest time needed.

警告:非甾体消炎药的副作用剥壳胃痛、皮疹、高血压、水潴留及肝肾或心脏问题。用药时间越长,这些问题发生的概率越大,有些患者轻微,有些患者严重。许多药物不可以与非甾体消炎药同时使用,因为非甾体消炎药改变了人体代谢其他药物的路径。用药前咨询医师,并以最低有效剂量进行控制疾病。

Some NSAIDs are available over the counter, but more than a dozen others, including a subclass called COX-2 inhibitors, are available only with a prescription.

有些非甾体消炎药属于非处方药,但是种类不多。 COX-2抑制剂(非甾体消炎药的一个亚类)是处方药物。

All NSAIDs can have significant side effects, and for unknown reasons, some people seem to respond better to one NSAID than another. Anyone taking NSAIDs regularly should be monitored by a doctor.

所有非甾体消炎药都有明显副作用,且不同患者对同一种非甾体消炎药治疗效果

Corticosteroids糖皮质激素

These strong inflammation-fighting drugs are similar to the cortisone made by our bodies. If NSAIDs alone do not control inflammation in people with ankylosing spondylitis, doctors may inject corticosteroids directly into the affected joints to bring quick but temporary relief. Injections may be given to the sacroiliac joint, hip joint, or knee joint, but are not given in the spine.

激素为强抗炎药,与我们身体分泌的可的松类似。如果单独使用NSAIDs不能有效抑制强直性脊柱炎的炎症,医师可能会将激素直接进行受累的关节腔注射而获得临时缓解。可进行骶髂关节、髋关节、膝关节注射。但不常进行脊柱关节注射。

Disease-Modifying Antirheumatic Drugs (DMARDs)改善风湿病情药

These drugs work in different ways to control the disease process of ankylosing spondylitis. The most commonly used DMARDs for ankylosing spondylitis are sulfasalazine and methotrexate.

这类药物通过不同的机制来控制强直性脊柱炎的金子。强直性脊柱炎最常用的DMARDs是柳氮磺吡啶和甲氨喋呤。

Biologic Agents生物制剂

Members of this class of medications are genetically engineered to block proteins involved in the body’s inflammatory response. Four biologics—adalimumab, etanercept, golimumab, and infliximab—are approved by the Food and Drug Administration (FDA) for treating ankylosing spondylitis. All four work by suppressing a protein called tumor necrosis factor-alpha (TNF-α), and are often effective for relieving symptoms when NSAIDs or other treatments are not. These drugs are taken by intravenous infusion or injection.

这类药物是作用于机体炎症反应的蛋白质,对像个蛋白质进行阻断。FDA批准4种生物制剂用于强直:阿达木单抗、依拉西普、戈力木单抗和英夫利昔单抗。这四种生物制剂均能抑制肿瘤坏死因子(TNF-α),对于NSAIDs或其他药物不能控制症状时可以选用。药物常为静脉注射或皮下注射。

Will Diet and Exercise Help?饮食和锻炼有帮助吗?

A healthy diet and exercise are good for everyone, but may be especially helpful if you have ankylosing spondylitis.

Exercise and stretching, when done carefully and increased gradually, may help painful, stiff joints.

健康的饮食和锻炼对任何人群都是有益的,对强直性脊柱炎患者更是如此。锻炼、拉伸逐渐进行,可帮助缓解疼痛和关节僵硬。

·Strengthening exercises, performed with weights or done by tightening muscles without moving the joints, build the muscles around painful joints to better support them. Exercises that don’t require joint movement can be done even when your joints are painful and inflamed.

·力量锻炼,进行举重或强健肌肉而不运动关节,可以使关节周围的肌肉得以加强。此类运动不需要关节活动,甚至在关节疼痛和炎症时期仍然可以进行。

·Range-of-motion exercises improve movement and flexibility and reduce stiffness in the affected joint. If the spine is painful and/or inflamed, exercises to stretch and extend the back can be helpful in preventing long-term disability.

Many people with ankylosing spondylitis find it helpful to exercise in water.

Before beginning an exercise program, it’s important to speak with a health professional who can recommend appropriate exercises.

活动度锻炼 可改善关节运动活动度,减少僵硬敢。如果脊柱是疼痛或炎症期,对背部进行锻炼和拉伸有利于预防关节致残。很多患者发现游泳对强直非常有邦族。在进行运动之前,咨询专业的医师很有必要。

When Might Surgery Be Necessary, and How Can It Help?何时需要手术,是否有帮助?

If ankylosing spondylitis causes severe joint damage that makes it difficult to do your daily activities, total joint replacement may be an option. This involves removing the damaged joint and replacing it with a prosthesis made of metals, plastics, and/or ceramic materials. The most commonly replaced joints are the knee and hip.如果强直导致了严重的关节损害,并使得日常活动难以进行,可选择关节值置换手术。手术会切除损坏的关节,并采用金属、塑料或陶瓷的假关节。最常见的置换关节是膝、髋关节。

In very rare cases, a procedure called osteotomy may be used to straighten a spine that has fused into a curved-forward position. This surgery involves cutting through the spine so that it can be realigned to a more vertical position. After the bones are realigned, hardware may be implanted to hold them in their new position while the spine heals.

在少数病例,骨切开术用于增强脊柱治疗脊柱变形。尤其是对于有前突患者。手术包括切开脊柱进行垂直矫形。脊柱关节重排后,植入硬物,以保持脊柱形态。

Surgery to straighten the spine can only be done by a surgeon with significant experience in the procedure. Many doctors and surgeons consider the procedure high risk.脊柱关节的矫形手术需在有经验的医师进行。手术存在风险。

What Are Some Things I Can Do to Help Myself?

我自己能做点什么对康复有帮助?

Aside from seeing your doctor regularly and following your prescribed treatment plan, staying active is probably the best thing you can do for ankylosing spondylitis. Regular exercise can help relieve pain, improve posture, and maintain flexibility. Before beginning an exercise program, speak with your doctor or physical therapist about designing a program that’s right for you.

除了有规律地看医师,以及完成治疗计划,保持积极运动是你能为自己康复做的最好的事情。有规律的运动可以帮你缓解疼痛、改善姿势、保持关节活动性。在进行运动志气,咨询你的医生或康复治疗师,为你制定一个康复运动计划。

Another important thing you can do for yourself is to practice good posture. A good test for posture is to check yourself in a mirror. First, stand with a full-length mirror to your side and, if possible, turn your head to look at your profile. Next, imagine you have dropped a weighted string from the top of your head to the soles of your feet. Where does the string fall? If your posture is good, it should pass through your earlobe, the front of your shoulder, the center of your hip, behind your kneecap, and in front of your anklebone. If you are not standing that way already, practice holding your body that way in front of a mirror until you know well how it feels. Practicing good posture can help you avoid some of the complications that can occur with ankylosing spondylitis.

另一项可以为自己做的事情是保持良好的姿势。你可以对着镜子检查自己的姿势是否良好。首先,站在能观察全身的镜子旁,侧头看镜子,观察。然后想象一个线团从你头上落到脚上。线团从哪些地方落下呢?如果你的姿势良好,线团应该经过你的耳廓,肩膀前部,髋部、膝盖以及踝关节。如果你的姿势不能够使假想中的线团经过这些地方,在镜子前面练习,直到你感觉正常的姿势。这样的姿势训练可以使你避免一些强直性脊柱炎带来的关节变形。

What Is the Prognosis for People With Ankylosing Spondylitis?

强直性脊柱炎预后如何?

The course of ankylosing spondylitis varies from person to person. Some people will have only mild episodes of back pain that come and go, while others will have chronic severe back pain. In almost all cases, the condition is characterized by acute, painful episodes and remissions, or periods of time where the pain lessens.

每个强直患者的病程不同。有些病人是偶尔发作的短暂的背部疼痛,有些人是慢性长期的背部疼痛。几乎所有的患者都有急性的疼痛期和缓解期。

In the sacroiliac joints and spine, inflammation can cause pain and stiffness. Over time, bony outgrowths called syndesmophytes can develop that cause the vertebrae to grow together, or fuse. Fusion can also stiffen the rib cage, resulting in restricted lung capacity and restricted lung function.

炎症可以导致骶髂关节、脊柱关节的疼痛僵硬。有时脊柱关节的骨性生长融合导致关节融合在一起,进而导致肋骨软骨僵硬、限制肺的呼吸功能。

A number of factors are associated with an ankylosing spondylitis prognosis. One study found that among people who had ankylosing spondylitis for at least 20 years, those who had physically demanding jobs, other health problems, or smoked had greater functional limitations from their disease. People with higher levels of education and a history of ankylosing spondylitis in the family tended to have less severe limitations from their disease.

很多因素与强直性脊柱炎的进展相关。一个对有20年病史的强直患者的研究发现,从事体力劳动、有其他健康问题、吸烟对强直引起的功能受限更为明显。 有高教育水平,有强直家族史的患者疾病导致的严重程度较轻。

A study supported by the NIAMS found that the likelihood of having severe joint damage increased with age at disease onset, and that men were twice as likely as women to be in that group. The study also found that current smokers were more than four times as likely to have severe damage as nonsmokers, and that having a genetic marker called DRB1*0801 seemed to protect against severe spine damage.

年纪越大发病的,累及关节越多,且已男性更为显著(2倍于女性)。吸烟者4倍于非吸烟者更容易发生严重关节损害。基因DRB1*0801阳性似乎对脊柱关节有保护作用。

What Research Is Being Conducted on Ankylosing Spondylitis?

In addition to the studies mentioned above, research has focused on finding the additional genes involved in the development of ankylosing spondylitis. In 2007, a large comprehensive genome-wide association scan led to the discovery of the genes ARTS1 and IL23R, which is bringing the scientific community closer to understanding ankylosing spondylitis. In addition, a 2010 study reported four genetic regions associated with ankylosing spondylitis risk, two of which encode for proteins that may play a role in ankylosing spondylitis susceptibility.

The IL23R gene plays a role in the immune system’s response to infection. ERAP1 (previously known as ARTS1) is involved in processing proteins in the cell into small “chunks” that can be seen—and fought—by the body’s immune system. Researchers believe the discovery could eventually lead to an understanding of the pathways that are involved in ankylosing spondylitis, and ways for doctors to inhibit or strengthen those pathways to better treat ankylosing spondylitis. The finding could lead to a blood test to predict ankylosing spondylitis risk or aid in early diagnosis.

Researchers are also investigating the inflammatory and immune underpinnings in ankylosing spondylitis and environmental factors that influence the course of the disease.

Scientists are also developing methods to quantify the progression of spinal fusion in patients with the disorder and are examining whether some of the newer drug therapies can stop its progression. In the meantime, medication and exercise are important for relieving the symptoms and enabling people to live well with the disorder.

Information on research is available from the following resources:

·National Institutes of Health (NIH) Clinical Research Trials and You was designed to help people learn more about clinical trials, why they matter, and how to participate. Visitors to the website will find information about the basics of participating in a clinical trial, first-hand stories from actual clinical trial volunteers, explanations from researchers, and links to how to search for a trial or enroll in a research-matching program.

·ClinicalTrials.gov offers up-to-date information for locating federally and privately supported clinical trials for a wide range of diseases and conditions.

·NIH RePORTER is an electronic tool that allows users to search a repository of both intramural and extramural NIH-funded research projects from the past 25 years and access publications (since 1985) and patents resulting from NIH funding.

·PubMed is a free service of the U.S. National Library of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences.

如需帮助,请在好大夫留言。

Best wishes.

Chen Yong(陈永)MD. PHD.

Internal Medical school, Fudan University

Rheumatology Department, Huadong Hospital, Shanghai China

Aim at: Serve patients's needs with Integrative Medicine

Web: sgcy88888888.haodf.com

Email:  417033196@qq.com

问医生

与医生电话交流 开始

网上免费问医生开始

发表于:2016-10-15 01:37

陈永大夫的信息

  • 感谢信: 0 感谢信 礼物: 0 礼物
  • 贡献值: 0

陈永大夫电话咨询

陈永大夫已经开通电话咨询服务
直接与大夫本人通话,方便!快捷!

网上咨询陈永大夫

陈永的咨询范围: 内科疾病:免疫风湿科疾病,痛风 类风湿性关节炎 老年性关节炎 干燥综合征 系统性红斑狼疮 强直性脊柱炎 白塞病 Good at treating immune rhematologic diseases and cancer rheumatoid arthritis, osteoarthritis,siogren syndrome,SLE, ankylosing spondylitis,bechet's disease,neck pain,lower back pain,pelvic inflmmation, cancers:gastric cancer, colon cancer, lung cancer ect. 更多>>

咨询陈永大夫