Thank you for your consultation appointment: How do you safely stop hormones in patients with thrombocytopenia?

In addition to different degrees of bleeding tendency, immune thrombocytopenia is also prone to repeated attacks. Most patients have longer treatment cycles, and many patients develop refractory thrombocytopenia, and patients need to find the right treatment to restore health Method, and patiently cooperate with treatment. Director Shi Shurong’s WeChat consultation platform: zkxk9999 Western medicine treatment of thrombocytopenia, hormones are the main drugs, but the side effects of hormone drugs can not be ignored, and may even cause secondary harm to patients. Therefore, after taking hormones to see the effect, you need to be in time Reduce hormones. But hormone reduction also needs everyone’s attention, because the “decrease” is not good, it is easy to cause the patient’s illness to rebound, then, what should I do when treating platelet reduction and hormone reduction? Experts introduce that many patients are eager to reduce hormones However, in the process of reducing hormones, especially when the reduction is too fast, the platelets will be repeated. If you can add Chinese medicine treatment, you can slowly increase the platelet value and improve the quality of the platelets. It can also reduce the side effects of hormones, and the amount of hormones will not rebound. Make patients adapt to normal work and life; improve clinical symptoms and improve quality of life. Traditional Chinese medicine treats each patient’s physique according to syndrome differentiation, that is, the root cause is the root cause, but the effect is slow, and it also takes time. Especially for patients who have used hormones and other Western medicines, symptoms usually improve in 1-2 months, but platelets rise Not obvious, so the treatment of ITP should not be too urgent. It is best to cooperate with Chinese medicine when reducing hormones. In addition, some patients who take hormone drugs are ineffective or ineffective, should join Chinese medicine as soon as possible to improve the efficacy of hormone drugs, stabilize platelet values, and avoid serious bleeding. More patient communication help can pay attention to the WeChat public account: Thrombocytopenia Patient Association

Vitiligo treatment-the harm of hormone abuse

After suffering from vitiligo, many patients hope to get rid of it as soon as possible, because it has a very large negative impact on people’s appearance. However, when treating vitiligo, you must choose the right method. Some patients first think of using drugs to treat leukoplakia. Some of the commonly used drugs for treating vitiligo are hormone drugs. Such drugs need to be used under the guidance of a doctor. Control dosage and dosage. So what are the hazards of using hormone drugs to treat vitiligo?   Easy to make the body dependent   Because some patients have insufficient understanding of vitiligo, they often fall into treatment misunderstandings, and random use of hormones is one of them. Although hormones can accelerate the growth of pigment cells, the side effects are also obvious. Clinical practice has proved that the harm is greater than the benefit. If you use hormone drugs for a long time, it will cause dilated capillaries and local skin atrophy in patients with vitiligo. However, no matter what method is used, hormone drugs cannot eliminate the inhibitory effect on the adrenal cortex of the body. Dependence.   led to a larger rebound    In order to restore health as soon as possible, some patients use hormones to treat leukoplakia. Although hormone drugs can alleviate the progress of autoimmunity and have a certain effect on the treatment of vitiligo, it is only applicable at the initial stage. Because hormones and immunosuppressants cannot fundamentally treat vitiligo, they are more likely to worsen the condition of leukoplakia. And patients who often take hormones and immunosuppressive drugs take the above drugs. Once the drug is stopped, it will not take long before the white spots will not only reappear, but may also worsen the condition. There are other adverse reactions. Most of the drugs used to treat vitiligo are hormone drugs. There are also drugs that inhibit growth and antitumor drugs. Although hormone drugs can exert a powerful anti-inflammatory effect, temporarily inhibit the toxin factors on the skin surface, let Some toxins are temporarily inactivated; but at the same time it can also cause disorders in the body’s secretion, leading to a series of adverse reactions in the body. And long-term use of hormone drugs will have varying degrees of liver and kidney damage and other symptoms in patients. Therefore, in order to avoid the above-mentioned adverse reactions, patients with vitiligo should use the medicine under the guidance of a doctor, use symptomatic medicine scientifically, and avoid random medication.

Shi Shurong Medical Talk: Case Sharing-How does an eight year old patient with thrombocytopenia recover?

Idiopathic thrombocytopenic purpura (ITP) is one of the most common hemorrhagic diseases in childhood. Many patients will take hormonal drugs to increase the platelet value when they are diagnosed, but the value rises quickly and falls quickly, and the hormone drugs There are also great side effects for pediatric patients. Director Shi Shurong’s WeChat consultation platform: zkxk9999 Patient: He Mou, boy, 8 years old, Shanxi people Course of disease: more than 1 year of suffering from thrombocytopenia: The patient found lower extremity bleeding spots, skin purple spots, oral blood bubbles in February 2012, after local treatment Unsuccessful; transferred to a local city hospital for testing, platelet 10, bone puncture confirmed ITP after hospitalization, and given hormone therapy; after discharge, hormone maintenance therapy was continued, and then platelet dropped to about 30,000 in January 2013, and then transferred to the city hospital for treatment There is no improvement; at the same time, due to the child’s long-term use of hormones, obesity, repeated hospitalization and restrictions on the child’s activities, this eight-year-old boy has an introverted personality. Treatment: The patient was transferred to Beijing for treatment in March 2013. Blood routine tests showed: WBC8.5, Hb121g/L, PLT28. The expert team conducted a detailed analysis of the child’s condition and established a combination of traditional Chinese and Western medicine in combination with the original treatment. Treatment plan, combined with traditional Chinese medicine conditioning after discharge. After being discharged from the hospital, the patient insisted on taking Chinese medicine for half a year, and the platelet value was rechecked within the normal range. Life and study were not affected. Following the follow-up, the patient He Mou still insists on a routine blood test about half a year, the platelet values ​​are within the normal reference range, and there is no sign of recurrence of colds. Blood disease experts reminded that children with thrombocytopenia need to increase the platelet value as soon as possible when the value is severely reduced in the acute stage to avoid serious bleeding symptoms. However, it is not recommended to use hormonal drugs for a long time, because side effects can easily affect the growth and development of children, and it is recommended to intervene in Chinese medicine as soon as possible. More patient communication help can pay attention to the WeChat public account: Thrombocytopenia Patient Association

Patients with thrombocytopenia: how to stop hormones to be safe?

The effect of hormone therapy on ITP is significantly obvious, but due to the effects of toxic and side effects and dependence, it is not possible to take it for a long time. It needs to be gradually stopped. Two points to be aware of when stopping the drug are: 1. Monitor the platelet count and observe the decline of platelet Running track and degree of descent. 2. As long as there is no worsening bleeding tendency, no active bleeding or fresh bleeding, the hormone dosage should be reduced according to the plan. How is it safe to stop taking hormones? Look at the sharing of this thrombocytopenic purpura patient to enter the first stage: Week 1 ~ 5 capsules of prednisone (25 mg)-4 capsules per week (20 mg); Week 2 ~ 3 capsules of prednisone ( 15 mg); Week 3 ~ Prednisone 2.5 capsules (12.5 mg) Week 4 ~ Prednisone 2 capsules (10 mg) Week 5 ~ Prednisone 1.5 capsules (7.5 mg) Enter the second stage: 6th Week / Week 7 ~ Prednisone 1 capsule (5 mg) Week 8 / Week 9 ~ Prednisone 0.5 capsule (2.5 mg) At the end of the hormone reduction, you need to find a targeted Chinese medicine to consolidate. Only then can the drug be completely stopped to prevent subsequent relapse. If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xxbjs1

Precautions for medication in patients with vitiligo

In the process of treating vitiligo, drugs are one of the commonly used treatment methods, and also the first treatment method considered by many patients. However, due to the complex etiology of vitiligo, and the difference in each body type, the treatment of vitiligo is also different. The use of drugs must be in accordance with the guidance of the doctor. The drugs cannot be used without authorization. So what are the common misunderstandings in the use of drugs?   1. Abuse of hormonal drugs    Hormonal drugs are effective drugs in the treatment of vitiligo, but hormone drugs are not suitable for long-term use. Because hormone drugs have side effects, long-term use will depend on the drug, and it must be used strictly in accordance with the guidance of the doctor. When treating vitiligo, doctors generally use it when the leukoplakia is in the rapid development period to control White spot avoids its further development.  2. Overdose   Internal and external medicine doctors will recommend starting with a small dose first. Regardless of Chinese medicine or Western medicine, overdose will cause some damage to the body. The side effects of Western medicine are more obvious. Excessive use of Western medicine will damage the liver of patients with vitiligo. Treatment of vitiligo cannot achieve crucian carp. Excessive drugs do not help the condition at all.  3. It is very casual when taking medicines. While taking medicines, some people will use coffee, tea, carbonated drinks, etc. However, these contain various chemical ingredients, which are easy to react with drugs and affect the efficacy. It is also important to note that you must not drink alcohol after taking the medicine.  4. Frequent drug changes  Medical treatment of vitiligo is a long-term process, most of which are effective within three months. Therefore, patients with medication need to persist for a long time to avoid self-stopping. If the use of the medicine slows down, you can also inform the attending doctor. The doctor can adjust the plan according to your condition, but avoid blindly changing the medicine yourself.

MDS patients, don’t let immunosuppressants kill you

Shi Shurong’s studio WeChat xyk261 immunosuppressant has a wide range of types, each of which has a different mechanism of action, but their common characteristics are able to suppress immune cells and reduce inflammatory factors. There are several types of immunosuppressants commonly used in clinical practice. Specialists will select the appropriate immunosuppressant according to the characteristics of each drug and the actual situation of the patient.   Glucocorticoids are also called steroidal anti-inflammatory drugs, that is, people often say “hormones”. The names of such drugs often carry a word “pine” or “dragon” at the end, such as prednisone, dexamethasone, methylprednisolone, etc. Hormones have a wide range of functions, such as anti-inflammatory, anti-rheumatic, anti-allergic, and immune system. It can effectively reduce inflammatory factors and suppress various immune cells.   Clinically, for those patients with strong immune response and severe inflammation, the use of hormones will have an immediate effect. However, it is precisely because the hormone has too much effect, so it is a “double-edged sword.”  Osteoporosis, necrosis of the femoral head, increased blood sugar, increased blood pressure, body fat, peptic ulcer, etc., are common adverse reactions of hormones. These adverse reactions often occur in patients who use hormones for a long time. Therefore, when the specialists use hormones, they will closely observe the condition, and once the condition is controlled, they will begin to reduce or stop the hormones in time. It is often accompanied by calcium supplementation and stomach protection during treatment to reduce side effects.  Recommend everyone to be very careful when using hormones. I once met an old woman who bought prednisone for a long time in a pharmacy. When the joint hurts, I took a few capsules, just like we usually eat sugar pills. After several years, not only the disease has not been cured, but bone Loose, severely deformed joints. There is also a patient with lupus erythematosus. After treatment in many hospitals and long-term use of large doses of hormones, the femoral heads were necrotic on both sides, and the femoral heads were changed at a young age. Many people have infections due to the use of hormones, and they may even be in danger of life.   Therefore, as a patient with MDS, in the treatment, do not blindly increase the amount due to the use of medicine, and you must consult a professional doctor to take medicine according to different personal conditions to avoid harm to your health.

Femoral head necrosis is getting younger and younger

In recent years, many diseases have begun to age, and bone diseases such as femoral head necrosis have frequently appeared among young people. The reason for the premature occurrence of this orthopedic disease has a lot to do with people’s living conditions and habits. 1. Working young people are very stressed about life and work. Drinking alcohol often becomes a way for them to relieve their stress. Some people have poor self-control, thinking that youth is the capital, and the body can bear it, and they continue to indulge, develop long-term alcoholism, and drink too much alcohol. Femoral head necrosis caused by alcoholism has accounted for three of the total number of cases. One in one. 2. Trauma Modern society has become more and more developed in traffic. There are endless streams of carts and carts on the roads, and the incidence of traffic accidents is also rising. Among them, more young people are involved in accidents. According to clinical statistics, trauma is the main cause of femoral head necrosis in young people. 3. Hormones The development of today’s society has spawned a large number of hormones. Young people are the largest group of hormones. I wonder if long-term large-dose use of hormone drugs or food will cause ischemic necrosis of the femoral head. Young people are the main consumer group of hormones, which greatly increases the chances of young people suffering from necrosis of the femoral head. The treatment method of femoral head necrosis failed to be found in time and failed to be treated in time. It was already serious when it was being treated. So what are the methods of treating femoral head necrosis? 1. Surgical treatment of femoral head necrosis includes the following: (1) osteotomy. (2) hip replacement. (3) central decompression. (4) Bone migration with blood supply. (5) Bone grafting. It should be noted that if the age is too young, it is recommended to do conservative treatment first. If the treatment is invalid, there is no other way to consider surgical treatment. Surgical replacement of the femoral head is used for up to 10-15 years and short 5-6 years, so generally We do not recommend surgical replacement for patients under 60 years of age. 2. Non-surgical treatment of femoral head necrosis (1) Avoid weight-bearing: including partial weight-bearing and non-weight-bearing, only applied to femoral head necrosis before collapse, the treatment method to avoid weight-bearing alone is not ideal, and the success rate is less than 15%. For a-type femoral head necrosis where the lesion is located inside the femoral head, this method may be considered. (2) Drug treatment: There are few reports on the treatment of femoral head necrosis with drugs. In short, the effect of drug treatment is still uncertain, but because of its noninvasive nature, it is still an important research direction.

Shi Shurong’s Medical Talk: What should I do if hormones treat thrombocytopenia and the body is severely swollen?

Many patients who have just been diagnosed with thrombocytopenia, especially those with lower values, will be treated with hormonal drugs, but the rapid increase of hormonal drugs will also bring many side effects. How should patients respond? Director Shi Shurong consulted Ms. Qi, a patient on WeChat zkxk9999: I am 25 years old, and my physical examination found that the blood routine platelet value is only 26, but the body has no discomfort symptoms, no bleeding, and only a slight bump is prone to bruising. After a bone marrow aspiration examination, the bone marrow hematopoietic function was normal. The doctor gave oral hormone therapy. Later, the platelet rose to 85, but after using the hormone for a month, the body was severely swollen and I dared not eat it again. Excuse me, is there any good treatment? ? Hematologist: Thrombocytopenia is a relatively common benign disease. The cause of the disease involves autoimmune disorders. In short, the patient spontaneously produces an anti-platelet growth antibody that destroys platelet growth. Commonly used therapeutic drugs have certain side effects. The most common side effects of hormones are: centripetal obesity, gastric mucosal damage, hypertension and elevated blood glucose; blood product infusions are only short-term effective, and their side effects are minor, but there are infections related to blood transfusion-related diseases Risk; while the spleen is removed for treatment, the spleen is an important immune organ of the human body, and the ability to resist infection will be reduced after resection, which needs to be evaluated by a specialist clinic. At present, for the treatment of targeted thrombocytopenia, the timely intervention of Chinese medicine and traditional Chinese medicine has made more and more patients see a more obvious increase in platelets. At the same time, compared with hormone therapy, traditional Chinese medicine will not let patients be affected by side effects. At the same time, after the patient’s platelet lifts and stabilizes, the chance of recurrence is also greatly reduced. Because thrombocytopenia is mostly related to the imbalance of the patient’s autoimmune function, even if the patient recovers and the platelet returns to normal, it is necessary to pay close attention, regularly review the blood routine, and monitor the platelet value. To emphasize, the lower the platelet value, the higher the risk of bleeding. Therefore, regardless of bleeding symptoms, patients should be actively treated to increase the platelet value and avoid serious bleeding. In addition, cold infections are also likely to cause relapse or exacerbation of thrombocytopenia, pay attention to prevention in life. For more thrombocytopenia disease knowledge or patient help, please pay attention to WeChat public number: xxbjs75

Xie Bielu medical words: Patient question: How can thrombocytopenia no longer recur?

Thrombocytopenia is a common hemorrhagic disease, but some patients have a low value, but they are accidentally found due to a bleeding point caused by a cold, which confirms the diagnosis of thrombocytopenic purpura. How to treat this situation? Director Shi Shurong consulted with WeChat zkxk9999 Hebei patient Mr. Wang: I found a skin bleeding spot to go to the hospital for a cold and was diagnosed with idiopathic thrombocytopenic purpura. Bone marrow aspiration showed megakaryocyte maturation disorder. Blood routine examination of platelet value 9. 2016 3 He was admitted to the hospital on the 24th of the month. He was checked for platelet 122 on the 29th of the month. He was discharged from the hospital on May 27. PLT8 was admitted to the hospital again. Intravenous infusion of dexamethasone 40mg, medication for four days, prednisone suspension, platelets 41, 3 mg of prednisone orally to stop after stopping the meter, in conjunction with eating Chinese medicines for platelet ascending, such as platelet decline to continue a large dose shock. After that, the condition was repeated twice, and each time required hospitalization, which was expensive. I don’t know how to treat it, so that thrombocytopenic purpura will not recur? Hematologist: According to the data, the diagnosis of idiopathic thrombocytopenic purpura is clear. The disease is humoral immune-mediated destruction of platelets. The traditional treatment methods include: hormone, splenectomy and immunosuppressive therapy. From the point of view of platelet values, platelets can be elevated after hormone shock treatment, indicating that the hormone is still effective. However, when taking oral hormones, the reduction and withdrawal should not be too fast. At the same time, since the effects of hormone drugs on increasing platelet value are mostly temporary, in order to avoid the occurrence of side effects and improve the efficacy of hormones at the same time, it can be combined with traditional Chinese medicine and conditioning. At present, the treatment of thrombocytopenic purpura is mostly based on the combination of traditional Chinese medicine and western medicine. Traditional Chinese medicine uses medicine based on syndrome differentiation. Western medicine treatment can prevent patients from severe bleeding and avoid life worries. Complementary treatment of traditional Chinese medicine and western medicine can stabilize the patient’s condition. , No more. For more thrombocytopenia disease knowledge or patient help, please pay attention to WeChat public number: xxbjs75

Advanced cancer, can eat and be in good spirits, even gaining weight, is it possible to get a cure

The cancer has spread, but the patient’s meal is okay, the spirit is also very good, and the weight is also increasing, what is the matter? When reading this question, I can’t help but feel a bit strange. The advanced patients with cancer spread are often bedridden, with no blood on the face, and a skinny image. This is completely related to the appetite, spirit, and weight gain in the problem. So why do the same advanced cancer patients behave differently? There may be the following factors: 1. The course of the disease sooner or later is like an imaginary bed-ridden, cancer-free, skinny, skinny tumor patient is often some advanced patients with tumor cachexia, and they have entered the final journey of life. However, some patients who have just discovered tumor metastasis, or local metastasis to non-essential organs, may have a better early state. 2. The tumor is controlled. The tumor cells compete for the nutrients needed for normal human activity to grow and proliferate in the human body, and can cause some symptoms, such as pain, compression, and obstruction. If the primary cancer or metastasis is effectively controlled after active treatment and the symptoms improve, the patient can also show signs of improvement in the overall state. 3. The use of hormones The progress of cancer patients adopts some active treatment methods, such as chemotherapy, radiotherapy, targeted therapy, immunotherapy, etc. or may be accompanied by some toxic and side effects. The use of hormones to reduce the response. Hormone is a more common drug that can affect metabolism. It can cause disorders of water, sugar, lipid and protein metabolism in the body. In addition, those who often use the drug after hormone use will have a big appetite, such as eating a lot of high-sugar and high-fat foods will also cause weight gain. 4. The types of cancer: oral cancer, esophageal cancer, gastric cancer, liver cancer, these digestive tract tumors, because they can affect the patient’s eating and affect the absorption of nutrients, the absorption of nutrients is reduced and the tumor should not reduce the nutrients, but reduce the nutrition With the absorption of substances, cachexia develops to a certain degree. Tumors such as breast cancer, thyroid cancer, and prostate have a relatively good prognosis and a relatively long survival period. If they do not metastasize to important organs, they rarely show obvious consumption status. Some tumors such as lung cancer can secrete some hormones such as adrenal cortex hormones during the course of the disease, and antidiuretic hormones can cause water and sodium retention in the body, causing increased appetite and weight gain. 5. Edema or chest and ascites fluids are in fact appetite, spirit, and weight gain are not effective indicators for evaluating the patient’s condition. Although some tumor patients eat well, the high consumption status of the tumor is greater than the body’s intake of nutrients, and it has always been negatively balanced. Hypoproteinemia. Decreased albumin can cause water to accumulate in the body, which can lead to lower limb edema, chest tightness, wheezing, increased abdominal circumference, and bloating. In summary, appetite, meal size, weight, etc. are not indicators for effective evaluation, and other indicators such as imaging examination results, tumor indicators, etc. need to be considered comprehensively.

What to do if you have genital warts during pregnancy

   Clinically, many people are infected with condyloma acuminatum after pregnancy, which brings great problems to doctors and also makes patients face painful choices.  A lot of patients come to the hospital and will consult. If they have condyloma acuminatum, can they get pregnant? Can be pregnant, does not affect fertility. The advice to these friends is to be treated within 3-8 months of pregnancy, so as not to affect the fetus during delivery.  Infection of genital warts during pregnancy, the influence of hormones in female receptors on local lesions will increase faster, and it is easy to grow more and larger warts. In order to ensure the healthy development of the fetus, the use of drugs is prohibited. At this time, it is recommended to remove local warts by freezing to temporarily control the hyperplasia. After the cesarean section, the hormones in the body will decline, and the condition will also be reduced. After the body recovers, complete the radical cure of genital warts with the Chinese medicine prescription No. 2011101665723. The above article comes from the WeChat public account “Condyloma Acuminatum Patent Formula”, for reference only, infringement deleted.

What should I do with the spots on my face after giving birth?

&nbsp.&nbsp.&nbsp. Long spots on the face after childbirth, which makes all the female friends who love beauty very upset. Some women have white and tender skin before giving birth, but they have grown spots under their eyes since they gave birth. Previously, I have always been proud of my supple and white skin. But now, the spots on his face can’t be removed, and everyone around him feels a pity.   Of course, the spots on the face after delivery should be removed. However, the survey found that the vast majority of women with long spots do not know how to choose the correct freckle removal method to achieve the scientific freckle removal effect. According to many women: Freckle products are not used less, but the effect is always not ideal, and some products even cause skin damage. Is it true that all kinds of stains are really invincible? According to the doctor’s diagnosis, such long spots on the face are symptoms caused by female hormonal disorders. Chinese medicine believes that the secretion of hormones is closely related to the liver, kidney and spleen of the human body, so if new moms want to improve the phenomenon of hormonal imbalance, they must first strengthen the spleen and stomach. Spleen and stomach can eat more intestinal food, such as persimmon, black beans, black fungus, corn, lemon, banana and so on. On the other hand, we can also try the laser freckle removal method. This method mainly uses ultra-light radio frequency to lighten the pigment of the dermis layer of the skin. It can wrinkles, red blood, freckles, sun spots, age spots, and pregnancy in the face of everyone. Streak has obvious treatment effect. After treatment, everyone knows that the photon spot removal effect is good and the facial skin quality is significantly improved, like the pH value, moisture retention and elasticity of the facial skin will return to a good young state.

Do allergic purpura have to eat hormones? Can you recover at the development stage?

Questions from local allergic purpura patients in Hunan-I heard that the disease is more and more difficult to treat, and it will definitely develop into purpuric nephritis later. Is this true? In addition, there are two additional questions-do you have to eat hormones for allergic purpura? Is it possible to recover at the stage of disease development? Does purpura relapse every time, will it further aggravate the condition? For the questions mentioned above, do related answers. Hormonal treatment of allergic purpura in most cases is relatively straightforward, but the cure rate is not impressive. In addition, the recurrence of purpura is not only cured by hormones, nor does it require long-term and massive consumption of hormones, and excessive treatment will not promote the recovery of the disease. The most worrying problem of recurrent purpura is affecting the kidneys, otherwise simple skin purpura will generally not have serious complications (except for some cases of local ulcers in the early stage). It is recommended to follow up urine routine and pay attention to the situation of purpura To adjust the treatment ideas, Chinese medicine who simply adjusts the body and does not aim at the problem of the disease is not recommended to eat, as this will only delay the duration of the disease. In addition, taboo is just a measure. In the long run, there are also unbalanced nutritional intakes. It is recommended to gradually add basic protein diets, including the control of activity, and the key is to treat, adjust the mental state and rest the body state. For every purpura, it will be worse than that, there is a certain basis, and most medical practitioners also agree with this statement. Purpura is a recurring process in the early days. Within this natural course, purpura may not necessarily be very heavy, that is, there are two phenomena: one is very serious before, and then gradually becomes lighter and lighter; the other The species is relatively mild before, and the number of repetitions is more than one, but the condition is getting more and more serious, which eventually affects the complications of organ damage. Once this part of the patient affects the kidney, the condition is also more stubborn. If targeted treatment is not done as soon as possible, continuous aggravation is possible. It is recommended to pay attention to treatment-whether it is early or the subsequent development stage of the disease, targeted treatment can achieve a complete cure. If you have any questions about this article or the disease, please feel free to follow us on WeChat and find out more: gmxzd1

Many kidney diseases require long-term use of hormones. How does it treat kidney disease? In-depth interpretation

Hello everyone, I am a nephrologist. When it comes to hormones, nephrologists probably have the right to speak, because many nephropathy patients are hormone users. For the special drug “hormone”, some say it is good, some say it is bad. Our sayings are good, we have real knowledge in practice, and the more we use and the more we see, the more experienced we are. As a nephrologist who has been dealing with hormones for a long time, today I will unveil the mysterious veil for everyone. What are hormones? ●Many rumors on the Internet say that hormones are life-threatening, @头条开谣, saying what will happen if you eat it. In fact, I might as well tell you that many of them don’t even know “what is a hormone”, just because there is a rhythm. If I think that “hormones” are just a class of drugs, I can only say that the understanding is too superficial. Hormones are actually secreted by our body all the time, like parathyroid hormone, growth hormone, glucagon, and cortisol are all “hormones” secreted by the body itself, it plays an important role in our life activities, and we also Use it. Due to the relatively large space, today I focus on explaining “glucocorticoid” and its application in kidney disease. ●The adrenal glands of our normal people (a small organ of the human body) can secrete about 10-20mg of cortisol (also known as glucocorticoid) every day. It has a characteristic of secretion, that is, it is released in a pulsating manner, with obvious day and night laws. It is the lowest during sleep at night. It begins to rise after 3-5 hours of falling asleep. It wakes up in the morning and reaches its peak, and then begins to decline again. It is such a cyclic process that its secretion is mainly affected by our high-level center (hypothalamus- Pituitary-adrenal) control. ●What are the types of glucocorticoid preparations of the drug? The classification of the drugs is mainly based on the half-life of the drug. According to its pharmacological characteristics, it can be divided into three types: short-acting, medium-acting and long-acting. Short-acting half-life is about 6-12 hours, more representative drugs such as cortisone, hydrocortisone; medium-acting half-life is about 12-30 hours, more representative drugs such as prednisone , Prednisolone, methylprednisolone, etc.; long-acting half-life is about 48-72 hours, more representative drugs such as dexamethasone, betamethasone, etc. How to use hormones in patients with kidney disease? ●According to the pathology of renal puncture, nephrotic syndrome can be divided into multiple types. Like effective pathological types of glucocorticoid alone: ​​minimally diseased nephropathy (more common in children), mesangial proliferative nephritis (more common in adolescents, including IgA nephropathy), focal segmental glomerulosclerosis FSGS (child More common in adolescents); the type of cytotoxic drugs that need to be combined (such as cyclophosphamide CTX): idiopathic membranous nephropathy & nbsp. (This is only a general division, and may be slightly different in clinical practice) ●However, hormone therapy is not Speaking of nephropathy, it is all right. According to the response after treatment, it can be roughly divided into three categories, that is, sensitive type: that is, clear pathology. After active and sufficient medication, the symptoms of nephrotic syndrome (edema, proteinuria, etc.) are quickly relieved; Dependence: that is, the effect is good during the treatment, and it begins to relapse after the reduction. (We talk about recurrences can be divided into 2 subcategories: infrequent recurrence: that is, once in the first 6 months and less than 3 times in 1 year. Frequent relapse: more than or equal to 2 times in 6 months and more than 3 times in 1 year) ● The last one is the hormone resistance type. Simply put, it is useless to use hormone therapy. Our evaluation standard is that the puncture is in accordance with a certain type of nephrotic syndrome, but you use it regularly and reach the treatment cycle of 8-12 weeks without remission. , Need to actively find the cause, such as whether it is complicated by infection, thrombosis, unspecified medication, gastrointestinal edema, etc. If there is no above-mentioned predisposing factors, consider adding immunosuppressive agents or other special treatment options. Personal experience of using hormones in patients with primary kidney disease ●For patients with kidney disease who need to use hormones, this medication principle must be followed. First, the starting amount should be sufficient. I take methylprednisolone as an example. The general therapeutic dose is 0.8-1.0mg. kg.d, roughly 40-60mg/day, mainly oral, and some slower reactions such as FSGS can reach 16-24 weeks (some people are afraid of side effects of hormones and reduce their doses by themselves. ) ● Second, reduce the drug slowly, that is to say, it will start to decrease every 2 weeks after reaching the time of full use

Precautions for chloasma

Precautions for chloasma 1. Normally, excessive sun exposure should be avoided, and excessive sun exposure should be avoided, especially in summer, when going out, it should be shaded. If you are outdoors, you must do sun protection seriously, you can wear a parasol, wear a sun hat, and apply sunscreen; 2. Always pay attention to avoid the use of hormone drugs or cosmetics containing hormones, hormones have non-specific anti-inflammatory effects, It can inhibit the secretion of melanin in the early period of use, so people can have a certain effect when applying it initially, but the color of the stain will recur after stopping use, and it will even increase. And long-term use of hormones can cause side effects, and even hormone-dependent dermatitis can occur. 3. Patients with chloasma should pay attention to adjusting their emotions, try to maintain a happy mood, have the ability to withstand stress, and be optimistic. You should also pay attention to getting enough sleep. In the treatment of chloasma, in addition to the treatment specifically for the elimination of spots, endocrine regulation should also be paid attention to, because chloasma has a direct relationship with the human endocrine system, so patients should remove both spots and regulate endocrine. 4. After the chloasma has grown, you can go to the hospital for examination. Active treatment of the original disease is necessary. If the disease is cured, the chloasma will disappear. 5. Patients with chloasma should also pay attention to actively enhance nutrition, eat more fresh vegetables and fruits. The diet should be light and nutritious, avoid high oil, high salt, spicy stimulation, etc. Eat more vegetables and fruits to supplement vitamins to adjust the body’s metabolism. Vitamin E can be added to scavenge free radicals, improve antioxidant capacity, and improve symptoms of chloasma. 6. Actively participate in appropriate sports, enhance physical fitness, and adjust endocrine.

Women’s whitening skin care products cause menstrual disorders or amenorrhea?

 Ms. Liu, 32 years old, suddenly stopped menstruation six months ago, went to gynecological examination but did not find the cause, and was introduced by the doctor to the endocrinology department and found that her prolactin level was twice as high as that of normal people, and the androgens were also abnormal. After excluding other incentives, the experts learned that the patient has been using a whitening skin care product for 1 year and the effect is obvious. Amenorrhea was 3 months ago. Experts recommend that they stop using the skin care product. Two months later, Ms. Liu came to review and found that prolactin dropped to normal. Such female patients are not uncommon clinically. The main cause of amenorrhea is related to the long-term use of whitening skin care products containing hormones or taking health care products. It not only causes menstrual disorders and amenorrhea, but also can cause infertility in severe cases.  The doctor pointed out that prolactin is a polypeptide hormone, also called prolactin, which is one of the hormones secreted by the pituitary gland. Its main function is to participate in the promotion of breast development and milk production. Proper secretion of prolactin can maintain the balance of the endocrine system in the body, women can have normal menstruation, ovulation and pregnancy. Many middle-aged women like to eat health products and skin care products. The ingredients of these health products and cosmetics are unknown, and often contain hormones, which will affect the endocrine system and cause prolactin abnormalities. Once the level of prolactin increases, it will lead to abnormal gonadotropins, follicles can not develop and mature normally, resulting in irregular or irregular menstruation. For unmarried women, once amenorrhea will lead to non-ovulation and cause infertility.   Remind you to use some cosmetics and health care products carefully. If menstruation is disordered and there is amenorrhea, you can go to the Endocrinology Department to check the level of prolactin under the premise of gynecological examination to exclude other diseases. Even if prolactin is abnormal, there is no need to panic, as long as it is disabled, it will generally return to normal.

Why is nasal spray hormone best used in the morning?

The human body has a set of physiological mechanisms to stabilize the internal environment-feedback, including positive feedback and negative feedback. There is relatively little positive feedback, such as urination. After the urination behavior begins, the body will order urination to strengthen until the urination is smooth. There are many negative feedbacks. For example, if the blood sugar has increased, the body will send a command to lower the blood sugar after receiving the information, and it cannot rise again. The physiological regulation of glucocorticoids is also negative feedback. When the concentration of glucocorticoids in the body increases, negative feedback inhibits the function of the adrenal glands, so that it no longer releases glucocorticoids. Controlled by the circadian clock, the secretion of glucocorticoids also has its day and night rules. From 3 am to 10 am, the secretion accounts for 3/4 of the secretion of the whole day. Therefore, those who use glucocorticoids for a long time and in large amounts will have a peak hormone in the morning. Give once a day to make the peaks of endogenous and iatrogenic glucocorticoids roughly overlap, avoid the secondary inhibition caused by the use of iatrogenic glucocorticoids at other times, and reduce the adrenal atrophy caused by long-term and heavy use of hormones. When the nasal spray hormone liquid flows into the throat, it is recommended to rinse the mouth to clean up and avoid the accumulation of the nasal spray for a long time. The nasal spray hormone is also a glucocorticoid, so it is recommended to use it in the morning. This is an optimized medication plan with no additional cost and only benefits.

How much do you know about hypothyroidism?

“Can hypothyroidism be cured?” “Will it affect pregnancy?” “Will the body be seriously hurt?” In medicine, the full name of hypothyroidism is “hypothyroidism”, which refers to the secretion of the thyroid Systemic hypometabolism caused by decreased hormones or decreased hormone effects. Compared to men, women are more likely to suffer from hypothyroidism. 01 What is hypothyroidism? Hypothyroidism is a disease in which the metabolism and secretion of thyroid hormones are reduced, leading to a decrease in the body’s metabolism. It is also a common endocrine disease in pregnant women. What are the manifestations of hypothyroidism during pregnancy? 1. Frequent feelings of weakness, lethargy, physical and mental strength are not as good as before. 2. It is difficult to concentrate, and memory loss. 3. Poor appetite but weight gain. 4. Fear of cold and cold, often in summer with long sleeves. 5. The skin condition is not good, pale, dry and inelastic, and easy to sweat. 6. Low mood, it is easy to produce negative thoughts, and tend to be depressed. 02 What are the hazards of hypothyroidism during pregnancy? 1. Increased miscarriage and premature birth rate. Abortion, premature birth, placental abruption, hypertension, preeclampsia, cardiac dysfunction and other adverse conditions are common symptoms of pregnant mothers with hypothyroidism. According to the survey, the risk of miscarriage in women with hypothyroidism is 1.6 times that of normal pregnant women. 2. Thyroid hormones that affect children’s normal development are one of the factors that affect fetal brain development. In early pregnancy, because the fetus’s own thyroid function has not been completely established, the thyroid hormone required by the fetus depends entirely on the supply of the mother. If the mother suffers from hypothyroidism during pregnancy and cannot provide adequate thyroid hormones for fetal development, it will lead to fetal growth retardation, abnormal bone development, and even damage to the baby’s intelligence and bone development after birth. 03 How to treat hypothyroidism? Hypothyroidism during pregnancy can be divided into clinical hypothyroidism during pregnancy and subclinical hypothyroidism during pregnancy. Pregnant mothers need to go to the hospital to find a professional doctor for a comprehensive diagnosis before they can treat the disease. 1. Clinical hypothyroidism during pregnancy under the guidance of a doctor, pregnant mothers with clinical hypothyroidism during pregnancy can take levothyroxine under the guidance of a doctor, the general starting dose is 50ug/day, according to laboratory test results and clinical symptoms, Adjust medication. 2. Pregnant women with subclinical hypothyroidism during pregnancy and subclinical hypothyroidism who are positive for TPOAb (thyroid peroxidase antibody), take levothyroxine sodium under the guidance of a doctor, the general starting dose is 25ug/day, according to the laboratory Check the results and clinical symptoms and adjust the medication. Tips: Sodium levothyroxine is the first choice for hypothyroidism. When pregnant mothers take it, they should pay attention to taking iron, calcium, aluminum and other drugs more than two hours apart; soy products will affect levothyroxine Sodium absorption, so avoid taking soy products while taking the medicine. 04Can women with clinical hypothyroidism still be pregnant? Women with hypothyroidism should control thyrotropin below 2.5mU/L, FT4 should be maintained at the upper 1/3 level of the non-pregnant normal range, and the function of thyroid function (FT3, FT4, TSH) is normal for pregnancy. During pregnancy, you should also regularly check for nail function and adjust the medication according to the levels of thyroid stimulating hormone (TSH) and free thyroid (FT4). 05 Do I need to continue taking medicine after my child is born? Pregnant mothers with clinical hypothyroidism need to have a thyroid hormone test after delivery. If the thyroid hormone is not within the normal range, they need to continue taking levothyroxine sodium, review the thyroid function, and adjust the medication plan. Most of the early symptoms of hypothyroidism are not obvious and are not easy to be noticed. Many pregnant mothers see the doctor early in pregnancy because the symptoms are similar to the early pregnancy reaction, so the editor recommends that you should seek medical treatment as soon as possible during the pregnancy.

Three mistakes to avoid when treating rheumatism

In my country, rheumatism is a common disease with a high incidence rate. Despite this, there are not many people who really understand rheumatism. Therefore, many patients will enter some misunderstandings during the treatment of rheumatism after the illness. Let’s take a detailed look at the misunderstandings of rheumatism in the treatment process: the misunderstandings of rheumatism treatment 1. Routine application of hormone therapy rheumatism: in fact Regarding the treatment of rheumatism, no matter what kind of treatment drug the patient chooses, it cannot be generalized, and it must be considered according to his condition and disease type. Generally, when hormones are used to treat rheumatism, patients must be familiar with the role of hormones and toxic and side effects before using hormones. For example, rheumatoid arthritis hormones cannot prevent the pathological process of arthritis from continuing to develop and cannot be cured. Long-term use or improper use will also bring many adverse reactions. These adverse reactions are even more harmful to the human body than rheumatoid arthritis itself. Myths about the treatment of rheumatism II. Many patients with rheumatism think that as long as the erythrocyte sedimentation rate, anti-“0”, rheumatoid factor, rheumatoid factor (anti-ENA antibody) and other immune tests are negative, rheumatism can be ruled out. Disease, in fact, this approach is also not conducive to the recovery of the disease. Misunderstandings in the treatment of rheumatism 3. I feel that as long as it is rheumatism, no matter what type it is, there is no cure. In fact, the current medical technology is developing rapidly. As long as the patient is diagnosed with the disease as soon as possible after the illness, and take the opportunity to give active and correct comprehensive treatment measures, the condition can be improved, stabilized or relieved, and the quality of life can be improved. Otherwise, if treated negatively and irregularly, it may develop into a severe disability or lead to serious complications and death.

Shi Shurong Medical Talk: How long does it usually take for hormone therapy to treat thrombocytopenia?

Many patients with thrombocytopenia will use hormonal drugs when they are diagnosed, especially when the platelet value is extremely low. Hormone drugs can quickly increase the platelet value, but they rise and fall quickly, so repeated, it is easy to cause hormone dependence. Therefore, hormone therapy for thrombocytopenia also needs to understand these problems. Director Shi Shurong’s micro signal zkxk9999 how long does hormone therapy generally take? What if there is no effect? For a child with thrombocytopenia, after the onset of the child, 4 days after the glucocorticoid is used, observe the treatment effect of the child. If the treatment effect is good, you do not need to continue to use it. If the child is relapsed and has been treated with C-ball, such a child needs to be treated with a sufficient amount of 2 mg of hormone per kg of body weight for 28 days to observe the treatment effect. If it does not work after 28 days, you need to change the medicine. Are there any side effects of hormone medication? How does it affect your health? The side effects of heavy hormone use: diabetes, high blood pressure, full moon face, buffalo back, centripetal obesity, skeletal abnormalities (decalcification), and easy infection. These are complications that occur during long-term use (1 to 3 months), but short-term large-dose shocks rarely occur. In patients with thrombocytopenia, are there other treatments besides hormones and globulin? For patients with thrombocytopenia, in addition to hormones and globulins, thrombopoietin and drugs that stimulate megakaryocyte receptors can also be used. The study found that the secretion of platelet growth factor in ITP patients is insufficient. If the bone marrow is stimulated by this growth factor, more platelets will be produced to compensate for immune platelet destruction. In addition, at present, more and more patients with thrombocytopenia choose integrated Chinese and Western medicine treatment. Targeted Chinese medicine can effectively reduce the side effects of hormonal drugs, while improving the efficacy and avoiding repeated attacks. More thrombocytopenia disease knowledge or patient help can pay attention to WeChat public number: xxbjs75