In the tactics of therapeutic measures, several basic provisions are important, arising from the pathogenesis of these diseases and the nature of the course of individual forms. First, one can say with certainty about the biphasic development of chronic inflammation of the joints – the primary synovitis phase is predominantly exudative, when there are still no immunological and morphological changes associated with autoagressive mechanisms, and
synovitis of a predominantly proliferative type, due to the “development of autoimmune reactions. In other words, both YUHA and RA do not appear immediately as diseases with little controlled disruption of the immune regulation, and this nature of them is formed during the evolution of the pathological process. This situation determines the need for a sufficiently early start of therapy, since only in this case it seems possible to prevent the subsequent development of destructive changes in the musculoskeletal system and the defeat of the internal nnih bodies.
In addition, based on the concept of auto-aggressive nature of the lesion, in the course of UXA and RA there is, in the direct sense of the word, an active and inactive phase, but there is only a different degree of activity (exudative phase of inflammation) detected by a complex of clinical and laboratory data. From these positions, the removal of activity (exudative inflammation) does not mean the termination of the pathological process and thus only partially determines the prognosis of the disease. Hence, a fairly important position in the treatment of this group of patients is the principle of fairly intensive treatment in the phase of clinical activity and the constancy of therapy in the period of remission of the pathological process and in the stage of partial or complete clinical laboratory. remission.
Finally, it must be emphasized that the medical treatment of patients with UHA and RA is only one of many methods for the rehabilitation of patients, such as physical therapy and massage, physiotherapy, surgical treatment, psychotherapy, etc.
Various medical preparations are used in the treatment of Yuha and RA. It is estimated, for example, that in the history of studying RA, about six thousand different drugs were proposed for its treatment. These data once again emphasize that the problem of drug treatment of these diseases has not yet been resolved. Conventionally, all drugs used for the treatment of UHA and RA can be divided into two large groups – agents aimed at relieving inflammation (anti-inflammatory drugs) and agents acting on impaired immunological reactivity (immunomodulating drugs). The group of anti-inflammatory drugs, in turn, is divided into non-hormonal and anti-inflammatory drugs and glucocorticoids, as well.immunomodulatory drugs for immunosuppressive and immunostimulatory drugs. Often, immunomodulatory drugs are classified as “basic”. Such a designation is only conditional, since the “basic” therapy can also be treatment with non-hormonal anti-inflammatory drugs, if they effectively support remission.