Treatment and prevention of Raynaud's syndrome
Raynaud's phenomenon - vasospastic disease with characteristic circulatory disorders affecting the peripheral vascular. Usually affects the brush stop, much less - the tips of the chin, nose, tongue.
In women the syndrome is more common. Skin during the attacks fades, then comes the stage of cyanosis and hyperemia. The main cause of illness - stress and hypothermia, but there are many other factors that triggers the mechanism of development of pathology.
The leading positions belong to the rheumatic diseases (systemic scleroderma) is there a syndrome plays the role of early symptom. Developing pathology and in case of use of individual drugs:
- ergot alkaloids;
- blockers of adrenergic receptors;
- anticancer agents (vinblastine, bleomycin, cisplatin).
Therapy in the latter case is quite simple - the doctor cancels these drugs. However, there are professional factors leading to the development of Raynaud's syndrome:
- contact with polyvinyl chloride;
- working with silica dust and heavy metals.
Versions of the origin
Doctors continue to explore the mechanism of the syndrome. A single concept is not yet developed, but there are many versions of the origin of the disease.
Here are the main theories:
- The Frenchman, who described the disease for the first time, believed that it is based on the increased activity of the sympathetic nervous system.
- The defect of limb vascular (vasodilator effect of endothelial prostacyclin).
- The increase in blood viscosity. The reason for this phenomenon is unclear, but there are some hypotheses about the deformation of red blood cells and of fibrinogen concentration in plasma. A similar condition is observed in cryoglobulinemia - constant feeling of cold (often affects the tips of the fingers).
- Angiospasm. Some scientists believe that the syndrome is manifested on the background of narrowing gaps (cerebral, coronary and muscular vascular).
- Emotional disorders. The symptoms of pathology are observed for stress, nervous exhaustion and severe emotional stress.
The disease affects mostly patients are middle-aged and young, but noted a number of cases of child morbidity (10-14 years). 50% set of cases of hereditary pathology.
Risk factors include:
- psychogenic etiology (the body's response to emotional stress);
- periodic(long-term) exposure to low temperatures (in the peripheral vascular of the blood circulation);
- dysfunction of the endocrine system and hormonal disorders;
- complex factors (hormonal changes in conjunction with the features of the circulatory system and prolonged hypothermia);
- prolonged use of vasoconstrictor drugs (ergotamine, beta-blockers).
Trigger the disease
Some of the disease serve as the backdrop for the development of Raynaud's syndrome.
- systemic disease (arteritis, arterial hypertension, primary pulmonary hypertension);
- the collagen diseases (group pathology of a systemic nature that affect connective tissue and blood vascular);
- poor circulation (thrombophlebitis, venous injury, heart failure, spasm of blood vascular of the retina and brain);
- lesions of the nervous system (syringomyelia, multiple sclerosis, constitutional acrodynia);
- splenomegaly (congenital hemolytic anemia) occurring on a background of hematopoietic disorders;
- dysfunction of the digestive tract (gastric ulcer, colitis, gastritis);
- hormonal disorders and endocrine diseases (hyperparathyroidism, tumors of the adrenal glands, hypothyroidism, menopausal syndrome, dysplasia of the uterus and ovaries);
- rheumatoid arthritis;
- arteriovenous aneurysm (affects the foot and hand);
- inflammation of the vascular walls (finger arteriitis, vasculitis);
- syndromes, cervical rib, anterior scalene muscle, lesions of the intervertebral discs;
- arterial segmental obliteration (the result of vasomotor disturbances of the feet and hands);
- occupational disease;
- nodular periarthritis;
- diseases of the blood (cryoglobulinemia, paroxysmal hemoglobinuria, thrombocytosis, multiple myeloma);
- neurogenic syndromes (lesion of carpal tunnel);
- prolonged immobilization;
- a paraneoplastic syndrome.
Stages and symptoms
Raynaud's syndrome has three distinct stages. The effectiveness of the treatment largely depends on accurate diagnosis, since the disease in each varies considerably.
- Stage 1. Slows down the blood flow to the tissues. Cold fingers, pale phalanges - the attack lasted about 2 minutes, but sometimes delayed for half an hour. After this takes place independently.
- Stage 2. The vascular are stretched so much that the blood on them is almost not flowing. Tissue numb asis no oxygen supply. Appears pain, then the swelling and lividity. The attack lasts for hours.
- Stage 3. Thinner fingers, because the blood flow to them is running out. The tips are formed of tiny wounds. Final - gangrene of the fingertips.
The syndrome is slow, and in some cases can suddenly be in remission.
The enabling conditions of remission, are as follows:
- changes in climatic conditions;
- postpartum period;
- the onset of menopause.
For the primary stage of the disease characterized by a stationary current.
In General there are the following symptoms:
- neurological disorders (headaches, discomfort in the spine, pain in extremities, sleep disturbances);
- heart pain of a functional nature;
- periodic increase in blood pressure;
- objective paraesthesia (very rare), increased sensitivity of the forearm and fingers to cold, numbness, itching and burning;
- convulsive crises (severe and frequent), affecting the scope of arteriocapillary.
Syndrome inherent to a paroxysmal character. During attacks the skin color of the limbs change gradually, from white and blue to reddish. The attack is accompanied by cutaneous hyperthermia, the patient feels a mild swelling and a fever.
Observed trophic changes:
- flattened/retracted the finger pads;
- reduced turgor of the skin;
- there are ulcers (heal, they are painfully slow).
Initially, the pathology affects the tips of several fingers, but over time being transferred to a whole hand (except the thumb). Another characteristic feature, which is manifested in the period of the attack - mesh livedo (figure, resembling marble). In the affected areas of the skin feels tingling and sudden numbness, skin abruptly grows cold.
For a successful diagnosis of the disease used conventional and special research methods. The primary diagnosis of the syndrome is made by exclusion of comorbidities. Further observations confirm or refute the initial diagnosis.
The following methods:
- blood tests (fibrinogen, protein fractions, protein);
- capillaroscopy (study of the degree of vascular lesions);
- coagulation (also studied the properties of blood, hematocrit, viscosity, agglutination of red blood cells and platelets);
- chest x-ray to identify the presence of cervical rib;
- immunological examination (rheumatoid and antinuclear factors, immunoglobulins, circulating immune complexes, antibodies to ribonucleoprotein and DNA);
- oscillography/rheovasography, ultrasonic Doppler (study of finger blood flow), angiography, laser Doppler flowmetry, digital plethysmography.
The diagnosis of "Raynaud's syndrome" is only if there is a clear set of criteria.
The patient should be detected:
- vascular spasm;
- symmetrical localization of vascular attacks;
- probing the pulsations of the arteries (this figure should correspond to the norm);
- the regular repetition of vascular attacks (the patient is doctors for 2-3 years).
For the last years is characterized by increased attention to the wide-field capillaroscopy of the nail bed, which is a progressive modification of the slit lamp. This method helps to detail the structural changes affecting the area of the nail bed.
The effectiveness of the treatment depends on elimination mechanisms, which are the provocateurs dysfunction vascular. In most cases, doctors recommend to drastically change their habits (quit Smoking, for example), but sometimes required move to another area or non-harmful professional activities. The warm climate effectively grapple with the disease syndrome gradually disappear without medical intervention.
If you comply with all conditions is not possible, the patient shows a drug therapy. This is to tell you more.
The emphasis is on vasodilators, the most effective of which are considered antagonists of calcium:
- the nicardipine.
Progressive form of the disease involves treatment Vazaprostan. The drug is administered intravenously drop by drop (a course of 10-20 injections). A positive effect of the drug is observed after the third treatment, the effectiveness is gradually increases.
Widely used antiplatelet funds:
- reopoligljukin and other low molecular weight dextrans.
In some cases, your doctor may prescribe ACE inhibitors or blockers HS2-serotonin receptors. In case of sudden attack, you can recover with the help of improvised means - warm water (it warms the limb), woolen fabric, soft massage orhot drink. With a long attack must be countered by antispasmodic drugs.
For this made of injection:
Medical therapy is good in combination with additional therapeutic methods.
Among them, worth noting:
- physical therapy;
- the extracorporal hemocorrection (assigned with the background development of the system of connective tissue);
- thermal procedures;
- hyperbaric oxygenation (meaning oxygen under pressure);
- regulation of the peripheral circulation (applied stem cells)
Approach to therapy invariably is comprehensive. Welcome drugs that reduce the viscosity of an application of the affected areas, physiotherapy. Treatment may take many years, so do not expect quick results and follow doctor's orders.
Raynaud's syndrome is a progressive disease, but the danger to human life does not carry. Spasms affect small blood vascular and do not affect the major organs. Frequent spasms provoke severe diseases of the skin and can cause the rejection of the fingertips.
To prevent attack, you need to follow certain precautions, eliminating precipitating factors:
- work with a voltage of the hands;
- contact with chemical substances, which are the root cause of vascular spasms.
Folk remedies are considered only as a Supplement to drug therapy. Recommended massage with strokes and taps of the fingertips. This massage dilates the capillaries and improves blood flow. Folk medicine combined with drug therapy and additional methods will help to stop further disease development.