Kev kuaj pom raws sijhawm ntawm cov tsos mob ntawm cov kab mob thaum ntxov yog ib qho tseem ceeb rau nws txoj kev kho mob zoo, tshwj xeeb tshaj yog tias muaj tus kab mob no. Tib yam siv rau cov kab mob xws li rheumatism.
Kev kuaj mob kom raug kuj tseem ceeb, uas yog siv ntau txoj kev kuaj mob. Hauv kab lus no, peb yuav xav txog dab tsi yog cov tsos mob ntawm rheumatism, hom kab mob, nws txoj kev kho thiab kev tiv thaiv.
Lub tswvyim ntawm rheumatism
Nyob rau hauv cov chaw kho mob niaj hnub no, rheumatism hu ua kab mob inflammatory ntawm lub cev ntawm cov ntaub so ntswg sib txuas, cov txheej txheem pathological uas nyob hauv thaj chaw feem ntau nyob rau hauv daim nyias nyias ntawm lub plawv cov leeg lossis hauv cov nqaij mos periarticular, tab sis kuj tuaj yeem ua tau. cuam tshuam rau lwm lub cev.
Feem ntau tus kab mob no tshwm sim hauv cov menyuam yaus. Tus me nyuam yau, qhov phem tshaj qhov rov tshwm sim ntawm tus kab mob. Nws yog ib qho tsim nyog los txheeb xyuas cov tsos mob hauv lub sijhawm, thiab kev kho mob rheumatism hauv cov menyuam yaus hauv qhov no yuav ua tau zoo dua.
Rheumatism tuaj yeem tshwm sim nws tus kheej hauv ntau yam hauv qab no:
- kab mob rheumatic - ib qho mob ntawm txhua daim nyias nyias ntawm lub plawv cov leeg, suav nrog myocardium;
- rheumatic pleurisy - kev puas tsuaj rau cov kab mob ua pa;
- daim tawv nqaij rheumatism - o ntawm daim tawv nqaij;
- rheumatic chorea - ib qho pathology tshwm sim los ntawm vasculitis ntawm cov hlab ntsha me ntawm lub hlwb (feem ntau hauv cov ntxhais);
- mob rheumatic - mob pob qij txha.
Nrog rheumatism, cov kabmob ntawm lub plab zom mov tsis tshua muaj cuam tshuam. Nyob rau hauv cov ntaub ntawv no, mob heev nyob rau hauv lub plab mog yuav tshwm sim, uas yog txuam nrog rheumatic peritonitis. Qee zaum muaj mob ntawm daim siab lossis raum.
Kev phom sij ntawm tus kab mob yog qhov tseeb tias yog tias koj tsis quav ntsej cov tsos mob ntawm rheumatism thiab kev kho mob, nrog rau kev soj ntsuam zoo los ntawm kws kho mob, cov kab mob loj ntawm lub hauv nruab nrab paj hlwb thiab lub plawv tuaj yeem txhim kho.
Ua rau kab mob
Txoj kev vam meej ua lub luag haujlwm tseem ceeb hauv qhov tshwm sim ntawm tus kab mob.
Feem ntau cov tsos mob ntawm rheumatism tshwm sim ib mus rau peb lub lis piam tom qab cov xwm txheej hauv qab no:
- nkag mus rau lub cev ntawm β-hemolytic streptococcus pawg A;
- ua rau cov ntaub ntawv mob ntev ntawm tonsillitis, pharyngitis, tonsillitis, otitis media;
- kab mob scarlet fever;
- puverperal fever.
Lub cev ntawm cuaj caum xya feem pua ntawm cov neeg uas muaj tus kab mob streptococcal tsim muaj kev tiv thaiv zoo. Tus so txhim kho cov lus teb inflammatory thaum rov ua dua.
Lub ntsiab tseem ceeb uas ua rau muaj qhov tshwm sim ntawm cov tsos mob ntawm rheumatism (cov duab ntawm kev tshwm sim tuaj yeem pom hauv kab lus) yog:
- txo qis kev tiv thaiv;
- koom nrog ntau tus neeg (tsev kawm ntawv, tsev so thiab lwm yam);
- negative social condition of existence;
- nrawm hypothermia.
Kev kho mob tshwm sim ntawm tus kab mob rheumatic mob plawv
hom mob rheumatism no txaus ntshai vim tias muaj nees nkaum feem pua ntawm cov neeg mob tuaj yeem xaus nrog cov kab mob plawv. Thiab yog tias cov neeg laus muaj peev xwm piav qhia meej txog qhov tshwm sim ntawm tus kab mob, cov menyuam yaus, raws li txoj cai, tsis txhob mloog lawv.
Cov tsos mob ntawm lub plawv rheumatism yog raws li hauv qab no:
- -tsis muaj zog, qaug zog, mob taub hau;
- tawm hws ntau dhau;
- ntse poob qab los;
- rub-stabbing mob nyob rau hauv cheeb tsam ntawm lub plawv;
- kub nce siab tshaj 38 degrees Celsius;
- sib siab poob;
- mob siab;
- Cov tsos mob hnyav ntawm lub plawv tsis ua haujlwm thiab lub plawv dhia tsis zoo.
Nws yog ib qho tseem ceeb heev los txheeb xyuas cov tsos mob ntawm lub plawv rheumatism nyob rau lub sijhawm - kev kho tus kab mob hauv qhov no yuav ua tau zoo dua.
Clinic ntawm articular rheumatism
daim ntawv mob hnyavrheumatism feem ntau pib 1-3 lub lis piam tom qab mob caj pas lossis lwm yam kab mob sib kis (flu, o ntawm pob ntseg lossis paranasal sinuses). Hauv qhov no, raws li txoj cai, cov menyuam yaus thiab cov hluas raug kev txom nyem. Cov tsos mob thiab kev kho mob rheumatism ntawm cov pob qij txha yuav tau tham tom ntej.
Cov neeg mob yws txog cov tsos mob hauv qab no:
- mob pob qij txha, feem ntau hauv cov loj - lub xub pwg, hauv caug, pob taws thiab lwm yam;
- pob qij txha;
- tsis tuaj yeem txav mus los vim qhov mob tsis zoo;
- kub nce mus rau 38-39 ° C;
- tawm hws hnyav tshwm (tshwj xeeb yog cov neeg mob hnyav hws thaum hmo ntuj thiab sawv ntxov);
- defeat tshwm symmetrically;
- pom tsis muaj zog, tsis muaj zog, los ntshav los ntawm qhov sinuses.
Ntau zaus tus kab mob pib mob hnyav, tsawg zaus nws maj mam zuj zus. Thaum kuaj xyuas cov neeg mob, lawv txoj haujlwm tsis muaj zog txaus nyiam - lawv zam qhov kev txav me ntsis vim qhov mob hnyav hauv qhov chaw mob. Cov tsos mob ntawm tes rheumatism zoo ib yam li lwm hom kab mob.
Feem ntau cov pob qij txha cuam tshuam loj, daim tawv nqaij ntawm lawv yog me ntsis hyperemic, kub rau qhov kov, ntub dej, qee zaum npog nrog cov pob liab liab.
Nyob rau hauv cov hnub thaum ntxov ntawm cov hlab plawv system, tshwj tsis yog rau nruab nrab tachycardia, tsis muaj kev hloov pauv. Mob pob qij txha yog volatile nyob rau hauv cov xwm, thiab nws feem ntau manifests nws tus kheej nyob rau hauv cov hluas, muaj zog cov neeg. Qhov swb ntawm txhua qhov sib koom ua ke tshiab tshwm sim hauv ob peb teev.
Cov tsos mob ntawm tus mob rheumatism hauv cov neeg laus tau tshwm sim raws li hauv qab no: ua ntej, ib lossis ob pob qij txha raug cuam tshuam, tom qab ntawd ntau thiab ntau tau koom nrog hauv cov txheej txheem. Qee zaum, yim pob qij txha tuaj yeem ua rau mob ib zaug, thiab qee zaum ntau dua.
Nyob rau hauv cov xwm txheej hnyav, cov kua dej edematous accumulates tsis tau tsuas yog nyob rau hauv lub sib koom kab noj hniav, tab sis kuj nyob rau hauv cov nqaij ntshiv periarticular thiab connective formations. Thaum lawv hnov, qhov mob tshaj plaws yog qhov chaw txuas ntawm fibrous fascia thiab tendons rau cov pob txha.
Nws yuav tsum tau hais meej tias cov pob qij txha uas tau mob tuaj yeem rov ua mob dua tom qab ob peb hnub, yog li ntawd qee tus ntawm lawv yuav raug cuam tshuam ntau zaus thaum mob rheumatism. Qhov no muaj tseeb tshwj xeeb tshaj yog rau rheumatism ntawm ob txhais ceg - cov tsos mob zoo ib yam li cov kev tshwm sim ntawm lwm yam kab mob.
Khev kho mob rau lwm hom mob rheumatism
Txhua yam ntawm rheumatism muaj nws tus yam ntxwv. Xav txog lawv ntxiv.
Rheumochorrhea yog tus yam ntxwv los ntawm cov tsos mob hauv qab no:
- tsis zoo rau lub cev muaj zog, kev sau ntawv, kev sib koom tes ntawm kev txav - cov tsos mob tshwm sim tsuas yog thaum tsaug zog;
- tshwm sim ntawm qhov tshwm sim tsis zoo, cov leeg tsis muaj zog, tsis muaj peev xwm taug kev thiab zaum;
- nqhis dej tsis meej;
- tus neeg mob tus cwj pwm hloov pauv mus rau qhov kev taw qhia ntawm kev tsis ruaj khov thiab hloov pauv - los ntawm kev ua phem thiab kev xav tsis txaus ntseeg tus neeg mob mus rau qhov tsis nco qab, tsis muaj zog, nws nkees sai.
Daim tawv nqaij ntawm tus kab mob yog tshwm sim los ntawm cov tsos mob hauv qab no:
- knottyerythema yog tus cwj pwm los ntawm kev txwv tsis pub ntawm daim tawv nqaij (tsuas yog nyob rau hauv qis extremities) nrog cov xim hloov mus rau tsaus liab, qhov loj yog los ntawm ib nrab ib centimeter mus rau plaub;
- erythema annulus yog tus yam ntxwv los ntawm qhov tsis mob daj ntseg liab ua pob liab liab nyob rau hauv daim ntawv ntawm cov rims;
- tshwm sim ntawm qhov ntom ntom tsis mob rheumatic nodules;
- nyob rau hauv tsawg zaus, nrog rau cov capillary permeability loj heev, me me capillary hemorrhages yuav tshwm sim;
- tawv nqaij;
- tawm hws ntau dhau.
Nodules tsis ua rau tsis xis nyob thiab ploj hauv ob mus rau peb lub lis piam.
Nws yog ib qho tseem ceeb kom paub tias cov tsos mob ntawm tus mob rheumatism yog dab tsi thiaj li mus ntsib kws kho mob tshwj xeeb hauv lub sijhawm los txiav txim seb hom kab mob.
Rheumatic pleurisy yog tus yam ntxwv los ntawm cov yam ntxwv hauv qab no:
- nce lub cev kub;
- mob plab thaum ua pa, mob hnyav thaum ua pa hauv;
- hnoos qhuav;
- qhia ua pa luv;
- tsis hnov ua pa ntawm sab cuam tshuam.
Cov tsos mob ntawm rheumatism hauv cov neeg laus feem ntau zoo ib yam li cov menyuam yaus.
Kev kuaj kab mob
Rau lub sijhawm kuaj pom tus kabmob, nws yog qhov yuav tsum tau mus ntsib kws kho mob raws sijhawm, leej twg yuav kuaj xyuas qhov tsim nyog. Nws cov txiaj ntsig yuav pab tsim kev kuaj mob kom raug thiab sau ntawv kho mob. Cov tsos mob ntawm tes rheumatism, zoo li lwm hom kab mob, zoo ib yam, thiab yog li yuav tsum tau ua tib zoo tshuaj xyuas.
Lab thiabinstrumental research.
thawj pab pawg suav nrog:
- kuaj ntshav. Lub xub ntiag ntawm tus kab mob yog qhia los ntawm cov tsos ntawm C-reactive protein, nce ESR, anemia, thiab hloov pauv ntawm leukocyte mis rau sab laug. Qhov tshwm sim yuav pab txiav txim siab txog qib ntawm cov kab mob ua haujlwm. Kev tshuaj ntsuam kuj txiav txim siab eosinophilia thiab ntshav ntshav.
- Kev tshuaj xyuas cov kua dej sib koom ua ke. Cov txiaj ntsig tau txiav txim siab seb puas muaj cov serofibrinous exudate nyob nrog ntau cov hlwb endothelial, neutrophils, ib leeg erythrocytes thiab fibrin flakes.
- Kev tshuaj xyuas cov kua dej pleural. Qhia pom muaj cov exudate zoo sib xws uas muaj ntau cov hlwb mesothelial.
- Smear. Kev tshuaj xyuas nrog ntau tus ntu ntawm neutrophils thiab lymphocytes, nrog rau neutrophils.
- ntsuas zis. Tus kab mob no lees paub tias muaj cov kab mob ntawm cov protein thiab cov qe ntshav liab.
- Diphenylamine (DPA) kuaj kuaj pom qhov nce qib ntawm mucoproteins, antistreptokinase, antistreptolysin thiab antihyaluronidase titers.
Instrumental studies muaj xws li:
- Electrocardiogram - qhia txog kev ua txhaum ntawm lub plawv cov leeg.
- kuaj mob lub plawv.
- FCG - txiav txim siab qhov kev hloov ntawm lub suab nrov thiab lub siab lub suab.
- X-ray - tso cai rau koj ntsuas qhov kev hloov pauv ntawm qhov loj ntawm lub plawv cov leeg, nws cov teeb tsa thiab kev ua haujlwm contractile.
Kev mob nkeeg
Cov kev kawm ntawm daim ntawv nquag ntawm rheumatism yog ntev heev, txawm hais tias kev sib koom ua ke feem ntau raug tshem tawm sai sai - txij li ob mus rau peb lub lis piam mus rau peb mus rau rau lub hlis.
Txawm tias muaj cov tsos mob me me ntawm rheumatism, cov txheej txheem hauv plawv thiab pob qij txha imperceptibly rau tus neeg mob thiab feem ntau rau tus kws kho mob txuas ntxiv inexorably. Qhov xwm txheej ntawm tus neeg mob rheumatism nyob rau hauv qhov tseeb tias lub sijhawm no cov pob qij txha tsis thab nws, qhov tsis xis nyob hauv lub plawv yog me ntsis, lub xeev ntawm kev noj qab haus huv zoo dua, yog li cov neeg tsis noj cov tshuaj tsim nyog. Thaum, tom qab ob peb xyoos, cov neeg mob nrhiav kev pab kho mob, cov txiaj ntsig ntawm kev tshuaj xyuas lub hom phiaj tau hais tias lawv muaj lub plawv tsis zoo nrog rau cov endocarditis thiab o ntawm cov hlab ntsha.
Qhov kev hloov loj tshaj plaws tshwm sim hauv cov hlab plawv. Rheumatism cuam tshuam rau myocardium, endocardium thiab pericardium. Ua ntej tshaj plaws, kev hloov pauv tshwm sim hauv cov leeg nqaij. Clinically, xya mus rau kaum hnub tom qab pib ntawm tus kab mob, nyob rau hauv nruab nrab ntawm kev sib koom mob, cov neeg mob tsim palpitations, ua tsis taus pa, hnyav, tsis xis nyob thiab mob nyob rau hauv lub plawv cheeb tsam.
Cov tsos mob ntawm rheumatism hauv cov menyuam yaus thaum pib yog qee zaum nyuaj rau kev txiav txim siab, vim tias tus menyuam tsis tuaj yeem piav qhia tau raug. Yog li ntawd, cov neeg laus yuav tsum tau xyuam xim rau cov cim pom tseeb nyob rau hauv daim ntawv ntawm qhov kub thiab txias, tsis muaj zog, sib koom ua ke o.
Cov qib hauv qab no ntawm cov kab mob sib txawv nyob ntawm seb cov tsos mob ntawm tus mob rheumatism yog li cas:
- ntse, tsis tu ncua manifest;
- subacute (kev ua haujlwm nruab nrab);
- latent, uas yog, qeeb, nrog kev ua haujlwm tsawg.
Rheumatism yog tus yam ntxwv los ntawm kev tawm tsam rov qab - rov ua dua los ntawm kev cuam tshuam sab nraud: hypothermia, kis kab mob, kev tawm dag zog lub cev. Cov tsos mob tshwm sim ntawm qhov rov ua dua qhov mob zoo ib yam li cov thawj coj, tab sis lawv tsis tshua meej, tab sis cov tsos mob ntawm lub plawv puas, ntawm qhov tsis sib xws, yeej.
Differential diagnosis of articular rheumatism
Thaum mob hnyav, kws kho mob tsis muaj teeb meem hauv kev kuaj mob, tshwj xeeb tshaj yog xav txog cov kab mob ntawm tus neeg mob lub siab.
Ua ntej ntawm tag nrho cov, nws yuav tsum paub qhov txawv rheumatic mob caj dab los ntawm rheumatoid (nonspecific, kis). Qhov zoo sib xws ntawm cov kab mob no nyob rau hauv qhov tseeb tias ob leeg tuaj yeem pib nrog qhov tshwm sim ntawm tonsillitis lossis qhov txhab ntawm cov kab noj hniav ntawm lub qhov ntswg, ua npaws.
Ntxiv rau kev mob caj dab rheumatoid, rheumatic mob caj dab yuav tsum tau sib txawv ntawm cov kab mob tshwj xeeb polyarthritis ntawm qee yam etiology. Ntawm no peb yuav tsum nco ntsoov txog tuberculosis, gonorrhea, brucellosis, dysentery, syphilis, influenza, typhoid, sepsis thiab mob me me kab mob.
Kev Tiv Thaiv thiab Tiv Thaiv Thawj
Kev ntsuas rau daim ntawv articular ntawm rheumatism yog txiav txim siab los ntawm qib ntawm lub plawv puas.
Cov kev hloov pauv hauv cov pob qij txha lawv tus kheej feem ntau xaus qhov zoo, thiab cov kev hloov pauv nyob rau hauv daim ntawv ntawm nruj txav los yog ankylosis yog tsawg.
Nrog rau lub sijhawm tshawb pom cov tsos mob thiab kev kho mob rheumatism, tus kab mob qiv nws tus kheej zoo rau kev kho mob. Qhov nyuaj tshaj plaws thiab tsis zoorheumatism rov tshwm sim.
Qhov tseem ceeb tshaj plaws yuav tsum tau muab rau cov neeg nyob hauv uas tus neeg tau rov zoo los ntawm tus kab mob thawj zaug lossis mob hnyav. Nws yog ib qho tseem ceeb los daws qhov txias, dampness, cua ntsawj ntshab, thiab ua hauj lwm ntau dhau los tiv thaiv kev mob rheumatism.
Txhawm rau kev tiv thaiv dav dav rau kev kho cov tsos mob ntawm rheumatism ntawm cov pob qij txha yuav tsum suav nrog kev ua kom lub cev tawv kom ua rau nws tsis kam ua kom txias, hloov pauv ntawm qhov kub thiab txias, dampness. Kev kawm lub cev thiab kev ua kis las yuav ua rau muaj kev cob qhia tsim nyog thiab ua kom lub cev tawv.
Tshuaj tiv thaiv thiab kho mob comorbidities
Kev kuaj xyuas txhua yam ntawm cov kab mob sib kis nyob hauv lub cev yuav tsum tau kho tam sim. Nws yog ib qho tsim nyog yuav tsum ntxuav lub qhov ncauj kab noj hniav, tshem tawm cov hniav carious, kho mob tonsillitis, o ntawm pob ntseg thiab kab noj hniav paranasal.
Lub xub ntiag ntawm cov kab mob inflammatory foci tsis tsuas yog tuaj yeem ua rau muaj kev sib kis thoob plaws hauv lub cev, ua rau muaj kev tsis haum tshuaj, tab sis kuj hloov nws cov reactivity thiab yog li tsim cov xwm txheej rau qhov pib ntawm rheumatism.
Ib txoj hauv kev uas tso cai rau tus kws kho mob kom paub meej tias muaj kev fab tshuaj yog kev kawm txog cov ntshav peripheral. Kev nce ntawm eosinophils ntau dua tsib feem pua yuav tsum nco ntsoov nyiam thiab ua rau muaj kev ntsuam xyuas zoo ntawm lub cev, thiab, yog tias tsim nyog, siv cov tshuaj desensitizing (diphenhydramine, diazolin, calcium chloride, thiab lwm yam).
Raws li kev tiv thaivThaum lub sij hawm exacerbation - nyob rau lub caij nplooj ntoos hlav thiab lub caij nplooj zeeg - lawv tau kho nrog tshuaj tua kab mob thiab tshuaj tua kab mob.
kev tiv thaiv thib ob
Cov dej num hauv qab no yog ib qho kev tiv thaiv thib ob:
- Nrog rau chav kawm ntawm tus kab mob, kev saib xyuas tas li los ntawm tus kws kho mob rheumatic yog qhov tsim nyog. Thaum xub thawj, nws raug mus xyuas txhua hli rau peb lub hlis los ntawm kev kuaj pom cov tsos mob ntawm rheumatism, thiab tom qab ntawd - ib zaug hauv peb lub hlis twg. Nws tseem yuav tsum tau mus nrhiav tswv yim los ntawm cov kws kho mob tshwj xeeb xws li kws kho mob neurologist, ENT, ophthalmologist, kws kho hniav, gynecologist.
- Txoj cai tsim nyog yog pub ntshav ntshav ib zaug ob lub hlis, thiab tso zis ib zaug hauv peb lub hlis twg.
- Kev kuaj mob peb hlis twg.
- Plaub zaug hauv ib xyoos pub ntshav rau kev kuaj mob rheumatic.
- Thaum cov txheej txheem ploj mus thiab hloov mus rau hauv daim ntawv tsis muaj zog, tus kws kho mob rheumatic tau mus ntsib ob mus rau plaub zaug hauv ib xyoos.
kho mob Rheumatism
Lub sijhawm nquag thiab mob rheumatism tau kho hauv tsev kho mob nrog pw tsaug zog nruj.
Cov neeg mob tau sau tshuaj nrog hyposensitizing thiab tshuaj tiv thaiv kab mob: cov tshuaj tsis-steroidal anti-inflammatory, corticosteroid cov tshuaj hormones. Tsis tas li ntawd, nyob rau hauv muaj cov kab mob foci, cov tshuaj tua kab mob tau muab tshuaj nrog lawv cov kev huv huv tib si (cov hniav carious, tonsillitis, sinusitis).
Ib zaug nrog kev kho tshuaj tseem ceeb, cov neeg mob tau muab tshuaj immunomodulators thiab sedatives. Nyob rau hauv cov ntaub ntawv ntawm kev kuaj mob plawv, diuretics thiab plawvglycosides.
Cov tsos mob thiab kev kho mob rheumatism hauv cov neeg laus feem ntau zoo ib yam li cov menyuam yaus.
chaw kho mob sab nraud:
- cov neeg mob yuav tsum saib xyuas lub txaj nruj thiab nyob hauv chav sov, qhuav, nyob rau hauv qhov chaw ntsiag to;
- Ykoj yuav tsum tau muab cov zaub mov zoo nrog cov vitamins txaus (A, C, B1);
- pom zoo kom ua kom txaus cov protein thiab carbohydrates nrog zaub mov;
- yuav tsum txwv tsis pub noj cov ntsev ntsev (txog 3-4 g), uas yeej muaj txiaj ntsig zoo ntawm cov txheej txheem inflammatory;
- vim tus neeg mob tawm hws, haus dej yuav tsum tsis pub tsawg.
Nyob rau hauv daim ntawv tsis muaj zog ntawm tus kab mob los ntawm cov tshuaj, thawj qhov chaw yuav tsum yog siv salicylates nyob rau hauv daim ntawv ntawm salicylic sodium los yog aspirin, nrog rau cov tshuaj tua kab mob (penicillin). Hloov chaw ntawm salicylic sodium, tshuaj aspirin tuaj yeem muab tshuaj, tab sis nws cov nyhuv yuav qis dua me ntsis.
Kev npaj tshuaj hormones kuj tseem siv - ACTH, cortisone thiab nws cov derivatives. Cov nyhuv hauv feem ntau yog qhov zoo, txij li cov tshuaj tau teev tseg muaj cov nyhuv antiallergic sib txawv thiab muaj peev xwm tiv thaiv kev tsis haum tshuaj thiab cov ntaub so ntswg hyperergic hauv cov neeg mob rheumatism.
Rau kev noj zaub mov hauv cov xwm txheej no, ntxiv rau kev txwv ntsev, ob mus rau plaub grams ntawm poov tshuaj chloride ib hnub yuav tsum tau muab.
Nyob rau hauv lub xub ntiag ntawm exacerbation ntawm mob tonsillitis los yog lwm yam foci ntawm tus kab mob, kev siv tshuaj tua kab mob hnyav tau qhia.
Physiotherapycov txheej txheem, nrog rau kev siv hluav taws xob ultraviolet, yuav tsum tau siv rau lub sijhawm ntev ntawm kev mob rheumatic kub taub hau, thiab kev kho lub cev yog qhia nyob rau tib lub sijhawm.
