l/pDofl6s -cfdjfthGo_ /f]ux?

sf] kl/ro, jlu{s/0f, lgbfg / lrlsT;f

8f= k|bLk s]=;L=

lj=P=Pd=P;= -l6=o'=_
Pd=8L=-l6=l;=Pd= l/pDff6f]nf]hL, lrg_
sfo{/tM :jf:Yo tyf hg;FVof dGqfno
l/pDofl6s zAb o'gfgL efiffsf] l/pdf af6 ag]sf] 5 h;sf] cy{ kfgL em}+ aUg] x'G5 . z/L/leq
kfgL em}+ aUg] j:t'x?af6 pTkGg x'g] b'vfO{ / zf]yhGo /f]ux?nfO{ l/pDofl6s /f]u elgG5 .
cfo'j]{bsf u|Gyx?df oL /f]ux?sf] nflu cfdjft eGg] zJbsf] pNn]v ePsf] kfO{G5 h;sf] cy{
cfd jf ckSj /; -/utdf ePsf ljiffQm j:t'x? h:t} 6f]lS;g, cvfB kbfy{ / cf}iflwx?sf]
cjz]if, /f]uk|lt/Iffaf6 z/L/leq pTkGg ePsf hl6n kbfy{x? cflb_ af6 jft jf z/L/sf
df+;k]zL, hf]gL{x?df ljR5Lb+zjt lk8f x'g' , ;'GgLg' jf /ftf] x'g' eGg] a'lemG5 . ctM l/pDofl6s
/f]ux? eGgfn] cfdjfthlgt /f]ux? eGg ;lsG5 .
;fdfGotof cfdjfthGo -l/pDofl6s_ /f]u eGgfn] z/L/sf df+;k]zLx?, hf]gL{x? / cGo
sf]dn tGt'x?df kL8f jf zf]y eP/ pTkGg x'g] /f]ux?nfO{ hgfpF5 . oL /f]ux?dWo] w]/}h;f]
/f]ux? zl//sf] /f]uk|lt/f]wfTds Ifdtfdfly cfg} z/L/n] cg]s k|sf/sf k|lt/IfL kbfy{x? agfP/
z/L/sf ljleGg sf]if / sf]ifcjojx?nfO{ gi6 u/L jf sf]ifx?sf] sfdnfO{ lgis[o kf/L pTkGg x'g]
u5{g . klxn] klxn] oL /f]ux?n] df+;k]zLxLhf]gL{x?nfO{ dfq} c;/ ug{ ;S5g\ eGg] dfGotf
ePtfklg xfn}sf cg';Gwfgx?af6 oL /f]ux?n] z/L/sf cGo cx? h:t} sf]dn tGt', ;+of]hg
tGt', /Qmsf]if, /QmgnL, kmf]S;f], d[uf}nf, d'6, :gfo', cfFvf, 5fnf cflb nfO{ klg c;/ ub{5g\ eGg]
k|dfl0ft e} ;s]sf] 5 . To;}n] xfn cfP/ cfdjfthGo -l/pDofl6s_ /f]ux?sf] ;FVof / bfo/f
km/flsnf] x'Fb} cfPsf] 5 .
cfdjfthGo -l/pDofl6s_ /f]udf d'Votof Rheumatoid Arthritis -xftsf ;;fgf
hf]gL{x? b'Vg] / lj:tf/} aff]l6f] eP/ ljs[t x'g] /f]u_, Systemic Lupus Erythematosus
-ljz]iftM lszf]/Lx?sf] 5fnfdf AjfF;f]n] 6f]s]h:tf] /ftf] /ftf] / ;lhn} lgsf] gx'g], cg'xf/df k'tnLsf]
cfsf/df /ftf] wAafx? aGg] /f]u_, Sjogren Syndrome -cfFvf, gfs, d'v, 3fF6L nufotsf
:yfgx?df ePsf cfF;' , ofn >fj u/fpg u|GyLx? z/L/sf] cfg} /f]u k|lt/f]wfTds k|0ffnLn]
glrg]/ jf e'njz gi6 u/L lj:tf/} tL 7fpFx? ;'Vvf x'Fb} hfg] /f]u_, Polymyositis,
Dermatomyositis or Juvenile dermatomyositis -s'g} sf/0fljgf xft v'fsf
b'j}tkm{sf glhstL/sf xLdf 6fl;g] df+zk]zLx?df ;'hg e} an gx'g], b'Vg], /utdf CPK,

AST, ALT LDH h:tf O{GhfOdx? a9\g] / 5fnfdf 8fj/x? cfpg] h:tf nIf0fx? x'g] /f]u_
Scleroderma -5fnf /jf z/L/sf leqL cx?df Jofks ?kdf kmfO{a|f]l;; eP/ s8f x'Fb} hfg]
/f]u_, Adult onset Still's disease -Hj/f] cfpg], hf]gL{ ;'GgLg] b'Vg] / kf]Ng], 5fnfdf 8fj/
cfpg], df;' b'Vg], lnDkm u|GyLx? ;'GgLg] / Zj]t /Qmsf]ifx? a9\g] nIf0f ePsf] lj/n} b]lvg] /f]u_,
Antiphospholipid syndrome -C0ffTds c0f' ePsf kmf]:kmf]lnkL8 / /utdf ePsf cGo
k|f]6Lgx?sf] lj?4 cfg} z/L/sf] /f]u k|lt/f]wfTds k|0ffnLn] k|lt/IfL tTjx?PG6Lkmf]:kmf]lnkL8
PG6Ljf]8Lx? agfP/ /utnfO{ clt afSnf] agfpg], /ut hd]/ g;fx? y'gLg], /ut hdfpg] sf]ifsf]
;FVof 36\b} hfg] / k6s k6s ue{kft e}/xg] /f]u, Gout Ko'/Lg gfds k|f]6Lgsf] kfs k|s[ofsf]
u8\a8Laf6 /utdf o'/Ls cDn a9L e} hf]gL{df hDdf eP/ pTkGg x'g] ;lGwjft /f]u_, Bechet's
Disease -jo:s k'?if / dlxnfdf # / $ sf] cg'kftdf b]lvg], ljz]if u/L dWok"j{ Pl;ofsf 6sL{,
O/fs, O/fg nufotsf b]zdf a9L b]lvg], k6s k6s d'v / hgg]Gb|Lox?df cN;/ aGg], cfFvfsf]
;'hg x'g], 5fnfdf xfgL k'ofpg] ;fy} /QmgnLx?, kfrg k|0ffnL, :gfo' k|0ffnL, kmf]S;f], d[uf}nf,
hf]gL{x?nfO{ klg gf]S;fgL ug]{ /f]u_, Mixed Connective Tissue Disease cGo
Rheumatic /f]ux?sf nIf0fx? ldl>t ?kdf b]vf kg]{, /utdf ANA, U1-RNP gfds
k|lt/IfL tTjsf] dfqf a9\g], /fOgfp8 k|s[of h;df lr;f]n] xftuf]8fx? z'?df lgnf] x'g] / kl5
/ftf] x'g], b'Vg] / ;GgLg] x'G5, hf]gL{ b'Vg], ;'hg x'g], xft ;'GgLg], cGggnLsf] sfo{ k|efljt x'g],
kmf]S;f] / d[uf}nfsf] sfo{Ifdtf 36\b} hfg], lnDkm u|GyL, /QmgnLx? k|efljt x'g] h:tf nIf0fx? x'g]
/f]u_, Erthema Nodosm -ljleGg sf/0fx?n] 5fnfd'gL ;'hgsf] sf/0fn] af];f]o'Qm cljlzi6 /
clglZrt cfsf/sf /ftf b]lv j}hgL /sf, bjfpFbf b'Vg], v'fsf] k5fl8 b]lvg] / lgsf] ePkl5 bfu
g5f]8\g] luvf{x? pTkGg x'g] /f]u _, Takayasu's Arteritis -7"nf wdgLx? ljz]iftM dxfwdgLsf]
aqmefu / To;af6 lg:s]sf wdgLx?, d[uf}nf, kmf]S;f] / d'6'df /ut k|bfg ug]{ wdgLx?df ljgf
s'g} sf/0f ;'hg pTkGg eP/ gf8L ult ge]l6g] b]lv lnP/ uDeL/ k|s[ltsf dlitis /QmgnLut
/f]u tyf /ut a9L e/LP/ x'g] x[bof3ft ;Ddsf cj:yfx? lgDTofpg] /f]u h'g #) jif{eGbf sd
pd]/sf dlxnfx?df k'?ifdf eGbf # b]lv !) u'0ff;Dd b]lvg ;S5_, Poliarteritis Nodosa 5fnf, gzf, cfGqx?, d[uf}nf cflbdf x'g] demf}nf vfnsf wdgLx?df ;'hg pTkGg u/fO{ df;' b'Vg],
lgj{ntf x'g], v'fsf df;' b'Vg], b'Anfpg], Ps jf j9L hf]gL{x?df ;d:of x'g], /Qmrfk a9\g], /utdf
gfO6f]hg, o'/Lofsf] dfqf a9\g], c08sf]if b'Vg], 5fnfdf 3fp aGg], k]6df /Qm;~rf/sf] sdLn] k]6
b'Vg'sf ;fy} cfGqx?df Kjfn kfg]{ /f]u_, Ploymyalgia Rheumatica -3fF6L, sfFw / lgtDasf
df+;k]zLx?df sDtLdf $ xKtf;Dd b'vfO{ / ljxfgLkv hs8fx6 x'g] ;fy} ;j{z/L/df ;'hgsf]
sf/0fn] ysfj6, tf}n sd x'g], kl;gf cfpg] / xNsf Hj/f] cfpg] /f]u_, Gaint Cell Arteritis
-%) jif{eGbf dflysf] pd]/df wdgLx?sf] leqL tx afSnf] eO{ gnLsf] Kjfn ;fF3'/f] x'g] ljz]ifu/L
Temporal artery, h;sf] sf/0fn] /Qm;~rf/ c;Gt'lnt x'g] / rZdf nufpFbf, d]sck ubf{

jf ;'Tbf 6fpsf] k'm6]h:tf] u/L b'Vg] tyf z/L/e/ ;'hgsf nIf0fx? b]lvg] /f]u_, HenochSchonlein Purpura - ljz]iftM & b]lv !$ jif{sf jRrfx?df Pnlh{sf] sf/0fn] /QmgnLx?df
;'hg x'g', Kn]6n]6sf] ;FVof sd gePklg z/L/df Purpura x? p7\g], hf]gL{ / k]6 b'Vg], k]6 /
cfGb|fx?df /Qm>fj x'g] / d[uf}nfsf] ;'hgx'g] nIf0f ePsf] /f]u_, Raynaud's Syndrome :gfo' k|0ffnLsf] sfo{ u8\j8Ln] ubf{ xftv'fsf cf}nfx?, sfg, gfs cflbdf /ut k|bfg ug]{ ;fgf
;fgf wdgLx?df /Qm;~rf/ /f]lsP/ b'j}tL/ /f]lsO{ /f]lsO{ ;]tf] x'g], lgnf] x'g] / /ftf] x'g] nIf0fsf]
;d'x_, Rheumatic fever -A ;d'xsf] x]df]nfOl6s :6]K6f]sf]s; gfds AofS6]/Lofsf] ;+qmd0fsf]
sf/0fn] ;Dk"0f{ z/L/sf ;+of]hs tGt'x?df kfs gx'g] t/ ;'hg x'g], ljz]if ?kdf d'6'sf df+;k]zLsf]
;'hg, d'6'sf eNesf] ljs[tL, hf]gL{df ;'hg, xftv'f sfFKg], 5fnfd'gL uLvf{ cfpg] / /QmgnL,
s]Gb|Lo :gfo'x?df ;d]t k|efj kfg]{ /f]u_, Ankylosing Spondylitis -:ki6 sf/0f yfxf
gePklg w]/}h;f] lszf]/x?df dfgj Zj]t /Qmsf]if k|lthg HLA-B27 sf] sf/0fn] z/L/sf
dWoefudf ePsf hf]gL{x?, k]zLaGwgx?df lj:tf/} zf]yhGo kl/jt{g eO{ d]?b08 afF;sf] cfFVnf
h:tf] x'g], d]?b08sf ;;fgf hf]gL{x? o'h eO{ d]?b08 k"0f{?kdf s7f]/ x'g], b'Vg], d]?b08 /
lgtDasf] hf]gL{df ;'hg x'g] /f]u_, Psoriatic Arthritis -5fnfdf rfFbL em}+ 6lNsg] ;]tf sTnf
aGg] / ;lhn} /Qm>fj x'g Psoriasis /f]usf] sf/0f hf]gL{ / To; jl/k/Lsf tGt'x?df tyf d]?b08
/ lgtDasf] hf]gL{df ;'hg x'g] / sfnfGt/df hf]gL{ grNg] /f]u_, Enteropathic Arthritis cfGb|fx?df ;'hgsf] x'g] /f]u IBD / Crohn's disease sf] sf/0fn] hf]gL{x?df ;'hg x'g] /f]u_,
Reactive Arthritis -z/L/sf] cGo s'g} efudf ljleGg k|sf/sf hLjf0f'x?sf] ;+qmd0fsf] sf/0fn]
;'hg eP kZrft k|lts[of :j?k v'fsf] s'g} Ps tk{msf] hf]gL{x?df hLjf0f'ljxLg zf]y pTkGg x'g]
/f]u_, Osteoarthritis -pd]/ 9Nsb} uPkl5 ljz]iftM ^)&) jif{lt/ a9L ef/ kg]{ lrNnf]
;txePsf rnfodfg hf]gL{x? h:t}M 3'F8f, 3fF6L, sDd/, cf}+nf, a'9L cf}+nfsf] km]+bsf] hf]gL{ cflbdf
zf]yhGo hf]gL{/f]ueGbf leGg t/Lsfn] hf]gL{sf] s'g} Ps efunfO{ dfq oflGqs ?kdf xfgL u/L
dlxnfx?df a9L b]lvg] /f]u_, Septic Arthritis -cljlzi6 / c;fdfGo hLjf0f'x?sf] ;+qmd0faf6
d'Votof 3'F8f / d]?b08sf] Psftkm{sf hf]gL{x? kfSg] /f]u_, Cervical Spondylosis -ckIfosf]
sf/0fn] 3fF6L / To; jl/k/Lsf tGt'x?df lj:tf/} ;'hg x'g], 3fF6Lsf s'/s'/] xL Ifo e} ;'if'Dgf /
ToxfFaf6 lg:sg] :gfo'x?, ;Dj}blgs :gfo'x? / 3fF6Lsf] wdgLnfO{ cfwft kf/L 6fpsf] b'Vg], xft
emDemDofpg], l/6f nfUg], ub{gsfFw3fF6L c//f] x'g] nufotsf nIf0f x'g] /f]u_, Osteoposrosis
-ljleGg sf/0fn] z/L/sf xLx?df cl:y wft'sf] dfqf sd eO{ xL leqsf] ;;fgf ;+/rgf
Ifltu|:t x'g] / xLx? ;lhn} efFrLg], 6'lqmg] /f]u_, Juvenile Rheumatoid Arthritis aRrfx?df hf]gL{x? lj:tf/} ;'GgLg], b'Vg], 5fndf 8fj/ cfpg], leqL cx?df klg lj:tf/} Iflt
k'ofpg] /f]u_ cflb kb{5g\ .

cfdjfthGo -l/pDofl6s_ /f]ux?sf] lgbfg ljz]if u/L nIf0fsf] cfwf/df, k|of]uzfnfsf]

cfwf/df / ljls/0ff/f k|fKt 5fFoflrqsf] cfwf/df u/LG5 . nIf0fsf] cfwf/df lgbfg ubf{ /f]usf]
Oltxf;, hf]gL{x?sf] ;+nUgtf Ps jf w]/}, ;d?ktf jf c;d?ktf, s]Gb|lt/sf jf aflx/lt/sf,
z/L/sf] ljr efub]lv glhs jf 6f9f /x]sf, ;'hg ePsf] jf gePsf], /utdf grflxg] s0fx? a9L
eO{ hf]gL{df hDdf eP/ jf geP/, b'vfO{sf] ljlzi6tf, kfl/jfl/s j[tfGt, cGo hf]gL{eGbf aflx/sf
nIf0fx?, zf/Ll/s kl/If0faf6 k|fKt tYox?nfO{ ljZn]if0f ul/G5 . k|of]uzfnfdf /utsf] ljleGg
hfFrx? h:t} M Erythrocyte Sedimentation Rate, C-Reative Protein,
rheumatoid factor, anti-cyclic citrullinated peptide antibodies, antinuclear antibodies (Anti-dsDNA, anti-histone, Anti-ENA, anti SSA-Ro,
anti SSB-La, anti-centromere, anti-Sci70, anti-Jo-1 etc), complements C3
& C4, cyroglobulins, synovial fluid analysis and synovial biopsy cflb ul/G5
/ ltgLx?sf] /f]u;Fu ;DaGwsf cfwf/df /f]usf] lgbfg u/LG5 . ljls/0ff/f k|fKt 5fFoflrqdf
ljz]ift z/L/sf ljleGg hf]gL{x?sf] PS;/], ;L=6L=:Sofg, Pd=cf/=cfO{=, cN6f;fpG8, cfyf]{u|fkmL,
xLsf] 3gTj gfKg] t/Lsf nufotsf k|ljlwx? kb{5g\ .
cfdjfthGo -l/pDofl6s_ /f]ux? cf}iflwsf] ;]jg u/]/ k"0f{tof lgsf] x'Fb}gg\ t/ cf}iflwsf]
;]jgaf6 oL /f]ux?sf] sf/0fn] z/L/sf cGo ck|Tox?df kfg]{ v/fj c;/x?nfO{ sd ug{ ;lsG5
. cfw'lgs lrlsT;fdf oL /f]ux?sf] lrlsT;fsf] nflu :6]/f]O{8 gldl;Psf ;'hg sd ug]{ cf}iflwx?
(NSAIDs), Un'sf]sf]l6{sf]O8x?, /f]ufj:yfnfO{ kl/jt{g ug]{ cfdjft/f]ugfzs cf}iflwx?
(DMARDs), h}ljs cf}iflwx? (Biological medicines), pRr dfqfdf cf}iflw lbP/
k|lt/Iff k|0ffnLnfO{ bjfpg] lrlsT;f (Hise-dose immunosuppressive therapy), /ut
agfpg] d'Vo sf]ifx?sf] k|Tof/f]k0f (Hematopoietic stem cell transplantation) cflb
kb{5g\ .
cfw'lgs lrlsT;f lj1fgaf6 oL /f]ux?sf] k"0f{ ?kdf pkrf/ gePsf]n] ;+;f/e/df a}slNks
/ k"/s lrlsT;f k4tLaf6 oL /f]ux?sf] pkrf/ ug]{sf] ;FVof cTolws 5 . c+u]|hL dft[efiff ePsf
lj/fdLx?df u/LPsf] cWoogdf $@ k|ltzt lj/fdLn] ! b]vL !^ k|sf/sf j}slNks / k"/s
lrlsT;faf6 pkrf/ u/]sf] kfO{of] . cd]/Lsfdf dfq k|ltjif{ #) cf}+ c/j 8n/ /sd uf]hL aflx/sf]
vr{sf] ?kdf o:tf lrlsT;f k4lt;Fu ;DalGwt cf}iflwx?df vr{ x'g] u/]sf] 5 . o:tf pkrf/
k4ltx?df Wofg ug]{, tgfj sd ug]{, k'hfkf7 ug]{, cfWoflTdstf, Jofofd, d;fh, vfglkg, of]usf
;fy;fy} hl8a'6Lx?sf] k|of]u / PSo'k~r/ lrlsT;f dxTjk'0f{ dflgG5 . cfo'j]{b lrlsT;f k4ltdf
o:tf /f]ux?sf] pkrf/sf] nflu w]/} hl8j'6Lsf] j0f{g u/LPsf] 5 t/ xfn;Dd j}1flgs cg';Gwfgsf]
cefjdf cfo'j]{bLo lrlsT;f u|Gyleq} ;Lldt 5g\ . Trypterigium wilfordii Hook. f.
gfds hl8j'6Ldf rLgdf ul/Psf] j}1flgs cg';Gwfgaf6 To;df ePsf lqmofzLn /f;folgs

kbfy{x?nfO{ lgsfnL agfO{Psf] Leigongteng gfds cf}iflw k|efjsf/L ePsf]n] clxn] ;du|
lrg nufot o'/f]k, cd]l/sf, hfkfg, ci6]lnof nufotsf d'nsdf oL /f]ux? dWo] w]/} /f]ux?df
k|of]u x'Fb} cfPsf] 5 . k/Dk/fut lrgLofF lrlsT;fdf cfwfl/t PSo'k~r/ lrlsT;f cfdjfthGo l/pDofl6s_ /f]ux?sf] pkrf/df cr's ;fljt ePsf] 5 h'g s'/f ljZj :jf:Yo ;+u7gn] u/]sf]
cWoog k|ltj]bgdf ;d]t pNn]v 5 . /f]usf] cj:yf x]/L cfjZostf cg';f/ cfw'lgs cf}iflwx?sf]
k|of]u ;;} oL j}slNks / k"/s lrlsT;fsf pkrf/ ljlwx?nfO{ Ps};fy pkof]u ug{;s] cfgf]
z/L/n] cfg} z/L/lj?4 jgfPsf oL cfdjfthGo -l/pDofl6s_ /f]ux?df 7"nf] ;kmntf xf;Ln
ug{ ;lsG5 .