2 English references skeletal fluorosis
Summary Osteofluorosis refers to chronic invasive systemic osteopathy involving bone tissue caused by long-term excessive intake of fluoride. Fluorosis involving teeth is called dental fluorosis. Patients often have symptoms such as muscle pain, dizziness, palpitation, weakness, drowsiness, loss of appetite, nausea, vomiting, abdominal distension, diarrhea or constipation. 190 1 year, Eaqer first reported dental fluorosis. 1932 Motlev and Gudi Jonson in Denmark were named "fluorosis" and thought that the disease was accompanied by osteoporosis.
Chronic skeletal fluorosis is a common disease. The pathogenic cause of skeletal fluorosis is that excessive fluorine enters the human body for a long time, and the way to enter the human body is through the digestive tract or respiratory tract. After fluorine enters the human body through the digestive tract or respiratory tract, it spreads to the whole body through blood circulation, causing various changes. The main clinical manifestations of skeletal fluorosis are waist and leg joint pain, joint stiffness, bone deformation and symptoms and signs of nerve root and spinal cord compression. Most patients with skeletal fluorosis died of chronic malnutrition or other serious complications.
4 disease name skeletal fluorosis
5 English name skeletal fluorosis
6. Skeletal fluorosis is also known as fluorosis; Osteopathy caused by fluorine
7 classification endocrinology >; Parathyroid diseases and calcium and phosphorus metabolic diseases
8 ICD number M85. 1
Epidemiology skeletal fluorosis in China was first discovered in Beijing and Taiyuan on 1930. 1932 Anderson described 54 cases of dental fluorosis in Langfang. In the same year, Kilborn conducted an investigation in Dusai, Qianxi, and found that dental fluorosis was widely distributed in this area, and there were many patients with "spondylitis". After 1960, Shandong, Shanxi, Hebei, Inner Mongolia, Northeast China, Ningxia, Shaanxi, Tianjin, Beijing and other regions made a large number of epidemiological investigations on skeletal fluorosis, which confirmed the incidence of skeletal fluorosis in northern China.
The human body needs 1.0 ~ 1.5 mg of fluoride every day. Drinking high fluorine water, eating vegetables containing fluorine pesticides and high fluorine grains are the common causes of fluorosis and skeletal fluorosis. In addition, the fluoride content in tea is extremely high, and the fluoride content in seawater is also very high. After eating seafood with high fluorine content for a long time, fluoride has been widely used in industry, and the number of industrial fluorosis patients has gradually increased.
10 Etiology Chronic skeletal fluorosis is a very common disease. The cause of the disease is that excessive fluorine enters the human body for a long time. The way to enter the human body is through the digestive tract or respiratory tract. Common causes of chronic fluorosis are:
10. 1 drinking water source pollution, such as spring water, especially hot spring water, has too high fluorine content. The fluorine concentration in drinking water is below 1× 106, and drinking water containing fluorine over 1× 106 for a long time may cause chronic fluorosis. In order to save fuel, residents often boil hot spring water, make soup, make tea, depilate chickens and ducks, and scald vegetables until they are half cooked, which will cause pollution.
10.2 food pollution caused by fluorine in coal when burning coal and drying grain.
10.3 Some raw materials in the smelting industry contain fluorine, which causes air pollution in the smelting process.
10.4 fluoride is used to treat osteoporosis because fluoride can cause bone growth. Osteoporosis patients can increase their bone density after fluoride treatment, which has attracted more attention in the medical field. However, the treatment of osteoporosis with fluoride is controversial. The reasons are summarized as follows: ① Although the BMD of osteoporosis patients increased after fluoride treatment, it did not prove that this treatment could reduce the occurrence of fractures. ② Abnormal mineralization of new bone formation caused by fluorine. This abnormality is more serious in low calcium intake, and even if calcium and vitamin D are given as adjuvant therapy at the same time, this abnormality cannot be completely prevented. ③ Due to the imbalance caused by backward mineralization of bone matrix (osteomalacia), some patients have lower limb pain, which may even aggravate the fracture.
1 1 Pathogenesis Fluorine enters the human body through the digestive tract or respiratory tract and spreads to the whole body through blood circulation, causing various changes.
1. fluoride can combine with calcium and magnesium ions in plasma, which can reduce the concentration of calcium and magnesium ions in blood. So there were symptoms such as tetany, muscle spasm and muscle pain. In addition, all enzymes that rely on calcium ions or magnesium ions to help them function are inhibited. Therefore, many metabolic processes are affected.
2. The influence of fluoride ion is a kind of poison to cytoplasm, which can affect the function of cells, and can be used as apatite on bones to replace its hydroxyl group, thus affecting bone metabolism, causing osteoporosis, osteoporosis or a mixture of the two, causing bone pain, fracture and deformation. Teeth are easily affected by fluoride in the growth process, causing dental fluorosis.
Clinical manifestations of skeletal fluorosis 12 The main clinical manifestations of skeletal fluorosis are pain in waist and leg joints, joint stiffness, bone deformation and symptoms and signs of nerve root and spinal cord compression.
Patients often complain of persistent pain in the joints of spine and limbs, which is aggravated at rest and can be relieved after exercise. There is no inflammation such as redness, swelling and heat in the joints. Nerve root compression pain aggravates, such as knife cutting or lightning-like pain, refusing to touch or support. When the condition is serious, the joints and spine are fixed, and the spine is scoliosis, hunchback or stiff limbs, making it difficult to take care of themselves. Patients with spinal cord or nerve root compression feel numbness in limbs or both lower limbs, and the trunk feels bound and painful, which may be accompanied by paraplegia, so that they curl up in bed, cough and turn over and cause severe pain. Most patients died of chronic malnutrition or other serious complications.
Patients often have symptoms such as muscle pain, dizziness, palpitation, fatigue, lethargy, loss of appetite, nausea, vomiting, abdominal distension, diarrhea or constipation, muscle atrophy, electromyography changes, etc., which can cause corresponding symptoms and signs when thyroid, adrenal gland, gonad, lens and central nervous system are involved. Serum free fluoride, thyroid hormone and TSH concentrations were observed in 37 patients. It was found that serum T4 and T3 in patients with fluorosis were significantly lower than those in normal control group, while TSH was significantly higher than that in normal control group. T3 concentration and T3/T4 ratio are negatively correlated with serum free fluoride concentration, so fluorosis can reduce thyroid function. But also related to the blood fluorine content.
Generally speaking, female patients with skeletal fluorosis have more serious symptoms than men. In areas where the fluorine content in drinking water is above 10mg/L, the female patients with spinal rigidity can reach 50%, while the male patients only have 7%, with scoliosis. 22.2% of women have hunchback or paralysis, and 7% of men have hunchback or paralysis. This gender difference may be related to pregnancy, childbirth and breastfeeding. Women are exposed to more air polluted by coal. The course of skeletal fluorosis can last for decades.
Complications of skeletal fluorosis 13 Most skeletal fluorosis patients died of chronic malnutrition or other serious complications.
14 laboratory examination 14. 1 urine fluoride determination reflects the recent fluoride intake. Normal value of urinary fluoride < 1 mg/24h. The number of patients with fluorosis has increased. If the urine fluoride in the population increases, it suggests that some reasons cause fluorosis in the population.
14.2 determination of fecal fluoride; The increase of fecal fluoride means that fluoride enters from the digestive tract.
14.3 determination of blood fluoride is of great significance for diagnosis. We studied 63 cases of skeletal fluorosis caused by chronic fluorosis. The serum fluoride in the patient group was 0.137 0.1ppm, which was higher than the normal value of 0.046 0.01ppm (P < 0.05 =.
14.4 renal function fluoride is toxic to the kidney. Severe fluorosis can lead to renal function damage.
14.5 determination of fluorine in environment, nails and hair. When people have chronic skeletal fluorosis, the fluorine content in drinking water is increased (normal < < 1ppm), and the fluorine content in food or air is increased, which has diagnostic significance. The fluorine content in hair and nails represents the storage of fluorine, which is also of diagnostic significance.
15 auxiliary examination 15. 1 X-ray manifestations (1) osteoporosis: the rough and sparse bone can be the only manifestation of early skeletal fluorosis.
(2) Osteomalacia: It is obvious in the spine and pelvis, with decreased bone density and blurred texture. Scoliosis and hunchback. Biconcave deformation of vertebral body. Pelvic contraction deformity and pseudofracture line formation. Osteomalacia can occur simultaneously with osteoporosis, osteosclerosis and soft tissue calcification, showing a mixed type.
(3) Osteosclerosis: Osteosclerosis often occurs in the spine, pelvis, ribs and skull. The bone is as thick as sack cloth or gravel sand. In severe cases, the bone is fused, the structure is vague, the X-ray transparency is low, and it looks like ivory. Osteosclerosis is often accompanied by osteoporosis at the extremities. When calcium intake is obviously insufficient, secondary hyperparathyroidism may occur, and fibrocystic osteitis may occur in the bones of limbs.
15.2 CT showed that the spine was bamboo-like, especially in the chest and upper waist. Vertebral adhesion density increased, bone hyperplasia and ligament ossification. There may be bony spinal stenosis.
15.3 MRI showed that the shape and signal changes of vertebral body were abnormal compared with MRI. The vertebral body has uniform or uneven low signal intensity. Heterogeneous signal is patchy or needle-like in vertebral body, which is the same signal area as normal bone marrow. Thickening of low signal area at the edge of vertebral body. Near the sagittal plane, the ligamentum flavum, which is hypertrophic and ossified by facet joints, is stepped. Spinal stenosis and dural sac compression deformation. Bone marrow can be compressed and edema, showing high signal on T2-weighted images.
15.4 SPECT showed that the radioactive signal of the hyperplastic part was strong and wide, but it was not specific.
15.5 after decalcification of bone biopsy, the sections showed that the bone plates were disordered, the contents of fluorine, calcium and magnesium in bone were all increased, and the bone phosphorus and blood phosphorus were normal. There are also specific changes in ultrastructure.
16 diagnosis of skeletal fluorosis 16. 1 the diagnosis of typical skeletal fluorosis is not difficult: ① people who have lived in endemic skeletal fluorosis areas for more than 2 years or have dental fluorosis. ② The clinical manifestations are consistent with the symptoms and signs of typical skeletal fluorosis. ③ Patients with bone-specific manifestations in imaging. ④ Support the laboratory examination results with diagnostic significance. Bone biopsy can provide microscopic data, which is helpful for early diagnosis and differential diagnosis of skeletal fluorosis.
Patients living in the ward have dental fluorosis (foreign adults have no dental fluorosis), and have clinical symptoms and signs such as joint pain and dysfunction. If X-ray shows signs of skeletal fluorosis, combined with epidemiological data, it can generally be diagnosed as skeletal fluorosis, and the fluorine content in blood and urine can be determined if necessary.
16.2 classification (degree) can generally be classified according to the following standards:
I degree: only clinical symptoms but no obvious signs.
Degree II: There are typical clinical manifestations such as joint pain and dysfunction, but I can participate in some manual labor.
Level 3: people who have lost their ability to work.
16.3 X-ray diagnosis, classification and grading of skeletal fluorosis X-ray photographs require clear display of bone lines, including at least the alignment of pelvis, lateral anterior wall and calf.
(1) classification: According to the main changes of bone mineral density and structure, it can be divided into three types:
① Sclerosing type: There are two main types: A. Bone density increases, trabecular bone thickens, fused cortical bone thickens, and medullary cavity narrows or disappears. B. ossification of interosseous membrane and surrounding ligaments.
② Loose type: It can also be divided into two situations: A. Decreased bone density and sparse trabecular bone. Bone has decalcification or bone deformation in different degrees. B. ossification of interosseous membrane or periosteal ligament.
③ Mixed type: It has the above characteristics (there are different degrees of hyperosteogeny and bone resorption at the same time) or cancellous bone has a reticular or cystic structure, cortical bone structure is loose, and the number of trabecular bone per unit area is obviously reduced.
(2) Gradual change: The above three types have different degrees of change, which can be divided into early changes and light, medium and severe changes.
① Early changes: One of the following signs can be diagnosed as early skeletal fluorosis: A. Only obvious patchy texture or disordered bone line can be seen at the end of long bone and pelvis. B There are more than two budding bone warts at the edge of the long bone cortex of the limbs, most of which are wavy hyperplasia at the radial ridge.
② Mild: A. The bone density is slightly higher than normal, the trabecular bone is thick and dense, and bone spots appear, and the trabecular bone becomes thinner and the density decreases. B sharp ossification and obvious interosseous membrane hyperplasia appeared at the attachment of musculoskeletal ligament.
③ Moderate: a. Bone mineral density increased obviously, cortex thickened, trabecular bone thickened and partially fused; Or the cortex is thinner, the trabecular bone is sparse and the density is reduced, or the trabecular bone is sparse, but the texture is thicker and the density is increased. B. The ossification range of interosseous membrane and periosteal ligament is large.
④ Severity: A. Bone trabecula became thicker, most of them merged into pieces, and the boundary between medullary cavity and cortex was unclear; Or osteoporosis is absorbed in pieces, and the cortical bone is partially interrupted and disappeared. Skeleton deformation is obvious. B the ossification of interosseous membrane and surrounding ligaments is more obvious, which can form a bridge shape, and calcified shadows of other soft tissues (such as blood vessels) can appear.
16.4 Precautions for diagnosis (1) You must have a personal medical history of living in a high-fluorine area for a long time, drinking high-fluorine water, eating food contaminated with fluorine or being in an air environment contaminated with fluorine. In addition, gender and renal function status are also related to diseases.
(2) The clinical manifestations are osteoarthralgia, limb dyskinesia or deformity accompanied by dental fluorosis (12 years old people who move to high fluoride areas may not be accompanied by dental fluorosis).
(3) The X-ray changes of bone are characterized by sclerosis and calcification of soft tissue around bone.
(4) Blood fluoride and urine fluoride exceed the normal range. Early skeletal fluorosis may be asymptomatic and X-ray abnormal. During this period, alkaline phosphatase increased, calcium in hematuria was low, and urinary hydroxyproline excretion was higher than normal, suggesting that fluoride could stimulate osteoblast activity and damage bone collagen. When osteoporosis and osteomalacia in patients with skeletal fluorosis are secondary to hyperparathyroidism, PTH in plasma and tartrate-resistant phosphatase in blood increase. Combined with the above changes, the diagnosis of typical endemic skeletal fluorosis is not difficult. Patients with industrial skeletal fluorosis often belong to osteosclerosis, and the history of fluoride exposure in life and occupational environment is helpful for diagnosis.
17 The differential diagnosis of typical cases is not difficult. Attention should be paid to the following situations when identifying.
1. Primary osteoporosis: X-ray shows osteoporosis, but generally there is no sclerosis. If X-ray shows osteoporosis and sclerosis at the same time, it is not consistent with primary osteoporosis (including senile osteoporosis). In addition, primary osteoporosis is seen in elderly patients, and there is no history of high fluoride intake, and blood fluoride and urine fluoride have not increased, which can be distinguished.
2. Osteomalacia: Osteomalacia has various causes, mostly due to vitamin D deficiency or abnormal metabolism, or abnormal calcium and phosphorus metabolism. Chronic fluorosis can be ruled out if there is no history of high fluoride intake and the fluoride content in hematuria does not increase.
3. Other metabolic bone diseases: Although it can cause bone pain, fracture or bone deformity, there is no history of high fluoride intake, and blood and urine fluoride are not increased, which can be distinguished.
18 treatment of skeletal fluorosis 18. 1 symptomatic treatment (1) Pain patients should be given appropriate amount of non-steroidal analgesics, such as aspirin 0.3 ~ 0.6g/ time,/kloc-0 ~ 2 times /d, or indomethacin 25mg/ time.
(2) Those with skeletal deformities should be fixed locally or underwent orthopedic surgery to prevent the deformity from getting worse.
(3) If there is spinal canal obstruction or paraplegia. Surgery should be performed as soon as possible to relieve nerve compression.
18.2 general treatment for patients with skeletal fluorosis, all kinds of support or adjuvant treatment are very important. First of all, we should strengthen nutrition, supplement protein, give vitamin D every day, supplement all kinds of vitamins (especially vitamin C), encourage patients with skeletal fluorosis to take outdoor activities, and take measures such as muscle * * * to help patients recover as soon as possible.
18.3 etiological treatment try to remove the cause of fluorosis, such as reducing the fluorine content in drinking water to meet the national health standards, changing the eating habits of residents in high-fluorine areas, and strictly implementing occupational health care measures. Avoid long-term excessive intake of fluoride by the body.
18.4 Special treatment (1) Fukangning capsule: Fukangning capsule is one of the effective drugs for treating moderate and severe skeletal fluorosis at present: the main component of Fukangning capsule is nux vomica, and each capsule contains 0.1g. The mechanism of treating fluorosis is that nux vomica selectively excites spinal nerves, increases the tension of skeletal muscles (especially extensor muscles), and improves the contracture and stiffness of joints, thus improving the bending, hunchback and limb deformity caused by fluorosis. In addition, it is possible to promote motor nerve, autonomic nerve and endocrine function, improve blood circulation and nutritional status of the whole body, further promote the repair of diseased tissues, and increase the activity of some enzymes through cerebral cortex reflection. Through the adjustment of body fluid circulation, the internal environment in the body reaches a new balance. The general dosage is 2 capsules each time, 3 times a day. The total dose is 40-200g. Supplemented with traditional Chinese medicine safflower, Achyranthes bidentata, calcium agent, vitamin D, etc. The treatment time was 38 ~ 2 10 day. It usually takes about 3 months.
Clinical verification shows that in addition to fluorosis, it also has curative effect on ankylosing spondylitis, rheumatoid arthritis, disc herniation, hyperosteogeny and other osteoarthropathy. The toxic reaction and side effects of routine application are extremely low, and the effect is lasting and stable. Some patients have mild convulsions or slight sweating, which is a normal drug reaction, but patients with severe cardiovascular and cerebrovascular diseases should use it with caution.
(2) Futongkang capsule or tablet: There is no significant difference in curative effect between the two dosage forms. However, it is difficult to swallow the capsule when taking it, and it is difficult for patients to persist in taking the whole course of treatment, thus affecting the curative effect of the drug; After the capsule is changed into tablet, it is convenient for patients to carry and take, so that more patients can insist on taking medicine according to the course of treatment. The two dosage forms have the same components, mainly consisting of serpentine, borax, vitamin C and oyster medicine. Serpentine is a mixture of natural minerals and belongs to hydrated magnesium silicate. Its main components are magnesium oxide (2 1% ~ 80%), aluminum oxide (0.6% ~ 8%), iron oxide (7% ~ 9%) and silicon oxide (about 40%). The fluorine substitution of serpentine lies in its magnesium ion. When serpentine is hydrolyzed, an alkaline solution is formed. In alkaline medium, the amount of fluoride deposited in bones decreases. Serpentine can increase urinary phosphorus and urinary fluoride excretion, slightly increase blood calcium, increase fecal fluoride, reduce ligament fluoride, improve ligament elasticity, increase joint activities such as spine, and alleviate nerve root compression symptoms. In addition, boron can combine with fluorine in bones and gastrointestinal tract to form BF4, which reduces the toxicity of fluorine. BF4 is absorbed by the digestive tract, stored in viscera and bones, and then excreted by the kidney, reducing the blood fluoride concentration.
Futongkang tablets are taken orally, 3 tablets each time, twice a day. The capsule preparation is taken orally 3 capsules each time, twice a day, and the course of treatment is 3 months. 350 cases (1994 ~ 1998) were treated with Flutongkang tablets, and 13 cases (3.7 1%) were cured, and 97 cases (27.7 1%) were clinically cured, with an effective rate of 2/kloc. There is no significant difference between the curative effect and the clinical grade, sex, age and years of illness.
(3) Calcium supplementation: The calcium metabolism of 40 patients with skeletal fluorosis in Huitang area of Hunan Province was studied. Balance test showed that patients with skeletal fluorosis had negative calcium balance (P < 0.0 1). After 1 month of calcium and vitamin D treatment, the patient's blood calcium returned to normal and blood fluoride decreased, but after 1 month of placebo treatment, there was no such effect. Because calcium can combine with fluoride ions in the digestive tract to form insoluble calcium fluoride, which is discharged with feces to reduce the absorption of fluoride. Therefore, calcium supplementation can regulate the imbalance of calcium and phosphorus metabolism in vivo, promote the recovery of normal bone tissue, and treat or prevent osteoporosis and osteomalacia caused by skeletal fluorosis. The content of citric acid in bone tissue of patients with skeletal fluorosis decreased significantly. Generally, on the basis of calcium supplementation, 2g citric acid is added, and the effect is more obvious, 3 times a day.
(4) Aluminum hydroxide: It can combine with fluorine in the digestive tract to form insoluble aluminum compounds, reducing the absorption of fluorine. Generally use aluminum hydroxide gel, 10 ~ 20 ml each time, 3 times/d. ..
(5) Haloalkali: 465,438+0 endemic fluorosis patients caused by drinking high fluorine hot spring water (8 ~ 65,438+065,438+0ppm) all the year round were given 2400mg/d of calcium carbonate and 300mg/d of magnesium oxide orally. After 3 days, the fecal fluoride excretion of patients increased significantly, and the blood fluoride decreased after 1 month. At the same time, it can improve the symptoms such as convulsion and bone pain, which shows that calcium-magnesium preparation can prevent intestinal absorption of fluoride and has the effect of treating and preventing fluorosis. The fluorine metabolism of 60 patients with skeletal fluorosis caused by drinking high fluorine hot spring water and the effects of calcium, magnesium and vitamin D treatment on fluorine metabolism were studied by metabolic balance method. The results showed that the fluoride intake, urine fluoride and blood fluoride of patients with skeletal fluorosis were several times higher than those of normal people. The intestinal fluoride absorption rate is 1.5 times that of normal people, and the fluoride intake is positively correlated with the intestinal fluoride absorption rate. The combination of calcium and magnesium with fluoride reduces the absorption rate of intestinal fluoride and increases the excretion of fecal fluoride, thus playing a role in preventing and treating fluorosis. Halogen alkali contains double salts of magnesium, calcium, sodium, chlorine and other components, which has many functions, mainly using magnesium ions to produce arrow-like effects on striated muscles and smooth muscles. Relax your muscles. Mg2 can also stimulate the activities of various enzymes. Mg2 and f have strong affinity. Making it an insoluble salt can reduce the absorption of fluorine. Generally, bittern is made into tablets for oral administration, 4 ~ 6g each time, three times a day, and taken after meals, or 5% bittern solution is mixed with 5% ~ 10% glucose solution for acupoint injection.
(6) Chinese medicine: Try 2g of Rehmannia glutinosa. Ginger 1 .5g, Cistanche deserticola 1 g, Erythrina bark 1 g, Chuanxiong rhizome 1 g, Pyrola1g, Raphani seed 0.5g, Spatholobus suberectus1.5g. In order to achieve the purpose of tonifying kidney, strengthening tendons, promoting blood circulation and relieving pain.
(7) Gubi Pill: Gubi Pill is used for goats suffering from skeletal fluorosis. After 6.25g daily treatment, bone fluoride decreased to 1.500 ~ 2.500mg/kg. If it is also used in human body, after a course of treatment, the fluoride accumulation in bones will drop below 5000mg/kg. It is generally believed that X-ray lesions will occur only when skeletal fluoride accumulates above 5000mg/kg, so the original X-ray images of patients may be obviously reversed after treatment.
(8) Selenium: The gastrocnemius muscle and brain of 4-month-old human embryos were cultured in tissue, and the effects of fluoride and fluoride plus selenium on their ultrastructure were observed. Results Fluorine can make the fibers of gastrocnemius muscle shrink, the mitochondria of cells decrease, the texture becomes empty, and the mitochondria and endoplasmic reticulum of brain tissue are damaged. Gradually involving the nucleus and nuclear membrane, leading to the disintegration and necrosis of the whole cell. After adding selenium, the above changes were alleviated. However, some reports are inconsistent with the above experimental results.
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18.5 therapeutic standard (1) Healing: systemic symptoms and signs disappeared, dysfunction recovered, and activities were normal (X-ray changes in patients with early osteoporosis skeletal fluorosis could basically disappear).
(2) Clinical cure: the symptoms and signs of skeletal fluorosis were obviously improved, and most of the dysfunction was recovered. X-ray has improved or stabilized, and the ability to work has basically recovered.
(3) Effective: the symptoms of skeletal fluorosis were obviously alleviated, the signs and functions were improved, and the working ability was restored.
(4) Ineffective: The symptoms, signs, functional status and working ability of skeletal fluorosis are the same as before treatment.
(5) Basic control standard of skeletal fluorosis: ① The preventive measures are reliable and regular. ② The fluorine content of drinking water reaches or approaches the national hygienic standard for drinking water. ③ Basically control the occurrence of patients with new skeletal fluorosis. ④ The vast majority of patients with Grade Ⅱ and Ⅲ skeletal fluorosis were effectively treated.
19 prognosis if the fluoride intake is kept at a fixed level, the fluoride deposited in the bone every day is equal to the fluoride released from the bone; If the intake of fluorine increases, half of the increase will be deposited on the bones until a new equilibrium state is reached. Therefore, drinking high fluoride water for a long time will inevitably lead to skeletal fluorosis. The more fluoride you ingest every day and the longer it lasts, the more serious the damage to bones and the metabolic disorder of the whole body will be. Severe bone injuries and deformities are difficult to recover. If the bone damage is not serious, patients with skeletal fluorosis can still live, work and have children. If preventive and therapeutic measures are taken and harmful fluoride is no longer ingested, fluoride will be gradually excreted, and the health, spirit and physical strength of patients with skeletal fluorosis will be better restored.
Prevention of skeletal fluorosis 1. We should eat clean water and food, but not high-fluorine water and food contaminated by fluorine. We should strengthen publicity and education to improve our understanding of the dangers and prevention methods of fluorosis. In the south, especially in places where hot spring water with high fluorine content is eaten, digging deep wells and eating non-high fluorine water are important measures to improve bad food storage and cooking habits and avoid food fluorine pollution.
2. Treat hot spring water with ferric chloride. At room temperature, 400mg FeCl3 _ 3 can reduce the fluoride ion concentration of 1 barrel (10l)10x106 high fluoride water to 1× 106.
3. Reduce the fluoride concentration in water. Alum [K2Al (S04) 2H2O]1mmol (0.313g) can reduce the fluoride ion concentration in 100ml 8× 106 fluoride-containing water to1×. The iron trifluoride and alum are easily available, cheap and convenient, and the treated water is colorless and odorless.
4. Taking ferrous sulfate, iron ions combine with fluorine to become compounds that are not easily absorbed, which is beneficial to the discharge of fluorine.
5. To prevent occupational fluorosis, it is necessary to strictly implement workers' labor health care standards, regularly detect the degree of environmental pollution, and determine workers' urine fluoride.
2 1 related drugs collagen, aspirin, indomethacin, vitamin c, borax, oxygen, magnesium oxide, aluminum hydroxide, calcium carbonate, glucose and ferrous sulfate.
Related tests of vitamin D, urinary fluoride, urinary calcium, urinary hydroxyproline, hydroxyproline, proline, vitamin C and urinary phosphorus.
Acupoint abdomen body part name for treating skeletal fluorosis Abdomen: Abdomen is the name of body part. Below the chest, between the diaphragm and pelvis. Among them, the part between the diaphragm and the umbilicus is the big (upper) abdomen; ...
Compound point pinyin: fê hé xué English: Compound point is grouping point. Acupoint combination refers to combining two or more acupoints to create a new name. ...
Beishu can be used for the treatment of viscera and diseases related to viscera, such as five zang-organs and nine orifices, flesh and blood, and can also be used for auxiliary diagnosis. Twelve back Shu points show six zang-organs and six fu-organs. ...
Yufu Yufu. Yufu point is mainly used for chest and lung diseases, such as cough, asthma, excessive phlegm, bone steaming hot flashes, hiccups, vomiting, chest tightness, anorexia, cough, chest pain and so on. ...
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