雷诺的现象

Raynaud’s phenomenon (Ray-nodes fen-om-e-non) causes blood to stop flowing properly to the outer parts of the body. This happens mainly when you get cold, and it can also happen because of stressful situations.

It most commonly affects fingers and toes, but can sometimes also affect lips, noses, ears and nipples.

发生的最常见的事情是指手指，脚趾稍微少一些，可以改变颜色。通常，它们会变白，然后蓝色，有时是黑色，然后是红色。

You may not experience all four stages every time. For example, your hands may just go blue then red.

这些颜色的变化通常与疼痛或刺痛感一起发生。

在寒冷的一天外出，甚至伸手去拿冷冻食物，可能会袭击雷诺。情绪强调的情况也会如此。

Raynaud的现象经常自行出现。这被称为主要雷诺的现象。初级雷诺（Raynaud）是一个相当普遍的情况。它影响女性比男人多。大多数患有Raynaud的人都不会继续出现任何进一步的问题。

Raynaud’s can also be linked with other conditions, such as硬皮病，，，，and less commonlylupus。发生这种情况时，被称为次要雷诺的现象。

主要雷诺的现象通常会影响年轻妇女和十几岁的女孩。但是男人，婴儿，孩子和老年人也会受到影响。有时会在家庭中运行。

Raynaud的现象主要影响手脚。

如果您有雷诺（Raynaud）的现象，那么您的手可能会在寒冷的天气下改变颜色，并且可能会有痛苦，麻木和麻木。

These attacks often only last a few minutes, but they can last two to three hours. You may find that moving into a warmer environment often stops the attack.

With primary Raynaud’s phenomenon your fingers usually go back to normal after each attack. Attacks of primary Raynaud’s phenomenon can be unpleasant and a nuisance, but they don’t usually damage your fingers.

Secondary Raynaud’s phenomenon can be severe and can cause ulcers on the fingertips and loss of tissue at the fingertip. However, this is very rare.

有些人发现他们的脚也受到影响，因此它们变得非常冷并改变颜色。耳朵，嘴唇，鼻子和乳头也可能受到影响。母乳喂养的妇女可以将雷诺（Raynaud）的乳头放在乳头上，尤其是当她们暴露于冷空气时。

We don’t fully understand why some people develop Raynaud’s phenomenon. However, we do know that the colour changes and pain of Raynaud's are due to a short-term reduction in blood supply.

The blood supply to the fingers and toes is controlled partly by nerves connected to the blood vessels. The nerves can reduce the blood supply in response to certain situations, one of which is extreme cold temperatures. This is a natural reaction, to prevent a loss of heat from the body.

People with Raynaud’s phenomenon probably respond too much to cold temperatures and shut off the blood supply more quickly than normal. The blood vessels reduce in size, and so less blood can flow through them.

情绪上的改变，例如感到担心，也可能通过触发神经关闭血液供应来引起雷诺的攻击。

Raynaud’s phenomenon can occur as a result of using vibrating machinery, for example pneumatic drills, hammer drills, hedge cutters and other power tools. This is called hand-arm vibration syndrome (or vibration white finger).

Raynaud’s may also develop as a side effect of some drugs such as beta blockers, which are used in the treatment of high blood pressure and angina.

尽管原发性雷诺的现象可能非常不舒服，但通常并不严重。寻找保持温暖并避免温度突然变化的方法。

If you’ve recently developed any symptoms of Raynaud’s, it’s best to visit a GP to get checked out. It may well be primary Raynaud’s phenomenon, especially if you’re a young woman. If your doctor is in any doubt, then they’ll arrange some tests. These may need to be done at the hospital.

大多数患有Raynaud现象的人总是会有这种状况，尽管它可以随着时间的推移而改善。如果有这种情况的根本原因，则有时可以删除或治疗。

For example, Raynaud’s caused by taking beta blockers can be ‘cured’ by stopping this medication. However, you must ask your doctor before stopping any regular medication.

您的医生将能够根据您的症状和任何检查结果进行诊断。进行这些测试以分辨情况的主要和次要形式。

What tests are there?

There are various tests your doctor can carry out if they suspect you have Raynaud’s phenomenon.

• Blood tests can show how many white and red blood cells you have, as well as other information that will help a doctor decide if you have Raynaud’s. Blood tests can also help to show if you have primary or secondary Raynaud’s.
• An x-ray can look for an extra rib at the base of the neck, called a cervical rib. This can cause Raynaud’s phenomenon by putting pressure on the blood vessels that supply blood to your arms.
• There is a test that involves looking at the tissue from a fingernail under a microscope. It will help doctors look closely at the small blood vessels in your fingers. This test is called a nailfold microscopy, or a capillaroscopy (cap-ill-er-os-copy).
• 在某些医院使用冷应力测试或热成像，以了解您对寒冷的反应。它涉及使用冷水并记录一部分脚或手恢复正常温度所需的时间。

If you have硬皮病，，，，it’s likely that you’ll get Raynaud’s symptoms at some stage. However, having Raynaud’s doesn’t mean that you’ll go on to develop scleroderma or another connective tissue disease.

试图让诊断早期发现如果你哈ve primary or secondary Raynaud’s.

There are several ways to help ease the symptoms of Raynaud’s phenomenon. Many of these are things you can do in your day-to-day life, but there are also a number of medications that may help.

Drugs

A number of drugs can be prescribed for Raynaud’s phenomenon. Most of these work by making the blood vessels wider.

Examples include nifedipine and amlodipine. These are in groups of drugs known as calcium channel blockers.

不幸的是，没有药物只能在手指和脚趾的血管上起作用，因此这些药物也可能引起副作用，例如脸部皮肤冲洗，头痛或头晕。这是因为药物会增加其他地方的血液流动。但是，许多人没有从毒品中产生副作用，发现它们非常有用。

喝葡萄柚汁和进食葡萄柚会增加硝苯地平副作用的风险。

Losartan and ACE inhibitors are more commonly used to treat high blood pressure, but they can also help control symptoms of Raynaud’s. These drugs also relax blood vessels and stop them from narrowing.

一种称为氟西汀的药物可以帮助改善循环。氟西汀也可用于治疗抑郁症。这是一个完全不同的用途，如果您为Raynaud开了处方，这并不意味着您的医生认为您很沮丧。

In severe cases – almost always in cases of secondary Raynaud’s – some treatments may be given as a drip directly into a vein, otherwise known as an intravenous injection. These intravenous drugs act directly on the blood vessels and cause them to open up. The most commonly used intravenous drug for this condition is伊洛列伯斯。

Another family of drugs used to treat severe Raynaud’s are the phosphodiesterase inhibitors (foss-fo-dye-ess-tur-aze in-hib-e-turs), which include sildenafil – trade name Viagra. These are drugs that can treat a number of conditions, including high blood pressure in the blood vessels supplying the lungs and erectile dysfunction. They can help with Raynaud’s because they improve blood flow around the body.

如果您打算为婴儿，怀孕，或者您想在任何一种药物服用时要母乳喂养，请与医生交谈很重要。

当您拥有Raynaud时，您可以采取一些措施来降低风险并控制攻击的数量。除药物外，以下情况可能会有所帮助。

Keeping warm

It’s important to keep your core temperature warm, as well as your hands and feet in particular.

Wearing several layers of clothing works better at trapping the heat than fewer layers of thicker clothes. Wearing warm socks and a hat can really help you.

You should wear warm gloves when outdoors in cold weather and warm your hands before you put the gloves on. It can help to keep the gloves in an airing cupboard or on a radiator, before putting them on.

You may find that so called ‘silver fibre’ products and self-heating gloves and socks are helpful. Your local职业治疗部门能够提供进一步的information.

You can also look out for the many small portable heating aids and hand warmers available online and from outdoor shops.

If you do get cold, you should get out of the cold environment as soon as possible. However, you should avoid warming back up too quickly, especially if your fingers or toes have changed colour and are painful. If blood goes back to a part of the body affected by Raynaud’s too quickly, this can be painful. Moving your fingers or toes around can help.

It can be difficult to completely avoid situations that may trigger attacks. But planning ahead as much as possible can help.

如果去超市的旅行会使您的雷诺德（Raynaud）的情况变得更糟，尤其是在冰箱或冰柜过道中，您可以带某人与您一起购物吗？另外，您可以向员工寻求帮助吗？戴上温暖的手套也可能会有所帮助。

Looking after your hands

湿手会导致您手上的裂缝发展。为了帮助您照顾您的手，每当您将它们放入水中时，请放上保湿霜，首先确保它们正确干燥。

You can either use a short-acting water-based cream, such as E45 or aqueous cream, or an oil-based cream that is thicker and longer lasting, such as emulsifying ointment. Older people or children should use a pH neutral unscented cream to avoid allergic reactions. Wearing protective gloves when you put your hands in water can help you look after your hands.

如果您必须使用振动工具，请确保正确使用它们，并且不要将其使用时间比必要的时间更长。使用任何必要的防护服和设备。

Advice for breastfeeding women who have Raynaud’s phenomenon

Raynaud’s phenomenon can affect women’s nipples, especially when breastfeeding. It can occur during or immediately after breastfeeding.

这通常被误诊为真菌感染。

If Raynaud’s is affecting your nipples, and you’d like to continue breastfeeding, there are steps you can take:

• It helps if you’re able to warm your nipples up before breastfeeding, talk to your midwife or health visitor about the best way to do this.
• 尝试减少乳头在婴儿闩锁之前和之后暴露在空气中的时间。
• 喂食后，切勿让乳头在空气中自然干燥，一旦您的宝宝从乳头上脱下来，用干净的乳房盖住它，然后轻轻干燥。
• 使用羊毛脂或水分屏障霜来照顾乳头。涂抹之前，请在手中加热奶油。
• Ensure your bathroom is warm before you undress for a shower or bath.

母乳喂养时可以开处方硝苯地平。如果您有任何疑问，请与您的医生交谈。并与您的健康访问者交谈以获取更多建议。

Keep an attack diary

您可能希望使用日记来跟踪Raynaud的攻击。这可能显示出一种模式，以帮助您控制症状并降低风险。

如果某事引起您的压力，通常会有一些方法可以首先减轻或避免压力，并更好地管理压力。与人交谈和良好的计划通常可以帮助应对压力。

Exercise

常规的exercise将改善您的循环，如果您在寒冷的一天保持活跃的情况下，将改善您的手和脚的血液流动，并帮助您保持温暖。

If you’re new to exercise or haven’t exercised for a while, start gradually and build up the amount you do. Doing something you enjoy, will help you do it regularly.

Stop smoking

吸烟会损害您的循环，因此，如果您患有Raynaud的现象，您不应该吸烟。

戒烟可能很难，但是那里有很多帮助和支持。您的医生可以提供建议和支持，并使您与可以进一步帮助的团体保持联系。

饮食

没有被证明可以帮助雷诺的现象的特殊食物或饮食。但是，吃健康，均衡的饮食仍然非常重要。

Complementary medicine

有人发现维生素补充剂，evening primrose oil，，，，fish oils，，，，生姜或Ginkgo Biloba帮助他们的Raynaud。但是，没有很好的证据支持这些使用。

In some rare cases, your Raynaud’s may suddenly become more severe. This may need urgent attention.

Look out for:

• ulcers or black areas on the fingers or toes
• 手指或脚趾的颜色变化不会像往常一样快地消失
• symptoms, particularly numbness, only affecting one side of the body
• joint pain
• skin rashes
• muscle weakness.

如果您出现这些症状之一，请参见您的医生或与您的联系护士专家，如果您有一个，请尽快。

These problems are uncommon, and they aren’t usually experienced by people with primary Raynaud’s phenomenon.

目前，我们正在为调查雷诺现象的许多研究项目提供资金。

曼彻斯特大学的Ariane Herrick教授正在调查使用手机应用程序监视Raynaud现象的使用。目前，很难监测Raynaud现象对日常生活的患者的影响，这使得很难进行临床试验，并减慢了新疗法的发展。该应用程序将监测诸如在寒冷天气中使用摄像机捕获的症状，例如在寒冷的天气下颜色变化，为患者提供了一种简单快速的记录症状的方法。

同样在曼彻斯特大学的安德里亚·默里（Andrea Murray）博士正在研究两种不同的成像技术，以测量雷诺（Raynaud）在硬皮病患者中的现象。硬皮病中的大部分疼痛和残疾来自手指，但目前尚无可靠地衡量手中血流或皮肤温度的变化。这使得很难评估治疗的有效性。这项研究将测试两种成像技术，激光多普勒成像和热力计，以检查这些方法是否可靠，并且可以在对治疗的响应中发现临床上重要的差异。

I first noticed symptoms of Raynaud’s in my teens. My hands would change colour in the cold, and I’d get really bad pain in my fingers.

I hadn’t had a diagnosis, until I had operations on my shoulder and hand recently. The operations weren’t related to Raynaud’s.

我告诉外科医生，我总是有冷手，我被称为风湿病学家。

I’m a nurse, and the air conditioning at the hospital where I work can make my symptoms worse.

我喜欢穿两层或三层衣服。在工作中，我穿磨砂膏，您只能在这些磨砂膏下放很多东西。

我的妈妈嘲笑我穿着“保姆的背心”。夏天，我总是戴着手套和围巾。即使在夏季中旬，我也可以发动攻击。我总是把像羊毛，帽子和围巾这样的衣服放在袋子和汽车上。

It’ important to keep my core temperature warm, so I’m always wrapped well.

我的女儿骑马，所以当她去农场时，我在外面度过了很多时间。

如果我以任何方式感到压力，即使我被包裹起来，我也会受到攻击。

When I go to the supermarket, I tend to whizz round the fridge and freezer aisles because I can feel it starting.

重要的是要继续前进并保持循环畅通。我总是在摇摆我的手指，只是为了保持血液的流动。我认为健康饮食也有帮助。

I describe it as sparklers going off at the ends of my fingers and it can be debilitating. A full-on attack can last a couple of hours.

My fingers go white and then blue or even purple. They can go cold and numb. A couple of times they’ve gone a dark grey, almost black. That was scary.

Because the feeling is not there, there can be a tendency to put my fingers in hot water, but I could burn yourself.

然后，当血液回来时，可能会很痛苦。

Sometimes I won’t be able to drive home until the pain has stopped in my hands and the feeling has come back. It can take a few minutes for feeling to come back once I’m in the warm, or it can take half an hour.

他们在冬天很频繁。它不一定要陷入寒冷的状态。如果温度不同，即使从我的客厅到厨房也可以触发一个。

In the winter, it can happen every day. I don’t let it stop me doing things though.