Pay attention to control and prevention ↑top Some people found hyperuricemia in physical examination, but there was no gout attack. Do you need treatment? Professor Chang said: "Generally speaking, you don't need medication, but you should pay attention to the following two points: First, avoid obesity, avoid high-purity and high-calorie foods, avoid alcoholism, combine work and rest, and avoid mental stress; Second, check blood uric acid regularly and pay attention to blood pressure, blood sugar and renal function. If the blood uric acid concentration is still high 6 months after controlling diet or stopping drugs that affect purine metabolism, treatment can be considered. " In acute gout attack, measures such as stopping joint activity, local cold compress and taking anti-gout drugs recommended by doctors can be taken. Cure the symptoms but not the root cause, and gout is no exception. The key to treat gout is to adjust the diet structure, balance the diet, mix meat and vegetables, and avoid eating foods rich in purine (which is converted into uric acid in the body). Taboo foods include: animal viscera such as liver, kidney, brain, intestine and so on. Some fish such as sardines, shrimps and crabs; Excessive meat (especially beef and mutton); Excessive beans (except tofu, soybean milk and soybean milk), mushrooms and cauliflower. Then stay happy and avoid mental stimulation; Avoid overwork; Cold and moisture-proof, prevent joint injury and trauma. The prevention of secondary gout is mainly to actively treat primary diseases such as leukemia, multiple myeloma and chronic nephropathy. 2. How to prevent gout attacks? ↑top After gout occurs, measures should be taken to actively prevent gout recurrence. The specific methods are as follows: (1) First, we should control our diet, avoid eating a lot of high-purity food, strictly abstain from alcohol and drink more alkaline drinks. (2) Drink plenty of water to help uric acid excretion. (3) prevent obesity. (4) Keep cheerful and avoid inducing factors such as overwork, mental stress, cold and humidity, and joint injury. (5) It is not advisable to use drugs that inhibit uric acid excretion, such as dihydrogram urine plug and furosemide. (6) Take medicine to reduce serum uric acid and actively prevent and treat complications. (7) Regular follow-up, regular review of blood uric acid. (8) The prevention of secondary gout is mainly to actively treat primary diseases such as leukemia, multiple myeloma and chronic kidney disease. 3. How to prevent kidney damage? Kidney is the most easily damaged internal organ of gout patients. In severe cases, uremia may occur and even lead to death. Therefore, it is very important to take active and effective measures to protect the kidney. The specific methods mainly include: (1) controlling hyperuricemia. (2) Actively prevent and treat urinary system infections. (3) Patients with hypertension should control their blood pressure at a normal level. (4) Avoid using drugs and contrast agents that are harmful to the kidneys. 4. What should I do after being diagnosed with gout? ↑top Once gout is diagnosed, we must first do proper examination to find out the cause of gout and whether there are related diseases. Clinically, gout can be divided into primary and secondary, and the uric acid value usually returns to normal after the cause of secondary gout is removed. And primary gout, the cause of which cannot be found, accounts for the vast majority. Secondly, it needs long-term patience to receive the treatment of specialists. After systematic and standardized treatment, the prognosis is generally good. Don't worry even if gout attacks. At present, there are very effective drugs to treat gout. The key is to insist on regular review and treatment, and never blindly publicize the so-called specific drugs, so as not to delay treatment. Gout is a relatively easy disease to treat, but it is based on the guidance and reasonable treatment of specialists. If misdiagnosed for a long time or the treatment is not standardized, it may develop into chronic gouty arthritis, widespread formation of tophi, joint deformity and dysfunction, gouty nephropathy, renal insufficiency, urinary calculi and so on. In the late stage of the disease, the best period of gout treatment is often lost, and the difficulty of cure will be greatly increased, and sometimes even the clinical symptoms are difficult to control. However, if reasonable treatment is carried out in the early stage, people can generally get a good recovery and rarely have serious complications. However, if there is no formal systematic treatment, disability may also occur. 5. What diseases are gout patients prone to? Top gout is easy to be complicated with hypertension, polydactyly, obesity, diabetes, arteriosclerosis, coronary heart disease (angina pectoris, myocardial infarction) and stroke (cerebral infarction, cerebral hemorrhage). About half of gout patients will be complicated with hypertension. At first, patients have no obvious symptoms except hypertension, so they are often ignored. But after a period of time, the heart will become bigger (hypertensive heart disease), and the small blood vessels in the brain, fundus and kidney will become thicker and brittle (arteriosclerosis). If left unchecked, great vessels may be damaged and the condition will become very serious. For example, cerebrovascular diseases can lead to stroke, heart involvement can lead to myocardial infarction, and kidney damage can lead to renal insufficiency. Therefore, gout is also easy to cause coronary heart disease (angina pectoris, myocardial infarction) and stroke (cerebral infarction, cerebral hemorrhage). 6. Stop your joints from groaning ↑ Top gout is a group of diseases caused by purine metabolic disorder. In recent years, with the improvement of people's living standards and the change of diet structure, the incidence of gout in China has increased significantly, especially among middle-aged and elderly people over 40 years old, with more men than women (possibly related to diet). The latest research results show that the disease is mostly caused by congenital enzyme defects in the body, but it may also be closely related to inducing factors such as improper diet. If gout patients are not controlled for a long time, it will cause joint deformity. More seriously, uric acid crystals will deposit in the kidney, which will lead to renal function damage and even evolve into uremia. Therefore, we should pay attention to the prevention and treatment of gout. 1. Clinical manifestations (1) Acute stage: It is characterized by redness and swelling of joints, mainly in limbs and other places, and tends to recur. Laboratory tests showed that the blood uric acid content increased (some patients had normal blood uric acid). (2) Chronic stage: it is characterized by gout nodule formation (that is, a hard small lump with pain under the joint skin), joint bone destruction, pain and dysfunction, which may be accompanied by urinary calculi and renal function damage to varying degrees. 2. Diagnosis and differentiation (1) Diagnostic basis: ① paroxysmal (single or multiple) joints are red, swollen and painful, and they often wake up in pain at night. ② The serum uric acid (VA) was increased, and the male was more than 400μ mol/L; Female > 350 μm ol/l③ Gout nodules can be seen in hand joints and auricles. (2) Differential diagnosis: This disease should be differentiated from rheumatic arthritis, rheumatoid arthritis, senile osteoarthropathy, traumatic osteoarthropathy, heart disease, liver disease and other diseases with impaired renal function. 7. Prevention and treatment of gout ↑ Top treatment principle (1) Diet therapy: At present, there is no effective radical cure for gout. Therefore, in addition to drug treatment, proper dietary restriction is of great significance to control the occurrence and development of the disease. The following foods are divided into three categories, and meals are arranged according to different situations. The first kind of food has high purine content, which is estimated to contain purine 100- 1000 mg per1000 g. This kind of food is forbidden in patients with gout in acute or remission stage. These foods include brain, heart, kidney, liver and goose, grouse, minced meat, thick juice, broth, mackerel, sand fish, roe, sea cucumber, scallop, oyster, mussel, yeast and alcohol. The second kind of food contains a moderate amount of purine, about 9-9-100 mg per100 g. Because this kind of food contains a moderate amount of purine, patients in remission can choose an animal food and a vegetable from it, but it is not advisable to eat too much. Animal foods of this kind of food are: fish, meat, poultry and shellfish; Plant foods include dried beans, lentils, asparagus, spinach and mushrooms. The third kind of food contains a small amount of purine, so patients can choose food at will without strict control. These foods include: barley, wheat, oats, bread, noodles, rice, corn flour, starch, cakes, biscuits, butter snacks, fruits, eggs, soybean milk, tofu, butter, cream, cheese, ice cream, almonds, walnuts, hazelnuts, sugar, jam, honey, vegetable oil, coffee, vegetables, cocoa and so on. (2) Drug treatment: ① Acute attack: Indomethacin or colchicine can be taken under the guidance of a doctor, which can quickly control the swelling and pain symptoms of gouty arthritis. The sooner you take the medicine, the better the effect. Colchicine acts quickly, but it can cause nausea, vomiting, diarrhea, leukopenia and other adverse reactions, so it should be used under the guidance of a doctor. Indomethacin is not as effective as colchicine, but it also has good anti-inflammatory and analgesic effects, 25-50mg each time, three times a day. After the symptoms are relieved, reduce the dosage and stop taking the medicine after the symptoms disappear. ② Remission period: The serum uric acid is elevated or normal, and drugs that inhibit uric acid synthesis can be used for a long time. The commonly used drugs are allopurinol, gout and elixir, probenecid and so on. It can control hyperuricemia and prevent gout recurrence. Taking the above drugs requires regular review of liver function and white blood cell count. References:
/doctor.htm#7 According to the classification of diseases in traditional Chinese medicine, gout belongs to "arthralgia". The pathogen of cold and dampness is the cause, and the disease is located in the meridians. Toxic pathogens invade, cold and dampness combine, turn into heat, accumulate heat into phlegm, lead to abnormal blood circulation, and gather in the skin to become toxic. Suddenly it became red, swollen, hot and painful, and the pain was very severe. If bitten by a tiger, it is untouchable, so it is called the White Tiger Festival. According to the principle of syndrome differentiation and treatment of traditional Chinese medicine, arthritis tends to wind, mainly to dispel wind. Those who are cold mainly disperse cold. Wet wins, and wet is the main thing. Heat and evil prevail, and clearing heat is the main thing. Gout patients should judge the nature of arthralgia syndrome according to the symptoms and characteristics of arthritis, whether it is acute attack, whether it belongs to wind-cold-dampness arthralgia or rheumatism arthralgia, and whether there is phlegm and blood stasis arthralgia, and then prescribe the right medicine. For example, people with wind, cold and dampness can add or subtract coix seed soup or Ji Fang Fuling soup; Patients with rheumatic joint pain can be modified with Baihu Guizhi Decoction or Simiao Pill. In case of phlegm and blood stasis syndrome, Taohong drink can be used to enhance the taste. The principle of treating gout in traditional Chinese medicine is to clear heat and promote diuresis, promote blood circulation and dredge collaterals, and add some biological components contained in traditional Chinese medicine to promote the excretion of uric acid. The syndrome differentiation in acute stage is damp-heat, and the treatment should focus on clearing heat and promoting diuresis; The syndrome differentiation in remission stage is blood stasis blocking collaterals, and the treatment should be mainly to promote blood circulation and unblock collaterals. It can also play a certain role in relieving symptoms in clinic. Many herbs can also be used to treat gouty arthritis, especially acute arthritis, such as fresh buttercup, clematis root, Polygonum cuspidatum, Scutellaria barbata, Lobelia chinensis, Radix Rehmanniae, Herba Lycopodii, Pericarpium Citri Reticulatae Viride, Cortex Acanthopanacis, and Herba Leonuri. Taiwan Province gout secret recipe prescription: (The effect varies from person to person due to different personal constitutions. The following formula is for reference only) eight pieces of white bitter gourd, two apples and one grapefruit, and juice is used as tea. Lily and barley porridge is very important to treat gout patients. In the process of dietotherapy, besides following the principle of low purine diet, we should also pay attention to choosing foods with special curative effects. Coix seed porridge can provide patients with the necessary calorie requirements, has a direct therapeutic effect on gout, and can improve the symptoms of arthritis, and is an ideal staple food for gout patients. In clinical treatment, the author found that under the principle of low purine diet, it is very effective for gout patients to take lily and barley porridge as their staple food. Materials and Methods: 60g of dried lily, 60g of Coicis Semen and 60g of stem rice were washed and boiled in a pot, and taken twice a day in the middle and evening, which are the staple foods of gout patients (others are treated according to the principle of nutritional treatment for gout patients, so they are not detailed here). Even after taking it, you must persist after the symptoms improve, at least 1-2 times a week to prevent gout from recurring. Results Analysis: The amount of serum uric acid decreased, the symptoms of arthritis were alleviated, and there was no recurrence. Discussion and analysis: Lily: sweet, slightly cold, has the effect of moistening lung and relieving cough, clearing heart and calming nerves. Modern research found that lily not only contains protein, fat, starch and vitamins, but also contains colchicine. Colchicine preparation is a specific drug for treating gout in clinic. By inhibiting C5a and leukotriene B4, it can inhibit the chemotaxis of various nuclear leukocytes, thus improving the symptoms of arthritis. Colchicine contained in lily has obvious therapeutic effect on gout patients, but its colchicine content is very small, and it can only play its therapeutic role after long-term administration, and it is safer than preparation and has no toxic and side effects. Coix seed: also known as Coix seed, it tastes sweet, light and slightly cold, and has the functions of diuresis, moisture absorption, spleen strengthening, diarrhea relieving, arthralgia relieving and heat clearing. It is said in "Effective Prescriptions of Famous Doctors in the World" that "Long-term administration of coix seed porridge can cure rheumatism and joint pain, tonify vital qi, remove evil spirits in the chest, harmonize the stomach and intestines, eliminate edema, and lighten the body and replenish qi"; "The Classic of Materia Medica" says that "the main tendons are cramped, unable to flex and stretch, and rheumatism is painful". Coix seed is widely used in dietotherapy, and it is often used as the main flavor of diuretic prescription, heat-clearing prescription and wind-dispelling prescription. Using it to treat gout can not only exert its diuretic effect and excrete more uric acid, but also improve the arthritis symptoms of gout patients by using its effect of expelling wind and removing arthralgia. The combination of the two, adding stem rice, as the staple food of gout patients, can not only provide the necessary calorie demand for gout patients, but also play a good role in dietotherapy, which is a good dietotherapy for gout patients. In the process of clinical dietotherapy, gout patients must follow the dietary principle of low purine diet, ban irritating foods such as alcohol, and actively cooperate with clinical treatment. As the staple food of gout patients, lily and barley porridge must be taken for a long time to exert its therapeutic effect. Clinically, gout patients are generally obese, and there is no need to add any seasoning to porridge. However, if the patient is thin, rock sugar can be added as appropriate to increase the appetite of the patient and better achieve the therapeutic purpose.