Gout is a recurrent inflammatory disease caused by increased purine biosynthesis, excessive uric acid production or poor uric acid excretion resulting in elevated uric acid in the blood and deposition of urate crystals in the synovial membrane, bursa, cartilage and other tissues of the joints. Gouty arthritis patients can control the attack of gout by improving their lifestyles.
First, pay attention to diet
80-90% of gout attacks are due to a decrease in uric acid excretion by the kidneys, and 10-20% are due to an increase in uric acid production. Under normal circumstances, 20% of blood uric acid comes from purine-rich foods and 80% from purine biosynthesis in the body. The total daily purine intake of a normal person on a normal diet is about 150-200 mg, while the total daily purine metabolism in the body is about 600-700 mg. Even if purine intake can be strictly limited, the blood uric acid level will decrease by 15-20% at most.
The amount of purine consumed in food directly affects the level of uric acid in the blood, and even triggers an acute attack of gout. Therefore, it is very important for patients with gouty arthritis to control their diet, the principle of which is three low and one high (low purine or no purine, low calories, low salt and a lot of water). It is recommended that patients drink 2000ml of water treatment daily to promote the excretion of uric acid from urine. According to the amount of purine content in food, food can be divided into purine-free food, low purine food (purine content <75mg per 100g), medium purine food (purine content 75mg-100mg per 100g) and high purine food (purine content 150
-1000mg).
Vegetables and fruits are mostly alkaline foods, which can increase the alkali reserves in the body, raise the pH of body fluid, prevent the formation of uric acid crystals and promote their dissolution, increase the amount of uric acid excretion, prevent the formation of stones and make the formed stones dissolve. Vegetables and fruits are also rich in potassium, which can promote the kidneys to excrete uric acid and reduce urate deposits. In addition, serum uric acid value and alcohol consumption are highly positively correlated, and alcohol consumption is one of the important causes of elevated serum uric acid value.
Second, long-term exercise
Long-term exercise can not only reduce the patient’s weight and blood uric acid, but also enhance physical fitness and resistance, which is beneficial to slow down joint pain and prevent joint contracture and muscle atrophy. However, it should be noted that the acute gouty arthritis attack period should avoid exercise, at this time, blind exercise, will make the acute gout adverse reactions aggravated, thus aggravating the disease. When the gout attack has improved, you can choose low-intensity sports to start exercising.
The best way to exercise is to choose aerobic exercise; when anaerobic exercise, blood uric acid and lactic acid levels will increase, inhibiting the excretion of uric acid by the kidneys, further increasing the level of uric acid in the body and triggering gout attacks. Exercise to the next day after exercise does not feel fatigue as a principle.
Third, actively learn the relevant knowledge
Patients with gouty arthritis should actively learn about gouty arthritis through the Internet, television, hospital education, etc., regularly test serum uric acid levels, kidney function, etc., control body weight, monitor blood pressure, blood sugar, blood lipids, avoid factors such as exertion, infection, trauma, eating high purine food, etc., and encourage family members to conduct serum uric acid screening for early detection of hyperuricemia.
Fourth, patients should pay attention to the following points
1. Gouty stone arthritis without wounds.
1) Soft clothing is preferred;
2) Keep the skin clean and intact to avoid injury;
3) Wear soft and appropriate shoes;
4) Do not cut open the gout stone arbitrarily, as the wound is difficult to heal; take uric acid-lowering drugs patiently;
5) Pay attention to the amount of urine on a regular basis and monitor blood BUN and Cr;
6) If the gout stone is deposited in the wrist, it will easily cause carpal tunnel syndrome, which requires surgical removal of gout stone or local injection of pain killer.
2. Gouty stone arthritis with wounds.
1) The wound often has gouty stone liquid or crystals flowing out, so it should be disinfected and cleaned when changing medication;
2) Aseptic operation;
3) If the wound is infected, bacterial culture should be done;
4) Amputation surgery and dietary guidance if necessary.
Long-term recurrent joint pain may lead to high mental stress, to actively communicate with family members and doctors to avoid excessive mental stress induced gouty arthritis attacks