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Abstract: A 45-year-old middle-aged male presented with pain and discomfort in the interphalangeal joints of both hands, elbow joints, knee joints and ankle joints with swelling after eating seafood, which was aggravated by activity and worsened at night. He was diagnosed as having gouty arthritis and was given pain-relieving medication, which relieved the symptoms at that time, but relapsed 2 weeks later. Later, he was given Chinese herbal medicine to relieve the symptoms and the pain and swelling of the joint improved significantly.
Basic information】Male, 45 years old
Disease Type】Gouty arthritis
Hospital】Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine
Date of Consultation】October 2021
Treatment plan】Chinese herbal medicine treatment (Phellodendron, Atractylodes, Salviae Miltiorrhiza, Hypericum, Hypericum, Gentianae, Gynostemma, Phyllostachys, Plantago ovata, Pericarpium glaucum)
Treatment Period】Outpatient consultation, 2 weeks of self-medication, regular follow-up
Treatment effect】Joint pain and swelling improved significantly and the treatment effect is good
I. Initial consultation
The patient reported that he had pain and swelling in the interphalangeal joints, elbow joints, knee joints and ankle joints after eating seafood, and the pain was worse at night. The blood uric acid level was 437μmol/L. X-ray showed bone destruction. He was diagnosed with gouty arthritis and was treated with pain medication, which relieved his symptoms. On examination, the patient was found to be fat, with localized redness and swelling of the joints, painful refusal to press, relatively high skin temperature, thick yellow tongue coating, and moist and stringent pulse.
II. Treatment history
The patient is middle-aged, with a fat body, red, swollen and painful joints, burning skin, drowsiness, thirst and irritability, a yellow, thick and dry tongue coating, and a moist and stringent pulse. The patient was given medication to clear heat and dampness, invigorate blood circulation, and relieve swelling and pain. After 1 week of follow-up, the patient’s joint pain was relieved and the swelling was reduced. The patient was given the formula again for one week. The patient was seen again, and his gait was as normal, and there was no obvious pain and discomfort in the joints.
III. Treatment effect
The patient’s joint pain was relieved by the treatment and Chinese herbal medicine, and the joint pain was not aggravated by daily activities, and outdoor activities such as jogging could be performed. The patient’s self-report: the amount of exercise gradually increased after the joint pain was relieved, and the weight loss, the previous sleepiness and thirst irritation also disappeared, and the blood uric acid was always within the normal range after regular re-examination. In conclusion, the patient was seen in the outpatient clinic, self-administered medication for 2 weeks and followed up regularly. At present, the joint pain and swelling have improved significantly and the treatment effect is good.
IV. Notes
The patient has recovered from the treatment and is truly happy for him. Patients should drink more water in daily life, preferably weak alkaline water, reduce the intake of high purine food such as animal offal, seafood, meat soup and hot pot, and consume more high vitamin diet, such as vitamin C rich fruits, which rarely have purines and help prevent gout attacks. Control alcohol consumption and do not recommend strenuous exercise, mainly aerobic exercise, such as jogging, swimming, walking, etc., to avoid joint damage caused by too much exercise.
V. Personal insights
Most of the patients with gouty arthritis have joint pain as a symptom, and most of them have temporary relief with oral pain medication, but they are prone to recurrence. Through the combination of traditional Chinese medicine, Chinese and Western medicine, we can optimize the treatment plan by clearing heat and dampness, activating blood circulation, reducing swelling and pain to clear the joints, dispersing nodes and swelling, and promoting uric acid excretion, most of the patients have relief of joint pain and can work and live normally. The majority of patients can work and live normally.