Gout: a curable and refractory rheumatic disease

Gout is a kind of body uric acid produce too much or uric acid excretion obstacle and cause blood uric acid elevation, urate crystals deposited in the synovial membrane of joints, bursa, cartilage and auricle and other tissues caused by recurrent inflammatory disease, belong to a kind of rheumatic diseases. The prevalence of gout in China is increasing year by year, and some data show that China currently has 120 million patients with hyperuricemia and 17 million patients with gout. A large number of patients are not cured for a long time, repeated attacks, and gradually gout stones and chronic kidney damage. What are the manifestations of gout? Gout is mostly seen in middle-aged men, the typical occurrence of gout as drinking or eating a lot of seafood late at night due to severe joint swelling and pain and wake up, the pain gradually aggravated, tear-like, cut-like, intolerable; most of the joints occur in the big toe (fingers, ankles, knees, etc. can also be seen), manifested as redness, swelling, heat, pain, more than a few days or 2 weeks of their own remission, remission lasted months, years or more than a decade after the recurrence of most patients within 1 year; patients recurring; the majority of the Most patients relapse within 1 year; some gout patients can see the gout stone on the edge of the ear. Gout should not be underestimated because of the great danger! Gout is harmful, not just joint swelling and pain, uric acid kidney stones, gouty nephropathy, acute or chronic renal failure are common complications of gout patients; in addition it is closely related to a variety of diseases. A survey in the United States found that people with gout are prone to heart attack and heart failure, and high uric acid significantly increases the prevalence of hypertension, diabetes mellitus, stroke, kidney disease, myocardial infarction and heart failure. Blood uric acid level is positively correlated with cardiovascular disease, the higher the blood uric acid level of gout patients, the higher the chance of combining diabetes, heart failure, hypertension, heart attack and obesity. Gout also increases the mortality rate of patients with kidney disease. Can gout be cured? First of all, it is very clear that gout is a curable disease. From the point of view of pathogenesis, gout is caused by hyperuricemia, theoretically, as long as the uric acid is controlled at the target level, gout should be curable. (Untreated gout can lead to joint deformities, which can seriously affect the patient’s quality of life) Why is gout still recurring after taking medication for gout, and it feels as if it can’t be cured? China’s gout patients blood uric acid standard rate of less than 10%, less than 1% of those who continue to meet the standard, since the uric acid can not meet the standard, gout recurrent attacks is inevitable. The reason: 1, gout attack early joint swelling and pain is intermittent, part of the patient even without treatment symptoms can be relieved on their own, resulting in a lack of long-term treatment of patients initiative; 2, the treatment cycle is long, high uric acid need to continue to reach the standard 1-2 years in order to fundamentally avoid gouty attacks; 3, many people attack, immediately start taking medication, such as uric acid once the decline in the drug, and fluke think they won’t have an attack. In fact, the sudden change of uric acid level, even at the lower level of uric acid, can trigger a sudden gout attack; 4, the early stage of lowering uric acid has the possibility of triggering gout attack, so that the patient can’t adhere to the treatment of lowering uric acid; 5, many people don’t realize that gout and hyperuricemia is harmful, in addition to the joints, but also renal insufficiency, cardiovascular and cerebral vascular disease, and even aggravate coronary heart disease, hypertension, diabetes, etc., and wait until these serious complications occur, the gout can also cause the gout. Waiting until the emergence of these serious complications has missed the best time for treatment; 6, the doctor’s knowledge of the old, did not recognize the danger of high uric acid, resulting in the lack of attention to the treatment of uric acid reduction. Gout how to do? 1, take antibiotics? Many people feel gout when the joints are red, swollen, hot, painful, thinking it is an infection, in fact, gout is the inflammation caused by urate crystals deposited in the joints, and bacterial infection is not the same thing, some people eat antibiotics after the pain improves, that may be a natural gout relief process, rather than eating antibiotics caused by gout improves, which is a big misunderstanding of the treatment. 2, acute attack, the first pain in the affected limb is too high, with a cool towel cold compress (hot compresses will exacerbate the pain); oral non-steroidal anti-inflammatory drugs (that is, the people say painkillers), but also in the pain at the external use of pain creams, etc., bear in mind: to be symptomatic relief must go to the hospital to receive rheumatology specialists formal treatment, after all, gout will be recurrent attacks, do not “good scars and forget about the pain! “Do not forget the pain. 3, usually pay attention to: gout to drink more water, promote the body of uric acid excretion. Eat more low purine food, such as vegetables, eat less animal offal, seafood, beer, etc., white wine and sugar-sweetened beverages can make uric acid rise, gout patients should try to avoid. Vitamin C, dairy products (low-fat milk and low-fat yogurt), cherries and red wine have the effect of lowering uric acid, can be appropriate to eat more. However, the elderly control of the diet at the same time need to pay attention to ensure the supply of normal nutrition, lean meat, milk, eggs, vegetables, fruits moderate intake, including soy products in the absence of renal function involvement can also be eaten. 4, uric acid continued to reach the standard is the key to curing gout: continued to reach the standard contains “continued” and “reach the standard” two meanings, “continued” refers to the continuation of the reduction of uric acid, the course of treatment takes months, years, the longer the duration of gout, the more the body of the gout, the more the body of the gout, the more the body of the gout, the more the body of the gout. The longer the duration of gout, the more gout stones in the body, the longer the duration of uric acid reduction. The longer the duration of gout, the more gout stones in the body, the longer the duration of lowering uric acid should be. “Achieve the standard” that is, to achieve the blood uric acid control standards, for men, uric acid should be controlled at 360umol / L or less, with gout stones should be controlled at 300umol / L or less. Studies have shown that the immediate benefits of sustained blood uric acid compliance are a reduction in the number of acute attacks of gout, a reduction in urate crystals that dissolve gout stones, prevention of joint damage, and a reduction in organ damage, and that sustained long term uric acid compliance can ultimately cure some gout patients.