Gout is a common disease caused by disorders of purine metabolism, excessive uric acid production and/or decreased uric acid excretion, resulting in increased uric acid in the blood and deposition of uric acid salts in joints or other parts of the body. The deposition of uric acid does not happen overnight, but accumulates over time, slowly depositing in the joint cavity and cartilage surface to a certain extent before gout is triggered. Once a gout attack occurs, it means that a lot of uric acid crystals have been deposited in the joint cavity, and if you don’t take regular uric acid treatment, you will definitely have frequent recurrences of gout in the future. Therefore, once you have an acute attack of gout, you need to lower uric acid regularly. The first step in lowering uric acid is diet control. If the diet is not well controlled, all uric acid-lowering drugs are worthless, and you also need to drink more water, as long as the diet is well controlled before the next step of drug uric acid-lowering treatment. The treatment of gout is also very simple, which is to find a way to get rid of the uric acid crystals deposited in the joints or other tissues of the body again. The saturated concentration of uric acid in the blood is about 360μmol/L. To dissolve the uric acid crystals in the joint cavity, we must ensure that the uric acid in the blood is less than 360μmol/L, preferably less than 300μmol/L. Therefore, it is difficult to achieve this goal simply by diet control and drinking more water, and we need to take uric acid-lowering drugs. The main mechanism of action is to make more uric acid excreted from the urine, so you need to drink more water to eat benzbromarone, and drink more water to have uric acid excreted. However, we should note that patients with kidney stones need to use benzbromarone with caution. 2, drugs that inhibit the production of uric acid, such as allopurinol and febuxostat, these drugs are mainly to make the body produce less uric acid, to control the production of uric acid from the source, allopurinol has more side effects compared to febuxostat, and allopurinol has a very large side effect, may cause systemic exfoliative dermatitis, which is life-threatening, so when using allopurinol, you need to check a susceptible allergic If HLA-B*5801 is positive, it is better not to use allopurinol and consider using other uric acid-lowering drugs. Febuxostat, a newly developed drug in recent years, has just been marketed in China for 2 or 3 years. It has good uric acid-lowering effect and relatively small side effects, but it is relatively expensive. 3, alkalizing urine drugs, such as sodium bicarbonate, is a very good drug, can make urine alkaline, can promote uric acid excretion, to prevent stone formation, but also protect the kidney function, and cheap side effects are very small. It is basically an anchor drug in terms of gout treatment. So how do we apply these drugs? Generally speaking, after an acute attack of gout, you need to wait 1-2 weeks after the joint pain is completely relieved before you can add uric acid-lowering drugs. If you are too eager to use uric acid-lowering drugs, you may trigger gout. Generally, after 2 weeks of complete relief of joint pain, uric acid-lowering drugs are added according to the patient’s condition, and uric acid is usually rechecked after 2 weeks, and uric acid-lowering drugs are adjusted to an appropriate level according to the results of the recheck. Since the uric acid crystals inside the joint cavity are slowly dissolved out into the blood and then excreted through urine, the blood uric acid needs to be controlled at about 300μmol/L, and it needs to be maintained for 6-12 months, during which the main purpose is to let all the uric acid crystals inside the joint slowly dissolve out, so that the gout is completely controlled, and then you can consider slowly reducing the medication. In some special patients with poor kidney function, there are not many uric acid-lowering drugs to choose from. While alkalizing the urine, you can consider using febuxostat to lower uric acid, mainly in small doses, and pay attention to adjust the drugs according to your condition. The treatment of gout is a long-term process, need to adhere to the diet control, need to appropriate exercise, need to drink more water, but also need to adhere to the medication, but also need to endure the gout recurrence, but this is how people “tolerate loneliness, in order to keep the prosperity”, really hope that the majority of patients can persist, many gout can be cured.