Gouty arthritis is a disease of acute arthritis with recurrent episodes of uric acid crystals in the connective tissue, or even gouty stones, which can develop into chronic gouty arthritis and joint deformities. Gouty arthritis, from the perspective of Chinese medicine, belongs to the category of damp-heat paralysis, which is a deficiency and a symptom of reality. Therefore, the treatment of this case should be to clear heat and dampness, dispel stasis and open the ligaments. Peng male, 42 years old, worker, April 5, 2013 Complaint: recurrent attacks of gouty arthritis for 7-8 years, aggravated for two days. Initial diagnosis: redness, swelling, heat and pain at the metatarsophalangeal joint of the right foot after consuming seafood yesterday, with severe pain and difficulty walking, high local skin temperature on touch, swelling and red color on observation. He was eating and sleeping well. He had yellow urine with low volume and dry stools. Laboratory tests: blood UA 471ummol/L. The tongue is red, the coating is yellow and greasy, and the pulse is counted. The patient’s consumption of fatty, sweet, and greasy products helps to produce phlegm, which hinders the spleen and stomach from transporting and transforming. The dampness and heat are strong inside, and the phlegm and stagnation of phlegm are intertwined, which tends to go down to the end of the foot Taiyin Spleen meridian – the joint of the big finger of the foot, followed by heat paralysis and flow of the joint, redness, swelling, and heat pain. The tongue is red, the coating is yellow and greasy, and the pulse is counted as a manifestation of damp-heat accumulation. The treatment should be to clear heat and dampness, remove blood stasis and promote circulation as a method, the prescription is as follows: prescription: honeysuckle, xuan ginseng, angelica, raw licorice, Han Fangji, Che Qianzi, raw astragalus, money grass, sea gold sand, white peony, slippery stone, Tu Fu Ling, red beans, Chuanxiong, safflower seven doses, one dose a day, water decoction. The patient was advised to have a light diet, drink more water and avoid the intake of high purine food. 2012-4-12 Second Consultation The patient’s symptoms improved significantly after the medicine, the redness and swelling subsided, the pain was reduced, the volume of urine was high, and the stool was 3 times a day. The tongue is red, the coating is yellow, and the pulse is counted. Laboratory examination: UA, 437.8ummol/L. This sign indicates that the patient’s damp-heat and stasis symptoms are reduced, while the sign of spleen deficiency is present, so the soup is removed from the heat-clearing and water-relieving products, and the medicine for strengthening the spleen and relieving dampness is added, and the prescription is as follows: the above formula is removed from Che Qian Zi, Adzuki bean, Chuan Xiong and Hong Hua, and Yam, Chuan Niu Knee and Job’s tear are added. 14 doses, 1 dose per day, with water decoction. 2012-5-17 Third consultation The patient reported that the painful redness and swelling of the joints had disappeared, and there was no redness and swelling in the joint of the big toe. However, the stool is thin and the volume of urine tends to be normal since taking the soup. The tongue is light red, with a slightly yellowish coating, and the pulse is sunken and sometimes knotted. This symptom indicates that the signs of damp-heat accumulation are greatly resolved, but the knot of spleen deficiency and dampness still exists. Therefore, the Chinese medicine Si Miao Wan was used to clear heat and dispel dampness, resolve blood stasis and clear the channels to consolidate the therapeutic effect. This case was basically cured with 21 doses of medicine, and was followed up by telephone for 6 months without recurrence. Press: Gouty arthritis is generally treated with non-steroidal anti-inflammatory drugs combined with drugs that inhibit uric acid production or promote uric acid excretion, such as colchicine, allopurinol, and benzbromarone, etc. However, either of them will have certain effects on liver and kidney functions, and they cannot be taken for a long time, and are prone to relapse after discontinuation of the drugs, and the long-term benefits are less than the current therapeutic effects. According to research, gout is often associated with metabolic syndrome, i.e. insulin resistance syndrome. Although about 80% of uric acid production is related to the body’s own production and about 20% is related to dietary intake, from another perspective, as long as the diet can be controlled, the gout attack can be well relieved. Acute attacks of gout belong to the category of “paralysis” in terms of clinical manifestations, but there are few records of it in the history books, and there is no specific discussion on it. The first medical practitioner to propose the name “gout” was Zhang Jingyue, who believed that “gout” or “gout at all times” was due to He believed that “gout” or “gout of the joints” was due to “deficiency of qi and blood, or due to drinking, opening of the coup, sweating when the wind, or due to fatigue, carelessness, resulting in the evil of three qi all over the joints, and the qi and blood fight and pain, or like the bite of a tiger, so it also has the name of white tiger of the joints”. For example, Wang Toi’s “Wai Tai Secret Essentials” said: “White Tiger disease, most of the wind, cold, summer and dampness of the poison, due to deficiency, will not take care of, subject to this wind, meridians stagnation, blood does not work, stored in between the bones and joints, or in the limbs, the flesh color does not change, the disease is quiet day and night, the hair is through the marrow, pain like a tiger’s bite, so the name white tiger disease”; Zhu Danxi “Ge Zhi Yu Lun It is said: “Gout is ‘pain in the extremities is also’, other prescriptions are called white tiger joint evidence, the majority of phlegm wind-heat, rheumatism, blood deficiency.” Danxi Xinfa says: “Fat people have pain in the limbs and joints, mostly due to wind-dampness and phlegm-drink flowing into the meridians and veins and pain”; Chao Yuanfang’s “Treatise on the Origin of Various Diseases” “The symptoms of wind in the joints, short breath from sweating, pain in the joints and unbearable, flexion and extension are also …… The wind and blood in the joints, so the pain, blood deficiency is sweating, wind and cold in the tendons, can not be flexed and extended”. The main pathogenesis is the invasion of dampness and heat or dampness and toxicity, resulting in stagnation of qi and blood, phlegm and stagnation of each other, and obstruction of meridians. Chinese medicine can regulate the body’s qi and blood from the perspective of yin and yang, correct abnormalities in the body, and improve metabolic disorders, so it can fundamentally reduce the attack of gouty arthritis. At present, Chinese medicine treats gouty arthritis by clearing heat, dispelling dampness and releasing paralysis, which is effective in reducing swelling and relieving pain. Li Dongyuan’s “Spleen and Stomach Theory” says: “treating dampness without urinating is not its cure. The paralysis is also closed, it is astringent and not smooth, Qi and blood coagulation and not work, treatment is appropriate to replenish Qi and Yang, guarding the spleen and earth, then the disease goes and the root does not shake. Although the symptoms of gouty arthritis belong to the real evidence, the root of the problem is still spleen deficiency. Therefore, while clearing damp-heat, removing blood stasis and opening the ligaments, we should not forget to protect the spleen and stomach. The patient’s initial signs of dampness and heat are obvious, so this evidence in the treatment first clear heat and dampness, remove blood stasis and open the ligaments, emphasizing the use of water-releasing and dampness-permeating products, so that dampness is facilitated from the small. After the medicine, damp-heat was reduced, attention was paid to the protection of the spleen and stomach, and yam and coix seeds were added to strengthen the spleen to achieve the effect of consolidating the root. At the third consultation, the patient’s symptoms disappeared, and the medicine was changed to Sifu Pill combined with Blood Mansions and Blood Stasis Capsules, which is intended to slowly remove dampness, resolve blood stasis, and regulate Qi and blood.