With the improvement of people’s living standards, gout has become a common and frequent disease in recent years. A set of authoritative survey data is alarming, in recent years China’s gout patients more than doubled, of which 95% are men; clinical findings of China’s gout patients have a trend of youthful development, causing a high degree of vigilance and concern of the medical profession. Early symptoms (1) acute arthritis attack more than once a month; (2) inflammation counter-check peaks within 1 day; (3) acute monoarthritis attack; (4) dark red skin visible in the affected joint; (5) pain or swelling of the first metatarsophalangeal joint; (6) mono-key arthritis attack involving the first metatarsophalangeal joint; (7) mono-key arthritis attack involving the tarsal joint; (8) suspicious gout nodules; (9) ) hyperuricemia; (10) X-ray radiography showing asymmetric intra-articular swelling; (11) X-ray radiography showing a submembranous cyst without erosion; (12) negative microbiological culture of joint fluid during an episode of arthritis, and chronically elevated uric acid in the blood is a key cause of gout. It brings a lot of inconvenience to life and work, and the quality of life is seriously reduced, especially when an attack occurs, it is worse than death. So what is gout? Why does gout occur? How to manage gout? Today we will talk to you about this topic. What is gout? According to Western medicine, gout is a disorder in the metabolic process of a substance called “purine” in the body, which increases the synthesis or decreases the excretion of uric acid (the oxidized metabolite of purine), resulting in hyperuricemia, and when the blood uric acid concentration is too high, uric acid is deposited in the form of sodium salts in joints, soft tissues, cartilage and kidneys. This causes a foreign body inflammatory reaction in the tissues and is called gout. Gout can be clinically divided into four stages: the first stage is the hyperuricemic stage, in which patients do not have clinical symptoms of gout except for elevated blood uric acid; the second stage is the early stage of gout, in which blood uric acid increases continuously, leading to a sudden attack of acute gouty arthritis, in which most people wake up in their sleep with pain like a knife cut. If the slightest breeze blows or touches the foot, the pain will immediately be as severe as if the toes were moving, but it will disappear within a few days or weeks. After one painful episode, it seems that the inflammation in the joint is eliminated and the person is like a normal person, but in fact, the uric acid crystals do not disappear and continue to play a role, and gradually the joint becomes swollen and stiff, and the flexion and extension are unfavorable. The joints of the fingers and toes are seriously deformed The third stage is the middle stage of gout, from the initial onset of a toe joint, gouty arthritis repeated acute attacks, after several acute attacks, gradually spread to the joints of the fingers, toes, wrists, ankles, knees and other joints throughout the body, and then the surrounding soft tissues and bones are also damaged and dysfunctional to varying degrees, and uric acid crystals are deposited continuously, slowly forming a stone like “gout stone”, at this time, the kidney function is normal or shows a mild decline. By the late stage, ulceration occurs The fourth stage is the late stage of gout, in which the patient’s joint deformity and dysfunction become increasingly serious, and the gout stones increase in size and easily break out white urate crystals, which affects daily learning, work and life due to permanent joint deformity and brings great physical and mental pain to the patient. Uric acid salt is deposited into the kidney, forming kidney stones, etc. Clinical swelling, oliguria, proteinuria, increased nocturia, hypertension, anemia, etc. indicate that kidney function is damaged and kidney function is significantly reduced. If the disease progresses further, kidney failure will occur, which is not easily reversible and life-threatening. Gout is also known as “gout” in Chinese medicine, and has been discussed by doctors for many generations. Yuan? Zhu Danxi “Ge Zhi Yu” has listed a special section on gout, cloud: “gout, most of the blood has been boiling since the heat, after or wading in the water or standing on the wetlands …… cold outside the fight, hot blood to get cold, sweat turbid stagnation, so the pain, the night is pain, line in Yang also.” Ming? Zhang Jinyue “Jing Yue Quanshu? Foot gas” that the outside is Yin cold water damp, now the damp evil attacked the flesh and tendons; internal by the plain fat and sweet excessive, wet congestion lower jiao; cold and damp evil conjunctive depression and heat, stay in the skin …… lesion parts red swollen hot, long then bone erosion. The clear? Lin Peiqin, “Classes of disease treatment cut”: “gout, pain paralysis one of the symptoms, …… at first because of wind, cold and damp paralysis of the yin part, for a long time will turn into heat to cause pain, to night more dramatic.” At the same time, the modern medicine of gout is also equivalent to the Chinese medicine of “pain paralysis”, “joint”, “foot gas” and other diseases. Chinese medicine has the following understanding of the cause and pathogenesis of gout: 1, the body Yang Sheng, the internal organs contain poison: the internal organs accumulate heat is the prerequisite for the formation of toxic attack into the bones, the accumulation of heat for a long time, heat for poison is the root cause of the disease. 2, dampness and heat turbid poison, stay injected joints: dampness and heat turbid poison, rooted in the spleen and stomach, stay in the meridians, congestion and closed meridians, flow injected joints, if the deficiency of evil love, dampness and poison does not go, through the meridians, attached to the bone, the formation of phlegm nucleus, hard as stone. Therefore, dampness, heat and toxicity are the main causes of gout stones. 3, spleen deficiency for this, dampness and turbidity as the standard: the spleen deficiency combined with poor diet, damage to the spleen and stomach, dysregulation of transportation, breeding dampness and turbidity, external injection of flesh and joints, internal stay in the internal organs, the development of the disease. 4, external evil invasion: external evil stagnation of muscle and joints, resulting in Qi and blood is not smooth, meridians and collaterals do not pass, not pass is pain, a long time can lead to Qi and blood loss, blood heat causes blood stasis, ligament obstruction, causing joint enlargement, deformity and stiffness. In the treatment of gout in Chinese medicine, the main treatment in the acute attack period is to dispel the evil, and the treatment method includes removing dampness, dispersing cold, clearing heat and detoxifying, activating blood circulation, etc. Commonly used prescriptions include Si Miao San, Bai Hu plus Gui Zhi Tang, Dang Gui Qixian Pain Soup, Xuan Piao Tang, and Shang Zhongxia Gout Formula. During the remission period, we can help to strengthen the spleen and Qi, tonify the liver and kidney, etc. Commonly used prescriptions include Zheng Ren Wan, etc. Other therapies such as acupuncture, tui na, bloodletting therapy, ternary metabolic therapy and ointment therapy are all effective. One, Four Wonderful San, drug composition: 30 grams of Coix Seed, 15 grams of Chuan Niu Knee, 10 grams of Phellodendron, 10 grams of Atractylodes Macrocephalae. Efficacy: Liver and kidney deficiency, damp-heat infusion, resulting in impotence. Second, Bai Hu plus Gui Zhi Tang, drug composition: 50 grams of gypsum, 18 grams of Zhi Mu, 10 grams of round-grained rice, 10 grams of Gui Zhi, 6 grams of licorice (roasted). Effects: Clearing heat, promoting circulation and relieving pain, warm malaria, with a flat pulse, no cold in the body but heat, pain and irritation in the bones, vomiting at times, rheumatic heat paralysis, strong heat and sweating, thick and irritable breath, swollen and painful joints, thirst with white fur and stringed pulse. Thirdly, Angelica sinensis soup, drug composition: 15 grams of Yin Chen, 15 grams of Pueraria lobata, 15 grams of Zhi Mu, 10 grams of Qiang Wu, 10 grams of Fang Feng, 10 grams of Sheng Ma, 10 grams of Bai Zhu, 10 grams of Scutellaria baicalensis, 10 grams of Bitter Ginseng, 10 grams of Angelica sinensis, 10 grams of Pig Ling, 10 grams of Ze Di, 6 grams of Glycyrrhiza glabra. Effects: Damp-heat infusion, annoying and painful limbs, heavy shoulders and back, unfavorable chest and diaphragm, pain all over the body, downward injection into the shins, and unbearable swelling and pain. Fourth, Xuan Piao Tang, composed of: Fang Ji 15 grams, Coix Seed 15 grams, Almond 15 grams, Slippery Rock 15 grams, Forsythia 10 grams, Gardenia 10 grams, Sempervivum (fried in vinegar) 10 grams, Late Silica 10 grams, Red Dou Xiao Pi 10 grams. Effects: Clearing damp-heat, damp-heat paralysis. Dampness gathering and heat steam, blocking the meridians, chills and fever, pain in the bones, impotence, short urine, yellow tongue coating or gray stagnation, impotence of the face. V. Gout formula “Si Miao Bai Hu Tang Plus Decrease”, drug composition: 50 g of raw gypsum, 30 g of Coix Seed, 30 g of Zhi Mu, 12 g of Atractylodes Macrocephalae, 12 g of Phellodendron Bark, 12 g of Gymnema sylvestre, 12 g of Forsythia lanceolata, 12 g of Mouton 12, 12 g of Qian Ren, 12 g of Di Long, 12 g of Old Stork Grass, 12 g of Chuan Niu Knee, 12 g of Wei Ling Xian. Efficacy: Dampness enters the body and turns into heat, or it is caused by the rising of Yang in the body, internal heat, and dampness-heat cross-steaming. The symptoms include redness, swelling, heat and pain in the joints, with rapid onset, localized burning, and relief when cooled. It is accompanied by fever, thirst, irritability, and short yellow urine. The tongue is red, the coating is yellow or greasy, and the pulse is slippery or stringy. The treatment is to clear heat and dampness, and to relieve pain. Gout, in fact, is a problem with the body’s metabolism. Which has gone wrong, the kidney and meridians out of order. We all know that the role of the kidney is mainly to filter. What is filtered? Filter the harmful substances in the blood, and then expel them from the body. Now the situation is, usually, the kidneys can filter out the harmful substances, but the metabolism is not outside the body, but is deposited in the joints, especially at the end of the limbs away from the heart, especially the toe joints and finger joints, so why is this? The human body is a circulatory system, our body’s blood is pumped from the heart, and finally back to the heart. This blood is constantly contaminated in the process of circulation and use, and in order to repeatedly use the blood in our body, it needs to be filtered. And this work is done mainly by our liver and kidneys. To help you understand my thoughts, let’s make an analogy. Let’s imagine the human body as a river. Where in the river does waste tend to accumulate? That’s right, it’s on the tributaries of the river, at the bends in the river. Similarly, it is easy to understand why gout stones are deposited in the joints. Then how to solve the problem of gout. According to Chinese medicine, the blood moves the wind to destroy itself. Therefore, the main problem is to solve the problem of blood circulation, which is solved by opening up the meridians. At the same time, to reduce the number of garbage already in the blood, this is mainly by detoxification to solve. Therefore, only when the amount of garbage in the body is reduced, and when the meridians are open, gout stones will not be deposited in the joints at the end of the limbs. I have mentioned this piece of gout when answering some patients’ questions. In fact, every one of us has gout stones, it’s just the size. If you have a massage therapist massage your toe joints, most people, will feel a lot of pain, and this pain, in fact, is the crystallization of uric acid. The following figure: in the black spot at the point of hard rubbing press, most people will feel severe pain, this is uric acid crystals. But when you massage these parts for a long time, these uric acid crystals will be rubbed open, rubbed away, along with the blood to bring these garbage back to the kidneys filtered and discharged from the body. Therefore, to strengthen the massage of the whole body is actually to accelerate the movement of qi and blood, just like a river, to speed up the flow, the sediment will naturally be reduced. At the same time, in terms of diet, we also need to control effectively, eat more grains, vegetables and fruits, eat less meat and seafood things that are easy to form garbage, and at the same time strengthen the drinking juice to detoxify, the gout problem is often easily solved. On the contrary, if we do not pay attention to the consequences, I do not say, I think you have seen the previous article. Here I would like to remind you in particular, do not use western drugs like colchicine, such drugs, often treating the symptoms but not the root cause, but more harmful to the liver and kidneys. Like drinking hemlock to quench your thirst. Colchicine, an alkaloid, was originally extracted from the lily of the valley plant Colchicine, so the name, also known as colchicine. Colchicine has a selective anti-inflammatory effect on acute gouty arthritis, but is ineffective against general pain, inflammation and chronic gout. The toxicity of colchicine is large, common nausea, vomiting, diarrhea, abdominal pain, gastrointestinal reactions are the precursors of serious poisoning, the symptoms appear when the drug is discontinued, renal damage can be seen in hematuria, oliguria, direct inhibition of bone marrow, cause granulocyte deficiency, aplastic anemia. The symptoms appear in the limbs and five senses, and the disease exists in the five internal organs. A gout problem, reflected in the end of the limbs, is rooted in the blockage of the meridians and the imbalance of the internal organs.