Gout is a common, multiple metabolic disease caused by disorders of purine metabolism, with acute and chronic attacks, often threatening the health and life of middle-aged and elderly people. According to statistics, the peak age of gout onset is around 50 years old. 63% of people develop gout after the age of 50, and the incidence is four times higher in women after menopause than before menopause. The incidence is much higher in men than in women. The occurrence of gout causes a lot of pain and inconvenience to middle-aged and elderly people. I. What is gout? Gout is a metabolic disorder of a substance called purine in the body, which increases uric acid, the end product of purine metabolism in the blood, so it is also called not hyperuricemia. Long-term hyperuricemia can cause uric acid salts to be deposited in the form of crystals in the joints, resulting in acute arthritis, or in the kidneys, resulting in uric acid nephropathy, both called gout. The cause of gout has not been fully identified, and some patients have a family history of mostly congenital purine metabolism defective disease. Some scholars have suggested that such congenital metabolic abnormalities can be inherited through heterozygous hemizygosity, with the affected gene in the X chromosome, and this type of gout is called primary gout. There is another type of gout, because of leukemia, lymphoma and other cancers, resulting in a large amount of nucleic acid decomposition in the human body and excessive production of uric acid; or because of the application of certain drugs, such as thiazides, salicylates, etc., which inhibit the excretion of uric acid by the kidneys; or because of reduced kidney function, uric acid excretion is reduced, these can cause excessive blood uric acid, and therefore called secondary gout. In addition, alcoholism, overeating and fatigue are also common triggers of gout. In addition, the kidney function of the elderly often has the same degree of decompensation, which can also cause the elderly to suffer from gout. What are the clinical manifestations of gout? Gout patients may have no clinical symptoms in the early stage, and occasionally find elevated blood uric acid during physical examination, and some patients only have simple hyperuricemia for many years, sometimes due to trauma, infection, alcoholism, fatigue, mental stress, etc., may trigger the aggravation of the disease, often with sudden onset, manifested as the first toe joint of the foot or thumb joint severe pain, accompanied by local redness, swelling, fever, etc., other joints such as wrist, elbow, ankle can also develop, while the shoulder, hip and other large joints rarely develop. Other joints such as the wrist, elbow and ankle can also develop, while large joints such as the shoulder and hip are rarely seen. The acute phase lasts about 1 week, and the signs and symptoms may resolve on their own. However, there may be repeated attacks, and after a long period of illness, the joints may be deformed, and gout stones may be palpable in the damaged local subcutaneous tissue or auricle. How to treat gout? For those whose blood uric acid is higher than 540 micromol/liter (9 mg/dl) for a long time, drugs that inhibit uric acid synthesis can be taken for a short time. During the acute arthritis period, the treatment includes bed rest, drinking more water and taking baking soda (sodium bicarbonate) to make the urine alkaline to facilitate the excretion of uric acid, which tends to form crystals in the kidneys in acidic urine. In addition, alcohol must be avoided and a low purine diet is required. The main treatment is to control pain and reduce the inflammatory response, and the drug of choice is colchicine. The first choice is colchicine, because the elderly are often accompanied by various organ function decreases, colchicine is easy to cause adverse reactions, if there is tolerance, you can use anti-inflammatory pain, inflammation pain Xikang, Pau Taisong and other non-hormonal anti-inflammatory and analgesic drugs, in the acute stage, suspend the use of drugs that inhibit uric acid production and promote uric acid excretion. It is important to be hospitalized for regular, systematic, scientific and effective treatment. Fourth, in the interval of acute arthritis attacks and chronic arthritis period of elderly patients, often with persistent hyperuricemia and gout stones, should take long-term treatment. The main purpose is to use drugs that excrete uric acid or inhibit uric acid synthesis in order to reduce the concentration of blood uric acid and keep it within the normal range. If the kidney function is still good, drugs that increase uric acid excretion, such as propofol, can be taken. In elderly patients with renal insufficiency, drugs that inhibit uric acid production, such as allopurinol, are appropriate. For those with joint movement disorders, physiotherapy and sports therapy can be carried out. V. What methods should be taken by middle-aged and elderly people to prevent the occurrence of gout? The main points are as follows: 1. Middle-aged and elderly people must experience the item of blood uric acid during the annual health check-up, especially those who take drugs that affect uric acid excretion; once the blood uric acid is found to be increased, it should be reviewed regularly. For the middle-aged and elderly people who are obese and addicted to drinking alcohol, pay attention to check the blood uric acid, and if it continues to increase, find out the reason to eliminate it; if no reason can be found, and the blood uric acid is higher than 540 micromol/l (9 mg/dL) for a long time, you can take medicine to treat it under the guidance of the doctor. 2. Middle-aged and elderly people who are obese should reduce their body weight. The amount of calories eaten should be calculated according to the amount of activity of each person. Proper physical activities can make the weight gradually reach the ideal level. 3.Be careful to control the diet. Some foods have high purine content and should not be eaten too much, such as animal offal, fish roe, beans, beer, fermented foods, etc. Do not drink alcohol and drink more water. Drinking more tea can promote the discharge of uric acid salts. 4, if suffering from acute gouty arthritis, timely treatment, even after the acute phase has passed, must still adhere to treatment to reduce recurrence and prevent joint deformity.