Gout is a crystalline arthritis caused by disorders of purine metabolism and/or decreased uric acid excretion. Clinical manifestations include acute arthritis characterized by hyperuricemia and urate crystallization, gout stone formation, gouty chronic arthritis, and uric acid nephropathy, uric acid urinary tract stones, etc. In severe cases, joint disability and renal insufficiency may occur. Gout is often associated with central obesity, hyperlipidemia, diabetes, hypertension, and cardiovascular disease.
Modern medicine mainly adopts colchicine, non-steroidal anti-inflammatory drugs and glucocorticoids for its acute phase; intermittent and chronic treatment mainly adopts propofol, benzosulfone, benzbromarone, allopurinol and other treatments. Although the disease is controlled to some extent, there is still a lack of long-term effective treatment methods, and because of its toxic side effects patients are difficult to accept treatment, while Chinese medicine treatment has greatly improved the long-term quality of life of patients.
Treatment method]
Patients have been eating alcohol, wine, spices, heat, dampness, heat and poisonous evil in the internal organs, or by the kidneys do not open and close, the three jiao unfavorable and other reasons to cause turbid poison can not be discharged from the body, poisonous evil internal ambush, this is the root cause of the gout attack. As stated by the “Ten Thousand Diseases Back to Spring”, “all gout limb pain, pain is fire, swelling is wet …… so sorghum people, more food fried and roasted stalks forced rancid any neptunium crystalline oh said the discipline of whacking selected Yiyi (15) women’s art eh animal! The coin is played with flea nightmare carbonyl Ti oh still Tamsuo cut weft fan lack edge which honestly honestly Ying supper crab ÒàÅè¹ rake wit jing sa recite weft fan questionable evenビ谑肿愎墙凇U纭吨樊≡春盥邸费裕骸叭榷酒釉喔觯ビ谑肿悖肿阍{热赤肿痛也.” It can be seen that the internal heat and toxicity of the internal organs is the internal reason for the formation of heat paralysis, while the external wind, cold and dampness is the external reason for the formation of heat paralysis, the result of the interaction between the internal and external help, is the formation of heat and toxicity attack on the bones of the hands and feet, stagnating the tendons and veins, paralyzing the fundamental basis of the meridians.
The main contradiction of gout is recurrence, and the main root cause of recurrence is that the evil is contained within the body, waiting for an opportunity to develop. The patient’s blood uric acid continues to increase, and when it encounters a trigger, it can lead to an acute attack. The increased blood uric acid belongs to the scope of “blood toxicity” and “turbid toxicity” in Chinese medicine. Therefore, the intermittent period is mainly characterized by blood poisoning and turbid poisoning, which is in line with the viewpoint of ancestral medicine of the internal content of volatile evil. Gout patients are mostly suffering from “internal accumulation of legacy evil and then recurrence”, so gout belongs to the dialectical scope of “blood poison” and “turbid poison”.
The basic treatment for gouty arthritis is to remove the toxins, and there are six types of methods to remove the toxins. One of the ways out lies in the urine. The urine is used to clear heat and diuretic drugs to facilitate urinary detoxification, so that the poisonous evil from the front yin out. The method of detoxification and detoxification is difficult to be effective, so it is necessary to use the method of benefitting the qi and strengthening the spleen, and slowly to detoxify the toxin out, so that the remaining toxin can be purified and the positive qi can be restored.
Commonly used prescriptions]
In the acute stage of gouty arthritis, the symptoms are mainly the symptoms of the actual condition, and in the remission stage, the symptoms of the actual condition are mainly the symptoms of the deficiency of the original condition, which are divided into three types.
1. Wu Wei Disinfectant Drink and San Miao San with reduction
It is used for the acute stage of heat and toxicity, which attack the limb joints. The symptoms include redness and swelling of the skin of the toe joints, localized burning, difficulty in walking, pain as intense as that of a tiger, light day and heavy night, or generalized fever, irritable thirst and sweating, red tongue, thin yellow dry coating, and counted pulse.
Evidence: Internal heat and toxicity, attacking the limbs and joints.
Treatment: Clearing heat and detoxifying the toxin, clearing the ligaments and relieving pain.
Prescription: Radix et Rhizoma Polygonati 24g, Radix et Rhizoma Forsythiae 12g, Radix Dandelion 18g, Radix Zingiber officinale 15g, Rhizoma Rheum 9g, Radix Phellodendron 12g, Semen Coix 30g, Salviae Miltiorrhizae 15g, Radix Paeoniae Alba 15g, Radix Glycyrrhiza Uralensis 12g.
Chuan Niu Knee 24g Tu Fu Ling 30g.
2.Dioscorea Z Fenqing Drink, Paeonia Lactiflora and Licorice Soup with Addition
Used for internal brewing of dampness and toxicity, which remains in the lower part of the body. Symptoms: swelling of the toes or other joints, or joint effusion, unbearable pain, day and night, vague pain, local burning, heavy bones, red tongue, yellowish greasy coating, slippery pulse.
Evidence: Dampness and heat, turbidity and toxicity, staying in the bones and joints.
Treatment: Relieve dampness and detoxification, subdue swelling and relieve pain.
Herbs: Dioscorea Z30g, Fu Ling 30g, Yun Ling 30g, Licorice 9g, Zeligia 30g, Rhizoma Alba 24g, Radix Bupleurum 24g, Rhizoma Cyperus 12g, Phellodendron 12g, Rhizoma Rheum 6g.
3.Fangji Huangqi Tang and Pigling Tang with addition and subtraction
For the evidence of spleen deficiency and dampness in remission
Symptoms: joint pains heal from time to time, but blood uric acid is increased, urine is cloudy, the spirit is atrophied and tired, weakness with little urination, unpleasant stools, tasteless mouth, light fat tongue with thin white or greasy coating, slippery pulse.
Evidence: deficiency of spleen qi and internal production of phlegm and dampness.
Treatment: Strengthening the spleen and benefiting Qi, promoting water detoxification.
Herbs: 12g of Radix Angelicae Sinensis, 30g of Radix Astragali, 12g of Atractylodes Macrocephala, 30g of Atractylodes Macrocephala, 15g of Radix Angelicae Sinensis, 30g of Poria Cocos, 15g of Semen Coix, 30g of Plantago Asiatica, 15g of Zelenia, 15g of Zedoaria, 15g of Poria Cocos, 15g of Yam.
Case Study]
Song Zhiqiang, male, 54 years old. He had recurrent swelling and pain in the left knee and right first big toe metatarsal joint for 3 years. 3 years ago, he had swelling and pain in the left knee, followed by pain in the right first toe metatarsal joint and right elbow joint, and was diagnosed with gouty arthritis at the provincial hospital with blood uric acid of 520 mmol/L. He was treated with western medicine, which was ineffective. Since then, he had recurrent attacks and the number of relapses increased after drinking alcohol. Present symptoms: pain in the left knee and metatarsal joint of the first toe of the right foot, aggravated at night, swelling in the metatarsal joint of the first toe of the right foot, burning when touched, red tongue, thin yellow fur, string pulse. The evidence belongs to heat and toxin, attacking the bones and joints. The treatment is to clear heat and detoxify the toxin. The formula: 9g of rhubarb, 30g of Fu Ling, 30g of Coix Seed, 30g of pig ling, 30g of peony, 20g of tiger scepter, 24g of snake’s tongue, 12g of licorice, 6g of leech, 15g of forsythia, 12g of Xia Ku Cao, the above 6 pairs of decoction to be taken twice daily. The above 6 decoctions were taken twice a day and advised to abstain from alcohol, abstain from food containing high purine and drink more water.
The second diagnosis of joint pain is obviously light, sleep at night, the same as before, the coating and pulse, abide by the law to the original formula of water Fan for the pill, twice a day, each time 3g, the symptoms alleviated, so far no recurrence.
① has been sick to prevent change: the patient has long been addicted to fat, sweet and thick flavors, dampness and heat are embedded in the internal organs of the poisonous evil, the evil poison within the ambush, Chao Yuanfang “the source of diseases and the theory of” said: “heat poison gas from the internal organs out, attacked in the hands and feet, hands and feet are {heat red swelling pain also.” Dampness and heat toxin is generated internally, filling the blood vessels, and when external evil is triggered and the toxin is sent outside, paralyzing the meridians, attacking the bones, so the left foot and the first metatarsal phalangeal joint of the right knee is swollen and painful; wine is the most damp-heat, damp-heat is aggravated after drinking wine, and the more toxic heat, so there are more recurrences after drinking; at night, the blood flow is slow, so the day is light and the night is heavy, and the tongue is red with thin yellow coating, and the pulse is stringed as a sign of burning heat and toxin. In the treatment, rhubarb to facilitate the stool, Tu Fu Ling, Coix Seed, pig ling to clear heat and dampness, to facilitate the urine, to facilitate the two stools so that the evil has a way out; white peony, licorice to ease the pain; tiger stick, white flower snake tongue grass to clear heat and detoxify; leech, forsy, Xia Gu Cao to activate blood stasis, eliminate swelling and disperse nodules.
②Preventing diseases before they happen: “Su Wen – Four Qi Tuning Shen Da Lun” points out: “Therefore, the sage does not treat the disease to treat the disease, not to treat the chaos to treat the chaos, this is also known as. The disease has become and medicine, chaos has become and after the cure, such as thirst and wear well, bucket and cast cone, is not also late!” The world today unreasonable diet, more hyperlipidemia, hyperglycemia, hyperuricemia, etc., indicating that over-eating sorghum thick taste, spicy fatty sweet, alcoholic wine and meat, the residual poison, must be deep into the bloodstream gum greasy wet stasis poisonous evil, detoxification, detoxification method is to treat its symptoms, it is difficult to cure the root, in remission period need to use the method of beneficial qi spleen detoxification, slow to poison and detoxification of the product, long-term service. Therefore, before the attack, take water pills that pass stools and facilitate urination all year round to prevent recurrence.