The acute flare-up of gouty arthritis is the days when the patient is just in pain. With treatment, the pain can usually be relieved. However, the principles of treatment for the acute and remission phases of gout are not the same. I have met many gout patients in the clinic and found that most of them have a misunderstanding of the medication for gout. Some of them think that painkillers are the “cure” for gout, so they don’t care about the uric acid indicator when the pain is relieved, and let it stay high and wait for the next attack before going to the hospital. As a result, the attacks become more frequent and more severe. Other patients, who are a little more aware of this, know that there are medications that can lower uric acid. However, they mistakenly believe that these medications can treat acute attacks of gouty arthritis, which leads to prolonged and worse acute pain periods. The first thing is to rest during an acute attack of gouty arthritis; the second thing is to take painkillers in time; the third thing is to drink more water to promote urination on the basis of a regulated diet. 1, drug treatment After an acute attack, rest and apply cold compresses to the affected area. You can go to the hospital to apply external heat-clearing and anti-inflammatory herbs, and you can use ice packs at home to apply cold compresses on your own. Then immediately take anti-inflammatory and pain-relieving drugs, such as diclofenac sodium, ibuprofen. If the symptoms are severe, glucocorticoids can be used in small amounts. 2.Diet adjustment Gout patients who have been confirmed to have hyperuricemia by laboratory test must strictly regulate their diet and control the intake of high purine food to promote the decrease of blood uric acid level. Beer is never to be drunk, and other alcohol is better to quit as well. Some patients feel that if they don’t drink alcohol, then they should drink beverages instead. It is not known that many high sweetness drinks can also promote the increase of blood uric acid. Soy products, seafood, and animal offal are to be controlled as much as possible. This concept has been deeply rooted. Finally, there is a clear indicator of the amount of water to drink, that is, 2L per day. general mineral water is 500 to 600ml a bottle, then refer to about 4 bottles of mineral water that amount to drink. Remember to have a glass before going to bed. Drinking water before going to bed, although it increases the trouble of getting up to go to the toilet, but can reduce the chances of acute attacks of gout due to blood concentration at night. 3, when to apply uric acid-lowering drugs Uric acid-lowering drugs are generally used after 2 weeks of acute inflammation control – that is, after no more pain, and then wait half a month. Patients with recurrent gout attacks, the presence of gout stones and urinary tract stones should take uric acid-lowering drugs. Patients who have a first attack and do not have any of the above-mentioned comorbidities may not need uric acid-lowering drugs for the time being, as there are risks associated with the use of such drugs. These patients should first control their diet and drink plenty of water, and have their blood uric acid reviewed regularly. If the blood uric acid is poorly controlled and the arthritis flares up again within 1 year, uric acid-lowering drugs should also be taken. The blood uric acid level should be maintained at ≤ 360 μmol/L (6.1 mg/dl). It is important to note that this indicator is lower than the highest value of the normal range suggested by general blood tests (usually around 400 μmol/L). A sufficiently low blood uric acid value is necessary to reduce the chance of gout recurrence and to promote the dissolution of gout crystals in the joints. The commonly used uric acid-lowering drugs are: propofol, benzbromarone, allopurinol, and the new clinical drugs are febuxostat (or febuxostat). Although they are over-the-counter drugs, they should be checked at the hospital before taking them and taken when it is clear that the liver and kidney functions allow it. Moreover, the liver and kidney function should be reviewed regularly during the taking period.