Gout is a curable and refractory metabolic disease, and gout patients can achieve the goal of cure with early, standardized and up-to-standard treatment under the guidance of a specialist. Analyzing my successfully cured gout patients, the vast majority of them are profoundly aware of the value of life and the preciousness of health, and thus are able to consciously resist bad habits; some of them have successfully controlled their weight and some have changed their dietary habits. In conclusion, in addition to the correct guidance from doctors, the key to successfully controlling recurrent attacks of gout also depends on oneself. Myth 1: Hormones are more dangerous than tigers, so you need to be cautious when choosing them. 1. Many people are afraid of hormones, which have many side effects, such as obesity, high blood pressure, high blood pressure, diabetes, osteoporosis, cataracts and stomach bleeding. Therefore, many people think that “hormones are more dangerous than tigers” and do not use them if they can. It is worth noting that these side effects of hormones are caused by long-term use. In the acute stage of gout, if you need to use hormones, use them for a short period of time under the guidance of a rheumatologist, and at the same time with drugs to prevent the side effects of hormones, generally speaking, they do not affect our body much, so there is no need to worry about it. 2. Hormones are not a conventional weapon for anti-inflammatory pain relief in the acute stage of gout, but are used as the ultimate weapon, just like the atomic bomb. So what kind of gout patients need to use hormones? Generally speaking, when non-steroidal anti-inflammatory drugs or colchicine are ineffective or intolerable, or acute gout with severe and recurrent attacks, or advanced stage and already have impairment of body function such as impaired kidney function (at this time, colchicine and non-steroidal anti-inflammatory painkillers can no longer be used), short-term use of hormones is possible for such patients. Myth 2: The use of colchicine 1. It is now believed that the use of low-dose colchicine in the acute phase of gout is equally effective and has significantly fewer side effects than high-dose colchicine (colchicine 0.5 mg, 3 times a day is recommended in the acute phase of gout diagnosis and treatment guidelines at home and abroad). “It has been eliminated. 2.Do I need to use colchicine in the non-acute stage? It is true that the first task of gout remission is to lower uric acid treatment, but it is necessary to use colchicine prophylactic anti-inflammatory at the same time during gout remission. The so-called prophylactic anti-inflammatory treatment means taking 0.5 mg (1 tablet) of colchicine daily along with uric acid-lowering medication, and the guidelines recommend a course of treatment for at least six months. Because, after taking uric acid-lowering drugs, the blood uric acid level drops suddenly, which can easily induce acute attacks of gout. Adding small doses of colchicine can not only reduce the acute attacks of gout, but also reduce the repeated fluctuations of uric acid, which is more conducive to the continuous and smooth reduction of uric acid to reach the standard. The actual pain is not painful, but the clinical situation often encounters this kind of patients who “forget the pain”, who will actively cooperate with the treatment in the acute attack of gout, but immediately stop the medication in the remission period, as soon as the doctor’s instructions are forgotten to the “ninth cloud”. The patient will continue to eat and drink. Only when the blood uric acid is controlled to the standard, can we fundamentally control the reoccurrence of gouty arthritis and prevent the related diseases caused by hyperuricemia. If only “pain treatment, no pain treatment” is “treating the symptoms but not the root cause”, and cannot control the uric acid level fundamentally, future gout attacks will become more and more frequent, and the resulting long-term harm is often very serious, such as joint deformity, uric acid nephropathy, stroke Therefore, the treatment of gout is a long-term project, and it is a long way to go. Myth 4: Gout attacks during uric acid reduction 1. There is a common phenomenon that gout patients have gout attacks after taking uric acid reducing drugs during the process of uric acid reduction, at this time many patients will think that it is the fault of uric acid reducing drugs, so they “angrily” stop the uric acid reducing drugs. In fact, this is completely wrong, the consequence is that gout continues to attack for a long time and can not be cured. This is a reaction to the effectiveness of uric acid-lowering drugs. Gout patients use uric acid-lowering drugs after the uric acid drops quickly, the uric acid crystals in the patient’s body will dissolve into uric acid particles, as the “snowman melted”. The urate particles that fall off the urate crystals are deposited on other joints in the body, causing pain, which is the process of the medication taking effect. What we should do at this point is to use a combination of colchicine or anti-inflammatory drugs to prevent the recurrence of gout. If we can keep the blood uric acid level below 360umol/L (for patients with obvious gout stones, it is recommended to control the blood uric acid level below 300umol/L), the gout stones deposited in the body can gradually dissolve and disappear, and no more attacks will occur, thus achieving the possibility of curing gout. Myth 5: Use antibiotics for acute attacks of gout 1. Many gout patients and even some non-specialist doctors will choose to use antibiotics for acute attacks of gout, such as intravenous penicillin and cephalosporin antibiotics, based on the belief that if there is redness, swelling and heat in the joints, then there must be a bacterial infection. The key is to use antibiotics for a period of time after the gout patients joint swelling and pain can also be relieved! 2, back to the point, gout acute attack need to use antibiotics? The answer is no. Because an acute attack of gout is a sterile inflammatory response caused by the deposition of uric acid crystals in the joints and surrounding tissues, it generally does not require antibiotic treatment unless the gout patient has a secondary infection or a combined infection in another part of the body, supported by clear evidence of infection and laboratory indicators. Then why many gout patients can be relieved of joint swelling and pain for a period of time after using antibiotics in the acute phase? In fact, it is not the effect of antibiotics, but the self-limiting nature of the acute phase in patients with early, less severe gout, so that the swollen and painful joints can be relieved naturally. The gout patients who use antibiotics tend to have recurrent attacks, one more serious than the other. So how should the acute stage of gout be treated? The current domestic and international gout guidelines recommend the use of non-steroidal anti-inflammatory analgesics, colchicine and glucocorticoids for the treatment of acute attacks of gout, with the aim of anti-inflammation (non-infectious inflammation of the joints caused by uric acid crystals) and pain relief (relief of severe pain in patients). Misconception 6: believe in surgery Modern medicine believes that gout belongs to the category of internal diseases (rheumatism), and even patients with gout stones are generally not preferred to surgery, unless the stones have caused damage to organ function and seriously affected the quality of life. If the blood uric acid level of gout patients does not meet the long-term standard, gout stones will continue to form and the surgical incision will be difficult to heal after surgery, which will greatly affect the quality of life of patients. For patients with gout stones, it is recommended to lower the uric acid to below 300umol/L. The gout stones may slowly soften and even be gradually absorbed. If you believe too much in surgery and ignore the standard medication for gout, the gout stones will only grow like a weed, “one year after another”. The first thing you need to do is to get rid of the problem. The question of “what you can eat” and “what you can’t eat” is one that almost every gout patient will ask. There is no doubt that a high purine diet (e.g. animal offal, seafood, beer) is a common cause of gout, but endogenous purine metabolism disorders are also an important mechanism for gout attacks. Traditionally, it is believed that the daily diet of gout patients should be strictly limited in purine intake, but in recent years, with the publication of research reports on gout mechanism and diet, some old dietary concepts of gout have been gradually corrected and some new concepts have been gradually proposed and emphasized. For example, gout patients are not absolutely “unrelated” to seafood. Seafood has a high nutritional value for people, and is better than meat for human health. At the same time, seafood, especially oily fish, is rich in unsaturated fatty acids, the body’s main source of unsaturated fatty acids, which may have a protective effect on the human cardiovascular system. And gout patients are a high prevalence of cardiovascular disease, so it does not mean that gout patients can only be “monks” eat vegetarian. There is no need for gout patients to choke on a vegetarian diet for a long time, and a long-term vegetarian diet can easily lead to malnutrition. Gout patients are advocating a controlled purine intake. Many studies have shown that if gout patients maintain their blood uric acid at the standard level (below 300umol/L), it is not alarming to eat foods with high purine content such as beef, lamb, shrimp and crab in moderation during the remission period. Seafood with low purine content: mackerel, herring, salmon, anchovy, tuna, white fish, lobster, crab, oyster, etc. Myth 8: The lower the blood uric acid, the better Most gout patients have kidney involvement, especially chronic gout patients, serious joint destruction deformity, kidney function damage and even uremia, gout patients are often accompanied by hyperlipidemia, hypertension, diabetes, atherosclerosis and coronary heart disease, seriously endangering the quality of life of patients. Therefore, many gout patients may think that since high uric acid is so harmful to the body, the lower the uric acid, the better. However, there are two sides to everything, the contradiction is the unity of opposites, and the lower the uric acid, the better. Large-scale epidemiological studies worldwide have found that uric acid is associated with degenerative lesions in brain tissue. Below normal uric acid can cause diseases such as Alzheimer’s and multiple sclerosis. The researchers used five years to compare 59,204 gout patients in the United Kingdom with 238,805 non-gout patients, a group with an average age of 65 years, who were similar. The study found that there were 309 cases of Alzheimer’s disease among gout patients and 1,942 cases among non-gout patients. The rate of Alzheimer’s disease was 24 percent lower in the gout patients than in the other group. The reason for this may be that uric acid protects against oxidative stress and it may help to slow down neurological aging. In addition, there are studies that show that uric acid is effective in maintaining blood pressure, and that low uric acid increases the risk of cardiovascular disease and dementia. We cannot ignore the beneficial aspects of high uric acid while paying attention to its harmful effects, in short, the right amount is beneficial, too much is harmful, yin and yang secret, gout patients to lower uric acid treatment generally blood uric acid level of not less than 180umol/L is appropriate. Myth 9: Gout cannot be cured As mentioned before, gout patients need anti-inflammatory and pain-relieving treatment in the acute stage, and uric acid-lowering treatment in the remission stage, so how long does uric acid-lowering treatment take, and does it require long-term medication? This question is often asked by gout patients in daily outpatient clinics, and doctors usually answer “the medicine needs to be taken for a long time”. In fact, many doctors do not know exactly how long the “long-term period” is for each person. We need to realize that gout, hypertension and diabetes are all chronic diseases, and hypertension has a goal of lowering blood pressure, diabetes has a goal of lowering sugar, and gout has a goal of lowering uric acid. Textbooks used to tell us that once uric acid treatment is started, it needs to be maintained for life to keep the blood uric acid level at the standard level. My personal clinical experience is that if the blood uric acid level is maintained below 300 (with gout stones) or 360umol/L (without gout stones) for more than a few months or even years, the gout stones deposited in the body will gradually dissolve and disappear, and the attacks will no longer occur (just like the bandits in Wulong Mountain have all been eliminated after a long period of banditry), and some patients can maintain the uric acid level at the standard for a long time through their own regulation, and can even stop taking the medication. In the future, as long as the diet is controlled, the gout will not recur, which is considered a clinical cure, which is the meaning of the current domestic and international belief that gout is a curable rheumatic disease. This is the meaning of gout as a curable rheumatic disease at home and abroad. At present, gout is considered to be a curable and refractory rheumatic disease, and patients with gout can achieve the goal of cure only by early, standardized and standardized treatment under the guidance of rheumatologists.