It is not difficult to alleviate this disease, the key is how to prevent recurrence. Excessive intake of high purine food is an important cause of hyperuricemia and the chief culprit of gout. Therefore, people should control their mouths, adjust their diet structure and choose their diet reasonably. According to the level of purine content, people generally divide the diet into three categories: high purine, medium purine and low purine. High purine food, that is,100g food contains150 ~ 500mg purine. These foods mainly include: animal offal, seafood, sardines, anchovies, hairtail, clams, chicken soup and broth. Gout patients try to fast these foods. Purine food, that is, 100g food contains 50 ~ 150mg purine. These foods mainly include: poultry and livestock meat, fish, shrimp, crab, eel, white fish, flat fish, silver carp, various beans, peanuts and sesame. Gout patients should try to eat less of this kind of food. In addition, some vegetables also contain high purine, such as leeks, cauliflower, bean sprouts, pea seedlings, lentils, cauliflower, laver, fungi and so on. So it's best not to eat or eat less. Low-purine food, that is, 100g food contains less than 50mg of purine. These foods mainly include eggs, duck eggs, milk, cheese and so on. These foods are edible. Fruits and vegetables, such as radishes, carrots, tomatoes, cabbages, potatoes and so on. The content of purine is extremely low, which is the recommended food for gout patients. Studies have shown that the concentration of uric acid in blood can be reduced by about 65438 0.2 mg/L after eating a purine-free diet for 7 days. The staple food of gout patients should be mainly flour and rice, such as pasta made of refined flour and refined rice, and coarse grains should not be eaten because the purine content in flour and rice products is less than that in coarse grains. Avoid drinking. Alcohol in wine increases lactic acid in the body, which will affect the excretion of uric acid by the kidneys and easily lead to urinary calculi. Ethanol can also increase purine synthesis in the body, especially beer, which will produce a lot of purine during fermentation, which is very unfavorable to gout patients. Secondly, ensure adequate water intake and drink about 2000 ml of boiled water every day, excluding liquid foods such as milk, soup and porridge. Because about 70% of uric acid in the human body is excreted from the kidneys, the daily urine output should reach about 1800 ml. Sweating and drinking water will increase in summer. Third, pay attention to the rules of life, work and rest on time, eat regularly, and be full at seven points. Maintain an ideal weight. Avoid fatigue and mental stimulation. Exercise properly, but not vigorously, such as playing football, running fast, skating, swimming, climbing, etc. , will make the body produce too much lactic acid, inhibit the function of renal excretion of uric acid, increase blood uric acid, and cause gouty arthritis. In addition, we should have regular physical examination, strive for early detection of hyperuricemia and take timely measures to prevent gout. Gout belongs to the "arthralgia syndrome" of traditional Chinese medicine, and it is divided into four types of treatment according to the symptoms of patients: 1. Clinical manifestations of rheumatic joint pain (clearing heat and dredging collaterals, expelling wind and removing dampness): joint swelling and pain, hot pain, acute onset, involving one or more joints, often accompanied by fever, bad wind, thirst, boredom or headache and sweating. Prescription: Baihu Guizhi Decoction combined with Simiao Yongan Decoction. Ingredients: Gypsum Fibrosum, Anemarrhena asphodeloides, Japonica rice, Glycyrrhiza uralensis Fisch, Ramulus Cinnamomi, Radix Angelicae Sinensis, Caulis Lonicerae, Fructus Forsythiae, Radix Scrophulariae, Rhizoma Smilacis Glabrae, Coicis Semen, Herba Lysimachiae Christinae, and Radix Clematidis; Rhizoma Dioscoreae Septemlobae, Folium Pyrrosiae, and Fructus Chaenomelis are added for those with wet weight; For those with severe joint pain, Hu Xuan and Scorpio were added. 2. Clinical manifestations of wind-cold-dampness arthralgia (dispelling wind and cold, removing dampness and dredging collaterals): joint swelling and pain, unfavorable flexion and extension, or subcutaneous nodules or tophi. Prescription: Coix seed soup. Comprise notopterygium root, radix Angelicae Pubescentis, radix Saposhnikoviae, rhizoma Atractylodis, radix Angelicae sinensis, ramulus Cinnamomi, herba Ephedrae, Coicis semen, radix Aconiti Preparata, rhizoma Zingiberis Recens and Glycyrrhrizae radix; Radix Clematidis and Curcuma Rhizome are added for patients with severe upper limb pain; Achyranthes bidentata and papaya are added to patients with severe lower limb pain; Rhizoma Arisaematis and Squama Manis can be added for patients with subcutaneous nodules. 3. Clinical manifestations of phlegm and blood stasis block (need to promote blood circulation to remove blood stasis, eliminate phlegm and dredge collaterals): joint pain recurs for a long time, sometimes light and sometimes heavy, or stings and fixes, joint swelling, even ankylosing deformity, unfavorable flexion and extension, subcutaneous nodules or dull skin color. Prescription: Taohong Siwu Decoction combined with Erchen Decoction. Comprise peach kernel, safflower, angelica, dried rhizome of rehmannia, rhizoma Chuanxiong, radix Paeoniae Rubra, Poria, tangerine peel, licorice, radix Clematidis, rhizoma Pinelliae Preparata, pangolin scales and Shā rotto Katakuri; Scorpio and Zaocys are added for patients with chronic joint pain; Rhizoma Smilacis Glabrae and Talcum are added for severe joint pain. 4. Deficiency of qi and blood, deficiency of liver and kidney (need to tonify qi and blood, regulate liver and kidney, dispel wind and overcome dampness, dredge collaterals and relieve pain) Clinical manifestations: joint pain recurs for a long time, sometimes becomes heavier or wobbly, and even joint deformation, unfavorable flexion and extension, waist and knee pain or heel pain. Prescription: Duhuo Jisheng Decoction. Comprises Radix Codonopsis, Poria, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix Rehmanniae Preparata, Rhizoma Chuanxiong, Cortex Eucommiae, Cortex Cinnamomi, Asari, Radix Angelicae Pubescentis, Herba Taxilli, Radix Saposhnikoviae, Radix Gentianae Macrophyllae and Glycyrrhrizae Radix. Astragalus membranaceus is added for patients with obvious qi deficiency; Patients with obvious blood deficiency are treated with Spatholobus suberectus western medicine, which has many side effects. 1) Patients receiving treatment during acute attack should stay in bed and raise their affected limbs. Generally speaking, they should rest for 72 hours until the joint pain is relieved, and then resume their activities. The sooner medication is given, the better. Early treatment can quickly relieve symptoms, while delayed treatment will make inflammation difficult to control. Commonly used drugs are as follows: 1. Colchicine: It has a special effect on this disease. Start with 0.5mg per hour or every 2 hours 1mg, and stop taking it when the symptoms are relieved or there are gastrointestinal side effects such as nausea, vomiting and diarrhea. Generally, it is about 4 ~ 8 mg. Symptoms can be relieved within 6 ~ 12 hours and controlled within 24 ~ 48 hours. If the gastrointestinal reaction is too severe, dissolve 1 ~ 2 mg of this product in 200ml of normal saline and inject it slowly intravenously within 5 ~ 10 minutes. However, care should be taken not to leak the drug, and it can be re-injected after 6 ~ 8 hours depending on the condition. If there is renal insufficiency, it should not exceed 3mg within 24 hours. Because of the outstanding clinical effect, experimental treatment can be carried out on cases with difficult diagnosis, which is helpful for differential diagnosis. Side effects: 1, gastrointestinal discomfort, hemorrhagic enteritis; 2. Leukopenia; 3. Aplastic anemia; 4, hair loss; 5, myopathy; 6, liver function damage; 7. Mental depression, etc. 2. Baotaisong or Hydroxybaotaisong: It has obvious anti-inflammatory effect and can promote uric acid excretion, which is still effective for patients who have been ill for several days. The initial dose is 0.2~0.4g, and then 0. 1g every 4 ~ 6 hours. After the symptoms improved, it was reduced to 0. 1g, three times a day, and the drug was stopped after a few days. This medicine can cause gastritis and water and sodium retention, and is prohibited for patients with active ulcer and cardiac insufficiency. Occasionally, there will be side effects of leukopenia and thrombocytopenia. 3. Indomethacin: The initial dose is 25 ~ 50mg, once every 8 hours. After the symptoms are relieved, take 25mg twice or three times a day for two to three days. The curative effect is similar to that of butazone, and the side effects are gastrointestinal irritation, water and sodium retention, dizziness, headache, rash and so on. Active peptic ulcer is prohibited. Toxic and side effects: 1, gastrointestinal reaction, bleeding, ulcer, perforation and active peptic ulcer are prohibited; 2, rash dermatitis; 3. Leukopenia and thrombocytopenia; 4, headache, dizziness; 5. Temporary depersonalization; 6, liver and kidney function damage. 4. Ibuprofen (Ibuprofen Propionate): It is a non-steroidal anti-inflammatory and analgesic drug, 0.2~0.4g, 2 ~ 3 times a day, which can quickly control acute symptoms within two or three days. The drug has little side effect, and has no obvious effect on hemogram and renal function, and occasionally gastrointestinal reaction and transaminase increase. 5. Tong Yan Xi Kang: The drug effect lasts for a long time, 20mg once a day, and occasionally there is gastrointestinal reaction. Long-term medication should pay attention to hemogram and liver and kidney function. 6. Naproxen (Xiaotongling): a non-steroidal anti-inflammatory and analgesic drug. Its anti-inflammatory effect is 1 1 times that of butazone, its analgesic effect is 7 times that of aspirin, and its gastrointestinal reaction is small. Take 500 ~ 750 mg orally every day, and take it twice. 7.ACTH and prednisone: when the condition is serious and colchicine and other treatments are ineffective, ACTH25mg can be added to glucose for intravenous drip or 40 ~ 80mg for intramuscular injection. This medicine takes effect quickly, but it is easy to rebound and relapse after stopping taking it. Colchicine 0.5mg can be added two or three times a day to prevent rebound. Triamcinolone acetonide 5 ~ 20 mg can also be injected into the arthritis site for treatment. Oral prednisone is also quick-acting, but it is easy to relapse after stopping taking drugs. Long-term use of hormones is easy to cause complications such as diabetes and hypertension, so try not to use it. (2) Intermittent and chronic treatment to prevent acute attack of gout. In order to prevent all kinds of complications, active treatment is still needed at this stage. 1. General treatment: Diet control is very important. Avoid eating a high purine diet. Purine is the most abundant in animal viscera, bone marrow, seafood, clams and crabs. Fish and shrimp, meat, peas, spinach, etc. It also contains a certain amount of purine; Vegetables, fruits, milk, eggs, etc. Purine-free Obese patients must reduce calorie intake and lose weight. Drink plenty of water to excrete uric acid. Avoid inducing factors such as overwork, tension, drinking, cold, humidity and joint injury. 2. Application of drugs for lowering serum uric acid: those whose serum uric acid concentration is still above 7 ~ 8 mg/dl after diet control; Acute attack more than twice a year; X-ray evidence of tophi or urate deposition; People with kidney calculi's disease or renal insufficiency; There are indications for using drugs to reduce serum uric acid. If the serum uric acid can be maintained at normal or near normal level after taking the medicine, it can often prevent the acute attack of gout, prevent the formation of tophus and reduce the damage to the kidney. There are two groups of drugs to treat hyperuricemia: promoting uric acid excretion and inhibiting uric acid synthesis. These two groups of drugs have no anti-inflammatory and analgesic effects, and may mobilize uric acid into the blood circulation during use, leading to acute arthritis, so they are not suitable for acute application. Which group of drugs to choose often depends on the patient's renal function and 24-hour uric acid excretion. Those with good renal function and below 600mg per day can use uric acid excretion drugs, and those with decreased renal function and above 600mg per day can use uric acid synthesis inhibitors. For patients with obvious increase of blood uric acid and massive deposition of tophi, it can also be used together to accelerate the decrease of blood uric acid and the regression of tophi. At present, there are three commonly used drugs to excrete uric acid: (1) probenecid, which mainly inhibits the reabsorption of uric acid by renal tubules and leads to uric acid diuresis. In order to prevent kidney damage and kidney calculi's side effects caused by uric acid discharged from the kidney in large quantities, the drug is often used in small doses, starting with 0.25g twice a day and increasing to 0.5g three times a day within two weeks, with the maximum daily dose not exceeding 2g. About 5% patients have skin rash, fever, gastrointestinal irritation, renal colic, acute attack and other side effects. (2) Sulfophenylpyrazolone: a derivative of phenylbutazone, which inhibits renal tubular reabsorption of uric acid. Its uric acid excretion is stronger than probenecid. Starting from a small dose, 50mg twice a day, gradually increasing to three times a day 100mg, and the maximum dose is 600mg per day. It has synergistic effect when combined with probenecid. This medicine can stimulate gastric mucosa, so patients with peptic ulcer should use it with caution. (3) Benzbromarone: a powerful diuretic, widely used in Europe for many years, with a dose of 25 ~ 100 mg once a day. Its toxic effect is slight and does not affect the function of liver and kidney. Rash and fever rarely occur, but they can cause gastrointestinal reaction, renal colic and acute arthritis. During the treatment of uric acid excretion drugs, take 3 ~ 6g of sodium bicarbonate orally every day, alkalize urine, and drink more water, and keep the daily urine volume above 2000ml to excrete uric acid. So far, only hydroxypurinol is a drug that inhibits the synthesis of uric acid. The drug can inhibit xanthine oxidase, so that hypoxanthine and xanthine can not be converted into uric acid, and gradually oxidized in human body to generate water-soluble isoxanthine, which can be excreted in urine in the presence of PRPP and converted into corresponding nucleotides, which consumes PRPP and inhibits PRPP Pat. It can reduce the synthesis of IMP, so it can quickly reduce the concentration of blood uric acid, inhibit the synthesis of tophus and renal uric acid stones, and promote the dissolution of tophus. The dosage of 100mg can be increased to 200mg three times a day. Combined use with uric acid excretion drugs can enhance the curative effect, but generally it is not necessary to use them together. Individual patients may have side effects such as fever, allergic skin rash, abdominal pain, diarrhea, leukopenia and thrombocytopenia, and even liver function damage. Generally, it can be recovered after stopping the drug and giving corresponding treatment. Occasionally necrotizing dermatitis is serious and should be treated immediately. Uric acid metastatic gout attack can also occur during medication, which can be supplemented with colchicine treatment. 3. Application of colchicine: In patients with recurrent gout, chronic inflammation is not easy to control. Despite the above treatment, there is still local joint pain or acute attack. At this time, low-dose colchicine can be used to maintain symptoms, and 0.5mg or 1mg per day is often enough to control symptoms, but attention should be paid to the inhibition of colchicine on bone marrow and the damage to liver and kidney function. 4. Others: Patients with complications such as hypertension, coronary heart disease, obesity, urinary tract infection and renal failure must be treated symptomatically. People who have difficulty in joint movement must receive physical therapy and exercise. Those whose tophi breaks into fistulas should be surgically removed. (3) There are different opinions on the treatment of asymptomatic hyperuricemia. It is generally believed that people with serum urate concentration below 8 ~ 9 mg/dl do not need medication, but they should avoid overeating (especially high purine diet), alcoholism, overwork, trauma and mental stress and other factors that induce acute attacks. Patients with hyperuricemia should be treated with isoprene alcohol.