It needs to be treated from three aspects: improving lifestyle, properly alkalizing urine and drug treatment.
Improve lifestyle:
1. Drink more boiled water: If you want to reduce uric acid, you need to drink more water. Drinking water can promote urination. You should maintain a daily liquid intake of 1.5 to 2 liters, and increase it to 3 liters in kidney calculi to increase uric acid excretion. Mainly boiled water, do not drink, especially beer; Don't drink strong tea, sugary drinks and vegetable soup.
2, healthy diet: people with gout and hyperuricemia, the diet should be based on low-purine food. Diet therapy can reduce serum uric acid by about 10%- 18% or 70-90μ mol/L. ..
Foods with high purine content include animal viscera, seafood, broth, fresh beans, nuts, mushrooms, laver, red meat (pork, beef and mutton) and so on. At the same time, some foods with low purine content will affect uric acid metabolism and lead to an increase in blood uric acid, such as beer, honey and sweets. This also needs to be restricted.
3, eat less white meat, do not eat red meat: meat is the heart of many wind friends, but in order to be healthy, we must control our diet, and only eat a proper amount of white meat: poultry, such as chickens, ducks and geese; Don't eat red meat: the meat of mammals, such as pigs, cows and sheep. Don't even eat white meat when gout attacks.
4. Winter melon soup: Friends with high uric acid can drink winter melon soup. The method of making winter melon soup is very simple. Cut the wax gourd into thin slices, then add a little oil to the water and cook the wax gourd. Winter melon soup has a very good diuretic effect, which can promote the excretion of human urine and reduce the concentration of uric acid.
5. Keep exercising and control your weight: Exercise moderately for more than 30 minutes every day. Obese people should lose weight and control their weight within the normal range. People with diseases should exercise under the guidance of professionals when necessary.
Why alkalize urine?
Generally, when the pH value of urine is between 6.2 and 6.9, it is beneficial to the dissolution of urate crystals and the excretion of uric acid in urine. Therefore, when the pH value of urine is lower than 6.0, it is necessary to alkalize urine. However, it should be noted that urine pH >: 7.0 is easy to form stones such as calcium oxalate. Therefore, in the process of alkalizing urine, the pH value of urine should be detected. Sodium bicarbonate or sodium potassium citrate is usually used to alkalize urine.
How to choose drugs to reduce uric acid?
At present, the common drugs in clinic are allopurinol which inhibits uric acid synthesis and benzbromarone which increases uric acid excretion.
1, allopurinol
(1) indications: ① For the treatment of chronic primary or secondary gout, colchicine or other anti-inflammatory drugs must be used at the same time to control the acute gout attack, especially in the first few months of treatment: ② for the treatment of uric acid nephropathy with or without gout symptoms; ③ For patients with recurrent uric acid stones; ④ It can be used to prevent urate deposition and kidney calculi in tissues after chemotherapy or radiotherapy for leukemia, lymphoma or other tumors.
(2) Precautions: The serious adverse reactions of allopurinol are related to the dosage. When the minimum effective dose can make the blood uric acid reach the standard, try not to increase the dose.
(3) Adverse reactions: including gastrointestinal symptoms, rash, liver function damage, bone marrow suppression, etc. , should be monitored. About 5% of patients can't stand it. Occasionally, there will be a serious "allopurinol allergy syndrome".
2. Benzbromarone
(1) indications: primary and secondary hyperuricemia, intermittent gouty arthritis and gouty nodular swelling, etc. Long-term use has no obvious effect on kidney, and it can be used for Ccr> patients with renal insufficiency for 20 ml/min. There is no need to reduce the dosage of 60 ml/min for Ccr> adults, 50 ~ 100 mg per day. Under normal circumstances, after taking benbromarone for 6 ~ 8 days, the serum uric acid is obviously decreased, and the intensity of reducing serum uric acid and the reaching rate are stronger than allopurinol. Long-term treatment 1 year or more (average 13.5 months) can effectively dissolve tophi. The drug has no drug interaction with antihypertensive drugs, hypoglycemic drugs and lipid-regulating drugs.
(2) Precautions: During the treatment, it is necessary to drink plenty of water to increase urine volume (the water consumption should not be less than 1500 ~ 2000 m 1 at the initial stage of treatment) to promote uric acid excretion. Avoid excessive excretion of uric acid to form urinary calculi. Sodium bicarbonate or citric acid mixture can be given as appropriate two weeks before starting medication, so that the pH value of the patient's urine can be controlled between 6.2 and 6.9. Regularly measure the pH of urine.
(3) Adverse reactions: gastrointestinal discomfort, diarrhea and rash may occur, but they are rare. Rare liver function damage, the incidence reported abroad is117000.