Monday, June 22, 2020

Gout knowledge Daquan, you want to know all here!

What is gout?

Gout is an ancient disease. According to Egyptian archaeological findings, gout was found in the bone remains very early. When the purine metabolism in the body is disordered, the synthesis of uric acid is increased or the excretion is reduced, resulting in increased uric acid, which is hyperuricemia such as male>420umol/L female>360u mol/L. When the concentration of uric acid in the blood is too high, uric acid is deposited in the form of sodium monourate crystals in the joints, cartilage and kidneys, causing chronic, recurrent attacks of tissue foreign body inflammatory reaction, which is gout. The record of the disease name of "gout" in traditional Chinese medicine was first seen in "Gezhiyulun·Gout" by Zhu Danxi, a physician in the Jin and Yuan Dynasties. The medical doctor Gong Tingxian of the Ming Dynasty pointed out that the disease is closely related to diet, and is also known as "the emperor's general disease", "wine disease" and "rich disease".

What are the symptoms of gout?

When the acute gout attacks, the joints appear red, swollen, hot, and severe pain. Some patients have attacks at night, and the first metatarsophalangeal joints of the ankle, knee, wrist, and elbow joints are severe, and the joints are severely painful. .

Who suffers from gout?

There are more males than females, mostly middle-aged and elderly men, and post-menopausal women. However, gout is younger and younger men are not uncommon. The prevalence in coastal areas is higher than in inland areas, and the prevalence in southern areas is higher than that in northern areas. The incidence of patients with family history of gout is significantly higher than that of the normal population. It is related to the frequent drinking of alcohol, the preference of eating seafood offal, causing hypertension, hyperlipidemia, obesity, and diabetes metabolic disorders. And it is related to wind and cold, vigorous exercise, a lot of sweating, and exposure to special chemical substances such as paint.

What are the hazards of gout?

Joint swelling and pain is only one of the clinical manifestations of gout. Patients should be alert to the harm caused by long-term high uric acid to the kidneys, heart and brain and blood vessel system. It can cause kidney stones, impaired kidney function, stroke, diabetes, myocardial infarction, atherosclerosis, etc.

What are the gout medications?

Modern medical treatment: Analgesic drugs: non-steroidal anti-inflammatory drugs (diclofenac, meloxicam, etoricoxib, etc.), colchicine, glucocorticoids; drugs that inhibit uric acid synthesis, including febuxostat, allopurinol Drugs that promote uric acid excretion, including benzbromarone; sodium bicarbonate to alkalize urine.

Motherland medical treatment: Chinese medicine orally taking Simiaosan addition and subtraction, Xuanbi soup addition and subtraction, topical preparation of our department's characteristic preparation rheumatism and swelling and pain relief cream can achieve good results.

What are the dietary notes of gout?

1. It is necessary to avoid all kinds of alcohol, animal offal, seafood, soup, and soup.

2. Meat red meat refers to the meat of mammals such as pork, beef, lamb, etc. Red meat is rich in purines, leading to an increased risk of gout. White meat refers to poultry meat. Daily intake of moderate amounts of poultry meat has little effect on blood uric acid levels. Poultry has high purine content in the skin and rich fat in the subcutaneous tissues, so skin should be removed when eating poultry food.

3. High fructose syrup, also known as fructose syrup or glucose isomer syrup, is a mixed syrup composed of glucose and fructose processed from corn as a raw material. It is widely used as a nutritive sweetener in carbonated beverages and fruit juices. In beverages, sports drinks, snacks, syrups, jellies and other sugar-containing products. High fructose syrup sugary drinks and juices have the same risk of gout as beer.

4. Fruits, fruits rich in fructose are positively correlated with the increase in the incidence of gout, so even without diabetes/metabolic syndrome, gout patients should eat less fruits with higher fructose, such as apples, figs, oranges, grapefruit, litchi , Persimmon, longan, banana, bayberry, pomegranate, etc. Fruits with low fructose content such as green plum, cucumber, watermelon, coconut water, grapes, strawberries, cherries, pineapples, peaches, plums, olives, etc. have little effect on gout, and patients with gout can increase their intake. Gout patients can increase the intake of cherries to prevent gout attacks.

5. Beans and soy products. Beans and soy products (such as tofu brain, tofu, soy milk, etc.) are traditional foods in Asia. In the past, they were considered to be high purine foods. It is recommended that patients with gout avoid eating. Current research has found that the uric acid excretion of legumes exceeds the effect of increased purine-containing blood uric acid synthesis.

Diet control includes not only the choice of food types, but also the control of quantity and calories. Special emphasis, no matter how important the importance of diet control, in the end it can not replace uric acid lowering medication. Strict diet control can only reduce blood uric acid by 60-90╬╝mol/L, and excessive diet control is more harmful to health.

How to improve the gout lifestyle?

1. Eat quantitatively or eat fewer meals frequently, do not overeat or eat a large amount of meat in one meal, and use less irritating seasoning.

Drink plenty of water.

2. Non-smoking: regular smokers around people have a 35% higher risk of developing gout/hyperuricemia than those around them

3. Avoid sudden cold

4. Adhere to exercise and control body weight. The greater the BMI, the higher the risk of gout. Reducing body weight can reduce the risk of hyperuricemia and ventilation. Obese people should lose weight to keep their weight within the normal range, and adhere to moderate-intensity exercise for at least 30 minutes every day.

Precautions for patients with gout?

For gout attacks, especially chronic gout arthritis, you should rest to avoid joint fatigue, in order to facilitate recovery. For patients with chronic joint injury, vigorous exercise is not recommended, to avoid the exercise of longitudinal pressure on the joint to prevent fractures and joint dislocation. Patients with high uric acid and gout are suitable for aerobic exercise and regular exercise. There are many aerobic exercises suitable for gout patients: walking, brisk walking, jogging, tai chi, radio exercises, swimming, skipping rope, dancing, yoga, non-confrontational table tennis, basketball, volleyball, badminton, etc. Replenish water after exercise, lemonade or soda is recommended. 

Is uric acid lowering treatment necessary?

Long-term hyperuricemia will accelerate the progression of chronic kidney disease, which will further reduce the kidney's ability to excrete uric acid. Long-term improper use of drugs that promote uric acid excretion may lead to blockage of the renal tubules and quietly form kidney stones, thereby accelerating kidney Disease progression. Controlling uric acid is extremely important. To follow the doctor's advice, regularly review the blood uric acid level every 2 months. If they can be discovered early, diagnosed early, and treated as directed, most gout patients can work and live like normal people. Through treatment, patients with chronic phase can reduce gout stone and improve joint function and kidney function to a certain extent!

What is the goal and duration of uric acid lowering treatment?

The ultimate goal of treatment is 300umol/l uric acid, and the primary goal is 360umol/l. Patients with gout have uric acid greater than 420umol/l to start uric acid lowering treatment; there are cardiovascular risk factors, cardiovascular diseases or metabolic diseases uric acid greater than 480umol/l to start uric acid lowering treatment; The disease also needs to start uric acid lowering treatment. If uric acid is below 420umol/l for 5 years, uric acid lowering therapy can be discontinued.

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