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*It is only for medical professionals to read for reference.
Gout requires comprehensive long-term management, and convenient shorthand formulas are here! 01// Gout concept formula//Now the standard of living is good, the incidence of gout increases.
Purine products are uric acid produced in the body and excretion less attached to the toe joints, swelling, hot, gout, gout [Analysis] In recent years, the domestic diet has become more abundant, and the standard of living has greatly improved , Eat a lot of high-purine foods
.
Excessive production of uric acid in the body, or obstruction of the excretion of uric acid due to kidney dysfunction, so that too much urate is deposited in the blood and tissues, and it will attach to the joints of the toes and fingers at the distal end of the body, causing the joints to be swollen and hot.
Pain and inflammation, causing gout
.
02// Diagnostic criteria for gout//It is not difficult to diagnose gout.
See the six manifestations of tophi in the synovial fluid under the microscope, which can be diagnosed.
One is acute arthritis, which appears at a peak in one day.
Three is inflammation of a single joint.
Red eyes can be distinguished from metatarsophalangeal joint pain.
Unilateral episodes of swelling involving my tarsal joints also have suspicious tophi Standard" (1) There are specific urate crystals in the synovial fluid
.
(2) There is tophi, which is confirmed to contain urate crystals by chemical method or polarized light microscope observation
.
(3) Those who possess 6 of the following 12 clinical, laboratory and X-ray signs
.
① More than one attack of acute arthritis
.
②Inflammation reached its peak within one day
.
③Onset of monoarthritis
.
④Redness of joints is observed
.
⑤ Pain or swelling of the first metatarsophalangeal joint
.
⑥ Unilateral attack involves the first metatarsophalangeal joint
.
⑦ Unilateral attacks involve the tarsal joints
.
⑧ Suspicious tophi
.
⑨ Hyperuricemia
.
⑩ Asymmetric swelling in the joint (X-ray photo)
.
⑪The subcortical cyst is not accompanied by bone erosion (X-ray photo)
.
⑫ During the onset of joint inflammation, the microbial culture of the synovial fluid was negative
.
03// Tips for the treatment of the acute phase // Reduce activities during the acute attack of gout, take more rest and raise the affected limbs.
Cold compress and foot massage but not suitable for medical treatment.
Three types of drugs can be remembered as early as possible in the list of colchicine and hormone non-steroidal anti-inflammatory drugs Hormonal anti-inflammatory drugs have the same effect.
If the patient has contraindications to take Qiu Shui medicine alone, the uric acid should be stable during this period.
Remember not to lower uric acid [Analysis] During the acute attack of gout, the patient should be instructed to minimize activities, rest in bed, and raise the affected limb.
Take a topical ice compress (or magnesium sulfate wet compress), which can lower the temperature and relieve redness and pain
.
In addition, topical Voltaren emulsion also helps to reduce local pain
.
Remember, massage and hot compresses are not allowed at this time.
Hot compresses will dilate blood vessels and aggravate local swelling and pain
.
It is recommended as soon as possible (symptomatic treatment within 24 hours)
.
There are three types of drugs to choose from: non-steroidal anti-inflammatory drugs, colchicine and glucocorticoids
.
Patients who are contraindicated with non-steroidal anti-inflammatory drugs are recommended to use low-dose colchicine alone.
Short-term glucocorticoids alone have similar efficacy and safety to non-steroidal anti-inflammatory drugs
.
During the acute attack of gout, the patient's blood uric acid concentration should be kept relatively stable as far as possible.
It is not recommended to add uric acid lowering drugs during the acute attack of arthritis
.
04// Uric acid-lowering treatment after the acute phase//Twice a year for gout, chronic gouty arthritis, and stones to accompany treatment, need to lower uric acid, promote acid excretion, probenecid, benzbromarone, curative effect test, inhibit the production of allopurinol due to low uric acid Unusually regularly check the liver and kidney function with a small amount of colchicine to prevent recurrence [Analysis] If acute gouty arthritis occurs more than twice a year, accompanied by chronic gouty arthritis or diagnosed with tophi, uric acid-lowering treatment is required Up
.
For drugs that inhibit the production of uric acid, it is recommended to use allopurinol or febuxostat; for drugs that promote uric acid excretion, it is recommended to use benzbromarone and probenecid
.
Monitor liver and kidney function levels during treatment
.
Since taking uric acid lowering drugs can lead to an increase in blood uric acid, it is necessary to take a small dose of colchicine at the beginning of treatment to prevent and treat acute gout attacks
.
05// Avoid uric acid-increasing drugs // People who relieve joint non-steroidal hyperuric acid should not lower blood pressure, lower blood sugar, insulin, anti-cancer, antibacterial immunity, and various diuretics, niacin, vitamin C and vitamin B1 [Analysis] for hyperuricemia People with symptoms and gout should avoid using the following drugs: (1) Non-steroidal anti-inflammatory drugs: aspirin and benoxate can cause uric acid to rise
.
(2) Diuretics
.
(3) Antihypertensive drugs: reserpine, diazoxide, telmisartan, losartan
.
(4) Antidiabetic drugs: insulin
.
(5) Immunosuppressants: cyclosporine, mercaptopurine, mycophenolate mofetil, tacrolimus, sirolimus, basiliximab (dose-related effects)
.
(6) Antibacterial drugs: penicillin, lomefloxacin, moxifloxacin; antituberculosis drugs pyrazinamide, ethambutol, etc.
reduce uric acid excretion and cause hyperuricemia
.
(7) Vitamins: niacin, vitamin C, vitamin B1
.
(8) Antitumor drugs: cyclophosphamide, ifosfamide, busulfan, cytepa, cytarabine, thioguanine, mercaptopurine, hydroxyurea, vinblastine, vincristine, asparaginase , Teniposide, cisplatin, carboplatin, lobaplatin, oxaliplatin, etc.
can cause hyperuricemia, and allopurinol should be given and urine alkalized at the same time during treatment
.
06// Contraindications for acute-onset drugs//Allopurinol inhibits uric acid and uses gout stone powder for a long time, but be careful not to relieve pain in the acute phase and dissolve indomethacin into crystals to induce gouty arthritis.
Avoid taking colchicine as soon as possible for two weeks.
After using allopurinol, aspirin can increase blood uric acid levels and increase renal retention.
These taboos should be remembered [Analysis] Long-term application of allopurinol can gradually shrink and dissolve the formed tophi
.
However, there is no anti-inflammatory and analgesic effect in the acute phase
.
In order to avoid the above situation, take colchicine as soon as possible.
Allopurinol is usually applied 2 weeks after the onset of gout has stabilized.
However, patients who have been used in the remission period can continue to use aspirin, benoxate, etc.
Relieve mild and moderate joint pain, but can reduce blood uric acid excretion, make uric acid retention in the body, and cause blood uric acid levels to rise
.
07// Diet chants//Fasting offal and broth, grilling, frying, high sugar, no fungus, less beans, shrimps, crabs, turtles, and turtles.
Restrict white and red appropriately [Analysis] Reasonable adjustment of diet structure can not only meet the body's nutritional needs, take into account the enjoyment of eating, but also control blood uric acid to reach the standard, and minimize the maintenance dose
.
(1) Fasting animal offal, fatty meat, gravy, thick soup, high-sugar foods (such as juice drinks, canned fruits)
.
(2) Fasting barbecue, fried food (such as: barbecue, fried chicken), stewed meat, braised meat
.
(3) Avoid eating hard shell seafood (such as shrimp, crab), deep-sea fish can be eaten in moderation
.
(4) Eat less or no fungus and soy products as much as possible
.
(5) Eat more alkaline foods and less acidic foods
.
(6) Milk, eggs, refined meat, etc.
are high-quality protein, which should be supplemented in an appropriate amount, and meat can be eaten appropriately (100-200 grams of refined meat and lean meat can be eaten every day)
.
(7) Eat more fresh fruits and vegetables
.
(8) Promote smoking cessation, ban beer, limit white wine, and drink red wine in moderation
.
08// Exercise method formula//Aerobic exercise should be moderate, jogging, swimming and cycling, if the heart rate is just one hundred and seventy, reduce the age for the first exercise, and then increase after a quarter of an hour and two weeks later, and then increase by five and thirty minutes a week.
resolved] adhere to regular exercise, gout patients more appropriate aerobic exercise, such as brisk walking, jogging, swimming and so on
.
(1) The amount of exercise should be moderate, the maximum suitable heart rate for aerobic exercise: 170-age
.
(2) The exercise should be gradual, the first exercise time is 15 minutes; if it is maintained for 2 weeks, it is increased to 30 minutes; after another 2 weeks, it is increased to 45-60 minutes, which can be maintained
.
If the exercise is suspended for some reason, the exercise time must be recalculated
.
(3) Exercise 5 times or more a week
.
09// Lose weight and drink// Keep your mouth open, open your legs and control your weight.
Drink more water and eat.
It’s often 80% full and hungry.
The weight loss effect is not good.
Salt can’t exceed 6 grams.
Drinking 3,000 ml is good.
Lose weight
.
According to the gout diet, if you insist on eating 8 minutes full for a long time, you can achieve the goal of gradually losing weight
.
The daily intake of sodium salt should not exceed 6 grams
.
The daily drinking volume of 2000-3000 ml is the best
.
Gout requires comprehensive long-term management, and convenient shorthand formulas are here! 01// Gout concept formula//Now the standard of living is good, the incidence of gout increases.
Purine products are uric acid produced in the body and excretion less attached to the toe joints, swelling, hot, gout, gout [Analysis] In recent years, the domestic diet has become more abundant, and the standard of living has greatly improved , Eat a lot of high-purine foods
.
Excessive production of uric acid in the body, or obstruction of the excretion of uric acid due to kidney dysfunction, so that too much urate is deposited in the blood and tissues, and it will attach to the joints of the toes and fingers at the distal end of the body, causing the joints to be swollen and hot.
Pain and inflammation, causing gout
.
02// Diagnostic criteria for gout//It is not difficult to diagnose gout.
See the six manifestations of tophi in the synovial fluid under the microscope, which can be diagnosed.
One is acute arthritis, which appears at a peak in one day.
Three is inflammation of a single joint.
Red eyes can be distinguished from metatarsophalangeal joint pain.
Unilateral episodes of swelling involving my tarsal joints also have suspicious tophi Standard" (1) There are specific urate crystals in the synovial fluid
.
(2) There is tophi, which is confirmed to contain urate crystals by chemical method or polarized light microscope observation
.
(3) Those who possess 6 of the following 12 clinical, laboratory and X-ray signs
.
① More than one attack of acute arthritis
.
②Inflammation reached its peak within one day
.
③Onset of monoarthritis
.
④Redness of joints is observed
.
⑤ Pain or swelling of the first metatarsophalangeal joint
.
⑥ Unilateral attack involves the first metatarsophalangeal joint
.
⑦ Unilateral attacks involve the tarsal joints
.
⑧ Suspicious tophi
.
⑨ Hyperuricemia
.
⑩ Asymmetric swelling in the joint (X-ray photo)
.
⑪The subcortical cyst is not accompanied by bone erosion (X-ray photo)
.
⑫ During the onset of joint inflammation, the microbial culture of the synovial fluid was negative
.
03// Tips for the treatment of the acute phase // Reduce activities during the acute attack of gout, take more rest and raise the affected limbs.
Cold compress and foot massage but not suitable for medical treatment.
Three types of drugs can be remembered as early as possible in the list of colchicine and hormone non-steroidal anti-inflammatory drugs Hormonal anti-inflammatory drugs have the same effect.
If the patient has contraindications to take Qiu Shui medicine alone, the uric acid should be stable during this period.
Remember not to lower uric acid [Analysis] During the acute attack of gout, the patient should be instructed to minimize activities, rest in bed, and raise the affected limb.
Take a topical ice compress (or magnesium sulfate wet compress), which can lower the temperature and relieve redness and pain
.
In addition, topical Voltaren emulsion also helps to reduce local pain
.
Remember, massage and hot compresses are not allowed at this time.
Hot compresses will dilate blood vessels and aggravate local swelling and pain
.
It is recommended as soon as possible (symptomatic treatment within 24 hours)
.
There are three types of drugs to choose from: non-steroidal anti-inflammatory drugs, colchicine and glucocorticoids
.
Patients who are contraindicated with non-steroidal anti-inflammatory drugs are recommended to use low-dose colchicine alone.
Short-term glucocorticoids alone have similar efficacy and safety to non-steroidal anti-inflammatory drugs
.
During the acute attack of gout, the patient's blood uric acid concentration should be kept relatively stable as far as possible.
It is not recommended to add uric acid lowering drugs during the acute attack of arthritis
.
04// Uric acid-lowering treatment after the acute phase//Twice a year for gout, chronic gouty arthritis, and stones to accompany treatment, need to lower uric acid, promote acid excretion, probenecid, benzbromarone, curative effect test, inhibit the production of allopurinol due to low uric acid Unusually regularly check the liver and kidney function with a small amount of colchicine to prevent recurrence [Analysis] If acute gouty arthritis occurs more than twice a year, accompanied by chronic gouty arthritis or diagnosed with tophi, uric acid-lowering treatment is required Up
.
For drugs that inhibit the production of uric acid, it is recommended to use allopurinol or febuxostat; for drugs that promote uric acid excretion, it is recommended to use benzbromarone and probenecid
.
Monitor liver and kidney function levels during treatment
.
Since taking uric acid lowering drugs can lead to an increase in blood uric acid, it is necessary to take a small dose of colchicine at the beginning of treatment to prevent and treat acute gout attacks
.
05// Avoid uric acid-increasing drugs // People who relieve joint non-steroidal hyperuric acid should not lower blood pressure, lower blood sugar, insulin, anti-cancer, antibacterial immunity, and various diuretics, niacin, vitamin C and vitamin B1 [Analysis] for hyperuricemia People with symptoms and gout should avoid using the following drugs: (1) Non-steroidal anti-inflammatory drugs: aspirin and benoxate can cause uric acid to rise
.
(2) Diuretics
.
(3) Antihypertensive drugs: reserpine, diazoxide, telmisartan, losartan
.
(4) Antidiabetic drugs: insulin
.
(5) Immunosuppressants: cyclosporine, mercaptopurine, mycophenolate mofetil, tacrolimus, sirolimus, basiliximab (dose-related effects)
.
(6) Antibacterial drugs: penicillin, lomefloxacin, moxifloxacin; antituberculosis drugs pyrazinamide, ethambutol, etc.
reduce uric acid excretion and cause hyperuricemia
.
(7) Vitamins: niacin, vitamin C, vitamin B1
.
(8) Antitumor drugs: cyclophosphamide, ifosfamide, busulfan, cytepa, cytarabine, thioguanine, mercaptopurine, hydroxyurea, vinblastine, vincristine, asparaginase , Teniposide, cisplatin, carboplatin, lobaplatin, oxaliplatin, etc.
can cause hyperuricemia, and allopurinol should be given and urine alkalized at the same time during treatment
.
06// Contraindications for acute-onset drugs//Allopurinol inhibits uric acid and uses gout stone powder for a long time, but be careful not to relieve pain in the acute phase and dissolve indomethacin into crystals to induce gouty arthritis.
Avoid taking colchicine as soon as possible for two weeks.
After using allopurinol, aspirin can increase blood uric acid levels and increase renal retention.
These taboos should be remembered [Analysis] Long-term application of allopurinol can gradually shrink and dissolve the formed tophi
.
However, there is no anti-inflammatory and analgesic effect in the acute phase
.
In order to avoid the above situation, take colchicine as soon as possible.
Allopurinol is usually applied 2 weeks after the onset of gout has stabilized.
However, patients who have been used in the remission period can continue to use aspirin, benoxate, etc.
Relieve mild and moderate joint pain, but can reduce blood uric acid excretion, make uric acid retention in the body, and cause blood uric acid levels to rise
.
07// Diet chants//Fasting offal and broth, grilling, frying, high sugar, no fungus, less beans, shrimps, crabs, turtles, and turtles.
Restrict white and red appropriately [Analysis] Reasonable adjustment of diet structure can not only meet the body's nutritional needs, take into account the enjoyment of eating, but also control blood uric acid to reach the standard, and minimize the maintenance dose
.
(1) Fasting animal offal, fatty meat, gravy, thick soup, high-sugar foods (such as juice drinks, canned fruits)
.
(2) Fasting barbecue, fried food (such as: barbecue, fried chicken), stewed meat, braised meat
.
(3) Avoid eating hard shell seafood (such as shrimp, crab), deep-sea fish can be eaten in moderation
.
(4) Eat less or no fungus and soy products as much as possible
.
(5) Eat more alkaline foods and less acidic foods
.
(6) Milk, eggs, refined meat, etc.
are high-quality protein, which should be supplemented in an appropriate amount, and meat can be eaten appropriately (100-200 grams of refined meat and lean meat can be eaten every day)
.
(7) Eat more fresh fruits and vegetables
.
(8) Promote smoking cessation, ban beer, limit white wine, and drink red wine in moderation
.
08// Exercise method formula//Aerobic exercise should be moderate, jogging, swimming and cycling, if the heart rate is just one hundred and seventy, reduce the age for the first exercise, and then increase after a quarter of an hour and two weeks later, and then increase by five and thirty minutes a week.
resolved] adhere to regular exercise, gout patients more appropriate aerobic exercise, such as brisk walking, jogging, swimming and so on
.
(1) The amount of exercise should be moderate, the maximum suitable heart rate for aerobic exercise: 170-age
.
(2) The exercise should be gradual, the first exercise time is 15 minutes; if it is maintained for 2 weeks, it is increased to 30 minutes; after another 2 weeks, it is increased to 45-60 minutes, which can be maintained
.
If the exercise is suspended for some reason, the exercise time must be recalculated
.
(3) Exercise 5 times or more a week
.
09// Lose weight and drink// Keep your mouth open, open your legs and control your weight.
Drink more water and eat.
It’s often 80% full and hungry.
The weight loss effect is not good.
Salt can’t exceed 6 grams.
Drinking 3,000 ml is good.
Lose weight
.
According to the gout diet, if you insist on eating 8 minutes full for a long time, you can achieve the goal of gradually losing weight
.
The daily intake of sodium salt should not exceed 6 grams
.
The daily drinking volume of 2000-3000 ml is the best
.
