Gout was first seen in On Sacred Diseases written by Hippocrates, an ancient Egyptian doctor, 7000 years ago. In the East, the word gout first appeared in the medical classics of the Southern and Northern Dynasties, and it was called "Tongbi".
From the point of view of western medicine, gout is a disease caused by long-term purine metabolism disorder, which is characterized by hyperuricemia, recurrent acute arthritis, tophus deposition, chronic arthritis and joint deformity, renal parenchymal lesions and urate stone formation. Gouty arthritis is characterized by joint swelling and pain, which belongs to the category of arthralgia syndrome in traditional Chinese medicine. Kidney calculi caused by gout belongs to the category of stranguria in TCM, while edema caused by gouty nephropathy belongs to the category of edema.
The prevalence of gout in Europe and America is 0.2%~ 1.7%. In China, the incidence of gout has been on the rise in recent years. The prevalence rate of gout in the general population in China is about 1. 14%, among which Taiwan Province Province and Qingdao City are high incidence areas, and the prevalence rate of aborigines in Taiwan Province Province above 1 1.7%. The occurrence of gout is related to sex and age, and it is more common in middle-aged and elderly people, accounting for about 90%. The peak age of gout is 40-50 years old, and the ratio of male to female is about 20: 1.
Gout belongs to "arthralgia syndrome" in TCM disease classification. All kinds of arthritis belong to arthralgia syndrome of traditional Chinese medicine. According to the principle of syndrome differentiation and treatment in traditional Chinese medicine, arthritis tends to wind, mainly expelling wind. Those who are cold mainly disperse cold. Wet wins, and wet is the main thing. Heat and evil prevail, and clearing heat is the main thing. Gout patients should judge the nature of arthralgia syndrome according to the symptoms and characteristics of arthritis, whether it is acute attack, whether it belongs to wind-cold-dampness arthralgia or rheumatism arthralgia, and whether there is phlegm and blood stasis arthralgia, and then prescribe the right medicine.
In recent years, gout is no longer a patent for middle-aged and elderly people, and the incidence of this disease is also increasing among young people, which is caused by many reasons. So there is no effective treatment in clinic at present, but Chinese medicine has a history of thousands of years and has a unique advantage in the treatment of gout.
Please click to enter a picture description.
Traditional Chinese medicine pays attention to syndrome differentiation and treatment, and different types of gout are treated differently. So what are the classification and treatment methods of gout in traditional Chinese medicine?
Syndrome Differentiation and Treatment of Gout in TCM
From the perspective of traditional Chinese medicine, the main pathogenesis of gout is liver and kidney deficiency, spleen and stomach damage, phlegm and blood stasis mutual resistance. The treatment should be to strengthen the spleen and regulate the stomach, nourish the liver and kidney, clear away the fire, eliminate phlegm and turbidity, remove blood stasis and dredge collaterals, treat both the symptoms and root causes, and add and subtract flexibly.
Damp blood stasis type
Clinical manifestations: at the onset of gouty arthritis, the joints are swollen and painful, the skin is red and hot, the tissues are swollen, the whole body is feverish, the urine is Huang Chi, the stool is dry and hard, the tip of the tongue is red, the coating is yellow and thick, and the pulse is strong.
Treatment: clearing away heat and promoting diuresis, removing blood stasis and dredging collaterals.
Prescription: Qubi Tongfeng Drink.
Medicine composition: Bupleurum chinense 12g, Scutellaria baicalensis Georgi 15g, Radix Puerariae 30g, Shā rotto Katakuri 12g, Herba Solani Cepae 12g, Equisetum equisetum 15g, Radix et Rhizoma Rhei 9g, Herba Hedyotidis Diffusae 12g and Coicis Semen 30g.
Application of addition and subtraction: when the blood stasis is obvious, remove Jinguolan and Scutellaria baicalensis, and add Radix Paeoniae Alba, Semen Persicae and Herba Artemisiae Anomalae.
When there are gout stones, soft and hard products such as dried tangerine peel, clam and Fritillaria thunbergii can be added.
When the damp heat is obvious, add gypsum and reuse rhubarb.
Qi stagnation and blood stasis type
Clinical manifestations: Gouty arthritis is chronic, with dark joints, less pain and swelling, increased tissue hardness, dark tongue and rapid pulse.
Treatment: promoting blood circulation, removing blood stasis and dredging collaterals.
Prescription: Qubi Tongfeng Drink.
Medicine composition: Bupleurum chinense 12g, Scutellaria baicalensis Georgi 15g, Radix Puerariae 30g, Shā rotto Katakuri 12g, Herba Solani Cepae 12g, Equisetum equisetum 15g, Radix et Rhizoma Rhei 9g, Herba Hedyotidis Diffusae 12g and Coicis Semen 30g.
Application of addition and subtraction: When the blood stasis is obvious, remove the Golden Orchid and Scutellaria baicalensis Georgi, and add madder, Eupatorium adenophorum and peach kernel.
When there are gout stones, soft and hard products such as dried tangerine peel, clam and Fritillaria thunbergii can be added.
Please click to enter a picture description.
Spleen deficiency and blood stasis type
Clinical manifestations: Intermittent gouty arthritis is more common in patients with recurrent chronic diseases, with pale face, weak constitution, mild joint pain, stiff muscles, rapid pulse, pale tongue and thin white fur.
Treatment principle: Warming kidney and strengthening spleen, removing blood stasis and dredging collaterals.
Prescription: Jianpi Gushen Tongfeng Decoction.
The medicinal composition: 20g of Angelica sinensis, Radix Rehmanniae Preparata 15g, Rhizoma Chuanxiong 15g, Radix Codonopsis 15g, 20g of Poria, Rhizoma Atractylodis 15g, Shā rotto Katakuri 12g, 30g of Radix Puerariae, 20g of Equisetum, 30g of Polygonum Multiflori Radix and 65438 of Glycyrrhiza uralensis.
Addition and subtraction: Polygonatum sibiricum and Polygonatum odoratum are added when kidney deficiency is obvious.
Atractylodis Rhizoma, Pericarpium Citri Tangerinae and Coicis Semen are added when spleen deficiency is obvious.
When blood stasis is obvious, Hirudo and Squama Manis are added.
Traditional Chinese medicine (TCM) has extensive and profound techniques, pays attention to syndrome differentiation and treatment, and treats diseases with different methods. At present, Chinese medicine is still the mainstream way to treat gout, and it has become the first choice for many patients because of its safety, high efficiency and no toxic side effects.
Typhoid fistula syndrome
It belongs to chronic illness, qi deficiency, stagnation of yin and cold, cold blocking coagulation, skin dystrophy, ulceration and fistula.
The treatment is oral Jisheng Shenqi Pill, each time 1 capsule, twice a day, and external use of Huiyang Yulong ointment to warm blood and promote granulation.
Dried ginger, cinnamon, kusnezoff monkshood root and rhizoma arisaematis are used for removing cold, resolving phlegm and activating muscles.
Radix Paeoniae Rubra and Radix Angelicae Dahuricae are used for removing blood stasis and promoting granulation.
Liver and kidney deficiency type
Gout lasts for a long time, the joints are swollen and deformed, they can't bend and stretch, the pain is heavy, the waist and knees are sore, the limbs are inconvenient, and the pulse is heavy and thin.
The treatment is mainly to tonify liver and kidney, eliminate dampness and dredge collaterals, and modify Duhuo Jisheng Decoction.
Drugs: Radix Angelicae Pubescentis, Radix Saposhnikoviae and Rhizoma Chuanxiong each 65438±00g, Radix Gentianae Macrophyllae, Radix Angelicae Sinensis, Radix Rehmanniae, Radix Paeoniae Alba, Cortex Eucommiae, Radix Cyathulae, Poria and Caulis Spatholobi each 65438±05g, Asari 3g, Cortex Cinnamomi, Ginseng 5g, Radix Glycyrrhizae 6g and Taxilli 20g.
Please click to enter a picture description.
Cold-dampness blocking collateral type
The symptoms of gout with cold-dampness blocking collaterals mainly include severe pain in joints of limbs, slight redness and swelling, reduced fever, unfavorable joint flexion and extension, local cold sensation, pale red tongue with white fur and tight pulse.
Medicine: 6 grams of Radix Aconiti, 6 grams of Herba Ephedrae, 20 grams of Radix Astragali, 65 05 grams of parched Radix Paeoniae Alba, Caulis Spatholobi, Radix Angelicae Sinensis, Coicis Semen and Rhizoma Dioscoreae Septemlobae, 9 grams of Radix Glycyrrhizae, 5 grams of Ramulus Cinnamomi, 3 grams of Asari, 30 grams of Rhizoma Smilacis Glabrae and 3 grams of ginger.
Spleen deficiency and dampness resistance type
The joint is sour, the painful part is motionless, the joint is deformed and stiff, and there are tophi.
Consciously short of breath, not hungry, pale red tongue, white and greasy fur, clearing turbidity and dredging collaterals, invigorating spleen and promoting diuresis decoction (empirical formula)
Medication:? , Atractylodis Rhizoma, Radix Cyathulae, and Folium Pyrrosiae each 20g, Polyporus, Talcum, and Peach Kernel each 65438 05g, Herba Dianthi, Semen Plantaginis (parched), cooked Radix et Rhizoma Rhei, Carthami Flos, Squama Manis, and Radix Angelicae Sinensis each 65438 00g, Ramulus Cinnamomi 5g, Coicis Semen 30g, and Rhizoma Smilacis Glabrae 50g.
Damp-heat block type
The main symptoms of this type of gout are joint swelling and pain, severe swelling and pain, tight tendons and veins, inaccessible hands, more difficult to get out of bed, light day and heavy night, red tongue with yellow fur and slippery pulse. The main treatment is clearing away heat and promoting diuresis, promoting blood circulation and dredging collaterals, and Xu 'anbi Decoction is modified.
Medicine: Stephania Tetrandra, Almond, Forsythia suspensa, Bombyx Batryticatus, Semen Phaseoli, Curcuma longa and Gentiana macrophylla each 65,438 05 g, Talcum, Cortex Erythrinae, Radix Clematidis and Alismatis Rhizoma each 65,438 05 g, Fructus Gardeniae and Rhizoma Pinelliae each 6 g, Coicis Semen and Rhizoma Smilacis Glabrae each 30 g, and Rhizoma Polygoni Cuspidati each 20 g..
In addition to the above oral treatment of gout, Chinese medicine also has external application therapy, which can achieve good results in the treatment of gout.
Please click to enter a picture description.
External application method for treating gout
External application prescription 1. Sulfur ointment
Dispensing: 20g of Bingboron Powder and sulfur ointment 15g were selected.
Usage: After mixing the above medicines, apply it directly to the affected area once a day, with one week as a course of treatment.
Efficacy: It is suitable for patients with gouty arthritis with mobility difficulties, and has the effect of promoting blood circulation and detoxifying. It usually takes 3 to 5 courses to relieve the pain.
External application prescription 2, gardenia egg white
Dispensing: take 30 gardenias and egg white 15g.
Usage: Mix the above substances into paste with high alcohol, apply it to the affected area, and wrap it with gauze once every two days.
Efficacy: It is suitable for patients with tophi and gout in the late stage, and the dosage can be increased as appropriate. During the application period, it is not advisable to drink alcohol or eat hot pot. It usually takes 2 to 3 days to take effect without any side effects.
Please click to enter a picture description.
External application prescription 3. Honey longan ointment
Dispensing: choose 30g longan meat and honey 15g.
Usage: Mash longan pulp, mix it with honey and apply it to the affected area, and wrap it with dry cloth twice a day.
Efficacy: It is used for patients with chronic gout, and has good curative effect on chronic arthritis and tophi in the late stage.
From the above introduction, we can find that the classification of gout is complicated, and each type of treatment is different. Gout attack has caused great harm to patients, so it is suggested that patients must be found early and treated early. The above treatment methods have good symptomatic treatment effect, and patients need to be treated under the guidance of professional doctors to avoid the effect of non-symptomatic drugs.
Prevention and nursing of gout
Please click to enter a picture description.
Summer is the season with high incidence of gout. Therefore, patients must do a good job in prevention and nursing, reminding everyone that in order to prevent gout in summer, we must first avoid eating, learn to keep your mouth shut, eat reasonably and develop good living habits.
1. Life should be regular: the occurrence of gout is directly related to the metabolic ability of the human body. Bad living habits such as staying up late will affect the body's metabolic ability, which will lead to gout.
2. Put an end to the high purine diet: gout is a disease caused by abnormal purine metabolism. In order to control it at the source, we have to reduce the intake of high purine diet, such as animal offal, seafood, beef and mutton, thick soup and so on.
3. Stay away from alcohol: It is scientifically proved that alcohol can accumulate lactic acid in the human body and inhibit the excretion of uric acid, which is extremely unfavorable for preventing gout! Friends who have drinking habits should reduce or avoid drinking.
4. Eat more alkaline foods and drink more water: The so-called alkaline foods refer to foods with more minerals such as potassium, sodium, calcium and magnesium, and the final metabolites in the body are often alkaline, such as vegetables, fruits and dairy products. Eating more alkaline food will help people to have a healthy constitution and neutralize uric acid in the body. In addition, we must ensure enough drinking water every day. More urination can promote the metabolism of uric acid and is conducive to the recovery of gout!
Chinese medicine often says: "Prevention is greater than cure", so many diseases should be prevented before they happen, instead of going to the doctor to take medicine and suffering physically and mentally. Many diseases can be prevented in advance. As long as we ensure good living habits and eating habits and improve immunity, most diseases will be rejected.