Gout is a common and complex type of arthritis, which can be affected by all ages, and the incidence rate of men is higher than that of women. During the acute attack of gout, patients often experience sudden joint pain at night, and severe pain, edema, redness and inflammation in the joint area. The process of pain gradually reducing and disappearing often lasts for several days or weeks, which seriously affects the normal life and work of patients. For this reason, patients with acute attacks of gout should take effective treatment measures in time.
Acute attack is mainly to relieve pain
It is recommended to take anti-inflammatory and analgesic treatment as early as possible (generally within 24 hours) during the acute attack of gout. Non-steroidal anti-inflammatory drugs, colchicine and glucocorticoids can effectively anti-inflammatory and analgesic and improve the quality of life of patients.
1. Non-steroidal anti-inflammatory drugs are usually effective in relieving joint pain and swelling. Commonly used drugs include indomethacin, diclofenac, etoricoxib and so on. After the pain and inflammation are relieved, non-steroidal anti-inflammatory drugs can be continued under the guidance of a doctor to prevent symptoms from reappearing.
2. Colchicine is a traditional medicine. It is an alkaloid extracted from the bulbs of colchicum. It can not only effectively inhibit cell mitosis, but also greatly reduce the release of inflammatory factors and significantly inhibit the chemotaxis of inflammatory cells. During the acute attack of gout, those who are contraindicated with non-steroidal anti-inflammatory drugs are recommended to use low-dose colchicine alone (15-18 mg/day), which is effective and has few adverse reactions, and the effect is better when used within 48 hours.
3. Glucocorticoids are mainly used for non-steroidal anti-inflammatory drugs, colchicine treatment ineffective or contraindications, renal insufficiency. In the acute attack of gout, short-term single use of glucocorticoids (30 mg/day, 3 days) has similar efficacy and safety to non-steroidal anti-inflammatory drugs.
In addition, other analgesics, resting splints, etc. can also be used to relieve pain. There is still controversy about the issue of whether cold compresses can be applied during an acute attack of gout. Although cold compresses can temporarily relieve local pain, low temperature can stimulate local vasoconstriction and blood flow, which is not conducive to the absorption and dissipation of inflammation. Moreover, local low temperature easily promotes more uric acid deposition under the skin, which further aggravates local inflammation. It is clear that hot compresses are forbidden during the acute phase of gout attacks, especially within 48 hours. Because hot compresses in the acute phase will aggravate congestion and edema of the lesion, not only can it not relieve the pain, but sometimes it makes the pain worse. In addition, it is not advisable to use physiotherapy that causes increased skin temperature and accelerated local blood circulation, and it is not advisable to apply safflower oil or bone-setting water. Of course, it is not suitable for sticking traditional Chinese medicine plasters such as Shangshizhitong ointment. Acupuncture, massage and other therapies can also aggravate local acute inflammation and should not be used.
In recent years, with the continuous increase in research on Chinese medicine, Chinese medicine has also achieved certain results in the treatment of gout. Relevant experts and scholars clearly pointed out that the most basic principles of TCM treatment of gout are clearing away heat and promoting blood circulation, removing dampness and dredging collaterals. For patients with acute gout, the main pathogenesis is dampness and heat, and treatment should be based on clearing heat and removing dampness; for patients with remission, the pathogenesis is congestion and obstruction of collaterals, and treatment should be based on promoting blood circulation and dredging collaterals. If necessary, Chinese medicine should be treated under the guidance of professionals.
Do daily care to avoid gout attacks
According to relevant research data, there is a very close relationship between gout attacks and patients’ own eating habits. When gout attacks, patients are prohibited from eating foods with high purine content, such as animal offal, sardines, crab roe and other seafood and thick broth. Milk and eggs with very low purine content can be selected as the main sources of high-quality protein in the diet, and refined noodles and white rice are the main sources of calories. It is recommended to choose low-purine vegetables and fruits to limit fat. Patients should ensure daily drinking water, more than 2000 ml per day, and avoid alcohol, sugary drinks, coffee, etc.
A big data statistics in my country shows that strenuous exercise is the third cause of gout attacks in men and women. Therefore, it is necessary to take rest during the gout attack to avoid fatigue. However, regular exercise is also necessary in daily life to maintain a healthy weight.
In addition, sudden cold is the second leading cause of gout in women and the fifth leading cause of men. Therefore, it is recommended to open windows for ventilation regularly to ensure adequate indoor care, fresh air and dry mattresses. At the same time, pay attention to the warmth work in daily life to avoid prolonged and excessive exposure to wind, moisture and cold to the joints.
In short, patients with gout should do a good job of daily condition monitoring and regular follow-up visits. Especially gout patients with diabetes, cardiovascular disease, and kidney disease need to pay special attention to monitoring their daily blood sugar and blood pressure levels.