Don't believe in gout secret recipes, random use of drugs is more harmful

Short story

Recently, I came across a gout medication consultation case. The patient is a 49-year-old male who has suffered from gout for ten years. In the past two years, tophi have affected multiple joints and limited his movements. When asked about his medication history, he took uric acid-lowering drugs irregularly. Five years ago, a friend introduced a folk doctor who had a secret recipe passed down from his ancestors. The doctor had a very good effect in treating gout, and one pill could significantly relieve the pain. One pill costs 20 yuan, and he would take a few pills every time he had an acute attack of gout.

So, is there really a secret ancestral recipe for treating gout?

From the perspective of traditional Chinese medicine theory, there is no so-called ancestral secret recipe for treating gout. The preparation of this secret recipe may have illegally added Western medicine ingredients. From the perspective of Western medicine theory, the added ingredients should be hormones, painkillers or colchicine. If the toxic and side effects are ignored in order to unilaterally increase the analgesic effect, two or even more Western medicine ingredients may be added at the same time.

Therefore, it is not recommended to take this homemade ancestral secret recipe. There is no quantitative standard for the dosage of Western medicine added during the preparation of the secret recipe, and the production process is not carried out in a sterile environment, which will cause the microbial limit to exceed the standard. Colchicine will inhibit hematopoietic function, painkillers will affect the digestive tract and liver and kidney function, and hormones have more adverse reactions. If colchicine, hormones or painkillers are taken in normal usage and dosage and avoid contraindications, it is generally considered safe. However, if Western medicine ingredients are added in large doses illegally, it is easy to cause drug hazards, especially when patients regard the secret recipe as a pure Chinese medicine preparation, they will subconsciously think that there are no side effects and take it in large doses for a long time. Colchicine, hormones or painkillers are used for acute attacks of gout, and they should be stopped when the disease is cured. There is no need to take them for a long time.

For acute gout attacks, treatment drugs should be selected according to individual pathological and physiological conditions. The goal of treatment during the acute attack of gout is to quickly control arthritis symptoms. During the acute phase, patients should rest in bed, elevate the affected limb, and apply local cold compresses. Drugs should be given as early as possible to control acute attacks; the earlier the treatment, the better the effect. Colchicine or analgesics are the first-line treatment drugs for acute arthritis attacks. When the above drugs are contraindicated or ineffective, hormones can be considered to control inflammation. For patients with acute attacks involving 1 to 2 large joints and ineffective systemic treatment, intra-articular hormone injections can be considered, but repeated use in the short term should be avoided.

Denying ancestral secret recipes does not mean denying traditional Chinese medicine !

TCM intervention for gout or hyperuricemia emphasizes the principles of both nourishment and treatment, disease-symptom combination, and stage-by-stage treatment. Patients should be cautious about their diet and avoid drinking or overeating fatty and greasy foods. They can take long-term dietary therapy that can correct physical imbalances, such as coix seed, Euryale ferox, and Chinese yam. At the same time, they can strengthen their physical fitness and regulate their spirit through exercise, which can prevent and treat diseases.

In terms of treatment, whether or not hyperuricemia has clinical symptoms, strengthening the spleen, dispelling turbidity and removing blood stasis are the basic treatment methods, which run through the entire treatment. Commonly used drugs include coix seed, smilax glabra, smilax glabra, radix polygoni multiflori, and polygonum cuspidatum. If the symptoms involve joints and sudden redness, swelling and burning pain occur, it is the acute stage of gout, which is mainly caused by evil. The methods of clearing heat and dampness, unblocking the meridians and relieving pain are often used. The prescriptions are Simiao San or Danggui Niantong Tang. Commonly used drugs include Phellodendron, Atractylodes macrocephala, Plantago seed, Artemisia capillaris, Notopterygium wilfordii, and silkworm sand. If the swelling and pain are prolonged and repeated, joint deformities are present, or accompanied by subcutaneous nodules and/or ulcers, it is the chronic stage of gout, which is a mixture of deficiency and excess. The methods of removing phlegm and removing blood stasis, removing numbness and unblocking the meridians are often used, and the spleen is strengthened, the kidney is tonified, and the liver is nourished. The prescription is the general gout prescription of Shangzhongxia, and the commonly used drugs are Clematis chinensis, Arisaema consanguineum, Curcuma longa, and Cinnamomum cassia.

If the symptoms are related to the kidneys, and there are sand and stones in the urine or oliguria and body swelling, it is gouty nephropathy. The treatment is still based on the method of strengthening the spleen and kidney, clearing turbidity and unblocking the meridians, and the treatment is based on the syndrome differentiation of deficiency and excess, cold and heat. In addition to turbidity and blood stasis, excess syndrome is mostly caused by dampness and heat, and stone obstruction. For dampness and heat, frequent urination, dripping and burning pain should be treated by clearing heat and removing dampness. The prescriptions for urination are Bazheng Decoction or Gexie Huadu Decoction. Commonly used drugs include Plantago, Pianxu, Taraxacum, Papaya, and Gentiana. For stone obstruction, urination is difficult or interrupted suddenly, or there are sand and stones in the urine. The treatment is to remove stones and unblock the stranguria. The prescription is Shiwei San. Commonly used drugs include Shiwei, Talc, and Sea Gold Sand. Deficiency syndrome is mostly attributed to the spleen and kidney. For those with yang deficiency as the main symptom, the treatment should be to warm the yang and transform the fluid. Recommended prescriptions include Wenpi Decoction combined with Jisheng Shenqi Pills. Commonly used medicines include Astragalus, Codonopsis, Eucommia, Cibotium barometz, Chuanduan, and Aconite. For those with yin deficiency as the main symptom, the treatment should be to nourish yin and consolidate the foundation. Recommended prescriptions include Zuogui Pills or Liuwei Dihuang Pills. Commonly used medicines include Rehmannia glutinosa, Polygonatum sibiricum, Lycium barbarum, Cornus officinalis, etc.

On the basis of syndrome differentiation and treatment, the selection of prescriptions and drugs can also refer to the results of modern pharmacological research and be used as appropriate. Studies have shown that Smilax glabra, Polygonum cuspidatum, Smilax china, and Curcuma longa can inhibit the activity of xanthine oxidase and reduce blood uric acid levels; Dioscorea ternata, Gardenia jasminoides, and Plantago asiatica can regulate the expression of urate transporters, reduce uric acid reabsorption, and promote uric acid excretion.

In addition, local treatments such as external application of Chinese medicine and fumigation and washing can make the medicinal effects directly reach the diseased area, helping to reduce swelling and relieve pain; Chinese medicine retention enema can both clear the bowels and detoxify, and can be absorbed through the intestines, allowing the medicinal effects to spread throughout the body; acupuncture combines local and meridian acupoint selection to achieve the effect of treating both the symptoms and the root cause.

For the treatment of gout, whether to choose Western medicine or traditional Chinese medicine should be determined according to the severity of the disease. Blindly relying on folk remedies and secret recipes is more harmful. If the uric acid level is relatively high, gout attacks are more frequent, or even tophi have formed, then Western medicine should be chosen as the main treatment to quickly control symptoms, reduce uric acid levels, and avoid further damage to joints and kidneys caused by urate crystals. In general, by adhering to a healthy lifestyle and standardized drug treatment, gout is a chronic disease that can be controlled, and there is no need to look for folk remedies or secret recipes.

Life Tips

The healthy lifestyle that gout patients need to maintain is different from that of other chronic diseases. The specific content is as follows:

1. Low-purine diet. Strictly limit the intake of high-purine foods such as animal offal, seafood and meat.

2. Drink plenty of water. People with normal heart and kidney function need to maintain proper body water, drink plenty of water, and maintain a daily urine output of 2 to 3L. You can drink milk and dairy products (especially skim milk and low-calorie yogurt), and avoid drinking cola, orange juice, apple juice and other fructose-containing beverages or sugary soft drinks.

3. Fruits can reduce the risk of gout attacks because they are rich in potassium and vitamin C. Gout patients can eat fruits with less fructose, such as cherries, strawberries, pineapples, watermelons, peaches, etc.

4. Quit smoking and drinking. Drinking alcohol can increase the risk of gout in patients with hyperuricemia, and alcohol intake is positively correlated with the risk of gout. Smoking or passive smoking increases the risk of gout, so you should quit smoking and avoid passive smoking.

5. Lose weight. Obesity increases the risk of gout in patients with hyperuricemia. Losing weight can effectively reduce blood uric acid levels. It is recommended that patients with hyperuricemia keep their weight within a normal range.

6. Regular exercise. Regular exercise can reduce the frequency of gout attacks and reduce deaths related to hyperuricemia. It is recommended to perform at least 150 minutes (30 minutes/day x 5 days/week) of moderate intensity aerobic exercise [heart rate during exercise within the range of (220-age) x (50% to 70%)]. During exercise, strenuous exercise or sudden exposure to cold should be avoided to avoid gout attacks.

Author: Liu Yanping