What is the best way to treat mild gout?

Gout is a common disease in life. There are many causes of gout, especially poor diet is an important cause of gout. If mild gout occurs, you should also be vigilant. You should do general treatment at ordinary times, especially pay attention to diet, and strictly consume some high-purine foods. If an acute attack occurs, it is best to rest in bed and treat it with certain medications.

What is the best way to treat mild gout?

1. General treatment

Protein intake is limited to about 1g/(kg·d). Do not eat high-purine foods (animal heart, liver, kidney, sardines, etc.), strictly abstain from alcohol, and avoid inducing factors. Encourage drinking plenty of water to keep urine volume above 2000ml/d. When the urine H2 concentration is below 1000 nmol/L (pH value 6.0), it is advisable to take alkaline drugs, such as sodium bicarbonate 1-2g, 3 times/day, to maintain the urine H2 concentration at 630.9-316.3 nmol/L (pH value 6.2-6.5). If the morning urine is acidic, taking 250 mg of acetazolamide at night can keep the urine alkaline, increase the solubility of uric acid, and prevent stone formation. At the same time, drugs that inhibit uric acid excretion, such as hydrochlorothiazide (hydrochlorothiazide), furosemide, ethambutol, pyrazinamide and niacin, should not be used.

2. Treatment of acute arthritis

You should absolutely stay in bed and raise the affected limb to avoid putting weight on the affected joint. This should last until about 72 hours after the joint pain is relieved before you can gradually move. The following medications should be used as early as possible to control arthritis and relieve symptoms.

(1) Colchicine:

It has significant therapeutic effect in controlling gouty arthritis and should be the first choice. Generally, symptoms will be relieved 6 to 12 hours after taking the medicine, and more than 90% of patients will be relieved within 24 to 48 hours. The usual dose is 0.5 mg per hour or 1 mg orally every 2 hours until symptoms are relieved or gastrointestinal side effects such as diarrhea occur, or if the condition does not improve despite the maximum dose of 6 mg, the drug should be discontinued. Intravenous colchicine is rapidly effective and has few gastrointestinal side effects. Usage: 2 mg of colchicine is dissolved in 10 ml of normal saline and injected slowly (the injection time is not less than 5 minutes). If the condition requires, 1 mg can be given after 6 hours. Generally, the total dose in 24 hours should be controlled within 3 mg. However, it should be noted that if the drug leaks out during intravenous injection, it may cause tissue necrosis and should be strictly prevented. In addition, in addition to causing gastrointestinal reactions, colchicine can also lead to bone marrow suppression, liver cell damage, hair loss, mental depression, ascending paralysis, respiratory depression, etc. Therefore, the dose for patients with existing bone marrow suppression and liver and kidney damage should be halved and they should be closely observed. It is contraindicated for patients with leukopenia.

(2) Nonsteroidal anti-inflammatory analgesics:

It is particularly suitable for patients who cannot tolerate colchicine. This type of drug can enhance the analgesic effect when used in combination with colchicine, but it should be taken after meals to reduce gastrointestinal reactions. Commonly used drugs include indomethacin, piroxicam (piroxicam), naproxen, ibuprofen, phenylbutazone and hydroxybutazone. Among them, indomethacin is the most widely used. This class of drugs is generally given at the beginning of treatment at a dose close to the maximum to achieve maximum control of acute symptoms, and then the dose is gradually reduced when symptoms are relieved.