16 Yantai boy Zhuang Zhuang (a pseudonym) is a chubby boy, with a height of 1.5 meters and a weight of 140 kg. Speaking of a strong diet, Ms. Liu, her mother, has a headache. Because Zhuang Zhuang used to have gout, Ms. Liu usually restricted him from eating taboo food. She didn't want him to steal a few mouthfuls of broth the other day and get gout.
Ms. Liu said that Zhuang Zhuang transferred to three hospitals last year because of joint pain, and was finally diagnosed with hyperuricemia in Yuhuangding Hospital, also known as gout. "Such a small child also has gout?" Ms. Liu was surprised to say that her son didn't eat seafood or drink beer.
Tang Yanchun, director of the Department of Rheumatology and Immunology of the hospital, explained that gout can be divided into hereditary and secondary, which are both induced by eating seafood and drinking beer, and also caused by abnormal purine metabolism in the body.
1. Foreign invasion. The body is attacked by damp-heat and turbid toxin, and it stays in the joints, which leads to the obstruction of qi, blood and meridians, and it hurts if it doesn't work.
2. Poor diet. Often eat fatty and thick food, or because of physical reasons, after the imbalance of transport and transformation in the body, it causes dampness and turbidity, which goes out to the joints of the flesh and bones and stays in the viscera, which is the disease.
3. The viscera contain poison. Vegetarians' body is full of yang, heat accumulates for a long time, heat is depressed and toxic, and meridians are closed, resulting in gout.
4. Deficiency of spleen and stomach. Spleen deficiency will make the transport of water in the body abnormal, and dampness will stay in the body for a long time to cause disease.
5. Blood heat leads to blood stasis. Long-term blood heat leads to vein blockage, which causes joint swelling, deformity and stiffness.
1. Syndrome of damp-heat accumulation
Damp-heat is a tangible evil, which will block meridians and cause qi and blood to be blocked. The disease is common in local joints, with redness, swelling and burning pain. The onset will be more acute, usually occurring in one or more joints, accompanied by fever, thirst, bad wind, night sweats, headache, short and yellow urine and other symptoms.
The main treatment is clearing away heat and dampness, expelling wind and dredging collaterals, which can be treated with Simiao Powder. On the basis of syndrome differentiation and treatment, Fructus Forsythiae, Flos Lonicerae and other medicinal materials can be added to clear away heat for those with severe heat, and Ophiopogon japonicus and Huang Xuan can be added for those with yin deficiency.
2. Syndrome of spleen deficiency and dampness resistance
When moisture invades the spleen, there will be symptoms such as burnout and loss of appetite. It is common in asymptomatic period or symptom remission period, and may be accompanied by mild joint pain, hyperuricemia, dizziness, soreness of waist and knees, abdominal distension and other symptoms.
Treatment should be based on invigorating spleen and resolving phlegm, eliminating dampness and dredging collaterals. It can be treated with Sijunzi decoction. Damp-removing drugs such as Polyporus and Alisma orientalis can be added to those with heavy dampness, and Eucommia ulmoides and Rhizoma Drynariae can be added to tonify liver and kidney to those with weak waist and knees.
3. Cold-dampness arthralgia syndrome
The invasion of cold pathogen will easily lead to symptoms such as unfavorable flexion and extension, local joint pain and skin numbness. This disease is common in joint swelling and pain, accompanied by local pain, unfavorable joint flexion and extension, or tophi deposition. Treatment should be based on dispelling cold and removing dampness, dredging collaterals and relieving pain, and can be treated with modified Huangqi Ji Fang Decoction. For those with severe cold pathogen, aconite can be added to warm yang.
4. Phlegm and blood stasis syndrome
Damp heat stays in the body for a long time, leading to blood stasis. The combination of blood stasis and damp heat will make the meridian block more serious, the pain more intense and the activity seriously limited. The common symptoms of the disease are recurrent joint pain, fixation pain, joint redness and swelling, and unfavorable flexion and extension.
Treatment should be based on promoting blood circulation and removing blood stasis, resolving phlegm and dredging collaterals. It can be treated with Taohong Siwu Decoction. For patients with joint pain, frankincense and myrrh can be added to relieve pain, and Radix Astragali and Radix Codonopsis can be added to strengthen the body resistance.
5. Deficiency of liver and kidney
Cold and dampness easily invade the liver and kidney, leading to bone loss and muscle loss, leading to bone damage and unfavorable joint flexion and extension. This disease is common in recurrent joint pain, manifested as wandering pain, or joint deformation, heel pain, fatigue and weakness.
Treatment should be based on tonifying kidney and liver, activating collaterals and relieving pain, and can be treated with Duhuo Jisheng Decoction. For severe cold pain, Sini decoction can be added to warm yang and dispel cold, and Anemarrhena asphodeloides and Cortex Phellodendri can be added to nourish yin and clear heat for those with yin deficiency and excessive fire.
The above prescriptions are for reference, and the specific treatment needs syndrome differentiation.
Many people think that gout is a "monk's disease". Once you get it, it can only be a simple meal and you can't touch anything.
This understanding is actually one-sided. Meat with high protein content belongs to high-quality protein, which is one of the main channels for human body to ingest protein. Protein can't maintain its normal physiological function without adequate intake.
For gout patients, we should pay attention to the choice of meat varieties when eating meat.
The intake of purine in acute gout patients should be controlled within 150 mg per day, and foods with low purine content should be selected.
Low-purine foods: Foods with a purine content of less than 50 mg per 100 g are low-purine foods, such as rice, dairy products, eggs, fruits, carrots, cucumbers, eggplant, tomatoes and potatoes.
Medium purine food: medium purine food, such as pork, beef, grass carp, eel, eel, flounder, lobster, crab, etc. Every 65,438+000 grams of food contains 50 mg to 65,438+050 mg of purine.
High-purine food: Foods with purine content exceeding 150mg per 100g are high-purine foods, such as animal offal, thick soup, hairtail, sardines, silver carp, dried fish, prawns, scallops and oysters.
Gout was not built in a day. In addition to reasonable intake of protein, patients with gout should pay attention to keeping their mouths shut, drinking more water and exercising more, so as not to aggravate the recurrence.
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