For convenience, domestic scholars have formulated a relatively simple standard: the typical acute arthritis attack can stop itself and enter the asymptomatic interval, and hyperuricemia can be diagnosed at the same time; Uric acid salt crystals were found in joint cavity effusion or white blood cells; Uric acid salt crystals were found in gout nodules. Anyone with one of the above three items can be diagnosed.
Diagnostic criteria of traditional Chinese medicine: The diagnostic criteria of gout in traditional Chinese medicine mainly adopt the criteria of "Diagnostic basis, syndrome classification and curative effect evaluation of gout" in "Diagnostic efficacy criteria of TCM diseases and syndromes" issued by state administration of traditional chinese medicine. The diagnosis is based on the following points.
(1) Most of them are single-toed joints, which suddenly swell and ache, and the pain gradually becomes as severe as being bitten by a tiger, which is light during the day and severe at night, with repeated attacks. Symptoms such as fever and headache may occur.
(2) It is more common in middle-aged and elderly men and may have a family history of gout. It is often induced by fatigue, overeating, high purine diet, drinking, exogenous cold and so on.
(3) At the beginning, it can be a single joint, especially the first toe joint. Then the ankle, heel, fingers and other small joints appear red, swollen, hot, painful, and even joint cavities may have exudates.
After repeated attacks, it may be accompanied by "lumps" around joints, auricles, helix and toes and phalanges.
(Tuofei).
(4) Serum uric acid and uric acid increased. The number of white blood cells increased during the attack.
(5) If necessary, do B-ultrasound scanning of kidney, routine urine test and renal function examination to understand the pathological changes of kidney after gout. X-ray examination can show that there are irregular perforation-like circular defects in the bone near the cartilage edge.
TCM syndromes are classified as follows.
(1) Damp-heat accumulation. The facet joints of lower limbs are suddenly red, swollen, painful and painful. If you refuse to press it, touch it locally, and you will be relieved when it is cold. Accompanied by fever, thirst, upset and yellow urine. Red tongue, yellow greasy fur and slippery pulse.
(2) Blood stasis and heat depression. The joints are red, swollen and tingling, and local swelling and deformation are not conducive to flexion and extension. The skin is purple and black, so press it hard. There may be lumps around the lesion and the skin is dry and dark.
The tongue is dark purple or ecchymosis, with thin yellow fur, thin and astringent pulse or heavy string.
(3) Phlegm obstruction. Joint swelling, even edema around the joint, local soreness and numbness, or lump induration without redness. Accompanied by dizziness, edema of face and feet, chest tightness. The tongue is fat, purple and dark, with white and greasy fur and a stringy or slippery pulse.
(4) Yin deficiency of liver and kidney. Repeated illness, joint pain like tiger bite, local joint deformation, light day and night, insensitive skin, difficulty in walking, tight muscles and bones, unfavorable flexion and extension, dizziness and tinnitus, red cheekbones and dry mouth. The tongue is red with little fur, and the pulse is thin or thin.