Gout

[Overview]
Gout is a metabolic disorder caused by Yin cast a glance of the disease, resulting in hyperuricemia and gout caused by repeated episodes of acute arthritis, tophi deposition, tophi, chronic arthritis and joint deformities, and often involving the kidney chronic interstitial nephritis, and uric acid kidney stone formation as the main clinical features. According to primary and secondary causes are divided into two major categories, except for a few primary causes as those caused by enzyme deficiencies, most are not clear, often accompanied by hyperlipidemia, obesity, diabetes, hypertension, arteriosclerosis and coronary heart disease, etc., is a genetic disease.Secondary can be made by kidney disease, blood disease and drugs from a variety of reasons I bow. The disease is more common in men over the age of 40, women after menopause who also have occurred. The disease is often due to food and wine disloyal, fatigue, chills, or recurrence of infection and other factors, the onset of spring and autumn are more sudden onset and often at midnight. The illness caused by drugs, most of the cause of the lack of treatment, and therefore can not cure, often accompanied by renal insufficiency late. Gout is a traditional Chinese medicine, “Bi Syndrome”, “calendar section of the wind,” “back pain” and other areas.

[Etiology and pathology]
The cause of gout is due to overeating Feigan, alcohol, fatigue, feelings of cold or heat so intense evil, caused by blood stagnation, phlegm and blood stasis Blockage, joint disease through the air barrier.
Pathological changes of the heat of the evil wind, and wet phase and, together evil, however; or ferrite liver yang wang, or wine and food, disloyal, Yun-sheng phlegm, rheumatic fever can be caused by evil, or the wind clip phlegm, retention meridian joint , Blockage of the blood, and for rheumatic fever paralysis.Cold dampness, the passage into the meridians, blood coagulation astringent, the gas barrier, and musculoskeletal development of the wind. Arthralgia unhealed course, a very poor blood to run on, then the phlegm stasis obstinate knot meridians that may cause joint irritation, nodules, deformed embolism. Evil love being hurt, spleen deficiency, which ultimately caused the astringent power, refined discharged, physical decline exhausted.

[Diagnostic points
1 middle-aged men, suddenly the great toe, plantar, ankle, knee, etc. single joint swelling and pain, limited mobility, or metatarsophalangeal, interphalangeal and metacarpophalangeal, etc. have tophi.
(2) intra-articular puncture, synovial fluid obtained optical microscopy, can be found in uric acid salt crystals; blood uric acid, uric acid may have kidney stones or proteinuria, and renal dysfunction and other kidney diseases.

[Type] dialectical
1 Bi rheumatic fever symptoms: toe joint pain, swelling, pain, or walk, or have a fever, sweating, Fan, sore throat. Thin red tongue, pulse a few strings.
Syndromes: rheumatic fever evil, passage into the body, injury to health table, fever, sweating, sore throat; into the meridian, Blockage of the blood, then the toe joint pain, swelling; cited hot and humid air, walking channeling meridians , the migratory pain; red. thin coating, pulse a few strings for rheumatic fever paralysis of the levy.
2 wind musculoskeletal symptoms: cold sore and swollen toe joints, Yuhan benefit show, Baldwin is reduced, local skin reddish or red. Pink tongue, thin pulse tension.
Syndromes: wind cold dampness evil, passage into the meridian, cold stagnate, so Blockage blood, caused by cold sore and swollen toe joints, Yuhan benefit show, Baldwin is reduced; cold injury yang, blood flow decline less Therefore, local skin reddish or red; pink tongue, thin pulse tension, as the wind of musculoskeletal symptoms.
3 Phlegm inveterate knot symptoms: joint irritation, aggravated at night, frequent seizures, with nodules, joint swelling, deformity, limited mobility. Dark red tongue, or ecchymosis, pulse string or astringent.
Syndromes: phlegm, retention meridians, qi and blood stasis, then see the joint irritation, multiple nodules; phlegm and blood stasis as the Yin Xie, night yang deficiency, phlegm and blood stasis Blockage Yi Shen, so the pain got worse, attack frequent; Phlegm long paralysis, obstinate knot meridians, joints through the air barrier, lost in the blood Ru Yang, the joint swelling and deformity, limited mobility; dark red tongue or ecchymosis, pulse string or astringent, as phlegm and blood stasis Bi resistance of the levy.
4 spleen deficiency symptoms: pale, hands and feet are not warm, waist pain, leg weakness, worse case of labor, lying is reduced, nocturia, less anemic. Pale tongue, thin white, thin pulse.
Syndromes: evil love falling, injuring righteousness, spleen deficiency, blood loss measured looking at the operation temperature of the white, hand, foot and not warm; kidney is back pain, leg weakness; Spleen impatience labor, labor is diseaseweight, lying by the disease; kidney deficiency, astringent loss Secretary, Kidney damage, not transpiration gasification, it nocturia; subtle loss, physical decline exhausted, the less weakly; pale tongue, thin white , the pulse small, both spleen and kidney yang of the levy.

[Type] treatment
1 Bi treatment of rheumatic fever are: expelling heat, dampness Tongbi.
Recipe: Four Miao San Jia Wei.
Treats herb 9 g 12 g 12 g Achyranthes skin Yiyiren 30 Ridge 12 Sanger branch Tong Clematis 12 grams 30 grams 15 grams of honeysuckle vine?? Grass Gentiana 10 grams 20 grams plus or minus with the disease: gout, see joint swelling Tong Shen, plus 15 g habitat, red peony 15 grams, earthworm 12 g, to Qingreliangxue meridians; with fever, sweating, thirst, plus gypsum 30 g (down), Anemarrhena 10 grams, Guizhi 6 grams, red peony 15 grams, with clear air cool camp.
2 wind musculoskeletal rule is: warm and cold, expelling wind and dampness.
Recipe: Aconitum Tonga flavor.
Chuanwu ephedra 9 g 9 g 12 g 15 grams of astragalus peony Monkshood 9 g Gui 9 grams 12 grams Atractylodes has anti-wind 9 g 12 g 6 grams of licorice subtraction with the disease: the thumb joint with dark purple, or gout nodules, plus peach 9 grams, safflower 9 grams, 6 grams of frankincense, myrrh 6 grams to Huoxuetongluo Sanjie.
3 Phlegm inveterate knot rule is: phlegm stasis, pass through Sanjie.
Recipe: Taohongsiwutang addition and subtraction.
Peach kernel safflower 9 g 9 g 9 g Angelica Clematis Chuanxiong 9 g 12 g 12 g pangolin bile Southern Star Mustard Seed 9 g 9 g Scorpion 3 g centipede a subtraction with the disease: joint pain, drama, plus the system Chuanwu , 6 grams of Aconitum, Asarum 3 grams, to warm through the pain; blood uric acid, plus Cork 9 grams of the herb 9 grams, 30 grams Yiyiren Menispermaceae 15 grams, to clearing Quxie.
4 spleen deficiency rule is: Warming spleen and kidney.
Prescription: Yougui Pill.
Rehmannia Cornus yam 15 grams 15 grams 10 grams 15 grams medlar Dodder 12 Kedu Chung 12 g cinnamon with piece 10 grams 2 grams (versus service) Codonopsis Astragalus 20 grams 12 grams 12 grams Atractylodes Zhigancao 3 g subtraction with the disease: urinary tract stones, plus money grass 20 grams, Lygodium 10 grams (including fry), Dong Kuizi 10 grams of amber powder 3 grams (versus service), Gallus gallus domesticus 9 grams, to clearing the row of stone; less satisfied, loose stools, add in ginger 5 grams of wood 6 grams of Amomum 3 g (later), the temperature transport Spleen.

[Chinese medicine]
Pittosporum tablets 6 grams each time, 3 times a day.

[Simple] side
Herb 10 grams, Treats 10 grams, 30 grams Yiyiren Achyranthes 10 grams, Shuijianbi day one. For gout is a painful swelling of joints were.

30 grams astragalus, 15 grams Atractylodes, anti had 15 grams, 15 grams of Clematis, Asarum 3 grams, Shuijianbi day one, for the case of gout musculoskeletal Mild wind.

[Other therapies]
External: joint swelling and pain at the Golden Plaster, dressing was changed every 2 to 3 days, 10 days a course of treatment.Gout is a rheumatic fever for Bi.
Acupuncture: Acupuncture Xie River, Kunlun, hanging bell, Yanglingquan, gu, Yifeng, foreign customs, music pool, Shenshu and other points, each hole 2 or 3 election, reinforcing-reducing, needle for 15 minutes .
Food therapy: fresh grapes 30 grams, 50 grams of rice, with the porridge, each R taking to promote uric acid excretion.

[Note]
1 gout often accompanied by obesity, high cholesterol, hypertension, coronary heart disease, diabetes and other diseases, and easily due to high uric acid involving the kidneys, causing renal insufficiency, it should be timely treatment of hyperuricemia.
(2) control diet, avoid alcohol, high fasting Han Piaoling various animal offal, broth, and some high protein and high fat fish, beans.