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Objective To observe the effects of urate-lowering therapy ( ULT) on indexes of inflammation, the frequency of gout flares, compliance of ULT, and the achieved rates of serum uric acid in patients at acute stage. Methods 151 patients with acute gout flares were randomly divided into observation group ( 60 cases with ULT in the acute phase) and control group (91 cases with ULT after 2 weeks of complete remission from acute flares). Visual analogue pain scores (VAS), joint swelling scores, white blood cell counts, erythrocyte sedimentation rates (ESR), as well as high sensitive-C reactive protein (hs-CRP) were measured respectively and compared between two groups. The observation group was treated with 40 mg/d of febuxostat for 12 weeks after effectively achieved inflammation ( VAS<3 points) , while the control group was treated with the same therapy after 2 weeks of symptoms complete remission from acute gout flares. Finally, these indexes were followed and recorded, including the number of gout flares, the compliance of ULT, the changes of liver and kidney function, and the proportion of patients with serum uric acid<360μmol/L. Results There was no statistical difference in the baseline condition, VAS pain scores, joint swelling scores, white blood cell counts, ESR, and hs-CRP between two groups after different ULTs ( all P>0.05) . There was no statistical difference in the frequency of gout flares between two groups during the ULT of 12 weeks ( P=0.658) . At the end of 12 weeks, the serum uric acid in the observation group was significantly lower compared with the control group [(318.38±95.16 vs 398.12±120.13)μmol/L,P<0.01]. The compliance rate of ULT and the rate of reaching the standard of serum uric acid<360μmol/L in the observation group were higher than those in the control group ( both P<0.01) . Conclusion The treatment of ULT with patients after effective achieved of acute gout inflammation has no detrimental effects on VAS pain, joint swelling score, the conversion of inflammation index, and the number of gout flares, while improving the compliance of ULT and the achieved rate of serum uric acid.
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Objective To investigate the effect of Anerdian type III solution on the treatment of acute gouty monoarthritis. Methods Total 108 cases of acute gouty monoarthritis were divided into two groups according to the method of random number table, including 56 cases in the Anerdian group and 53 cases in the Votalin group, respectively. The Anerdian group was applied Anerdian type III solution to compress the swelling joint wet for 30 minutes, while the Votalin group was given Votalin Emulgel for external application in the swollen joint. Then the scores of pain and redness were calculated, and the effects of local treatment were compared directly before and after the treatment, and these variables were also compared after 7 days. Results 24 hours and 72 hours after the treatment, the pain score in the Anerdian group was 3.44 ± 0.89 and 2.43 ± 0.73 (t=2.375, 3.393, P<0.01), while the pain score in the Votalin group was 3.85 ± 0.74 and 3.14 ± 0.68 (t=2.208, 3.120, P<0.01), respectively, which referred to improvement in both groups.And the score of redness in the Anerdian group was 1.57 ± 0.70 and 1.13 ± 0.35 (t=0.589, 0.964, P<0.01), while the score of redness in the Votalin group was 1.95 ± 0.73 and 1.61 ± 0.49 (t=0.151, 0.623, P=0.091, P<0.01) respectively. 24 hours and 72 hours after the treatment, the score of redness in the Anerdian group was smaller than that in the Votalin Group (t=3.379, 4.290, P<0.01). In Anerdian group, local treatment showed fully cured in 28 cases, marked effective in 15 cases, effective in 11 cases, not effective in 2 case, and total effective rate was 96.4% (54/56) after 7 days′treatment, while in Votalin group, local treatment revealed fully cured in 24 cases, marked effective in 11 cases, effective in 8 cases, not effective in 9 case, and total effective rate was 83.0% (44/53). There was statistically significant difference between the two groups in local treatment ( χ2=4.019, P<0.05). Conclusion Anerdian type III solution can alleviate the symptoms of acute gouty unilateral arthritis quickly. It hasbetter curative effect on local treatment of acute gouty monoarthritis than Votalin.
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Objective To Qingre ChuBi decoction combined with psychological intervention efficacy and safety in the treatment of patients with acute gout were analyzed. Methods In our hospital from March 2014 to November 2016 received 68 cases of acute gout patients as the research object, according to patients were randomly divided into control group and treatment group, 34 cases in the control group were treated with Etoricoxib Tablets and psychological intervention treatment, 34 cases of patients in the treatment group in the control group plus Chubi decoction for clearing. Results Two groups of patients before treatment VAS score were compared, no significant difference; The VAS score after treatment compared with before treatment were significantly decreased (P<0.05), comparison between groups had significant differences; compared with control group, VAS score improved more obviously (P<0.05), comparison between groups had significant differences. Conclusion Qingre ChuBi decoction combined with psychological intervention has a good effect on the treatment of acute gout, high safety, worthy of clinical application.
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Objective To observe the clinical efficacy of Xiezhuo Zhubi Decoction combined with Etoricoxib for the treatment of acute gout arthritis.Methods Seventy acute gout arthritis patients were randomly divided into treatment group and control group,35 cases in each group.Based on the fundamental treatment,the control group were given oral use of Etoricoxib and the treatment group was treated with Xiezhuo Zhubi Decoction combined with Etoricoxib.The treatment for both group lasted for 7 days.Before and after treatment,the changes of blood uric acid,C-reactive protein and erythrocyte sedimentation rate in both groups were observed.After treatment,the clinical efficacy was evaluated,and the toxic and adverse effects were also monitored.Results (1) In the treatment group,the total effective rate was 91.4％;in the control group,the total effective rate was 71.4％.There were significant differences between the two groups(P ＜ 0.05).(2) After treatment,blood uric acid,C-reactive protein and blood sedimentation rate were much improved in both groups (P ＜ 0.05 compared with those before treatment),and the treatment group had better effect on improving blood uric acid and C-reactive protein(P ＜ 0.05).(3) The control group had 3 cases of nausea,while no adverse reactions occurred in the treatment group.Conclusion Xiezhuo Zhubi Decoction combined with Etoricoxib is effective for the treatment of acute gout arthritis,and its effects on relieving clinical symptoms and decreasing blood uric acid and erythrocyte sedimentation rate are better than Etoricoxib alone.
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Objective:To analyze dynamic change and severity of IL-1 beta, TNF alpha, COX-2 detected by automatic enzyme immunoassay analyzer on patients with acute gout.Methods: Ninety cases of acute gout patients selected according to the different degrees of severity, and were divided into three observed groups. Thirty health people were treated as the control group. IL-1β, TNF-α, COX-2 levels of dynamic change were recorded and compared within the four groups of patients.Results: The serum IL-1β, TNF-α, COX-2 levels in the 1st, 3rd, 7th, 10th day in the observation group 1 and group 2 in acute gout attacks were significantly higher than the control group; The serum levels of IL-1β, TNF-α, COX-2 levels in the 7th 10th day in observation group 1 in acute gout was significantly higher than observation group 2; The serum IL-1β, TNF-α,COX-2 levels in observation group 3 have not significant difference with control group 2; The serum IL-1β, TNF-α, COX-2 levels in observation group1,2,3 in acute gout attacks in the 14th days have not significant difference with control group.Conclusion: After analgesic drugs for the treatment of acute gout patients from 10 to 14 days, the inflammatory cytokines can be completely back to normal. The results provided important evidence for the introduction of analgesic drugs in patients with acute gout treatment.
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A 54-year-old male on chronic hemodialysis, who was taking rifampicin for tuberculous lymphadenitis, was admitted for an acute gout attack. After administrating 3.6 mg of colchicine for 2 days, symptoms began to alleviate. Despite the relatively high dosage in this end-stage renal disease patient, there were no adverse effects, such as diarrhea, vomiting, or myopathy. After 1 and 6 hours of 0.6 mg colchicine administration, serum colchicine was 1.3930 ng/mL and 0.2464 ng/mL, respectively. These values were lower than the mean concentrations in 13 other patients with chronic kidney disease (CKD) after the same time intervals (4.34+/-0.56 ng/mL and 1.49+/-0.15 ng/mL, respectively). As rifampicin is an inducer of cytochrome P450 3A4, metabolism of colchicine had increased. When taking colchicine and rifampicin simultaneously, a higher colchicine dose may be needed for the treatment of acute gout in patients with CKD.
Subject(s)
Humans , Male , Middle Aged , Colchicine , Cytochrome P-450 Enzyme System , Diarrhea , Gout , Kidney Failure, Chronic , Metabolism , Muscular Diseases , Renal Dialysis , Renal Insufficiency, Chronic , Rifampin , Tuberculosis, Lymph Node , VomitingABSTRACT
[Objective]To introduce the knowledge for the diagnosis of acute gout arthritis that attacked initially in the knee and improve its early treatment.[Method]Seventeen cases with acute gout arthritis in the knee were diagnosed and treated under arthroscopy since 2000.The experiences were analysed retrospectively and the therapatic results were observed through a follow-up of more than 6 months.[Result]Before arthroscopy,only 5 cases were considered as acute gout arthritis,the other 12 cases were given a misdiagnosis.All the patients were diagnosed and given a debridment simutaneously under arthoscopy.Then,the patients were given an postoperative systematic drugs therapy.The follow-up(ranged from 10 to 24 months)showed that all the patients acquired a short-term and long-term satisfactory therapeutic effect.[Conclusion]The acute gout arthritis attacked initially in the knee is rare and its misdiagnosis rate is very high.The significant improvement and extensive application of arthroscopic techniques will improve its diagnosis rate and provide a new way for its early surgical treatment.