ABSTRACT
Objective:To observe the efficacy and safety of Qifu Huazhuo decoction in treating intermittent and chronic gout. Method:A total of 160 eligible patients with intermittent and chronic gout were divided into intervention group and control group according to treatment methods， 80 cases in each group. Qifu Huazhuo decoction combined with febuxostat was given in intervention group by oral administration， while the patients in control took febuxostat combined with sodium bicarbonate tablet. After twelve weeks of treatment in both groups， the onset frequency of gout， the degree of joint pain， the levels of uric acid， creatinine， alanine transaminase in the blood， number of cases to use analgesics and adverse events were recorded compared before and after treatment. Twelve weeks follow-up was also conducted after the treatment. Result:The total effective rate was 91.25% （73/80） in intervention group， higher than 83.75% （67/80） in control group， with a significant difference between two groups （χ2=0.16， P<0.05）. Intervention group was superior to control group in improvement of onset frequency of gout， joint pain （P<0.05）， and blood uric acid （P<0.05）. There was no significant difference between two groups in blood creatinine and alanine transaminase. The number of patients using analgesics was less in intervention group （P<0.05）. In terms of adverse reactions， there were two cases of fever， two cases of abnormal liver function， six cases of abnormal kidney function and three cases of gastrointestinal reaction after the treatment in intervention group. While for control group， there were one case of fever， two cases of abnormal liver function， eight cases of abnormal kidney function and five cases of gastrointestinal reaction， without significant differences between two groups. Conclusion:The Qifu Huazhuo decoction can effectively reduce the onset frequency of gout and the degree of joint pain in intermittent and chronic phases， effectively control the level of blood uric acid， and reduce the number of cases using analgesics， with less adverse reactions， so it is suitable for clinical use.
ABSTRACT
Objective To analyze the structure and component of gouty tophus around joint, and provide basis to select solvent of gouty tophus and surgical cleaning method.Methods The sample of gouty tophus were obtained from 6 patients in 187 hospital of PLA from January2016 to December 2017, which were rinsed by distilled water, and then dried and accepted other dispose.The sample were analyzed by Fourier Transform Infrared Spectroscopy (FTIR), scanning electron microscope and thermal gravimetric analyzer.Results Sodium urate was the main component of the uratoma, the proportion was 56％;the organic component was about 14％of the uratoma.The microstructure of the uratoma under scanning electron microscope have two forms, the one looks like column crystal and the other like granules head up to lump.Conclusion The main component of the gouty tophus are sodium urate and organic tissues, the possible solvent should react on the both of them.
ABSTRACT
Recently, gout prevalence is increasing, but in Vietnam the knowledge of gout is not enough. Objectives: (1) Describe clinical X-ray manifestations of bone and joint damage related to chronic gout. (2) Identify suggestive factors to make diagnosis of bone and joint damage related to chronic gout. Methods: The cross-study included 54 patients with chronic gout presented in the Rheumatology Department of Bach Mai Hospital from March-2003 to June-2004. All of them were diagnosed gout according to the criteria of Bennett and Wood-1968 and had tophi nodules. Results: The common findings are polyarthritis (79.6%), lower limbs are involved more common than upper limbs (75-80% of patients had ankle, knee, first metatarsophalangeal joint arthritis) and symmetric arthritis (60% to 70%). All patients had a history of acute gout. 80% of patients had chronic gout presented in X-ray images, including joint space narrowing, erosion, new bone formation at the edge of a gradually expanding tophus. Important factors can be considered of chronic gout were male, middle age, symmetric arthritis of lower limbs, tophi nodules. Conclusions: Suggestive factors and X-ray of bone and join contribute to earlier diagnosis of bone and joint damage in chronic gout.