OBJECTIVETo search for a new method for treatment of acute gouty arthritis.

METHODSOne hundred cases of acute gouty arthritis were randomly divided into an observation group and a control group. The observation group were treated with local blocking and electroacupuncture at Yinbai (SP 1), Taichong (LR 3), Sanyinjiao (SP 6), Zusanli (ST 36), Fenglong (ST 40), Yinlingquan (SP 9) and Ashi points, and the control group were treated with oral administration of 25 mg Indomethacin, thrice each day, and 100 mg Allopurinol, thrice daily. The therapeutic effects and changes of pain score, serum uric acid were observed in the two groups.

RESULTSThe effective rate was 96.4% in the observation group and 84.1% in the control group, the former being better than the later (P < 0.05). Before and after treatment, pain scores were 3.48 +/- 1.05 and 0.94 +/- 10.85, 3.45 +/- 1.07 and 2.11 +/- 0.91, and serum uric acid contents were (539.16 +/- 34.49) micromol/L and (376.30 +/- 52.85) micromol/L, and (552.29 +/- 46.15) micromol/L and (425.79 +/- 48.69) micromol/L in the two group, respectively. After treatment, pain score and serum uric acid content very significantly decreased in the two groups (both P < 0.01) and the observation group in the analgesic effect and the effect in decreasing serum uric acid content was better than the control group (both P < 0.01).

CONCLUSIONElectroacupuncture combined with local blocking is an effective method for treatment of acute gouty arthritis and it can decrease blood uric acid level.

Acupuncture Points ; Acute Disease ; Adult ; Aged ; Allopurinol ; administration & dosage ; Arthritis, Gouty ; therapy ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Indomethacin ; administration & dosage ; Male ; Middle Aged

OBJECTIVETo study the effect of retention enema of Chinese herbal medicine combined with allopurinol in treating hyperuricaemia (HUE).

METHODSSeventy-eight patients with HUE were assigned to two: groups, the 40 patients in the treated group were treated with retention enema of Chinese herbal medicine combined with oral intake of allopurinol, and the 38 patients in the control group were treated with allopurinol alone. The therapeutic course for all was 6 weeks. The clinical efficacy, changes of symptoms, blood levels of uric acid and lipids, renal function, and 24 h urinary micro-albumin were observed.

RESULTSThe total effective rate was: 92.5% in the treated group, which was significantly higher than that in the control group (68.4%, P<0.05). After treatment, the score of symptoms in the treated group decreased from 9.43+/-1.15 scores to 3.25+/-0.85 scores, significantly lower than that in the control group (9.75+/-1.43 scores vs 9.25+/-0.82 scores, P<0.01). Moreover, the post-treatment improvements in blood uric acid, blood lipids, renal function and 24h urinary micro-albumin in the treated group were all better than those in the control group (P<0.05 or P<0.01).

CONCLUSIONRetention enema with: Chinese herbal medicine combined with allopurinol could obviously reduce the uric acid level in blood, improve patients' renal function and lipid metabolism, and alleviate the clinical symptoms in patients with HUE.

Adult ; Aged ; Allopurinol ; administration & dosage ; adverse effects ; Blood Urea Nitrogen ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Enema ; Female ; Humans ; Hyperuricemia ; drug therapy ; physiopathology ; Lipids ; blood ; Male ; Middle Aged ; Uric Acid ; blood

PURPOSE: It has previously been reported that citrate, thiazide, allopurinol and magnesium (CTAM) have inhibitory effects on calcium oxalate crystallization, but the effects of CTAM on the matrix proteins of stones in vivo has not been studied. Using an ethylene glycol-induced urolithiasis model, we investigated the effects of CTAM on renal crystallization and the expression of osteopontin (OPN), which is an important stone matrix protein. MATERIALS AND METHODS: Adult Sprague-Dawley rats (200-250gm) were divided randomly into 6 groups of 10 rats. Group 1 was left untreated, and served as a control. Group 2 (CID group) was fed 0.8% ethylene glycol and 1% ammonium chloride (crystal-inducing diet, CID) in drinking water for 4 weeks. Groups 3, 4, 5 and 6 (CTAM groups) were fed the same CID as group 2, but were also treated with either potassium citrate or hydrochlorothiazide or allopurinol or magnesium hydroxide, for 4 weeks, respectively. We biochemically analyzed the 24-hour urine and serum samples. The renal calcium content was measured by atomic absorption. The kidneys were histologically examined for crystal deposit with HandE staining, and for OPN expression with immunohistochemical staining. RESULTS: The grade of calcium oxalate crystal deposits, and renal calcium content, were significantly decreased in the CTAM groups compared to the CID group, which also correlated with the decreased expression of OPN proteins in the kidneys of the CTAM-treated rats. CTAM were all effective in preventing calcium oxalate crystal formation, and decreasing the expression of OPN in rat kidneys. CONCLUSIONS: Our results suggest that CTAM are effective in preventing calcium oxalate stone formation, and that OPN plays an important role in calcium oxalate nephrolithiasis.
Absorption ; Administration, Oral* ; Adult ; Allopurinol* ; Ammonium Chloride ; Animals ; Calcium Oxalate* ; Calcium* ; Citric Acid* ; Crystallization ; Diet ; Drinking Water ; Ethylene Glycol ; Hand ; Humans ; Hydrochlorothiazide ; Kidney ; Magnesium Hydroxide ; Magnesium* ; Nephrolithiasis ; Osteopontin* ; Potassium Citrate ; Rats* ; Rats, Sprague-Dawley ; Urolithiasis*

The aim of this study was to observe the effects of uric acid lowering therapy (UALT), febuxostat and allopurinol, on blood pressure (BP) and serum creatinine level. Post-hoc data were derived from a phase-III, randomised, double-blind, 4-week trial of male gouty patients that compared the safety and efficacy of febuxostat and allopurinol in adults with gout. The subjects were randomly assigned to one of five groups, 35-37 in each group (febuxostat: 40, 80, 120 mg/d; allopurinol: 300 mg/d; control group: placebo). Blood pressure and serum creatinine level were measured at baseline and at weeks 2 and 4. Diastolic BP and creatinine level had decreased significantly in the UALT groups compared to the control group at week 4. Diastolic BP had decreased significantly in the allopurinol group and serum creatinine level had decreased significantly in the febuxostat groups at week 4. After adjusting for confounding variables, serum uric acid changes were found to be significantly correlated with changes in serum creatinine level but were not associated with changes in systolic or diastolic BP. UALT in gouty subjects significantly decreased diastolic BP and serum creatinine level. Changes in uric acid were significantly correlated with those in serum creatinine level, suggesting the feasibility of renal function improvement through UALT in gouty men.
Allopurinol/*administration & dosage ; Biological Markers/blood ; Blood Pressure/*drug effects ; Creatinine/*blood ; Dose-Response Relationship, Drug ; Gout/*drug therapy ; Gout Suppressants/administration & dosage ; Humans ; Hypertension, Renal/diagnosis/etiology/*prevention & control ; Male ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Thiazoles/*administration & dosage ; Treatment Outcome

In this study, SD rats were orally administrated with oteracil potassium (300 mg . kg-1 . d-1 ) to prepare the hyperuricemia model, and divided into normal, model, Allopurinol, LE high dosage, middle dosage and low dose (200, 100, 50 mg . kg-1 . d-1) groups. The rats were orally administrated with test drugs 1 hour later after being orally administrated with Oteracil potassium. After 7 days, serum uric acid, serum creatinine, uric acid and expression of relevant transporters in kidney were tested to study the regulatory effect of leonurus extracts on serum uric acid, renal function and relevant transporters in kidney of rats with hyperuricemia. Compared with the model group, the leonurus extract group could significantly down-regulate serum uric acid and creatinine levels of rats with hyperuricemia, and increase the urine uric acid level. Meanwhile, leonurus extracts could notably down-regulate the mRNA expressions of urate transporter 1 (URAT1) and glucose transporter 9 (GLUT9), up-regulate the mRNA expressions of organic cation transportanter (OCT) and Carnitine transporter (OCTN) and promote the excretion of uric acid of kidney.
Allopurinol ; pharmacology ; Animals ; Blood Urea Nitrogen ; Creatinine ; blood ; Disease Models, Animal ; Down-Regulation ; Gene Expression Regulation ; drug effects ; Hyperuricemia ; blood ; drug therapy ; Kidney ; drug effects ; Leonurus ; chemistry ; Male ; Organic Anion Transporters ; genetics ; Oxonic Acid ; administration & dosage ; Plant Extracts ; isolation & purification ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Specific Pathogen-Free Organisms ; Up-Regulation ; Uric Acid ; blood