Adolescent ; Gout ; diagnosis ; drug therapy ; Humans ; Male

OBJECTIVE: To observe the diurnal difference of acute gout attacks in men, and provide reference for accurate clinical prevention and treatment. METHODS: Using a single-center, cross-sectional study design, the patients diagnosed with gout in the outpatient department of Rheumatology and Immuno-logy of PLA Joint Logistic Support Force No.980 Hospital from October 2021 to April 2022 were selected. The information about the patient's current/last acute gout attacks (less than 2 weeks from visit), date and time of attacks, joint symptoms and signs, medication use, and relevant biochemical tests on the day of visit was recorded. The diurnal time difference of acute gout attacks in male patients was analyzed, and univariate comparison and multivariate Logistic regression analyses were conducted to compare the diurnal difference of acute gout attacks with clinical characteristics and biochemical indicators. RESULTS: A total of 100 male gout patients were included, and 100 acute attacks were recorded. Diurnal distribution of acute gout attacks: morning (6:00~11:59, 18, 18%), afternoon (12:00~17:59, 11, 11%), the first half of the night (18:00~23:59, 22, 22%), the second half of the night (0:00~05:59, 49, 49%); During the day (included morning and afternoon, 29, 29%) and at night (included the first half of the night and the second half of the night, 71, 71%). The rate of acute gout attack was significantly higher at night than in the day (about 2.5 ∶1). No matter the first or recurrent gout, no matter the duration of the disease, the number of acute gout attacks had the difference of less in the day and more in the night. Serum urate (SU) level was higher in the patients with nocturnal attack than in those with daytime attack (P=0.044). Comorbidities were significantly different in the day-night ratio of the number of acute gout attack (P=0.028). Multiple Logistic regression analysis showed that SU level (OR=1.005, 95%CI: 1.001-1.009) and comorbidities (OR=3.812, 95%CI: 1.443-10.144) were the correlative factors of nocturnal acute gout attacks. CONCLUSION No matter the first or recurrent gout, no matter the duration of the disease, it has a diurnal variation characterized by multiple attacks at night, increased SU level and comorbidities are correlative factors for nocturnal acute attack of gout.
Humans ; Male ; Cross-Sectional Studies ; Gout/drug therapy* ; Arthritis, Gouty ; Gout Suppressants/therapeutic use* ; Comorbidity

This study aims to compare the urate-lowering response rate of febuxostat and allopurinol in gout patient using a model-based meta-analysis. The literature search identified 22 clinical trials of gout with a total of 43 unique treatment arms that met our inclusion criteria, and a total of 6 365 gout patients were included in the study. The response rates of allopuriol and febuxostat were characterized by Tmax model and Emax model respectively, and the effect of baseline serum uric acid (sUA) and patient type on the drug effect was tested. The results showed that allopurinol can reach an average maximum response rate of 50.8% while febuxostat can reach a 100% response rate within a very short time, and the ED50 was 34.3 mg. Covariate analysis revealed that baseline sUA has a negative effect on response rate of allopurinol, and a positive effect on the predicted ED50 of febuxostat. For patients who had shown inadequate response to prior allopurinol treatment, the average response rate was about half that of the allopurinol responder patients.
Allopurinol ; therapeutic use ; Febuxostat ; Gout ; blood ; drug therapy ; Gout Suppressants ; therapeutic use ; Humans ; Thiazoles ; therapeutic use ; Uric Acid ; blood

OBJECTIVETo observe the curative effect of the self-formulated Jiangzhuo Huoxue Yishen Decoction (JHYD) combined with Western medicine in treatment of gout.

METHODSA total of 90 gout patients were randomly assigned to two groups, the control group (45 cases) administrated with Finbid orally in the acute stage and allopurinol in the remission period; and the treatment group (45 cases) treated with the same treatment plus oral administration of JHYD. The therapeutic course for both was 4 weeks. The total curative effect, the effect on main symptoms and on different syndrome types, changes of blood uric acid, adverse reactions and recurrence of gout were observed and compared between the two groups.

RESULTSThe cured and markedly effective rate and the total effective rate in the treatment group were all obviously higher than those in the control group (P<0.05). And the effect was better in the treatment group in decreasing blood uric acid, improving symptoms of main joints and stabilizing the curative effect. The curative effect of the combined therapy on different syndrome types was basically consistent, and it showed few adverse reactions.

CONCLUSIONThe self-formulated JHYD showed synergistic effect with Western medicine in treatment of gout, which could decrease blood uric acid level and improve clinical symptoms.

Adult ; Allopurinol ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gout ; drug therapy ; Gout Suppressants ; therapeutic use ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome

Allopurinol ; adverse effects ; Drug Hypersensitivity ; etiology ; mortality ; Gout ; drug therapy ; Gout Suppressants ; adverse effects ; Humans ; Monitoring, Physiologic ; methods ; Nephrology ; methods ; Risk ; Treatment Outcome

Qigui Tongfeng tablet (QLTFT) is a traditional Chinese medicine with good effect for treating gout. Here, network pharmacology method and molecular similarity analysis were utilized to study the effective substance basis and molecular mechanism of the QLTFT on the gout. The similarity to the medicinal compounds is reflected in the Tanimoto coefficient that gives the structural similarity of two compounds. Operationally, similar modifiers were described as pairs of concepts with a similarity score of 0. 500. The results of the molecular similarity analysis suggested that the flavonoids in QLTFT could be new leads for gout. Furthermore, complex biological systems may be represented and analyzed as computable networks. Two important properties of a network were degree and betweenness. Nodes with high degree or high betweenness may play important roles in the overall composition of a network. And the results of network analysis showed that dongbeinine, verticinone-N-oxide, verticine N-oxide, peimine, peiminine, isobaimonidine, dongbeirine, peimisine and simi-arenol which with high degree acted on xanthine dehydrogenase/oxidase, matrix metalloproteinase-9, an arachidonate 5-lipoxygenase-activating protein, tyrosine-protein kinase and etc. Inhibition of these targets can prevent the formation of uric acid, reduce inflammation by uric acid and regulate the body's immune response. Thus, these compounds may be the main effective substance basis. The research results not only reveals its molecular mechanism, but also provide a theoretical basis for the quality control of drugs and clinical application.
Gout ; drug therapy ; Humans ; Medicine, Chinese Traditional ; Pharmacology ; methods ; Tablets ; Technology, Pharmaceutical ; methods

Drugs, Chinese Herbal ; therapeutic use ; Gout ; diagnosis ; drug therapy ; Humans ; Medicine, Chinese Traditional ; Phytotherapy

OBJECTIVETo study the correlation in the material foundation in compatibility of Ermiao wan categorized formulas (Ermiaowan, Sanmiaowan, Simiaowan and modified Simiaowan) and to explore its characteristics changes.

METHODDetermined the fingerprint of the effective parts of Ermiao wan categorized formulas in anti-gouty syndrome of damp and heat and compared the composition features and compatibility changes of total peaks by establishing the HPLC fingerprint and using reference substances to identify the ingredients of the common peaks, the ascription and the source of the chromatographic peaks.

RESULTThe effective parts of modified Simiao Wan had 60 total peaks which come from the sites of alkaloids, flavonoids, organic acids. There were some change principles in the number of total peaks and relative peak area ratio between basic formula and categorized formulas.

CONCLUSIONErmiaowan categorized formulas have same substance-foundation and there are some correlations in the compatibility changes.

Alkaloids ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Flavonoids ; chemistry ; Gout ; drug therapy ; Gout Suppressants ; chemistry ; therapeutic use ; Hot Temperature

No abstract available.
Alcohol Drinking/adverse effects ; Carpal Tunnel Syndrome/diagnosis/*etiology ; Gout/*complications/diagnosis/drug therapy ; Gout Suppressants/therapeutic use ; Humans ; Male ; Risk Factors ; Tomography, X-Ray Computed

Colchicine plays an important role in the treatment of gout and some other diseases. Besides gastrointestinal symptoms, myopathy has been reported as a rare side effect of colchicine in some patients. We report a case of myopathy in a patient with chronic kidney disease caused by high-dose colchicine, and then review literature on colchicine-induced myopathy, so as to provide some experience for the clinical diagnosis, treatment and medication safety. A 51-year-old male patient with 10 years of gout and 5 years of chronic kidney disease history and irregular treatment was admitted to the hospital with complaint of recurrent left wrist arthralgia and emerging lower extremities myalgia after intake of 40-50 mg colchicine in total within 20 days. Laboratory examinations showed significantly increased creatine kinase (CK) and then colchicine-induced myopathy was diagnosed preliminarily. After withdrawl of colchicine and implementation of hydration, alkalization and intramuscular injection of compound betamethasone, the symptoms of arthralgia and myalgia were relieved within 3 days and CK decreased to normal range gradually. According to literature reports, colchicine related myopathy was mostly characterized by proximal myasthenia and myalgia, accompanied by elevated CK level, which usually occurred days to weeks after initial administration of colchicine at the usual dosage in patients with renal impairment or a change in the underlying disease state in those receiving long-term therapy, and the features might remit within three to four weeks after the drug was discontinued. Electromyography of proximal muscles showed myopathy marked by abnormal spontaneous activity and muscle pathology waa marked by accumulation of lysosomes and autophagic vacuoles. Chronic kidney disease, liver cirrhosis, higher colchicine dose and concomitant cytochrome P450 3A4 (CYP3A4) inhibitors were associated with increased risk of myo-pathy. Based on the similar efficacy and lower adverse reaction rate compared with larger dosage, small dose of colchicine was recommended by many important current guidelines and recommendations in the treatment of gout. In consideration of potential risks, colchicine should be used with caution in patients with kidney or liver impairment, and in those taking CYP3A4 or P-glycoprotein inhibitors. For those patients, the drug dose should be adjusted and the latent adverse reactions should be monitored carefully.
Colchicine/adverse effects* ; Gout/drug therapy* ; Humans ; Kidney ; Male ; Middle Aged ; Muscular Diseases/chemically induced* ; Renal Insufficiency, Chronic/complications*