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

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

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

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

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

The gout is a hereditary condition of disturbed uric acid metabolism. There are medical and surgical management in tophaceous gout for prevention of recurrence of acute attack and creation of a negative uric acid balance. The surgical management is removal of tophaceous material in the soft tissue and osseous structure. Aditionally, the resection of bone and joint, arthrodesis and bone graft improve the functional capacity of the gouty patients. A 53 years old man was managed by removal of tophaceous materials in both prepatellar area, left olecranon area and both feet and arthrodesis of left first metatarsophalangeal joint with autogenous iliac bone graft and supportive medication with probenecid and indomethacine, and was followed up from March, 1986 to April, 1987. There was no significant difference in duration between the union of nonpathologic fracture and the union of arthrodesis area in this gouty patient. We found the progressive recovery of normal trabeculation in previous destructive bone lesions with drug therapy, but there was no specific change in the soft tissue lesions.
Arthrodesis ; Drug Therapy ; Foot ; Gout ; Humans ; Indomethacin ; Joints ; Metabolism ; Metatarsophalangeal Joint ; Olecranon Process ; Probenecid ; Recurrence ; Transplants ; Uric Acid