Gout
Gout is a crystal-associated arthropathy caused by the deposition of monosodium urate (MSU) crystals. It is directly associated with hyperuricemia resulting from disordered purine metabolism and/or reduced uric acid excretion, and falls within the category of metabolic rheumatic diseases. Gout specifically refers to acute characteristic arthritis and chronic tophaceous disease. It may be complicated by kidney disease and, in severe cases, joint destruction and impaired kidney function. It is also commonly associated with other components of metabolic syndrome, such as abdominal obesity, dyslipidemia, hypertension, type 2 diabetes, and cardiovascular disease.
TCM Pattern Differentiation and Medication Reference
|Common Symptoms
Technical description:
Joints are red, swollen, hot, and painful, with sudden onset. Fever and thirst may also occur, along with scant, dark-yellow urine, a red tongue with a yellow or yellow-greasy coating, and a wiry, slippery, rapid pulse.
In plain language:
- Joints become red, swollen, hot, and painful; they may feel hot to the touch.
- Onset is sudden, and symptoms develop quickly.
- Fever and thirst may occur at the same time.
- Urine may be yellow and low in volume.
- The tongue may look red, with a yellow coating.
- The tongue coating may also appear yellow and greasy.
- On pulse examination, the pulse feels taut like a stretched string and smooth, with a faster-than-usual rate.
|Treatment Approach
Technical description:
Clear heat, drain dampness, unblock the collaterals, and relieve pain.
In plain language:
- Clear heat → Reduce internal heat, easing discomfort such as redness, swelling, a burning sensation, sore throat, thirst, and restlessness.
- Drain dampness → Promote the elimination of dampness through urine and sweat, helping ease heaviness, a sticky or greasy sensation, swelling, weeping, and a feeling of heaviness in the joints.
- Unblock the collaterals → Promote the flow of qi and blood through the channels and microcirculation, helping improve numbness, stiffness, and restricted movement.
- Relieve pain → Help ease pain, aching, stabbing sensations, and pulling discomfort.
|Related Products
The products below are provided for information only and do not constitute medical advice or a prescription. Refer to the outer packaging and package insert, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Technical description:
Joint symptoms are not prominent. There may be fatigue and a heavy feeling in the body, reduced appetite, and fullness or stuffiness in the upper abdomen. The tongue may be pale and enlarged, with a white or thick, yellow-greasy coating, and the pulse may be fine or wiry and slippery.
In plain language:
- Joint symptoms may be mild or not particularly noticeable.
- You may feel tired and low in energy, with a general sense of sluggishness.
- Your appetite may decrease, and you may eat less than usual.
- You may feel fullness or discomfort in the upper abdomen and abdomen, as if it is distended.
- The tongue may appear pale and slightly enlarged.
- The tongue coating may be white or yellow, thick, and greasy.
- On pulse examination, the pulse may feel fine, or taut like a stretched string and smooth.
|Treatment Approach
Technical description:
Strengthen the spleen, drain dampness, supplement qi, and unblock the collaterals.
In plain language:
- Strengthen the spleen → Support the TCM spleen and stomach’s ability to transform and transport, including digestion, absorption, and fluid metabolism; this may help address poor appetite, abdominal bloating, loose stools, and a heavy feeling.
- Drain dampness → Promote the elimination of dampness from the body, including through urine and sweat, helping ease heaviness, stickiness, swelling, and a heavy feeling in the joints.
- Supplement qi → Support physical vitality and the functions of the internal organs, helping ease shortness of breath, fatigue, and reluctance to speak.
- Unblock the collaterals → Promote the flow of qi and blood through the channels and microcirculation, helping ease numbness, aching, and restricted movement.
|Related Products
The products below are provided for information only and do not constitute medical advice or a prescription. Refer to the outer packaging and package insert, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Technical description:
Joint pain is localized and the area is not hot. Bending and straightening the joint may be difficult, and the skin in the area may feel numb. The tongue coating may be thin and white or white and greasy, and the pulse may be wiry or soft and slow.
In plain language:
- The joint pain stays in one place and does not move around; it remains localized when pressed or moved.
- The painful area does not feel hot to the touch and may feel normal or slightly cool.
- The joint may be difficult to bend or straighten, and movement may feel restricted.
- The skin near the painful area may feel numb, with reduced sensation to touch.
- The tongue coating may appear thin and white, or white and greasy.
- On pulse examination, the pulse may feel taut like a stretched string, or soft and somewhat slow.
|Treatment Approach
Technical description:
Warm the channels and disperse cold (and eliminate dampness and unblock the collaterals).
In plain language:
- Warm the channels → Warm the channels and address cold-related constriction, helping ease stiffness and cold pain that may worsen with exposure to cold.
- Disperse cold → Dispel cold from the body or affected area, helping ease aversion to cold and cold pain, which may feel better with warmth.
- Eliminate dampness → Address dampness in the body and support fluid metabolism, helping ease heaviness, stickiness, swelling, and a heavy feeling in the joints.
- Unblock the collaterals → Promote the flow of qi and blood through the channels and microcirculation, helping improve numbness, spasms, and restricted movement.
|Related Products
The products below are provided for information only and do not constitute medical advice or a prescription. Refer to the outer packaging and package insert, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Technical description:
The condition is longstanding, with recurrent joint pain that may be stabbing. In severe cases, joints may become rigid or deformed, and subcutaneous nodules may appear. The skin may be purplish and dull, and the pulse may be wiry or deep and choppy.
In plain language:
- The condition has lasted a long time and may persist without readily improving.
- Joint pain may recur, or feel like a stabbing sensation.
- In severe cases, joints may become stiff or even deformed.
- Small nodules may develop under the skin and feel like hard lumps.
- The skin may look purplish or dull, rather than bright in color.
- On pulse examination, the pulse may feel taut like a stretched string, or be more noticeable with deeper pressure and feel rough or uneven.
|Treatment Approach
Technical description:
Invigorate blood, resolve stasis, transform phlegm, and disperse nodules.
In plain language:
- Invigorate blood → Promote blood circulation, helping ease pain, stiffness, and numbness.
- Resolve stasis → Address blood stasis, helping reduce stabbing or localized pain and swelling.
- Transform phlegm → Address phlegm-dampness in the body, helping ease chest tightness, excess phlegm, and a sticky or sluggish feeling.
- Disperse nodules → Soften and disperse hard lumps and nodules, helping ease swelling, tenderness, and pulling discomfort.
|Related Products
The products below are provided for information only and do not constitute medical advice or a prescription. Refer to the outer packaging and package insert, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Technical description:
The condition is longstanding and recurrent, and may gradually affect more joints. Tophi may develop, and a small number of patients may experience impaired kidney function. The tongue may be pale and enlarged, with a white, greasy coating; the pulse may be fine and choppy or deep and fine.
In plain language:
- The condition has lasted a long time and has not improved, despite persisting for an extended period.
- Symptoms may flare up repeatedly, with periods of improvement and recurrence.
- More joints may become affected over time, with the area involved gradually expanding.
- Tophi may develop and feel like hard lumps.
- A small number of people may experience impaired kidney function.
- The tongue may appear pale and enlarged.
- The tongue coating may be white and greasy, making the surface look coated.
- On pulse examination, the pulse may feel fine and somewhat rough or uneven, or be fine and more noticeable with deeper pressure.
|Treatment Approach
Technical description:
Strengthen the spleen, tonify the kidney, dispel blood stasis, and unblock the collaterals.
In plain language:
- Strengthen the spleen → Support the TCM spleen and stomach’s transforming and transporting functions, helping address poor appetite, abdominal bloating, loose stools, heaviness, and fatigue.
- Tonify the kidney → Nourish kidney qi and kidney essence, helping address soreness and weakness in the lower back and knees, fatigue, frequent nighttime urination, or aversion to cold.
- Dispel stasis → Address blood stasis and obstruction, helping gradually ease stabbing or localized pain, purplish discoloration, bruising, and swelling.
- Unblock the collaterals → Promote the flow of qi and blood through the channels and microcirculation, helping improve numbness, stiffness, and restricted movement.
|Related Products
The products below are provided for information only and do not constitute medical advice or a prescription. Refer to the outer packaging and package insert, and use under the guidance of a doctor or pharmacist.
References
- Rheumatology Branch of the Chinese Medical Association. Guidelines for the Diagnosis and Treatment of Primary Gout[J]. Chinese Journal of Rheumatology, 2011, 15(6): 410-413.
- Zhu Wei, Liu Jingdong. Advances in research on the epidemiology and influencing factors of hyperuricemia and gout[J]. Jiangxi Medical Journal, 2013, 48(5): 459-462.
- Miao Zhimin. Gout[M]. Beijing: People’s Medical Publishing House, 2006.
- Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China: Chinese Patent Medicines Volume[M]. 2015.