The Pain of Gout! What Are the Advantages of Traditional Chinese Medicine in Treating Gout?

In daily life, an increased intake of high-purine foods such as animal organs (liver, kidney, brain, intestine, tongue, etc.), seafood (shrimp, crab, shellfish, sea fish, fish roe, etc.), meat soups, and fresh mushrooms can lead to disorders in purine metabolism. This can result in reduced uric acid excretion, leading to elevated blood uric acid levels, the deposition of monosodium urate crystals, and the development of gout.

Gout causes sudden joint pain, swelling, redness, and inflammation, often occurring at night. The pain can last from a few days to several weeks. The onset is sudden, but the recovery is slow.

In recent years, China has seen a noticeable increase in the incidence and a trend toward a younger age of onset for high blood uric acid and gout. The overall prevalence of gout is approximately 1.1%, affecting about 14.66 million people. If gout is not treated in a timely manner, it may progress to gouty arthritis or gouty nephropathy. Gout can be divided into the following stages: asymptomatic hyperuricemia, acute gouty attack, intercritical gout, chronic gouty arthritis, and gouty nephropathy (including uric acid nephrolithiasis, chronic urate nephropathy, acute uric acid nephropathy).

Gout patients not only need to adjust their diet but also require treatment with medications. Although conventional medicines have precise short-term effects, their long-term use carries significant side effects. Traditional Chinese medicine is considered safer and more effective in improving chronic uric acid metabolism and treating gout.

1. How Traditional Chinese Medicine Views Gout

Traditional Chinese Medicine (TCM) views gout as “zhuo yu bi,” characterized by the accumulation of damp-heat, toxins, stagnant phlegm, and obstructed tendons, leading to the condition. The primary causes are the disharmony of the spleen, liver, and kidneys, resulting in the formation of phlegm-dampness and blood stasis.

In daily life, gout patients should be mindful of avoiding exposure to wind and cold, limiting tobacco and alcohol consumption, and reducing the intake of fatty and rich foods. They should consume foods like Job’s tears and corn silk to correct their constitution. In addition, engaging in physical activity can enhance their constitution, and maintaining a positive mindset helps with prevention.

TCM adopts an approach of nourishing and treating, a syndrome differentiation-based treatment, and a staged treatment to emphasize the prevention of uric acid stone formation in various stages.

TCM classifies gout patterns into four categories: damp-heat accumulation, phlegm obstruction, blood stasis obstruction, and liver-kidney yin deficiency. Treatment approaches are mainly based on clearing turbidity, resolving stasis, invigorating the spleen, eliminating dampness, clearing heat, and promoting urination.

2. Traditional Chinese Medicine for Lowering Uric Acid in Gout

❶ Damp-Heat Accumulation

This pattern is commonly seen during the acute phase of gouty arthritis. Clinical symptoms include joint redness, swelling, heat, intense joint pain, frequent and sudden attacks of joint pain, fever, restlessness, bitter taste in the mouth, bad breath, sticky or foul-smelling stool. The tongue is red, with a yellow or thick yellow coating, and the pulse is stringy or slippery. Treatment mainly focuses on clearing heat, resolving toxins, and promoting diuresis while eliminating dampness.

Classic formulas include the Four Marvels Powder and Danggui Nian Tong Tang.

Chinese patent medicines include Xinhuang Tablets, Tongzhi Su Run Jiang Capsules, Four Marvels Pills, Synovitis Granules, Slippery Synovitis Granules, Zheng Qing Feng Tong Ning Sustained-Release Tablets, and Feng Tong An Capsules.

❷ Phlegm Obstruction

This pattern is commonly seen during the chronic phase of gouty arthritis. Clinical symptoms include recurrent joint pain, local hardness, dark red skin, joint stabbing pain, joint stiffness or deformity. The tongue is dark, and the coating is white and greasy. The pulse is stringy or stringy and slippery. The treatment primarily focuses on eliminating phlegm, dissolving obstruction, promoting blood circulation, and activating collaterals.

Classic formulas include Upper, Middle, and Lower Gout Formula and the Shuanghe Decoction.

Chinese patent medicines include Blood Stasis Arthralgia Granules and Yishen Juanbi Pills.

❸ Blood Stasis Obstruction

This pattern is commonly seen during the chronic phase of gouty arthritis. Clinical symptoms include red and swollen joints, pain and tenderness, localized swelling and deformation, joint difficulty in flexion and extension, and skin dryness and dark pigmentation. The tongue is dark with petechiae, and the coating is thin and white. The pulse is thin, rough,or deep string-like. The treatment mainly involves promoting blood circulation, resolving stasis, clearing damp-heat, and alleviating pain.

Classic formulas include Xuefu Zhuyu Tang and Quyu Qingre Tang.

Chinese patent medicines include Xuefu Zhuyu Wan.

❹ Liver-Kidney Yin Deficiency

This pattern is commonly seen in gouty nephropathy and the chronic phase of gouty arthritis. Clinical symptoms include recurrent joint pain, joint stiffness or deformity, general fatigue, lumbago, sore and weak limbs, and systemic edema. The tongue is pale with a white coating, and the pulse is deep and slow. The treatment primarily involves invigorating the spleen, nourishing the kidneys, and eliminating dampness.

Classic formulas include Jisheng Shenqi Wan and Shenling Baizhu San.

Chinese patent medicines include Huangkui Capsules and Yixie Fenqing Pills.

3. Traditional Chinese Medicine External Treatments

For clinical symptoms of joint swelling and pain in gout patients, TCM external treatments like acupuncture, bloodletting, external application of Chinese herbal medicine, and herbal soaking can significantly improve their condition. Acupuncture and acupoints such as Zusanli, Sanyinjiao, Taichong, Yinlingquan, Hegu, and Quchi can be used. Bloodletting therapy often employs acupoints like Ashi points, Taichong, and Xingjian. Soaking and external applications use Chinese herbs such as Da Huang, Cang Zhu, Huang Bai, Niu Xi, Ren Dong Teng, Hu Zhang, and Wei Ling Xian to clear heat and eliminate dampness.

Important Note

For the treatment of specific diseases based on individual patient conditions, it is recommended to consult with a TCM practitioner in a reputable hospital or healthcare facility.