The Oretical And Clinical Research Of Huangqi Guizhi Wuwu Tang And Puhuang San On The Treatment Of Inter-critical Gout

Gout are a group of habitual diseases due to the disorder of purine metabolism, characterized as hyperuricemia and recurrent acute gouty arthritis caused by hyperuricemia, tophi deposition, chronic tophaceous gouty arthritis and joint deformities, often inducing chronic interstitial nephritis and formation of renal calculi due to high level of uric acid. Clinically it is divided into primary gout and secondary gout. The former is mostly caused by congenital disorders of purine metabolis, often associated with obesity, lipid disorders, hypertension, atherosclerosis and coronary heart disease; the later is induced by some systemic diseases or drugs. Primary gout is considered rare in our country previously, but there have appeared many of them in recent years due to factors as improved conditions, prolonged average life expectancy, as well as our increased attention to gout. The prevalence of gout shows gender difference, which is more common in male. The occurrence ratio between male and female is20to1and the occurrence of gout increases with the growing of age. Although Chinese literature recorded the disease name of gout, it has wider concept than what it is today in modern medicine. Most physicians did not distinguish Bi syndrome and gout clearly as they considered gout is another kind of Bi syndrome with more severe pain."Gout" in modern medicine equals to "evil wind","Bi Syndrome","White Tiger disease","White Tiger joint running","joint running wind","beriberi","Zouzhu (flowing toxic wind)" and other diseases. Based on experience of previous physicians Zhu Danxi in Yuan dynasty first proposed the name "Tongfeng (podagra)", quite close to gouty arthritis in modern medicine. Based on the theory of traditional Chinese medicine and Zhang Zhongjing’s expositions in Golden Chamber, from the perspective of pathogenesis, clinical manifestations and features of gout, this paper believes that the main pathogenesis of inter-critical gout is Ben Xu Biao Shi (asthenia in root and asthenia in superficiality). Qi deficiency of spleen and kidney and blood deficiency are root causes of inter-critical gout, while the accumulation of toxicities like wind, cold, heat and dampness inside the body as well as phlegm and blood stasis blocking collaterals are superficial factors of inter-critical gout. The treating principle of inter-critical gout should focus on the root causes, with combination of the treatment on superficial causes. Clinical researches were conducted on the treatment of inter-critical gout with Huangqi Guizhi Wuwu Tang and Puhuang San, results indicated that this decoction can significantly lower blood uric acid levels in patients with inter-critical gout, reduce the number of joints attacked by gout, decrease the duration of gout attacks, ease the pain during acute phase and the longer the treatment would help to achieve more significant efficacy. In terms of Chinese syndromes, patient’s syndromes improved significantly after treatment, and prolonged treatment helped to improve the clinical performance better. For patients with inter-critical gout, besides Western medical treatment, Chinese medicine can also provide a reliable and effective treatment with fewer adverse reactions.