This Doctor is Great

"Related studies have shown that when the body temperature drops, "uric acid salt" will still precipitate even if the body temperature is not 37 degrees, and then cause gout. "

"At present, our season is winter. The cold air and the temperature are very low in the past few days, basically around 3-9 degrees..."

"In the south, we don't have floor heating like in the north. It's really cold when the weather is cold, so the patient's body temperature will definitely drop."

The emergency doctor next to him: "..."

Interns: "..."

Dumbfounded!

understood!

Unexpectedly, there is such a saying about gout.

Sure enough, rote memorization will not work, you must understand thoroughly.

The 420 indicator cannot be used as a support.

Zhou Mo: "I suggest, give him a blood gas analysis to see the pH."

Teacher Zhang Mei nodded, and quickly called the nurse.

soon,

The nurse draws blood, puts it in the analyzer, and the results come out soon.

pH value: 7.36...

Acidic!

Zhou Mo said at this time: "Just now you said that your husband's knee pain is not so severe now. It may be because there is heating in the hospital, and the body temperature has risen, so the gout has eased."

(Question 1: Are hot compresses and traditional Chinese medicine hot compress bags useful for gout?)

(Question 2: Is this the same as the saying "old cold legs"?)

Zhou Mo smiled slightly: "Combined with the acidic blood, the current low temperature, and the value of 395, it can basically be diagnosed as gout!"

The three interns looked at Zhou Mo with admiration.

"I'll go, this senior brother is awesome!"

"Amazing!!"

At this time, Zhou Mo said again: "But... this gout is not necessarily gout, my diagnosis is not 100% guaranteed... If you want to further screen, you need to do another test."

Chen Xu: "..."

My day!

Are you still checking?

What a waste of money!

But think about it, I may be tortured by this disease for a lifetime.

Thinking about it this way, it seems necessary to carefully examine and make a serious diagnosis.

Chen Xu couldn't help asking, "How does the doctor check?"

Zhou Mo: "There is a test called "dual-energy CT", which is an important non-invasive test in the differential diagnosis of gout. Studies have shown that its sensitivity and specificity reach 91.9% and 85.4% respectively..."

The so-called specificity refers to the specificity, which is used to distinguish it from other diseases.

The sensitivity is whether this test can reflect the disease.

Finally, Zhou Mo said:

"However, you can do it or not... because you can take the medicine first, and then use the results of the medicine to deduce whether it is the pain caused by "gout". If the pain is gone after taking gout medicine, it should be "gout". "

After saying this, Zhou Mo glanced at Zhang Mei.

Zhang Mei nodded.

There is no objection.

The patient Chen Xu hurriedly said: "Then I won't do any examinations, I will choose to take medicine first... What kind of medicine will I take?"

About taking medicine for ventilation,

Then you have to do it again.

As mentioned earlier, gout is "high uric acid" + "poor urination"...

Therefore, the purpose of the drug is to "reduce the increase in uric acid" + "increase the excretion of uric acid"!

Therefore, it is necessary to eat less seafood, beer, and Laohuo soup.

In addition, excretion is naturally to drink plenty of water, and then take some diuretic drugs if necessary.

also,

There are also drugs that inhibit uric acid production.

In the past, more drugs were used, called "allopurinol", which mainly inhibited xanthine oxidase and then reduced the production of uric acid.

However, it was later discovered that its side effects were a bit large, and it had a very heavy burden on the kidneys.

Easily lead to kidney failure.

Gout patients are generally older, and commonly have high blood pressure, high blood fat, and diabetes.

These patients generally have a decline in renal function.

Therefore, after taking allopurinol, it will further increase the burden on the kidneys.

then,

Gradually by the emergence of new magic medicine.

—— "Febuxostat"!

The effect is the same as "allopurinol", which can inhibit xanthine oxidase.

But it is much easier to use than allopurinol, and has a wide range. Allopurinol can reduce it, it can reduce it, allopurinol cannot reduce it, it can still reduce it, and the side effects are small...

Except for one downside - expensive.

Especially gout is a disease that cannot be cured, so it is necessary to take medicine frequently.

In the long run, the cost of medicine is a very big burden.

Moreover, one more thing was discovered later, which made this medicine fall from the altar of 'magic medicine'.

It can easily lead to heart disease.

This is going to kill me.

then,

"Allopurinol" has begun to become a magic drug again.

"Now you have two choices, one is the expensive "Febuxostat" and the other is the cheap "Allopurinol". Their advantages and disadvantages are..."

Zhou Mo introduced it once, and then said.

"You chose..."

Patient Chen Xu thought for a while: "Let's take "Allopurinol" first..."

The economic conditions of his family are not very good either.

Zhou Mo looked at Chen Xu's hair: "However, allopurinol has another disadvantage, that is, it is prone to skin allergies, and even peeling and hair loss are one of its side effects..."

Chen Xu: "..."

"Then I'll take Febuxostat first..."

There is a reason why you are expensive.

For a man, the head can be broken, but the hair cannot fall out.

Zhou Mo recently read the news that there is a challenge of not using shampoo for 14 days. The general meaning is that if a person does not wash with shampoo, the first few days may be particularly oily, but in the following days, the hair will become drier and drier, and it will start to dry out. Longer hair, better hair quality.

Zhou Mo doesn't know if this is true, but many people have testified that this method is good.

To be honest, Zhou Mo was very moved.

...

In addition to this drug that inhibits xanthine oxidase and reduces purine production,

There are two types of drugs,

The first one: anti-inflammatory and pain-relieving.

Zhou Mo said: "The first choice for this type of drug is colchicine, which is a specific drug for the treatment of gouty arthritis. It can inhibit the deformation and chemotaxis of inflammatory cells, thereby relieving inflammation. In addition, there are non-steroidal anti-inflammatory drugs. Drugs, aspirin, ibuprofen sustained-release tablets, diclofenac, etc., can inhibit the synthesis of prostaglandins, thereby achieving analgesic and anti-inflammatory effects.”

"In addition, there are drugs that enhance urinary excretion, such as benzbromarone, probenecid, etc., which can increase the excretion of uric acid and reduce the level of uric acid..."

"Only these three categories, I will prescribe medicine for you later, go back to eat, drink more water, drink less soup, don't eat seafood, drink beer and so on... Let's see if the condition will be relieved..."

Zhou Mo exhorted.

Teacher Zhang Mei next to her did not express any objection.

Patient Chen Xu nodded again and again: "Good doctor. Thank you doctor."

Zhou Mo thought for a while, and then warned: "By the way, don't catch a cold, and try not to catch a cold, fever and other infections, which will cause gout...and joint damage, which will also accelerate gout, so don't exercise vigorously and with high load... ..."

"Okay okay."

Patient Chen Xu was already pecking at the rice.