This Doctor is Great

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

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

"In the south, unlike the north, where there is floor heating, it is really cold when the weather is cold, so the patient's body temperature will definitely decrease."

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

Interns: "..."

Stunned dog!

understood!

Unexpectedly, gout still has such a statement.

Sure enough, rote memorization won't work, you have to understand it thoroughly.

The 420 indicator cannot be used as a support.

Zhou Mo: "I suggest giving him a blood gas analysis to check the pH."

Teacher Zhang Mei nodded and quickly called for a nurse.

soon,

The nurse drew blood and put it into the analyzer, and the results came out soon after.

ph value: 7.36…

Acidic!

Zhou Mo said at this time, "You said your husband just now that the pain in his knee 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 "old cold legs" in the saying?)

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 cannot be 100% guaranteed... If you want to further screen, you need to do another examination."

Chen Xu: "..."

my day!

Are you still checking?

So expensive!

But think about it, you may have to suffer from this disease for a lifetime.

Thinking about it this way, careful inspection and serious diagnosis seem to be necessary.

Chen Xu couldn't help but ask, "How exactly should 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 are 91.9% and 85.4% respectively..."

The so-called specificity is 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 result of the medicine to determine whether it is the pain caused by "gout". If there is no pain after taking gout medicine, it should be "gout". "

After saying this, Zhou Mo glanced at Zhang Mei.

Zhang Mei nodded.

No objection.

The patient Chen Xu quickly said, "Then I won't do any tests. I choose to take medicine first... What kind of medicine should I take?"

About ventilation and medicine,

Then try again,

As I said before, 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 old-fashioned soup.

In addition, excretion naturally means drinking more water, and then taking some diuretic drugs if necessary.

also,

There are also drugs that inhibit the production of uric acid.

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 found that its side effects were a bit large, and it had a very heavy burden on the kidneys.

Can easily lead to kidney failure.

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

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

Except for one disadvantage - expensive.

In particular, gout is a disease that cannot be cured, so it is necessary to take medicine regularly.

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

Moreover, another thing was discovered later, which made this medicine fall into the altar of "magic medicine".

It can easily lead to heart disease.

This is getting old.

then,

"Allopurinol" began 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 yourself..."

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

The economic conditions of his family are not very good.

Zhou Mo looked at Chen Xu's hair: "However, allopurinol also has a disadvantage, which is that 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..."

Expensive reason.

Men, the head can be broken, but the hair can't fall out.

Zhou Mo recently saw the news that there is a challenge of not using shampoo for 14 days. The general meaning is that if people don't use shampoo to wash, the first few days may be very oily, but in the following days, the hair will become more and more dry, and it will start to dry. Long hair, better hair quality.

Zhou Mo doesn't know if this is true or not, but there are many people who come forward and say 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: anti-inflammatory pain relief.

Zhou Mo said: "The first choice for this type of drug is colchicine, which is a special drug for the treatment of gouty arthritis, which 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..."

"That's all, I'll prescribe medicine for you later, go back to eat, drink more water, drink less soup, don't eat seafood, drink beer, etc... Let's see if the condition will ease... "

Zhou Mo warned.

The teacher Zhang Mei next to him did not express any objection.

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

Zhou Mo thought about it for a while, and then warned: "By the way, so don't catch a cold, and try not to catch a cold and other infections such as fever, which will cause gout... and joint damage, which will also speed up gout, so don't do strenuous high-load exercise..."

"Okay okay."

The patient Chen Xu has already eaten rice.

..

​​