• 제목/요약/키워드: gout

검색결과 164건 처리시간 0.025초

급성 통풍에 적용한 침전기자극술에 대한 체계적 문헌 고찰 및 메타 분석 (Systematic Review and Meta-analysis of Electoacupunture Efficacy on Acute Gout)

  • 황지혜;송애진;송호섭
    • 대한한의학회지
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    • 제43권2호
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    • pp.92-109
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    • 2022
  • Objectives: The objective of this study was to appraise the effect of electroacupuncture (EA) for the treatment of acute gout. Methods: Since no suitable study could be found in the domestic database, we performed a literature search up to the end of December 2020 using four international electronic databases. Randomized controlled trials (RCTs) evaluating the effectiveness of EA in the treatment of acute gout were included. The risk of bias was evaluated from the Cochrane risk of bias tool. Results: Eight appropriate RCTs were included and analyzed. Three evaluation tools were mainly used: Total Effective Rate (TER), Uric acid (UA), and Pain score (VAS). In the case of TER, in all eight cases, electroacupuncture alone and combined treatment showed a statistically significant level of improvement compared to Western medicine treatment. In the case of VAS score, electroacupuncture alone and combined treatment showed a more significant effect than Western medicine treatment. In the case of UA level, electroacupuncture combined treatment showed a more significant effect than western medicine treatment. Although not all three evaluation tools were used in all studies, the majority of studies showed that electroacupuncture was effective for acute gout patients. Conclusions: The results of this study suggest that EA treatment may be effective for acute gout. It should be noted, however, that the studies included in this study were geographically biased, small in number, and mostly at high risk of bias. More well-designed studies are needed in the future.

족부 제 1중족 족지 관절에 발생한 만성 결절성 통풍의 수술적 치료 (Surgical Treatment of Chronic Tophaceous Gout in the 1st Metatarso-Phalangeal Joint)

  • 이태훈;남일현;안길영;이영현;이용식;최영득;이희형
    • 대한족부족관절학회지
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    • 제22권4호
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    • pp.156-160
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    • 2018
  • Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.

거골 내측 결절에 발생한 골연골종과 통풍 발작에 의한 발목 내측 충돌 증후군: 증례 보고 (Medial Ankle Impingement Syndrome due to Talar Osteochondroma and Gout Attack: A Case Report)

  • 경민규;전동준;이동연
    • 대한족부족관절학회지
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    • 제28권1호
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    • pp.31-35
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    • 2024
  • Osteochondromas are benign bone tumors typically found in the metaphyseal region of long bones. These tumors are often asymptomatic and detected incidentally. However, their occurrence in atypical sites such as the talus can pose significant diagnostic and treatment challenges. This report describes a rare case of osteochondroma of the medial tubercle of the talus, which is an unprecedented location based on a review of relevant literature. A 28-year-old male presented with worsening medial ankle pain and limping. Imaging revealed a lesion consistent with osteochondroma contributing to medial ankle impingement syndrome. Uniquely, this case also featured a coinciding gout attack in the ankle joint. Surgical removal of the lesion resulted in significant symptom relief and functional improvement. This case underscores the need to consider rare diagnoses, such as talar osteochondroma, when presented with persistent medial ankle pain and highlights the potential presence of concurrent conditions, such as gout.

인동(忍冬)이 Monosodium Urate로 유발(誘發)된 백서(白鼠)의 통풍(痛風)에 미치는 영향(影響) (The Effect of Yindong on Gout of Rats induced by Monosodium Urate)

  • 이홍진;조충식;김철중
    • 혜화의학회지
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    • 제17권1호
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    • pp.83-93
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    • 2008
  • In order to study the Effects of yindong(LC) on the variation of blood and joint value the gout induced by microcrystalline sodium urate in rats, for LC is one of the important medicine on gout. After pretreatment of LC(50, 500mg/kg) for 5days, the Effects of LC was evaluated on Serum albumin, Serum globulin, glutamate dxalacetate transminase(AST), glutanate pyruvate transminase(ALT), blood urea nitrogen(BUN), Serum creatitine, Serum uric acid, xanthine oxidase activity, Erythrocyte Sedimentation Rate(ESR), WBC, platelet were measured. The results were obtained as follows : Joint value Increase ratio was not significantly decreased in all LC taken groups compared with the control group. Serum albumin was significantly different in all LC taken groups compared with the control group and Serum globulin was significantly dicreased in 500mg/kgLC taken group compared with the control group. Serum AST, ALT were significantly dicreased in 500mg/kgLC taken group compared with the control group. Serum BUN was significantly decreased in all LC taken groups and Serum creatinine was significantly decreased in 500mg/kgLC taken group compared with the control group. Serum uric acid was significantly different in 500mg/kgLC taken group, and changes in xanthine oxidase activity was significantly decreased in 500mg/kg, 50mg/kgLC taken group. ESR was significantly decreased in all LC taken groups compared with the control group. WBC, platelet count were significantly decreased in 500mg/kgLC taken group compared with the control group. From above results it may be concluded that Yindong can be used for treatment and preventive medcine of gout induced by microcrystalline sodium urate in clinic.

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급성 요통을 일으킨 결핵과 통풍이 혼재된 척추관절병증 (Acute Low Back Pain from Coexisting Gout and Tuberculous Spondyloarthropathy)

  • 박융;하중원;권지원;엄광식
    • 대한정형외과학회지
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    • 제56권4호
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    • pp.351-356
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    • 2021
  • 부고환 결핵으로 부고환 절제술 및 항결핵제제를 복용중인 67세 남자 환자가 급성 요통 및 방사통을 주소로 내원하였다. 환자는 통풍의 과거력은 없었으나 혈액 검사상 고요산혈증 소견을 보였으며, 요추 후관절 및 후궁 부위의 골 파괴 병변이 관찰되었다. 요추 후관절 부위의 컴퓨터 단층촬영 유도하 바늘 생검을 실시하여 조직학적 검사를 시행한 결과 통풍성 척추관절병증 및 결핵성 척추염이 진단되었다. 환자는 통풍성 관절염에 대한 보존적 치료를 통해 증상은 호전되었다. 항결핵제제 복용 등 고요산혈증 위험을 가진 환자가 급성 요통을 호소하는 경우 통풍성 척추관절병증을 감별진단해야 하겠다.

통풍환자에 대한 간호사 주도 환자교육의 효과 (Effects of Nurse-led Patient Education for Gout Patients)

  • 유인설;정선경
    • 산업융합연구
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    • 제20권7호
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    • pp.97-105
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    • 2022
  • 통풍은 관절염뿐만 아니라 심혈관질환 등을 유발하는 만성염증질환이다. 하지만 대부분의 환자들이 단순히 관절질환으로 인식하고 있어 치료에 장애로 작용한다. 이 연구를 통해 간호사 주도의 통풍환자 대상 교육이 환자의 통풍에 대한 인식 개선 및 질병 경과에 미치는 영향을 확인하고자 하였다. 교육전문 간호사가 상급종합병원 류마티스내과 외래에 내원한 환자를 대상으로 통풍에 대한 일대일 교육을 시행하였고 환자의 만족도 및 복약순응도, 혈중 요산치의 변화 정도를 측정하였다. 교육을 받은 환자군의 진료만족도는 대조군에 비해 유의하게 높았으며 두 번째와 세 번째 외래 방문 시에 측정한 복약순응도와 혈중 요산치는 대조군에 비해 교육군에서 유의하게 개선이 되었다. 결론적으로 간호사 주도 환자교육은 진료 만족도 개선 및 질환 경과의 호전에도 도움이 되는 것으로 확인되었다.

Systematic Review and Meta-Analysis of Efficacy and Safety of Fire Needling and Warm Needling on Acute Gout

  • Ji Hye Hwang;Aejin Song;Ho-Sueb Song
    • 대한약침학회지
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    • 제25권4호
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    • pp.301-316
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    • 2022
  • Objectives: This study aimed to evaluate the efficacy and safety of heat stimuli (e.g., fire needling, warm needling) in acupuncture for acute gout. Methods: Four international online databases (PubMed, Cochrane, Embase, and Chinese National Knowledge Infrastructure) were searched to identify randomized, controlled trials (RCTs) that used fire needling and warm needling for acute gout. The methodological quality of the RCTs was evaluated using the Cochrane risk-of-bias (RoB) tool. Thirteen RCTs (840 patients) were included and analyzed. Three evaluation tools (total effective rate, uric acid level, and pain score) were mainly used. Comparisons were made between Western medicine (WM) and i) fire needling or warm needling treatment alone, ii) fire needling and bloodletting combination treatment, iii) combination of fire needling, bloodletting, and herbal medicine, iv) warm needling (concurrently). Heat stimuli in acupuncture alone or in combination treatment were more effective in terms of the total efficacy rates, uric acid levels, and pain scores than WM alone. Results: In all the evaluation tools, the treatment effects in the fire needling alone or warm needling alone treatment group and the fire needling and bloodletting combination intervention group were significantly better than those in the WM control group. The warm needling and WM combination intervention groups also experienced significantly better treatment effects in terms of total efficacy rates and uric acid levels. Only the pain scores in the fire needling, bloodletting, and herbal medicine combination groups demonstrated significant improvement. Only four studies mentioned adverse reactions: one reported loss of appetite; three studies reported none. According to the Cochrane RoB tool, most studies showed either high or uncertain RoB. Conclusion: Heat stimuli during acupuncture could be effective for acute gout. However, as the included studies were regionally biased, more high-quality studies are needed to confirm the level of evidence.

가마의이인탕이 통풍유발 흰쥐에 미치는 영향 (Effects of Modified Gami-Yiyiren-tang on the Gout Induced ICR Mice)

  • 엄현성
    • 동의생리병리학회지
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    • 제21권5호
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    • pp.1087-1091
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    • 2007
  • In order to obtain practical application of Yiyiren-tang against gout disease, water extract of modified Gami-Yiyiren-tang(GYYT) added with Lonicera japonica is prepared through decoction and freeze drying. The effects were evaluated with blood sample from ICR mice treated with MSU intra-peritoneal injection 1 time a day, 3 days consecutively. The results were as follows. GYYT decreased C-reactive protein level and HDL cholesterol levels. But the creatinine, the LDL cholesterol levels, triglyceride and uric acid levels were not changed were decreased significantly. These results show that GYYT can be used effectively against the urate-related gout disease. But not better than effects of the Gami-daehwangmokdan-tang.

Familial Juvenile Hyperuricemic Nephropathy and Uromodulin Gene Mutation

  • Lee, Young-Ki;Lee, Dong Hun;Noh, Jung-Woo
    • Journal of Genetic Medicine
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    • 제10권1호
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    • pp.7-12
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    • 2013
  • Familial Juvenile hyperuricemic nephropathy (FJHN) is a rare autosomal dominant disorder, characterized by early onset of hyperuricemia, gout and progressive kidney disease. Hyperuricemia prior to renal impairment and decreased fractional excretion of uric acid are hallmarks of FJHN. Renal dysfunction gradually appears early in life and results in end-stage renal disease usually between the ages of 20 and 70 years. FJHN is mostly caused by mutations in the uromodulin gene located at 16p12. The course of FJHN is highly variable. Treatment includes management for hyperuricemia, gout and progressive kidney disease. Individuals with gout have been usually treated with allopurinol. But controversy exists as to whether uric acid lowering therapy prevents the progression of chronic kidney disease.

가미대황목단탕(加味大黃牧丹湯)이 통풍유발 흰쥐에 미치는 영향 (Effects of Gami-Daehwangmokdan-tang on the Gout Induced ICR Mice)

  • 엄현섭
    • 동의생리병리학회지
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    • 제21권2호
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    • pp.399-403
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    • 2007
  • In order to obtain practical application of Daehwangmokdan-tang gout disease, water extract of Gami-daehwangmokdan-tang(GDMT) added with Lonicera japonica is prepared through decoction and freeze drying. The effects were evaluated with blood sample from ICR mice treated with MSU intra-peritoneal injection 1 time a day, 3 days consecutively. The results were as follows. GDMT decreased BUN, creatinine and C-reactive protein level in serum significantly. But the HDL and LDL cholesterol levels were not changed in spite of positive tendency in HDL cholesterol. Triglyceride and uric acid levels were decreased significantly too. These results show that GDMT can be used effectively against the urate-related gout disease.