TREATING GOUT CAUSED BY RENAL INSUFFICIENCY WITH ACUPUNCTURE AND MOXIBUSTION: A CASE REPORT
Keywords:
acupuncture, arthritis, CRP, gout, moxibustion
Abstract
Gouty arthritis is a condition whose etiology and treatment have been studied for decades. Acute gouty arthritis attacks can be very painful, and the principal course of action in Western Medicine is to use anti-inflammatory drugs, which however have constraints, counterindications and side effects. Acupuncture and moxibustion have been applied in numerous such cases and usually with very positive effects. A 66-year-old male presented himself with an acute case of gouty arthritis; the subject was in otherwise good health, although it was subsequently discovered that he also suffered from renal insufficiency. Acupuncture and moxibustion were performed to treat the gouty arthritis over a period of four days, and subsequently, in four consecutive sessions, acupuncture was used to attempt to counter the renal insufficiency. The patient was cured of gouty arthritis, but the uric acid levels remained high due to the aforementioned renal insufficiency, which was not cured, owing to the very few therapies. We therefore conclude that acupuncture and moxibustion can be applied to treat gouty arthritis, even without using other medication and even if the arthritis is not nutrition-associated.
References
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[45] I. Heinonen, R. M. Brothers, J. Kemppainen, J. Knuuti, K. K. Kalliokoski, and C. G. Crandall, "Local heating, but not indirect whole body heating, increases human skeletal muscle blood flow," Journal of Applied Physiology, vol. 111, no. 3, pp. 818-824, 2011, doi: 10.1152/japplphysiol.00269.2011.
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[49] B. Hartmann, D. Czock, and F. Keller, "Drug therapy in patients with chronic renal failure," Deutsches Ärzteblatt International, vol. 107, no. 37, p. 647, 2010.
[2] J. S. Bomalaski, G. Lluberas, and H. R. Schumacher, Jr., "Monosodium urate crystals in the knee joints of patients with asymptomatic nontophaceous gout," (in eng), Arthritis Rheum, vol. 29, no. 12, pp. 1480-4, Dec 1986, doi: 10.1002/art.1780291209.
[3] R. Wernick, C. Winkler, and S. Campbell, "Tophi as the initial manifestation of gout. Report of six cases and review of the literature," (in eng), Arch Intern Med, vol. 152, no. 4, pp. 873-6, Apr 1992.
[4] M. A. Martillo, L. Nazzal, and D. B. Crittenden, "The crystallization of monosodium urate," (in eng), Curr Rheumatol Rep, vol. 16, no. 2, p. 400, Feb 2014, doi: 10.1007/s11926-013-0400-9.
[5] A. Danve, S. T. Sehra, and T. Neogi, "Role of diet in hyperuricemia and gout," Best Practice & Research Clinical Rheumatology, vol. 35, no. 4, p. 101723, 2021/12/01/ 2021, doi: https://doi.org/10.1016/j.berh.2021.101723.
[6] E. W. Campion, R. J. Glynn, and L. O. DeLabry, "Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study," (in eng), Am J Med, vol. 82, no. 3, pp. 421-6, Mar 1987, doi: 10.1016/0002-9343(87)90441-4.
[7] Y.-L. Nian and C.-G. You, "Susceptibility genes of hyperuricemia and gout," Hereditas, vol. 159, no. 1, p. 30, 2022/08/04 2022, doi: 10.1186/s41065-022-00243-y.
[8] B. Engel, J. Just, M. Bleckwenn, and K. Weckbecker, "Treatment Options for Gout," (in eng), Dtsch Arztebl Int, vol. 114, no. 13, pp. 215-222, Mar 31 2017, doi: 10.3238/arztebl.2017.0215.
[9] M. J. Pu, C. J. Yao, L. M. Liu, L. J. Ren, Y. L. Li, and Y. Xie, "Traditional Chinese medicine for gouty arthritis: A protocol for meta-analysis," (in eng), Medicine (Baltimore), vol. 100, no. 3, p. e23699, Jan 22 2021, doi: 10.1097/md.0000000000023699.
[10] X. L. Liu, D. J. Han, and X. Y. Yang, "[Analysis of the Characteristics of Acupoint Selection in the Treatment of Gout by Acupuncture]," (in chi), Zhen Ci Yan Jiu, vol. 42, no. 6, pp. 557-61, Dec 25 2017, doi: 10.13702/j.1000-0607.2017.06.018.
[11] W. W. Lu, J. M. Zhang, Z. T. Lv, and A. M. Chen, "Update on the Clinical Effect of Acupuncture Therapy in Patients with Gouty Arthritis: Systematic Review and Meta-Analysis," (in eng), Evid Based Complement Alternat Med, vol. 2016, p. 9451670, 2016, doi: 10.1155/2016/9451670.
[12] G. Lee, F. Y. Cho, B. Goo, and Y. C. Park, "Acupuncture for gouty arthritis: A PRISMA-compliant protocol for a systematic review and meta-analysis of randomized controlled trials," (in eng), Medicine (Baltimore), vol. 99, no. 49, p. e23527, Dec 4 2020, doi: 10.1097/md.0000000000023527.
[13] H. Liang et al., "Efficacy and Safety of Acupuncture Combined with Herbal Medicine in Treating Gouty Arthritis: Meta-Analysis of Randomized Controlled Trials," (in eng), Evid Based Complement Alternat Med, vol. 2021, p. 8161731, 2021, doi: 10.1155/2021/8161731.
[14] A. Periferakis, [The Appearance of Acupuncture in Europe 1683-1850]. Athens: Akadimia of Ancient Greek and Traditional Chinese Medicine, 2021.
[15] A. Periferakis and K. Periferakis, "On the Dissemination of Acupuncture to Europe," JournalNX, vol. 6, no. 07, pp. 201-209, 2020 2020.
[16] W. Zhang, M. Chen, and J. Hu, "[Long-snake moxibustion for rheumatoid arthritis:a randomized controlled trial]," (in chi), Zhongguo Zhen Jiu, vol. 36, no. 7, pp. 694-698, Jul 12 2016, doi: 10.13703/j.0255-2930.2016.07.005.
[17] S. Wang, G. Ye, Y. Zhang, S. Guan, X. Liu, and W. Ren, "[Flipping moxibustion of Hui medicine combined with western medication for rheumatoid arthritis with cold dampness bi syndrome]," (in chi), Zhongguo Zhen Jiu, vol. 37, no. 10, pp. 1047-51, Oct 12 2017, doi: 10.13703/j.0255-2930.2017.10.006.
[18] T. T. Zhu, Z. T. Zhao, Y. K. Zhao, and X. K. Yan, "[Review on Modern Repair Mechanism of Moxibustion for Treating Inflammatory Damage of Rheumatoid Arthritis]," (in chi), Zhen Ci Yan Jiu, vol. 42, no. 3, pp. 271-4, Jun 25 2017.
[19] J. A. Singh and J. D. Cleveland, "Gout is associated with a higher risk of chronic renal disease in older adults: a retrospective cohort study of U.S. Medicare population," BMC Nephrology, vol. 20, no. 1, p. 93, 2019/03/15 2019, doi: 10.1186/s12882-019-1274-5.
[20] H.-Y. Chang et al., "Hyperuricemia as an independent risk factor of chronic kidney disease in middle-aged and elderly population," The American journal of the medical sciences, vol. 339, no. 6, pp. 509-515, 2010.
[21] S. P. Juraschek, L. C. Kovell, E. R. Miller, and A. C. Gelber, "Association of kidney disease with prevalent gout in the United States in 1988–1994 and 2007–2010," Seminars in Arthritis and Rheumatism, vol. 42, no. 6, pp. 551-561, 2013/06/01/ 2013, doi: https://doi.org/10.1016/j.semarthrit.2012.09.009.
[22] J. S. Yu, C. H. Ho, H. Y. Wang, Y. H. Chen, and C. L. Hsieh, "Acupuncture on Renal Function in Patients with Chronic Kidney Disease: A Single-Blinded, Randomized, Preliminary Controlled Study," (in eng), J Altern Complement Med, vol. 23, no. 8, pp. 624-631, Aug 2017, doi: 10.1089/acm.2016.0119.
[23] W. Xiong et al., "Acupuncture Application in Chronic Kidney Disease and its Potential Mechanisms," (in eng), Am J Chin Med, vol. 46, no. 6, pp. 1169-1185, 2018, doi: 10.1142/s0192415x18500611.
[24] G. Soulié de Morant, Précis de la Vraie Acuponcture Chinoise. Doctrine-Diagnostic-Thérepeutique. Paris: Mercure de France, 1934.
[25] X. Cheng and L. Deng, Chinese Acupuncture and Moxibustion. Foreign Language Press, 1987.
[26] A. Tilikidis, [The Basic Theory of Traditional Chinese Medicine]. Athens: Akadimia of Ancient Greek and Traditional Chinese Medicine, 1999.
[27] M. Chenle, "Clinical observation onmongolian medicine combined with silver needle in the treatment of 25 cases of gout," Journal of Medicine and Pharmacy of Chinese Minorities, vol. 5, pp. 7-8, 2015.
[28] Y.-b. Li and W. Wei, "Points selection pattern in acupuncture-moxibustion treatment of gouty arthritis: an analysis based on bibliometrics," Journal of Acupuncture and Tuina Science, vol. 16, no. 1, pp. 59-66, 2018/02/01 2018, doi: 10.1007/s11726-018-1025-3.
[29] Y.-L. Lian, C.-Y. Chen, M. Hammes, and B. C. Kolster, H. P. Ogal and W. Stor, Eds. The Seirin Pictorial Atlas of Acupuncture. An Illustrated Manual of Acupuncture Points. Ljubljana, 2000.
[30] A. Xiang, K. Cheng, X. Shen, P. Xu, and S. Liu, "The Immediate Analgesic Effect of Acupuncture for Pain: A Systematic Review and Meta-Analysis," (in eng), Evid Based Complement Alternat Med, vol. 2017, p. 3837194, 2017, doi: 10.1155/2017/3837194.
[31] L. Zhao et al., "Effectiveness of moxibustion treatment as adjunctive therapy in osteoarthritis of the knee: a randomized, double-blinded, placebo-controlled clinical trial," Arthritis Research & Therapy, vol. 16, no. 3, p. R133, 2014/06/24 2014, doi: 10.1186/ar4590.
[32] M. D. Harris, L. B. Siegel, and J. A. Alloway, "Gout and hyperuricemia," (in eng), Am Fam Physician, vol. 59, no. 4, pp. 925-34, Feb 15 1999.
[33] W. Z. Zhang, "Why Does Hyperuricemia Not Necessarily Induce Gout?," (in eng), Biomolecules, vol. 11, no. 2, Feb 14 2021, doi: 10.3390/biom11020280.
[34] K. G. Saag et al., "Lesinurad combined with allopurinol: a randomized, double‐blind, placebo‐controlled study in gout patients with an inadequate response to standard‐of‐care allopurinol (a US‐based study)," Arthritis & Rheumatology, vol. 69, no. 1, pp. 203-212, 2017.
[35] B. F. Mandell, A. E. Yeo, and P. E. Lipsky, "Tophus resolution in patients with chronic refractory gout who have persistent urate-lowering responses to pegloticase," (in eng), Arthritis Res Ther, vol. 20, no. 1, p. 286, Dec 29 2018, doi: 10.1186/s13075-018-1782-x.
[36] M. Andrés, F. Sivera, and E. Pascual, "Rapid Crystal Dissolution in Gout. Is It Feasible and Advisable?," International Journal of Clinical Rheumatology, vol. 9, no. 4, pp. 395-401, 2014.
[37] M. C. Symons, "Self-treatment for gout," (in eng), Med Hypotheses, vol. 57, no. 2, pp. 241-2, Aug 2001, doi: 10.1054/mehy.2001.1346.
[38] S. Kádár et al., "Understanding the pH Dependence of Supersaturation State—A Case Study of Telmisartan," Pharmaceutics, vol. 14, no. 8, p. 1635, 2022. [Online]. Available: https://www.mdpi.com/1999-4923/14/8/1635.
[39] S. Lee et al., "Multiple pathways of crystal nucleation in an extremely supersaturated aqueous potassium dihydrogen phosphate (KDP) solution droplet," Proceedings of the National Academy of Sciences, vol. 113, no. 48, pp. 13618-13623, 2016, doi: doi:10.1073/pnas.1604938113.
[40] I. Russo Krauss, A. Merlino, A. Vergara, and F. Sica, "An Overview of Biological Macromolecule Crystallization," International Journal of Molecular Sciences, vol. 14, pp. 11643-11691, 05/31 2013, doi: 10.3390/ijms140611643.
[41] A. Ducruix and R. Giegé, Crystallization of nucleic acids and proteins: a practical approach. OUP Oxford, 1999.
[42] A. McPherson, Crystallization of Biological Macromolecules. Cold Spring Harbor, New York: Cold Spring Harbor Laboratory Press, 1999.
[43] B. Rupp, Biomolecular crystallography: principles, practice, and application to structural biology. Garland Science, 2009.
[44] A. McPherson and J. A. Gavira, "Introduction to protein crystallization," (in eng), Acta Crystallogr F Struct Biol Commun, vol. 70, no. Pt 1, pp. 2-20, Jan 2014, doi: 10.1107/s2053230x13033141.
[45] I. Heinonen, R. M. Brothers, J. Kemppainen, J. Knuuti, K. K. Kalliokoski, and C. G. Crandall, "Local heating, but not indirect whole body heating, increases human skeletal muscle blood flow," Journal of Applied Physiology, vol. 111, no. 3, pp. 818-824, 2011, doi: 10.1152/japplphysiol.00269.2011.
[46] C. G. Crandall et al., "Effects of passive heating on central blood volume and ventricular dimensions in humans," (in eng), J Physiol, vol. 586, no. 1, pp. 293-301, Jan 1 2008, doi: 10.1113/jphysiol.2007.143057.
[47] M. Bagath et al., "The impact of heat stress on the immune system in dairy cattle: A review," (in eng), Res Vet Sci, vol. 126, pp. 94-102, Oct 2019, doi: 10.1016/j.rvsc.2019.08.011.
[48] S. R. Kingsbury, P. G. Conaghan, and M. F. McDermott, "The role of the NLRP3 inflammasome in gout," (in eng), J Inflamm Res, vol. 4, pp. 39-49, 2011, doi: 10.2147/jir.S11330.
[49] B. Hartmann, D. Czock, and F. Keller, "Drug therapy in patients with chronic renal failure," Deutsches Ärzteblatt International, vol. 107, no. 37, p. 647, 2010.
Published
2023-04-14
How to Cite
Periferakis, K., & Periferakis, A. (2023). TREATING GOUT CAUSED BY RENAL INSUFFICIENCY WITH ACUPUNCTURE AND MOXIBUSTION: A CASE REPORT. Romanian Journal of Clinical Research, 6(1). Retrieved from https://rjcronline.com/index.php/rjcr/article/view/180
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