![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
尿酸场面600左右,前天发作痛风,自己买了扶他林外用和内服的。今天内分泌科开了秋水仙碱,苏打片。(男,35岁)
尿酸场面600左右,前天发作痛风,自己买了扶他林外用和内服的。今天内分泌科开了秋水仙碱,苏打片。
能买西乐葆和安康信配合着吃么
其他用药:再平宁,他汀,倍他乐克,二甲双胍
图片因隐私问题无法显示
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
您好,疼痛期,阵痛的非甾体药就吃一种,吃依托考昔吧,加上秋水仙碱,小苏打
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,董医生。不痛之后要不要吃降酸药物,非步或者苯溴马隆么?要吃多久。不吃会反弹么
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
我体重比较大。200斤,175
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
我自己还有高血压,高血脂,再吃再平宁,他汀,倍他乐克,二甲双胍
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
要吃降尿酸药,长期吃,让尿酸持续维持到300以下
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
吃非布司他或者苯溴马隆(有肾结石不吃苯溴马隆)
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,董医生,降酸药和目前吃的心脑血管药冲突么。
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
小苏打也要长期吃么。还是就发作时候吃
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
还有,就是是不是要等不痛后开始吃非布吧
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
体重降了,有没有机会停药。目前在减重,有瘦了一点
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
收到了,董医生。很详细。就是秋水仙碱听说副作用比较大,长期吃能行不
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
我原来没有吃降尿酸药
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
主张在起初降尿酸时吃3-6个月,就是复查肝功能,血常规,一般问题不大,因为现在主张的是小量吃,早晚各,0.5mg,如果这个量有腹泻,就再减
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,收到,谢谢主任。二甲双胍继续吃可以么,预防糖尿病
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
心脑血管药目前吃再平宁,阿伐他汀,倍他乐克。是否继续或者调整
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
继续用这些药,血压理想就行
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,谢谢主任
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
👌不客气
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
主任,昨天半夜踝关节又很痛,原来大拇指的地方已经好多了,今天又不能下地
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
急性期是不是会这样?
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
还有昨天吃秋水仙第三次的时候,吃完就拉肚子了,要不要减量
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
秋水仙碱不是让吃 0.5mg 每天两次吗
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
昨天下午15点多说,秋水仙碱,早晚各0.5mg,怎么就出来第三次了
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
可以这样,急性期,另处关节疼痛
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
急性期,医院的医生让我吃两天,一天6片,后面随餐服
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
一天3片
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
您昨天的意思,是说降酸的时候,我理解的是,一天两次。一次0.5
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
这种吃法已经淘汰,说明书也都没改,但治疗指南已经改了
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
哦哦,明白,那您看下急性期怎么吃
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
就是早晚各一片,这样也有人腹泻,就减为早晚各半片
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
我昨晚半夜3点疼,起来吃了个安康信和0.5秋水仙
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
可以偶尔临时加服依托考昔,
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
但依托考昔也是基本一天一次,睡前或晚餐后吃
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
120mg
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,主任。还有个问题,就是急性期,大拇指疼已经缓解了,现在是踝关节疼,类似骨折那种感觉,急性期是不是会这样
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
会
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
多处关节结晶沉积
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
如果疼痛难忍,就上激素类了
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
短时间吃,泼尼松(期间停依托考昔或双氯芬酸这类药)三五天停药
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,主任。医院开了洛索洛芬可以么
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
外用的可以用
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的好的,明白了。吃激素的时候,秋水仙还是正常用吧
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
可以
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,明白了,谢谢主任。
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
秋水仙碱就一直吃,启用激素几天内就不吃非甾体类了
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
图片因隐私问题无法显示
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
图片因隐私问题无法显示
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
收到了。还有个问题,我昨天刷到一个视频说,吃他汀和秋水仙碱,冲突。能一起吃么
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
我现在不是也在吃立普妥么
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
能,稍微增加了另外一个药的药物浓度,但很少
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
还有,注意复查肝功能
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,昨天肝功查出胆红素偏高,32,转氨酶正常
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
图片因隐私问题无法显示
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
主要注意丙氨酸氨基转移酶
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
就是谷丙转氨酶
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的👌🏻好的,谢谢主任
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
一个月复查尿酸,肝功能
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的好的
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
急性期是尿酸下降的,都有600多,平常更高
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
😢😓
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
😂😂
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
太惨了,去年12月减脂,降到500左右,这两个月又高了
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
老天爷给的这体质,上哪说理去,生活方式太难了,也就起到10-20%作用。还是靠药物吧
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
图片因隐私问题无法显示
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
去年12月的检查报告
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
嗯嗯,明白了
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
接受,服药,复查
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,主任
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
客气了
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
感谢主任
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
💝😊
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
主任,我要是用司美格鲁肽控制体重可以么
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
可以
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
试试效果
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,那我去试一下。用的时候,二甲双胍能继续吃么。
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
没多大必要吃了
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
血糖本不高
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的好的
![](https://resourced.chunyu.mobi/bYUAAAC157uiqXUX-52322201-a109-410f-8fda-2e597cd23684_w500_h500_.png?imageMogr2/thumbnail/150x)
董学勤医生
👌
提示:疾病因人而异,他人的咨询记录仅供参考,擅自治疗存在风险。
咨询时间: 2024-03-30