Refractory gout belongs to “stubborn

bi

（痹）” in traditional Chinese medicine （TCM）. In clinical practice， professor ZHOU Zhongying would focus on the disease mechanism and syndrome differentiation， and treat the disease from the theory of “damp-heat and turbidity toxin” （as the main pathogenic factors） entering the collate-rals. The location of the disease is at the collaterals， and the basic pathogenesis is the dysfunction in spleen and kidney causing internal accumulation of damp-heat and turbidity toxin. As the disease progresses， new pathological factors such as phlegm and stasis are formulated. Finally， multiple and mixed pathological factors， mainly manifested as damp-heat and turbidity toxin in combination with phlegm stasis and static heat of unclear cause-and-effect relationship， lead to the disease. The treatment should focus on clearing and discharging damp-turbidity， resolving toxins and unblocking the collaterals， and self-made

Tongluo Tongxiao Formula

（清络痛消方） is used. Additionally， professor Zhou will use the methods of dissolving phlegm to dispel stasis and the methods of cooling the blood to dissolve stasis based on the disease progression and pathological factors observed， integrate Chinese and western medicine， and give full play to the multiple effects of each herb， thereby obtaining definitive effect in the treatment of refractory gout.