The potential of Chinese medicines in the treatment of hyperuricemia

The annual incidence of gout is increasing along with lifestyle and dietary changes. Accumulation of urate crystals in joints and tissues when the amount of uric acid exceeds its saturation concentration causes acute inflammation that leads to gout. Reducing the serum uric acid concentration is the key to treating gout. Allopurinol, febuxostat, benzbromarone, and other drugs are effective, but side effects of treatment such as toxicity and recurrence after drug withdrawal cannot be ignored. Recent studies have found that many Chinese medicines are effective and safe, provide durable efficacy, and are associated with low recurrence rates. This article reviews recent investigations of Chinese medicines for lowering uric acid, including components such as berberine, luteolin, and others; single medicines such as Smilax glabra Roxb., Reynoutria japonica Houtt., and Plantago asiatica L.; and compounds such as Wuling Powder and Compound Tufuling Granules. Mechanisms of lowering uric acid, including inhibiting uric acid production and promoting uric acid excretion are discussed. Clinical studies and basic research are reviewed.