OBJECTIVE: To probe into the efficacy of live combined Bifidobacterium

Lactobacillus and Enterococcus capsules combined with febuxostat in the treatment of patients with gout attack intermission and its effects on intestinal flora. METHODS: A total of 110 patients with intermittent gout admitted into this hospital from Mar. 2019 to Mar. 2021 were extracted to be divided into the febuxostat group（ n = 55） and the viable bacteria group（ n = 55） by block randomization method. Patients in both groups were given the controlled diet and oral febuxostat

while the viable bacteria group received oral live combined Bifidobacterium

Lactobacillus and Enterococcus capsules on this basis

and both groups were treated continuously for 8 weeks. The levels of interleukin 1β（ IL-1β）

interleukin 6（ IL-6）

xanthine oxidase（ XOD）

urea nitrogen（ BUN）

creatinine（ Cr）

uric acid（ UA） and erythrocyte sedimentation rate（ ESR） before and after treatment

changes of intestinal flora and gout attack during treatment were compared between two groups. RESULTS: After treatment

the levels of IL-1β

IL-6

XOD

UA and ESR in two groups were all lower than those before treatment. The levels of IL-1β（ P = 0. 018）

IL-6（ P = 0. 044）

XOD（ P =0. 000）

UA（ P = 0. 000） and ESR（ P = 0. 003） in the viable bacteria group were significantly lower than those in the febuxostat group

the differences were statistically significant. There were no significant differences in levels of BUN and CR between two groups before and after treatment（ P > 0. 05）. Differences in the number of Bifidobacterium

Lactobacillus

Enterococcus faecalis

Bacteroidetes and Enterobacteriaceae in the febuxostat group before and after treatment were not statistically significant（ P>0. 05）. After treatment

the number of Bifidobacterium

Lactobacillus

Enterococcus faecalis and Bacteroides in the viable bacteria group increased

and the number of Enterobacteriaceae decreased

compared with the febuxostat group before and after treatment

the differences were statistically significant（ P<0. 05）. During treatment

the rate of acute gout attacks was 3. 64%（ 2/55） in the viable bacteria group

lower than 12. 96%（ 7/54） in the febuxostat group

the difference was not statistically significant（ P > 0. 05）.CONCLUSIONS: Adjuvant therapy with live combined Bifidobacterium

Lactobacillus and Enterococcus capsules in patients with intermittent gout attack can lower the uric acid levels

reduce the inflammatory response and acute gout attacks; the mechanism may be related to the involvement of live combined Bifidobacterium

Lactobacillus and Enterococcus capsules in purine oxidation metabolism and promotion of uric acid decomposition and excretion.