Treatment of Refractory Gout With ACTH or Methylprednisolone

Inclusion Criteria: * (123 items and 1 item from 4-7 are met simultaneously) : 1. Meet the 2015 ACR/EULAR classification diagnostic criteria for gout 2. Acute gouty arthritis 3. Age ≥18 4. Repeated attacks and prolonged pain (more than 1 month); 5. poor response or intolerance to colchicine or NSAIDs; 6. Liver and kidney dysfunction; 7. Old age; Exclusion Criteria: * 1\) History of gastrointestinal bleeding and active ulcer 2) The application history of glucocorticoids and ACTH in 1 month before screening 3) Pregnancy and lactation 4) Drug and alcohol abuse 5) Malignant tumor (treated or untreated within 5 years) 6) Mental illness inability to communicate or have language barriers and inability to fully understand and cooperate 7) negligent compensatory heart failure, unstable angina pectoris, stroke, transient ischemic attack, myocardial infarction, and severe arrhythmia occurred within 6 months 8) The investigator did not consider it appropriate to participate in the study