Abstract: Objective To compare the relieving effects of different doses of colchicine on pain and inflammation in patients with acute attack of gout, and to explore the best dose of colchicine in the treatment of gout. Methods A total of 94 patients with gout acute attack admitted to Taizhou First People' s Hospital from January 2019 to January 2020 were randomly divided into two groups:group A (47 cases) and group B (47 cases). Both groups were treated with routine therapy and colchicine. The initial dose of colchicine in group A was 1 mg, then 0.5 mg/h or 1 mg/h, and the maximum dose on the first day was 6 mg. The initial dose of colchicine in group B was 1 mg, then 0.5 mg/time, 3 times/d. The efficacy, pain relief (VAS score, pain relief time), and inflammation relief were compared (IL-1, IL-6, CRP) and adverse reactions (gastrointestinal symptoms, abnormal blood routine, abnormal blood pressure, liver function damage). Results The total effective rate of group B (89.4%) was similar to that of group A (93.6%), P>0.05. The VAS score in group B[(2.4±0.8) points] was lower than that in group A[(3.2±1.1) points], and the time of pain relief[(26.1±9.7)h] was shorter than that in group A[(37.5±10.4)h], all P<0.05. The IL-1, IL-6 and CRP in group B[(18.2±3.7)pg/mL, (41.4±7.6)pg/mL, and (6.3±2.0)mg/L] were lower than those in group A[(26.4±4.5)pg/mL, (53.2±9.4)pg/mL, and (9.4±2.6)mg/L], all P<0.05. The incidence of adverse reactions in group B (17.0%) was lower than that in group A (36.2%), P<0.05. Conclusion Colchicine can relieve the pain and inflammation of patients with gout acute attack in a small dose. The total effective rate of clinical effect is the same as that in a large dose, and the incidence of adverse reactions is significantly reduced, which is worth popularizing.