The cause of SLE is unknown, but most of scholars hold the view
that it may be related to autoimmunity and genetic factors. Many
organs and connective tissues of the body may be involved. The
disease is often accompanied with many serological and
immunological changes. It is seen more often in young females.
In TCM the disease is categorized as "xu lao" (consumptive
diseases), "shui zhong" (edema), "bi zheng"
(arthralgia-syndrome) "wen du fa ban" (epidemic disease with
eruptions), etc.
Main
Points of Diagnosis
1.The onset of disease is slow, early symptoms include fatigue,
anorexia, emaciation, arthralgia, low fever, skin rash,
photosensitization, etc. The initial symptoms are usually
atypical, and diagnosis is difficult.
2. Functional damages of multiple organs: As the disease
progresses, there appear functional damages of the liver,
kidney, cardiovascular, digestive and nervous systems.
Cardiovascular and renal damages are predominant features and
renal failure is the major cause of death.
3. Accessory examinations
(1) Blood picture shows anemia, decreased numbers of white blood
cells and platelets. ESR may be increased.
(2) Serum albumin is reduced, with elevated globulin. IgG
(Immune globulin G) is elevated markedly, elevation of ¦Á2
globulin in patients with prominent renal lesions. Some of the
patients are positive for rheumatoid factor (RF).
(3) Lupus cells are positive in 70-80 percent of the patients,
ANA (antinuclear antibody) is positive, up to 95 percent;
sensitivity to anti-DNA-antibody is high in some cases; serum
total complements and C3 can be used to determine
whether SLE is complicated by lupus nephritis. Skin biopsy is
specific for diagnosis.
Differentiation and Treatment of Common Syndromes
1. Domination of Heat-toxin
Main Symptoms and Signs: Sudden onset, high fever, flushed face,
fresh red-colored skin rash, purpura dotted over the skin,
irritability, thirst, even coma and delirium in severe cases,
arthralgia, constipation, scanty and dark urine, deep red tongue
with yellow greasy fur, full and rapid or taut and rapid pulse.
Therapeutic Principle: Clearing away pathogenic heat and toxic
materials, cooling blood and nourishing yin.
Recipe: Modified Antipyretic and Antitoxic Decoction.
buffalo horn powder (taken after being mixed with the finished
decoction)
dried rehmannia root
red peony root
moutan bark
gypsum
anemarrhena rhizome
scrophularia root
honeysuckle flower
forsythia fruit
arnebia or lithosperm root
ophiopogon root
cogongrass rhizome
All the above herbs except buffalo horn powder are to be
decocted in water for oral administration.
2. Internal Heat due to Yin-Deficiency
Main Symptoms and Signs: Low-graded fever or hectic fever in the
afternoon, feverish sensation in the palms and soles. deep
red-colored eruption, night sweat, fatigue, irritability,
insomnia, aching pain of joints, soreness of waist, baldness,
red tongue with thin yellowish fur or mirror-like tongue,
thready and rapid pulse.
Therapeutic Principle: Nourishing yin and clearing away
pathogenic heat, cooling blood and removing toxic material.
Recipe: Modified Sweet Wormwood and Turtle Shell Decoction in
combination with Bolus for Replenishing Vital Essence.
sweet wormwood
stellaria root
wolfberry bark
picrorhiza rhizome
dried rehmannia root
scrophularia root
anemarrhena rhizome
phellodendron bark
arisaema tuber
ophiopogon root
fresh-water turtle shell
prepared licorice root
All the above herbs are to be decocted in water for oral
administration.
In case of deficiency of the liver-yin and kidney-yin manifested
as vertigo, blurred vision, tinnitus, dryness of mouth and
throat, 12 grams of glossy privet fruit and 12 grams of eclipta
should be included in the above prescription.
If the case is marked by jaundice, hypochondriac distension and
pain, abdominal distension and anorexia, hematemesis, nosebleed
and hepatosplenomegaly, belonging to impairment of the liver due
to heat, treatment should be aimed at soothing the liver,
regulating the circulation of qi and promoting blood circulation
to remove stasis. The recipe preferred for it is modified
decoction for Dissipating blood Stasis under the Diaphragm. The
compositions are bupleurum root 10g, Chinese angelica 10g, red
peony root 10g ,white peony root 10g, giant knot-weed rhizome
10g, Sichuan chinaberry 10g, corydalis tuber 10g, curcuma root
12g, globethistle 10g. All the above drugs are to be decocted in
water for oral administration.
If the articular symptoms are dominant marked by migratory
arthralgia, heat, pain and swelling in the affected region,
difficulty in flexion and extension, etc. the suitable treatment
should be aimed at clearing away heat, dispelling wind and
removing dampness to dredge the channels and collaterals. The
chosen recipe is modified White Tiger Decoction and Pubescent
Angelica and Loranthus Decoction. The compositions are pubescent
angelica root 10g, loranthus mulberry mistletoe 18g, large-leaf
gentian root 15g, notopterygium root 10g, Ledebouriella 10g,
spatholobus stem 30g, achyranthes root 10g, anemarrhena rhizome
10g, gypsum 30g, Chinese angelica 10g, hypoglauca yam 12g, giant
knotweed rhizome 12g, honeysuckle stem 30g. All the herbs are to
be decocted in water for oral administration.
3. Deficiency of the Spleen-Yang and Kidney-Yang
Main Symptoms and Signs: pale complexion, puffy face, edema of
limbs, distension and fullness of abdomen, cold extremities,
shortness of breath, disinclination to talk, disturbance of
urination, loose stool, pale tongue with whitish moist fur, deep
and thready or thready and weak pulse.
Therapeutic Principle: Warming and invigorating the spleen and
kidney and activating yang to promote diuresis.
Recipe: Modified Decoction of Two Immortals Drugs combined with
Powder of Five herbs with Poria.
curculigo rhizome
epimedium
astragalus root
dodder seed
codonopsis root
cinnamon twig
umbellate pore-fungus
poria
water-plantain tuber
white atractylodes rhizome
waxgourd peel
cogongrass rhizome
All the above herbs are to be decocted in water for oral
administration.
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