Systemic Lupus Erythematosus
Lupus is a chronic inflammatory condition caused by
an autoimmune disorder. Discoid
lupus is only the skin involved and systemic lupus erythematosus (SLE) is
internal organs involved too, and the both in women more than in men (about
eight times more). The disease can affect all ages, but most commonly begins
from age 20 to 45 years. Exactly factors that cause lupus are still not known,
but genetics, viruses, ultraviolet light, and drugs may all play some role.
In discoid lupus, only the skin is involved but 5 to 10% may develop SLE
finally. The skin lesion discoid lupus is often found on the face and scalp,
which is usually red, may have raised borders and can scar.
The rashes are usually painless and do not itch, but scarring of discoid
skin lesions can cause permanent hair loss.
Patients with SLE can develop different combinations of symptoms and
organs involvement. Common symptoms include fatigue, low-grade fever, loss of
appetite, muscle aches, arthritis, ulcers of the mouth and nose, butterfly rash,
photosensitivity, pleuritis and pericarditis, and Raynaud's phenomenon. More serious organ damage involves inflammation of the brain
tissue, hepatitis, and kidney damage and failure. Certain blood cells and blood clotting factors can also be
affected, thereby increasing the risk of infection and bleeding.
The eleven criteria are used for the diagnose of SLE: malar (over the
cheeks of the face) "butterfly" rash; discoid skin rash, patchy
redness that can cause scarring, photosensitivity, mucus membrane ulcers,
arthritis, pleuritis/pericarditis: inflammation of the lining tissue around the
heart or lungs, kidney abnormalities, brain irritation, blood cell disorders,
immunology disorders. There is no
permanent cure for systemic lupus. The goal of treatment is to relieve symptoms
by decreasing inflammation and/or the level of autoimmune activity in the
body.
Etiology
and pathology
There is not similar TCM illness as SLE.
Because the symptoms and signs might be changed with its multiple organs
damaged, TCM diagnosis also is deferent, which might be “Redu”
(Heat-toxin syndrome), “Bizheng (Painful joints syndrome);
“Fuzhong” (Edema), etc. The possible TCM causes of SLE include excessive
branch, such as EPI invading and the root deficiency, such as congenital kidney
deficiency and over exertion, etc. Its
multiple organs functions disorder might cause any kind pathological changes,
such as qi stagnation, dampness stagnation, and blood stasis.
Differentiation
and treatment
1.
Heat-toxin domination
Clinical
manifestation: Acute onset, high fever, flushed face, fresh red skin rash,
purpuras on skin, painful and swollen joints, even coma, red tongue with yellow
fur, rapid pulse
Treatment
principle: Clear heat-toxin, cooling blood
Herbal
prescription: Modified Xijiao DihuangTang
Acupuncture:
Dazhui (DU14), Quchi (LI11), Hegu (LI4) and Shaosheng (LU11)
2.
Yin deficiency
Clinical manifestation: Slow
onset, or in a chronic stage, afternoon low fever, bright red face, night
sweating, emaciated, fatigue, or fresh red skin rash, purpuras on skin, painful
joints, even coma, narrow red tongue body with yellow fur, rapid, thin and weak
pulse
Treatment
principle: Nourishing yin, clearing yin deficient heat
Herbal
prescription: Modified Qinghao Biejia Tang
Acupuncture:
Shenshu (BL23), Taixi (KI3), Zhaohai (KI6), Sanyinjiao (SP6) and Dazhui (DU14)
3.
Yang-qi deficiency
Clinical
manifestation: Chronic fatigue, pale complexion, edema, or ascites, or
hydrothorax, poor appetite, limbs cold, short breath, or short urination or
night frequent urination, pale big tongue body with white fur, weak and deep
pulse
Treatment
principle: Tonifying yang-qi and draining dampness
Acupuncture:
Shenshu (BL23), Pishu (BL20), Yinlingquan (SP9), Zusanli (ST36) and Guanyuan
(RN4)
Copyright
by Kai Chen Ph.D. in Chinese Medicine
Kai Chen Ph.D. in
Chinese Medicine