Systemic Lupus Erythematosus (SLE) is an autoimmune disease with multi-system involvement caused by auto-antibodies against cell nuclear components produced by abnormal human immunity. At present, the disease has been transformed from an incurable disease to a chronic disease, and the 10-year survival rate of patients has reached more than 84%.
The etiology of SLE is still unclear and is generally considered to be multi-causal, with its onset being related to a variety of factors such as genetic quality, estrogen levels, ultraviolet radiation, certain drugs and foods, and infections. These factors interact with each other and lead to malfunction of immune function in the body, producing excessive autoantibodies and combining with autoantigens in the body to form immune complexes, which are deposited in the skin, joints, small blood vessels, glomeruli and other parts of the body, causing acute and chronic inflammation and tissue necrosis, or cell destruction, thus causing multi-system damage in the organism.
The clinical manifestations of SLE are diverse, but multisystem involvement is its main clinical feature. However, at a certain period of the disease, it can be prominent in a certain organ or a certain system, so that it can be easily misdiagnosed as simple nephritis, pericarditis, thrombocytopenic purpura, epilepsy or arthritis. The clinical severity of the disease also varies widely, with some patients having prominent skin lesions and mild visceral involvement; some having positive serologic indicators and mild clinical symptoms; some having acute attacks with violent onset; some having alternating attacks and remissions; and a few cases lasting for years in remission.
Due to the diverse manifestations of SLE, there are various symptoms in Chinese medicine, such as facial skin damage, which can be classified as “Yin Yang Poison”, “Ghost Face Sore”, “Butterfly Dan” and so on. Those with joint lesions can be classified as “paralysis”; those with swelling due to kidney involvement are classified as “edema”; and those with hematological SLE lesions are often classified as “deficiency labor”.
According to TCM, SLE is an evidence of deficiency and symptomatic reality, and the symptomatic reality is mainly hyperthermia, but there is a distinction between real fire and deficiency fire. The actual fire is mostly due to external heat or sun poisoning, or internal injury to the heart and liver; the deficiency fire is mostly due to Yin deficiency and Yang hyperactivity. This deficiency is mostly due to liver and kidney yin deficiency or spleen and kidney deficiency. Therefore, Chinese medicine diagnosis and treatment of this disease, first of all, distinguish between the symptoms and the deficiency, the symptoms of the emergency treatment, the original emergency treatment, both the symptoms and the original emergency treatment of the same treatment. When the disease is active, it is supplemented by clearing heat and detoxification, cooling blood and removing blood stasis; when the disease is in remission, it is supplemented by activating blood circulation and removing blood stasis.
Health guidance
The principles of health care and prevention of SLE are: avoiding various triggers that stimulate or aggravate the disease, strengthening physical fitness, adjusting emotions, paying attention to life and living, and reducing the chances of various infections. After the onset of the disease, we should actively cooperate with Chinese and Western medicine treatment, and pay proper attention to Chinese medicine regimen to prevent complications and reduce the number of recurrence.
I. Prevention before the onset of the disease
According to Chinese medicine, the onset of SLE is related to the external evil, diet and the seven emotions. Therefore, it is important to keep the emotions open, the diet moderate, and the daily life normal, so that the body’s internal organs can function in harmony, the qi and blood can be harmonized, and the yin and yang can be secreted to prevent or reduce the occurrence of the disease.
(a) Avoid external evil
Cold and flu is one of the main factors that trigger and aggravate the condition of SLE. Those who have photosensitivity or skin damage should avoid direct skin exposure to the sun, and can use UV-protective parasols or high-intensity UV-protective sunscreens.
(B) adjust the diet
1, food taboo
(1) skin damage or photosensitive people, should not eat fresh mushroom food, celery, grass head (southern clover, purple clover), figs and other foods that can easily increase photosensitivity.
(2) Since this disease is mostly seen in the evidence of Yin deficiency and Yang hyperactivity, patients who belong to this type of physique should avoid warm foods, such as mutton, dog, horse, donkey, venison, beef, etc. in meat; pepper, green pepper, garlic, onion, leek, etc. in plants; cinnamon, litchi, dragon fruit, mango, orange, cherry, peach, etc. in fruits; alcohol, coffee, black tea, etc. in beverages. Nicotine and other harmful ingredients in cigarettes can stimulate the blood vessel wall and aggravate vasculitis should be quit.
(3) Patients with rashes, ulcers or asthma should refrain from eating “hairy foods” that Chinese medicine believes will stimulate the disease, such as fish, crab, shrimp, bamboo shoots, lettuce, etc., based on their past experience.
2.Drug avoidance
(1) The following western drugs can often trigger or aggravate SLE, avoid using them, such as hydrazinebendazide, benzoin, chlorpromazine, propyl or methylthioxypyrimethamine, gold, D-penicillamine, sodium phenytoin, isocoumarine, streptomycin, penicillin, sulfonamides, etc.
(2) The following drugs can cause photosensitivity and should be used for a short period of time or not under the guidance of a physician, such as psoralen, doklam, comfrey, comfrey, tribulus terrestris, dahurica, etc.
(3) Because the onset of SLE is related to the increase of estrogen, some supplements or drugs containing estrogenic substances should be avoided, such as Zihecuo (placenta), umbilical cord, toadstool oil, royal jelly, isoflavones, estrogen-containing birth control pills, etc.
(4) Because the development of SLE is related to the abnormal increase of antibodies in the body, some non-specific supplements to enhance the immune function of the body should be used with caution under the guidance of doctors, such as ginseng, American ginseng, gynostemma and its compound preparations.
(5) Some drugs have no effect on normal liver and kidney functions, but once liver and kidney functions are impaired, such as lupus hepatitis and lupus nephritis, their use may aggravate the disease, such as Gansui, Eucommia, Perilla, Mouton, Ironwood leaves, Wangnanzi, Daylily root, Cangerzi, Neem, Neem root bark, Huang Yaozi, etc.
(C) Smooth the emotions
The occurrence of this disease, according to Chinese medicine, is mostly related to the internal fire, and all kinds of bad emotions, such as depression and fear, irritability, great joy and sadness, thinking and worrying, etc., can produce internal fire, injuring the qi and blood of the five internal organs and aggravating the disease. Modern medicine also believes that abnormal emotions can affect the immune function and lead to disease activity. Therefore, attention to mental regulation is an important means to prevent the onset of disease. If you have already got the disease, you should make peace with it and maintain an optimistic and positive attitude to actively cooperate with the doctor for treatment.
(4) Careful living
When the disease is not onset or in remission, patients can participate in social activities and work appropriately, but should pay attention to the combination of work and rest, appropriate exercise, not overworked.
II. Post-onset care
(A) Targeted care according to symptoms
1.Arthritis and arthralgia: protect the joints, reduce joint activities, rest more, maintain the correct posture of the joints, and keep appropriate activities. For obvious local swelling and pain in the joints, local fumigation treatment with external Chinese herbal medicine is available. Generally, there are two types of pain: cold and hot.
(1) Cold dampness blocking type: the joint is not red or hot locally, preferring warmth and pressure, increasing pain when cold and decreasing pain when hot. We can use 10 grams of Sichuan wu, grass wu, cinnamon stick, safflower, silkworm sand, sea breeze vine, turmeric, 6 grams of each, decoction of water, twice a day, 15 minutes each time.
(2) Damp-heat blocking type: localized redness, swelling, heat and pain in the joints, which cannot be touched and pressed, with pain decreasing when cold and increasing when hot. The decoction of tiger scepter, percussive herb, lonicera vine, luo shi vine, mulberry branch, haitongpi, alum 15 grams each, ice chips 6 grams, twice a day, 15 minutes each time.
2.Fever: Measure body temperature accurately and regularly, ensure rest and adjust room temperature to promote heat dissipation. If there is no edema, encourage patients to drink more water to replenish water, and if necessary, ice pack to cool down or go to hospital for treatment.
3, skin erythema: keep the skin clean and dry, avoid direct sunlight or ultraviolet radiation, check the skin every day to observe whether new lesions appear, and apply topical preparations under the guidance of the doctor when the lesions are serious. Do not overheat the bathing water and avoid using irritating bathing and cleaning products. For facial erythema, avoid using alkaline soap and cosmetics or ointment to prevent skin allergy to increase skin damage.
4. Lupus-like alopecia: Wash your hair with warm water 1-2 times a week, and moisturize your scalp while washing. At the same time, the following external washing formula can be used to promote hair growth: 15 grams each of ginseng leaves and yucca, decoction water washing, twice a week, 15 minutes each time.
5, mouth ulcers: can use watermelon cream spray, bead yellow powder and other external application, keep the mouth clean; if there is an infection, available 1: 5000 furacilin solution gargle, local application of tin class or ice borax, etc.; such as mold infection, available mycobacterial glycerin external application.
6.If there is cardiopulmonary damage, pay attention to the vital signs and changes in the peripheral circulation at any time. If there is shortness of breath, drop in blood pressure, irregular heart rhythm, edema of the limbs, coldness, etc., the physician should be informed quickly so that timely medical treatment can be carried out.
7. Those with hematologic system effects should pay attention to regular review of blood routine, and seek medical attention promptly if dizziness and weakness worsen, skin purple spots, mucous membrane bleeding, or menstruation persists, so as to avoid critical situations such as infection and central hemorrhage due to excessive blood cell decline.
8. If there is a history of central lupus, the patient should be observed for behavioral changes, confusion, hallucinations, delusions or emotional instability, convulsions, etc. If the above phenomena occur, the patient should be sent to hospital for treatment in time, and the escort should protect the patient appropriately to prevent accidents such as falling, falling out of bed or biting the tongue.
9. See lupus nephritis for the care of those with kidney damage.
(2) Points of care for hormone application
Most patients with rheumatic immune diseases need to use hormone therapy, and the following points should be noted when using hormones, and other rheumatic immune diseases can also refer to the implementation.
1.Once glucocorticoids are used, they should be increased or decreased under the guidance of doctors according to the condition and laboratory indexes, and should not be suddenly stopped or casually increased.
2.Appropriate supplementation of calcium and activation of vitamin D to prevent and treat osteoporosis.
3, pay attention to monitoring blood sugar and urine sugar to prevent drug-induced diabetes, once found abnormal blood sugar should be under the guidance of endocrinologists for glucose-lowering treatment.
4. Pay attention to the color of stool and gastrointestinal symptoms, and regularly check stool occult blood for early detection of gastrointestinal bleeding or ulcers.
5.People with high-dose hormone therapy may experience insomnia, mental hyperactivity and transient muscle weakness, and due to the high metabolism caused by hormones, they may develop hyperphagia, full-moon face, buffalo back and other centripetal obesity phenomena, so attention should be paid to mental conditioning, appropriate supplementation of protein, potassium-containing food, salt and water to avoid the increase of metabolites and water retention and aggravation of physical discomfort.
(3) Dietary care
Patients with SLE are mostly identified by Chinese medicine as having liver and kidney yin deficiency and internal disturbance of heat and toxicity, while some are suffering from deficiency of both lung, spleen and kidney qi and yin. Patients with SLE have decreased resistance due to the long-term application of hormones and immunosuppressants, and may suffer from lung and spleen qi deficiency due to recurrent colds, so the dietary regimen mainly focuses on these types of evidence.
1.Yin deficiency of liver and kidney
(1) Chinese wolfberry sesame porridge
Ingredients: 30 grams of Chinese wolfberry, 15 grams of black sesame, 10 red dates, 60 grams of round-grained rice.
Practice: the four flavors on the porridge with water in the usual way. Breakfast and dinner, can often serve.
Function: Nourish the liver and kidney, nourish the deficiency.
(2) Two vegetable soup
Ingredients: 10 grams of light vegetables, 30 grams of capers.
Practice: first add the appropriate amount of water, cook water for half an hour, and then put the capers boiling water that is ready. Drink soup and eat vegetables, 1 to 2 times a day.
Function: nourish the liver and kidney, benefit essence and blood.
(3) turtle fish nourishing kidney soup
Ingredients: turtle fish 1 (more than 300 grams), 30 grams of Chinese wolfberry, 15 grams of ripe earth o
Directions: Scald the turtle fish in a pot of boiling water, chop off the head and claws, remove the turtle nails, remove the internal organs and yellow fat, wash, cut into small squares and put into an aluminum pot; then put in the cleaned Chinese wolfberry and ripe groundnut, add the right amount of water, bring to a boil, change the fire to simmer until the turtle meat is cooked. If often eaten, can be served with meals, can be eaten alone.
Function: Nourishing Yin and tonifying the kidney.
2.Heat toxin internal disturbance evidence
(1) water chestnut porridge with melon rind
Ingredients: watermelon rind, water chestnuts in appropriate amounts.
Practice: watermelon rind cut into pieces, remove the emerald coat and flesh, take the white layer of shredded water chestnuts and mix well with seasoning. Do not add salt if swelling is obvious.
Function: Clearing heat and relieving dampness.
(2) Job’s tear congee
Ingredients: 60 grams of raw coix seeds.
Directions: Add water to coix seeds, boil it into porridge, add sugar and eat on an empty stomach. Once a day.
Function: Raw coix seeds can clear heat and permeate dampness, strengthen the spleen and benefit the stomach, and clear heat and water for those with damp heat.
(3) stewed pig’s trotters with money grass
Ingredients: 100 grams of Szechuan money grass, 10 grams of cumin, 2 pig’s feet.
Practice: money grass, cumin and pig’s trotters stewed together until the pig’s trotters are cooked and rotten, drink soup and eat pig’s trotters.
Function: Strengthening the spleen and clearing heat and dampness.
(4) cooling blood five flowers tea
Ingredients: safflower, cocklebur, lingxiao, rose, wild chrysanthemum 8g each.
Practice: the above medicines together in a thermos bottle, brewed with boiling water in the right amount, cover smothered 15 minutes, take the juice to drink as tea. 1 dose daily. Not to be used by those with weak Qi and blood and pregnant women.
Function: Cool the blood and invigorate the blood, remove wind and detoxify.
3.Qi and Yin deficiency evidence
(1) mulberry yam porridge
Ingredients: 30 grams of mulberry, 30 grams of yam, 30 grams of raw coix seed, 10 jujubes, 60 grams of corn.
Method: The above five flavors, the usual way to cook porridge. Served in 2 to 3 times.
Function: Benefit Qi and nourish blood, strengthen the spleen and permeate dampness, harmonize the stomach and produce fluid.
(2) Astragalus stewed pigeon
Ingredients: 30 grams of astragalus, 30 grams of Chinese wolfberry, 1 squab pigeon.
Practice: the first squab pigeon to remove the hair and viscera, and astragalus, wolfberry stew cooked, drink soup and eat meat.
Function: Tonify the middle and benefit the qi and nourish the yin.
4, lung and spleen qi deficiency evidence
(1) hen astragalus soup
Ingredients: astragalus 120 grams, hen 1.
Practice: slaughter the hen and wash the guts, and astragalus stewed, skim off the floating oil, drink soup and eat meat, 3 to 4 times a month.
Function: Tonifying Qi, diuretic and swelling.
(2) Atractylodes macrocephala pork belly porridge
Ingredients: 30 grams of white wood, ginger 2 grams, betel nut 10 grams, pork belly 1, 100 grams of round-grained rice.
Practice: wash the pork belly, cut into small pieces, with white atractylodes, betel nut, ginger cooked together, until the belly stew is cooked, take the juice, the juice cooked japonica rice for porridge, sesame sauce, soy sauce mixed with pork belly, accompanied by meal medicine porridge.
Function: Strengthen the spleen and benefit the qi, eliminate food and stomach.
(3) pig spleen porridge
Ingredients: 1 pig spleen, 15 grams of ginseng, 6 grams of orange red, 100 grams of round-grained rice, ginger, white onion and salt.
How to do: Wash the ginseng and japonica rice, add water, boil the ginger (scrape off the skin and wash, slice), continue to cook until the rice is thick, put the pig spleen (clean, thinly sliced), white onion, orange red (both washed first), until the porridge is ready, remove the orange red, add salt to taste, eat on an empty stomach.
Function: Tonifies the qi and strengthens the spleen, warms the middle and moves the qi.
(4) turtle meat stew with Cordyceps
Ingredients: 250 grams of turtle meat, 30 grams of Cordyceps sinensis, 20 grams of ginseng leaves.
Directions: Put the turtle into a basin, heat water (about 40°C), drain the urine, slaughter the head and feet, cut open the shell, remove the internal organs, wash, and put into a tile jar. Then put the cleaned northern cordyceps and ginseng leaves into the turtle meat jar, add water to the right amount. First boil with martial fire, then cook slowly with civil fire until the turtle meat is cooked, and then eat as usual.
Function: To benefit the lungs and kidneys.
(D) Acupressure
The onset of SLE is related to the abnormal regulation of human immune function, and Chinese medicine blames the dysfunction of liver, spleen and kidney, so the usual maintenance can be carried out by massaging the acupuncture points of the Ren and Du channels, liver meridian, spleen meridian and kidney meridian according to the evidence of one’s own constitution.
1, liver and kidney yin deficiency evidence: Sanyinjiao, Kidney Yu, Liver Guan, Yuan Yu, Yanglingquan, Diaphragm Yu, Taixi.
2, lung and spleen qi deficiency evidence: Fengmen, Dazhi, Foot Sanli, Spleen Yu, Zhongyu.
3, heat toxin internal disturbance: Quchi, Hegu, Fengchi, Baihui.