Gao Lan, Wang Yongfu, Feng Xiuyuan, Lu Fuai, Yang R, Yin Jiawei
Department of Rheumatology and Immunology, The First Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia (014010) Department of Nutrition, The First Affiliated Hospital of Baotou Medical College, Gao Lan
Systemic lupus erythematosus (SLE) is a diffuse connective tissue disease caused by the production of autoantibodies in the body, the formation of immune complexes and defects in the regulation of immune complex clearance, resulting in tissue damage and the involvement of multiple organs throughout the body. The patient and her family are faced with many doubts about the possibility of having children and whether the disease will be passed on to them. As a chronic disease, it also has the five D’s of rheumatism, Discomfort, Disability, Dollar loss, Death and Drug toxicity.
The disease itself brings about physical distress, mental anxiety, loss of function, threat of death, and forced acceptance of poverty and drug toxicity due to the disease. These many problems inevitably create a very large shock wave to the family and even to the family, and the stability of the family is at stake. The family is the cell of society. Therefore, SLE is not only a problem of individual disease, but also a problem of family and society. On the basis of medical treatment, it is especially important to pay attention and focus on the psychological problems of patients and psychotherapy.
Let’s start with the skin involvement of this disease. Ultraviolet radiation, which can trigger or aggravate SLE. every patient with rash or photosensitivity, is told by doctors to avoid light. Chloroquine is taken to bind to the melanin in the skin to block out the light, but the resulting darkening of the skin robs lupus patients of their beautiful white appearance. Not to mention the rash of lupus itself, which is almost disfiguring to the face. For women who love beauty, this can be a fatal blow. Fear of disease, multiple stresses as mentioned above, shock waves from family members, etc., one can imagine what kind of dark and gloomy life the patient’s psyche endures, and the gloom of the mind that cannot see the sunlight cannot be cured by medicine.
The treatment of SLE patients with hormones and immunosuppressants has made promising progress in terms of minimizing local vascular inflammation, reducing the production of antibodies and immune complexes, and stopping the progression of the disease. 15-year survival rate is 60-64% [2]. However, as a chronic disease, there are problems with discontinuation and post-discontinuation relapse, side effects of drugs and susceptibility to infections. Every lupus patient and rheumatologist cannot avoid it. For patients and their families, who are not equal in knowledge, many problems make them like people lost in the forest. They look for doctors and treatment options that they can “trust”. Many patients keep seeing specialists from different regions, hospitals and levels. Today, with highly developed information technology, there are many people who get a lot of disease-related information from the Internet. However, they do not have the ability to distinguish and analyze the information as a whole. It is not easy for doctors to establish trust-based cooperation with patients and their families in a short period of time in the face of their doubts and anxieties.
A lupus patient once wrote in his diary, “The sun is my enemy. We all know that everything grows by the sun, and the sincerity and love between people is the sun. The sunlight of true love in this world is really expected to light up the dark inner world of patients through the layers of fog. As rheumatologists, we are required to systematically learn some knowledge of psychology, talk therapy and some skills, etc., and apply them continuously in practice. But in my opinion, the most direct and time-saving thing is to maintain a healthy state of one’s body and have a real happiness. Bringing this happiness to the patient and allowing the patient to benefit from the contact with us. By educating patients about their illnesses, communicating patiently, and putting ourselves in their shoes, we can accept and understand their true feelings. Stabilize patients’ emotions and let them open their hearts so that the sunshine of friendship can shine through their hearts and melt the ice at the bottom of their hearts, and also let their dark hearts really see the light and be warmed by the sunshine, so that patients and their families can feel at ease and reassured in the shortest time, and put aside all kinds of doubts, anxieties and anxieties, and believe and trust and then cooperate with the treatment in the true sense, so that the best and most beautiful treatment effect can be achieved.
About 25%-50% of SLE patients will have gastrointestinal symptoms, and about 10% of patients will have the first symptoms of the disease. All parts of the gastrointestinal tract can be involved. Gastrointestinal symptoms can occur throughout the course of SLE, and almost all drugs used to treat SLE have gastrointestinal side effects. Therefore, dietary treatment is very important for SLE patients to recover from the disease. A healthy diet requires a balanced diet to meet the human body’s needs for all nutrients and an appropriate ratio of various nutrients.
The Dietary Guidelines for Chinese Residents (2007) recommends ten dietary guidelines for the general population, which are suitable for normal people above 6 years old. These ten articles include: 1. Eat a variety of foods, mainly cereals, with coarse and fine grains; 2. Eat more vegetables, fruits and potatoes; 3. Eat milk, soybeans or their products every day; 4. Eat an appropriate amount of fish, poultry, eggs and lean meat; 5. Reduce the amount of cooking oil and eat a light, low-salt diet; 6. Eat fresh and hygienic food. The dietary pagoda is divided into five layers, and the different positions and areas of each layer reflect the status and proportion of each type of food in the diet. Cereals are in the bottom layer, each person should consume 250g-400g per day; vegetables and fruits are in the second layer, 300g-500g and 200g-400g per day; animal foods such as fish, poultry, meat and eggs are in the third layer, 125g-225g per day (50g-100g of fish and shrimp, 50g-75g of animal and poultry meat, 25g-50g of eggs); milk and legumes are in the fourth layer. Daily should eat the equivalent of fresh milk 300g of milk and milk products and the equivalent of dry beans 30g- 50g of soybeans and products. The fifth tier is cooking oil and salt, with cooking oil not exceeding 25g or 30g and salt not exceeding 6g per day.
SLE patients with skin rashes should avoid eating foods such as celery, figs, mushrooms, smoked foods, and alfalfa seeds, as these foods may cause lupus flare-ups [1]. Three meals should be arranged scientifically, and yellow foods such as soybeans, corn, millet and carrots should be eaten for breakfast. According to the theory of Chinese medicine, 7-9 a.m. and 9-11 a.m. are the time when the stomach and spleen meridians are in order, and among the five organs, the spleen belongs to the earth, which is yellow in color. SLE is a chronic wasting disease with appropriate amount of protein-rich food, such as lean meat, fish, poultry, eggs, etc., to facilitate recovery. Dinner is light. For lupus nephritis and elderly people with osteoporosis, it is appropriate to eat black food. In Chinese medicine theory, 5-7 p.m., the kidney meridian when the order, the five organs of the kidney is water, the main bone, water color black, black food kidney, osteoporosis also has a good therapeutic effect, black food kelp, nori, black sesame, black beans, etc. rich in calcium. To be the advocate and practitioner of healthy diet concept, every doctor is duty-bound.
As the new era of knowledge women, in all walks of life made a lot of work and pay a lot, enjoy equal status with men. Then as women in the new era, how to have a healthy body and mind and stay away from autoimmune diseases like lupus erythematosus is also a topic of great concern to lupus patients. The great thinker Confucius said, “If you can’t do something, ask yourself for help”. The Yellow Emperor’s Classic of Internal Medicine tells us to “rely on ourselves for a long and healthy life”. Women who work outside the home should always find their place in the family and put things that are not related to the home outside the door before entering. Work together with your husband, live in harmony, and share the burden of carrying on the family tradition and educating the next generation. Be a part of harmony in the family and set an example for your children by leading by example and modeling your behavior. In ancient times, it took a Mencius mother to have a Mencius son. Learning from a Mencius mother who can stand on her own feet and teach her son is a teacher for all women in the world. A woman is like water, Lao Tzu said: “good as water”. Always keep the mind like water, moisten everything without sound, without argument, natural, calm, pure, no worries, everything in its natural way, the body is naturally healthy. Starting from harmonizing oneself, contributing one’s lifelong duties and aspirations to family and society, this is the real successful and wise life. In Suwen Shanggu Tianzhen, there is, “calmness and emptiness, the true energy from it, the spirit within the guard, the disease is safe from, is to have a free will and less desire, the heart is safe and not afraid”. The real wisdom of traditional Chinese medicine is that it does not treat the sick to cure the sick. Chinese doctors also have a long way to go to be the pioneers of health and wellness.
References
[1] JIANG Ming DAVID YU 《Chinese Rheumatology》, August 2004, First Edition, Huaxia Publishing House, 2003
[2] ZHAO Xiaoxia, translation, Kelley’s Rheumatology, 7th edition, People’s Health Publishing House, 1061.