In the past, when mentioning lupus erythematosus, many women are easily associated with the presence of red spots on their bodies. Experts point out that, in fact, the clinical manifestations of this disease are complex and diverse, mostly with insidious onset, starting with mild arthritis, skin rash, occult nephritis, thrombocytopenic purpura, etc. A small number of patients may also show menstrual irregularities and increased hair loss. Many patients may be stable in a subclinical state for a long time and show mild disease characteristics. However, if the disease is not diagnosed and treated reasonably in time, it can mutate from mild to severe lupus, and more often, it gradually develops from mild to multi-system damage such as liver and kidney. Therefore, pregnancy and childbirth were once listed as contraindications for such female patients. However, the effect of combining Chinese and Western medicine on the control of mild and moderate disease has become more and more satisfactory. It is particularly gratifying that most unmarried and infertile female patients can safely become pregnant and have children after their disease has been effectively controlled. Menstrual disorders due to “lupus”? Lupus erythematosus is mostly insidious, and patients do not always have obvious butterfly spots or joint pain, but menstrual disorders, increased hair loss or mouth ulcers can be early signs of the disease. Menstrual disorders for six months are actually caused by “wolf”. In the past, when lupus erythematosus was mentioned, many women were easily associated with red spots on their bodies. Like most people, Juan, who was only 24 years old, could hardly imagine that menstrual disorders and hair loss were also signs related to the onset of the disease. She thought she had just joined a foreign company and was working overtime and not getting enough rest, so she went to the pharmacy and bought Wuji Baifeng Pills on her own. Six months later, after she had adapted to her work, she still had menstrual disorders, her hair was falling out more and more, and she had fatigue, weakness and joint pain. The doctor thought she should be hospitalized in the hematology department for examination. After she was hospitalized, she developed swelling in both lower extremities and her urinalysis showed positive urine protein, as well as positive autoantibodies. ”You have systemic lupus erythematosus (SLE for short) and should be transferred to the rheumatology department for treatment.” The doctor’s words made Ah Juan fall into a cloud: “I don’t have red spots on my face, I just have irregular menstruation, how can it be lupus erythematosus?” Nearly 30% of patients have joint pain as the first symptom In fact, the clinical manifestations of SLE are complex and diverse, and the disease mostly starts insidiously, so many patients do not pay much attention to it in the early stage. However, 80% of SLE patients can have various skin and mucous membrane damages (lesions are commonly found on exposed areas, and 50% of them can have typical butterfly erythema), 30-60% of patients have photosensitivity, more than 50% of patients have heart damage (common pericarditis), 10-20% of patients have Raynaud’s phenomenon, and 10-30% of patients have muscle aches and pains. Among the patients, the first one with joint symptoms (27%), fever onset (25%), rash onset (20%), other patients with thrombocytopenia, hemolytic anemia, thromboembolic vasculitis, etc. as the first symptoms, and relatively few patients with menstrual disorders and increased hair loss as the first symptoms. It is no wonder that Juan failed to associate menstrual disorders with it in time. However, afterwards, she also developed joint pain, which should have been taken seriously because 90% of SLE patients have joint damage. However, when symptoms such as hair loss and joint pain occur, it is important to do screening for SLE, dry syndrome and rheumatoid arthritis, etc. at the same time. Compared with other conditions, arthritis caused by SLE is non-erosive and asymmetric, and may involve 2 or more peripheral joints, which may be accompanied by pressure, swelling or fluid accumulation. In addition, 90% of SLE patients can have kidney damage. Juan later developed swelling in both lower extremities and abnormal urinalysis, pointing out that this is actually a manifestation of SLE affecting the kidneys. The clinical manifestation of renal damage is often edema. Laboratory tests may show urine protein greater than 0.5g/24h or ++++, or tubular, or occult blood. Some patients may also be misdiagnosed with nephritis, but a renal puncture biopsy can distinguish between the two. Ninety-seven percent of these patients have a biopsy with a large number of immune complex deposits, which is typical of SLE. However, there are a few atypical patients who present with renal insufficiency at the onset, or even in the uremic phase of renal failure. Mild type patients are easily overlooked and stable condition does not affect fertility Through long-term clinical observation, it is found that some atypical SLE can manifest as multiple and recurrent episodes of arthralgia and arthritis that persist for years without producing deformities, thus making it difficult to detect early and miss the best time for treatment. He pointed out that, in fact, through blood tests or over to be early detection, the presence of a variety of autoantibodies in the serum represented by anti-nuclear antibodies and the involvement of multiple body systems are two of the main clinical features of SLE. However, there are many patients who are stable in a subclinical state or light lupus for a long time, and are usually found only after the sudden change from light to severe lupus or the gradual appearance of multi-system damage. However, as people become more health-care conscious, fewer cases are delayed until severe disease is treated, and most patients are still in mild to moderately active lupus when diagnosed. The prognosis of this disease has been significantly improved compared with that of the past. Statistics show that after regular treatment, the 1-year survival rate of such patients can be as high as 96%, the 5-year survival rate is 85%, and the 10-year survival rate is more than 75%. Since SLE is more prevalent in women of childbearing age, it is 7-9 times more common in women than in men. This is the biggest concern for unmarried, infertile women like Juan: if they are unfortunate enough to contract this disease, will they be able to get pregnant and have children? In the past, pregnancy and childbirth were contraindications for SLE, but nowadays most SLE patients can safely have children after their disease has been controlled. Generally speaking, pregnancy is allowed when there is no significant organ damage, the disease has been stable for one year or more, cytotoxic immunosuppressants have been stopped for six months, and hormones are only maintained in small doses. However, he reminded that after pregnancy, SLE patients should be followed up by both obstetricians and rheumatologists. If the disease fluctuates during pregnancy, the decision to terminate the pregnancy should be made on a case-by-case basis. Light to medium-sized patients can be better treated with Chinese and Western medicine “People used to be scared of ‘wolf’, but now with the increased awareness and improved treatment level, people are not as scared as before when this disease is mentioned.” Although there is still no cure for SLE and the key to treatment is still to re-establish normal immune function, proper treatment can lead to complete remission in most patients. Clinically, patients with mild to moderate activity receive more stable results from Chinese and Western medicine, and have relatively few side effects and are less likely to relapse, which can effectively avoid or delay pathological damage to tissues and organs. Corticosteroids (GC) in combination with cytotoxic drugs are still the current preferred regimen for the treatment of SLE in Western medicine. Corticosteroids need to be started in larger doses with a view to suppressing the disease within l to 2 weeks. However, prolonged use of high doses of corticosteroids can cause serious side effects, including weight gain, infection, diabetes, facial deficiency swelling, and large joint necrosis. Therefore, many patients look to Chinese medicine for treatment. Chinese medicine alone may not be able to obtain satisfactory results in the treatment of SLE. However, as part of synergistic treatment, the interventional role of TCM is gaining more and more attention, especially for mild and moderately active patients, the involvement of TCM in treatment can reduce the dose and course of hormone use accordingly and reduce the effects of adverse drug reactions on the body. TCM believes that the onset of SLE is related to special constitution, and women of childbearing age with yin deficiency, qi deficiency and phlegm stasis constitution may be more susceptible to this disease. In view of the characteristics of SLE as a chronic disease, the key to TCM treatment is to correct the deviations of the patient’s constitution and improve her ability to resist the disease. In the long run, the holistic regulation and evidence-based treatment of TCM treatment can treat the root cause more than the symptoms, which has the effect of enhancing the efficacy and stabilizing the disease. Clinically, for long-term use of hormones and immunosuppressants, the immunity of the body is weakened, and it is easy to complicate the infection or further spread the original infection. When the dosage of western medicine cannot be stopped or temporarily reduced, Chinese herbal medicines such as ginseng, astragalus, atractylodes, rehmannia and angelica are often used to enhance the immunity of the body. If hormones induce gastrointestinal damage, and those who still have gastrointestinal discomfort symptoms despite the use of western medicine, Si Jun Zi Tang and Ginseng and Atractylodes are often used to strengthen the spleen and eliminate food. For those who are prone to osteoporosis and fracture due to long-term use of hormones, Jin Kui Kidney Qi Wan and Dou Wu Xie Sheng Tang are often used. For those who have bruises or bruises on the tongue due to hormone damage to the blood system, Tao Hong Si Wu Tang and Blood Mansions and Blood Stasis Soup are often used.