Keywords: Chinese medicine, Chinese herbal medicine, acupuncture, systemic lupus eruthmatosus, autoimmune disease, inflammation
Note: This article has been abstracted and condensed from Bob Flaws & Philippe Sionneau's The Treatment of Modern Western Medical Diseases with Chinese Medicine published by Blue Poppy Press.
Also known as disseminated lupus erythmatosus, this is yet another autoimmune disease causing inflammation of the connective tissue. According to Western medicine, its etiology is unknown. Ninety percent of SLE patients are female. It predominantly affects young women, but it may also occur in children. Lupus may begin abruptly with fever or may develop insidiously over months and years. Although symptoms may manifest in any organ system, 90% of patients complain of articular symptoms ranging from intermittent arthralgias to acute polyarthritis. A past history of "growing pains" during childhood is not uncommon.
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This condition is characterized by butterfly-shaped malar erythema. Other skin conditions may include discoid lesions and erythematous, firm, maculopapular lesions on the face, exposed areas of the neck, upper chest, and elbows. Oral ulcers are common, and generalized alopecia is frequent during active phases of this disease. Forty percent of lupus patients are also photosensitive. Generalized adenopathy is common, especially in children, young adults, and Afro-Americans, and splenomegaly occurs in 10% of patients. CNS involvement can cause headache, personality changes, epilepsy, psychoses, and organic brain syndrome. Lupus patients frequently experience spontaneous abortions (probably due to autoimmune ovaritis), and postpartum flares are common.
Disease categorization
In Chinese medicine, various of the main clinical manifestations of SLE have traditionally been categorized as diseases in their own right. The skin lesions of lupus are variously called hong mu die chuang, red butterfly lesions, zhu yu dan, Evodia redness, ri shai chuang, sunshine lesions, yin yang du, yin yang toxins, xue feng chuang, blood wind lesions, mian fa du, face emission toxins, etc. Other of the symptoms of lupus fall under the categories of shui zhong, water swelling (or edema), xu sun, vacuity detriment (fatigue), chuan xi, panting breath (dyspnea), xue zheng, bleeding conditions, guan ge, block and repulsion (inability to swallow), and bi zheng, impediment condition (joint pain).
Disease causes
Former heaven natural endowment insufficiency (i.e., genetics), external contraction of the six environmental excesses (infection), both unregulated emotions and unregulated eating and drinking, and over-taxation
Disease mechanisms
Any of the above causes can result in loss of regulation of yin and yang, qi and blood depletion and vacuity, lack of ease or smoothness in movement and transportation, qi stagnation and blood stasis, and channel and network vessel obstruction which may then give rise to the multiplicity of signs and symptoms associated with this disease. Because this disease mostly occurs or worsens after exposure to sunshine, it is believed to be mostly due to external contraction of heat toxins evils. These heat toxins enter the interior where they scorch and burn yin and blood, impede and obstruct the channels and vessels, damage the viscera and bowels, and corrode the sinews and bones and the skin. In addition, allergic reactions to foods and medicinals, addiction to thick-flavored foods, living in damp environments, and contraction of the six environmental evils may all give rise to internal engenderment of heat toxins. If the former heaven natural endowment is insufficient and original yin or original yang are depleted and vacuous, then this can give rise to all the various symptoms of SLE. Joint pain associated with SLE is mainly due to wind damp heat impediment.
Treatment Based on Pattern Discrimination
1. Heat evils blazing & exuberant pattern
Main symptoms: A high fever or a continuous fever which will not recede, the emission of red macules or edematous red macules on the skin of the facial region, if severe, these lesion may be large or they may be blood blisters, generalized lack of strength, muscle and joint aching and pain, vexation and agitation, insomnia, emotional worry and anxiety, possible spirit clouding and delirious speech, spasms and contractures, dry, bound stools, short, reddish urination, oral thirst with a predilection for chilled drinks, red eyes, red lips, possible spitting blood, spontaneous ejection of blood (i.e., epistaxis), and/or hemafecia, possible sores inside the mouth, sore, swollen throat, a red, crimson, or purplish, dark tongue with yellow, slimy, yellow, dry, or yellow and white, slimy fur or a smooth bare tongue, and a bowstring, rapid pulse
Note: This pattern describes the signs and symptoms of the initial attack or a subsequent acute, active exacerbation of this disease. Such active episodes can be life-threatening and should be treated with a combination of modern Western and Chinese medicine.
Rx: Qing Wen Bai Du Yin Jia Jian (Clear the Scourge & Vanquish Toxins Drink with Additions & Subtractions).
Ingredients: Uncooked Gypsum Fibrosum (Shi Gao), 60g, Cornu Bubali (Shui Niu Jiao), 30g, Rhizoma Anemarrhenae Aspheloidis (Zhi Mu), Rhizoma Coptidis Chinensis (Huang Lian), Radix Scutellariae Baicalensis (Huang Qin), Fructus Gardeniae Jasminoidis (Zhi Zi), Fructus Forsythiae Suspensae (Lian Qiao), and Radix Scrophulariae Ningpoensis (Xuan Shen), 15g each, uncooked Radix Rehmanniae (Sheng Di), Cortex Radicis Moutan (Dan Pi), Radix Rubrus Paeoniae Lactiflorae (Chi Shao), and Radix Angelicae Sinensis (Dang Gui), 20g each, and Folium Bambusae (Zhu Ye), Radix Platycodi Grandiflori (Jie Geng), and Radix Glycyrrhizae (Gan Cao), 9g each.
Additions & subtractions: For dry, bound stools, add nine grams of Radix Et Rhizoma Rhei (Da Huang), decocted later. For high fever which will not recede or essence will symptoms, add 0.3-0.5 grams of Cornu Antelopis Saigatatarici (Ling Yang Jiao), swallowed down with the decoction. For low-grade fever which will not recede, add 15 grams each of Radix Stellariae Dichotomae (Yin Chai Hu) and Cortex Radicis Lycii Chinensis (Di Gu Pi). For bleeding, add 9-20 grams each of Nodus Rhizomatis Nelumbinis Nuciferae (Ou Jie), Rhizoma Imperatae Cylindricae (Bai Mao Gen), Herba Agrimoniae Pilosae (Xian He Cao), and/or Cacumen Biotae Orientalis (Ce Bai Ye) depending on the site and cause of the bleeding. If damp heat is marked with thick, slimy tongue fur, add nine grams each of Rhizoma Atractylodis (Cang Zhu) and Rhizoma Acori Graminei (Shi Chang Pu) and delete the Sheng Di, Xuan Shen, and Zhi Mu. For arthralgia, add nine grams each of Radix Et Rhizoma Notopterygii (Qiang Huo), Radix Gentianae Macrophyllae (Qin Jiao), and Radix Angelicae Pubescentis (Du Huo). For severe thirst, add 12 grams each of Tuber Ophiopogonis Japonici (Mai Men Dong), Herba Dendrobii (Shi Hu), and Rhizoma Polygonati Odorati (Yu Zhu). For profuse erythema, petechiae, or purpurae, add 12 grams each of Radix Lithospermi Seu Arnebiae (Zi Cao), Flos Immaturus Sophorae Japonicae (Huai Hua Mi), and Flos Campsitis (Ling Xiao Hua).
2. Wind damp heat impediment pattern
Main symptoms: Early stage disease with profuse, severe joint pain, especially in the fingers, toes, ankles, and wrists, migrating pain of several joints, fever, dry throat, oral thirst, sore, aching muscles, weakness of the limbs, possible joint swelling, a red tongue with yellow and/or slimy fur, and a bowstring, slipery pulse
Rx: Du Huo Ji Sheng Tang Jia Jian (Angelica Pubescens Decoction with Additions & Subtractions)
Ingredients: Uncooked Gypsum Fibrosum (Shi Gao), 30g, Ramulus Loranthi Seu Visci (Sang Ji Sheng), 15-30g, Cortex Erythinae (Hai Tong Pi), 15g, and Radix Et Rhizoma Notopterygii (Qiang Huo), Radix Gentianae Macrophyllae (Qin Jiao), Radix Clematidis Chinensis (Wei Ling Xian), Radix Ledebouriellae Divaricatae (Fang Feng), Radix Stephaniae Tetrandrae (Fang Ji), and Rhizoma Anemarrhenae Aspheloidis (Zhi Mu), 9g each.
Additions & subtractions: If fever abates and only joint pain remains, Shi Gao and Zhi Mu should be replaced by Cortex Phellodendri (Huang Bai) and Rhizoma Atractylodis (Cang Zhu) and nine grams each of Radix Angelicae Sinensis (Dang Gui) and Radix Albus Paeoniae Lactiflorae (Bai Shao) should be added. If there is then marked fatigue, add 15 grams of Radix Astragali Membranacei (Huang Qi) and nine grams of Radix Codonopsitis Pilosulae (Dang Shen).
3. Heat damaging qi & yin pattern
