从温病学说卫气营血辨证论治系统性红斑狼疮

Treatment of systemic lupus erythematosus based on the theory of syndrome differentiation of Weifen,Qifen,Yingfen and Xuefen in the doctrine of epidemic febrile disease

系统性红斑狼疮(SLE)是一种典型的自身免疫系统疾病,我国SLE患病率约70/100000,以女性为多,男女发病比例为1∶7~1∶9,在疾病发展过程中,患者会出现发热、疲乏、皮损、关节肿痛等临床症状。然而其西医发病机制尚未明确,临床通常采用激素疗法,副作用大,对患者生活产生了严重影响。近年来,越来越多的学者将目光聚焦到了SLE的中医诊治中。根据温病学说的卫气营血辨证理论,先天禀赋不足、真阴亏虚,后复感外邪,使卫气营血功能失调,导致SLE表现出“热象偏重,易化燥伤阴”的临床特点。本文根据卫气营血特有的生理功能,分析SLE的病因病机,辨证论治,施以解表透邪、清泄里热、透热转气、清热凉血等治疗,为本病的治疗提供新的诊疗思路。

Systemic lupus erythematosus(SLE)is a typical autoimmune dise ase with a prevalence rate of about 70/100000 in China,with the majority of SLE in females,and the incidence ratio of male to female is 1∶7-1∶9.During the development of the disease,patients may present fever,fatigue,skin lesions,arthralgias and other clinical symptoms.However,the pathogenesis of SLE has not been clearly defined from the perspective of western medicine,and hormone therapy has been a common treatment in clinical practice,which has serious side effects and causes severe influences on patients’lives.In recent years,increasing scholars have focused on the diagnosis and treatment of SLE with Chinese medicine.According to the theory of syndrome differentiation of Weifen,Qifen,Yingfen and Xuefen in the doctrine of epidemic febrile disease,the insufficiency of innate endowment and genuine Yin followed by the invasion of exogenous evils may cause the dysfunction of defense Qi,construction Qi,nutrient Qi and blood Qi,resulting in the clinical characteristics of SLE,which is"excessive heat tends to cause dryness and damage Yin".In this paper,the etiology and pathogenesis of SLE are analyzed based on the unique physiological functions of the defense Qi,construction Qi,nutrient Qi and blood Qi,and it is recommended for doctors to treat the disease based on syndrome differentiation,and apply treatments such as relieving superficies,clearing the internal heat,promoting Qi circulation by relieving Yingfen,and removing heat to cool blood.The new treatment ideas mentioned in this paper are intended to provide a reference for the treatment of SLE.