何世东分期辨治系统性红斑狼疮

The Clinial Experience of Professor HE Shidong Treat SLE

何世东教授认为系统性红斑狼疮为"久病入络";肝肾阴虚,络脉瘀阻贯穿始终。急性期:热毒炽盛,入营入血,宜清热凉血,清营汤、五皮饮。缓解期:虚实挟杂,宜扶正培本,六味地黄丸、四君子。雷诺现象乃肢端脉痹,遇冷加重、得温可减系局部阳气闭郁、气血瘀滞,黄芪桂枝五物汤或阳和汤。慢性血细胞减少活动期治疗原发病为主,缓解期宜生血治疗,选用健脾益气、柔肝益肾之品,如黄芪、熟地、鸡血藤、枸杞、阿胶、女贞子等,亦可用血肉有情之品、至阴聚秀之物滋填,如龟甲、鳖甲、紫河车等。针对蛋白尿、血尿,何师尤擅用活血化瘀及虫类药物,茜草、蒲黄、水蛭等。激素相关性痤疮、溃疡,何师强调平衡养阴与燥湿,选健脾、芳香、淡渗药物五爪龙、白术、茯苓、泽泻、车前子、薏苡仁、竹茹、砂仁等,祛湿而不伤阴,清润而不滋腻。孕育困难,补肾化瘀,调经助孕,选熟地、鸡血藤、菟丝子、山茱萸益肾填精,当归、川芎、丹参、益母草、三七、绞股兰活血化瘀生新,肾阳虚加淫羊藿、杜仲、覆盆子加强补益肾阳,肾阴虚加女贞子、旱莲草、桑葚补益肾阴,使冲任气血调和而易受孕。

Abstract Pro. HE diagnoses and treats SLE： main symptoms： fever, new red skin rash, oral ulcer, joint swelling, the vasculitis of hands and feet, etc. relevance organ： liver and kidney, main pathogen： hereditary factors, seven emotions, overwork, sexual overstrain, method： removing heat to cool blood, strengthening body resistance to consolidate constitution, persistent illness entering coL＇aterals is the main pathogenesis of SLE, the stagnation of collaterals and the deficiency of liver-yin and kidney-yin all the way through. The initial, during the acute phase, the basic pathogenesis is the excessive toxic heat, and heat entering construction- blood, state the treatment of removing heat to cool blood, it representative decoction are Qingying decoction and Wupi drink; in paracmasis are treated with strengthening body resistance to consolidate constitution, and the square choose the Liuwei dihuang pills, Sijunzi decoction; the raynaud＇s phenomenon is the tendon and channels stasis in extremities, in the temperature is reduced, dor this reason above all-the movement of Yang-Qi are stagnating, Qi stagnation and blood stasis. This phenomenon should be treated with Huangqi guizhi wuwu decoction or Yanghe decoction; chronic granulocytopenia, in active stage, basically be remedial the primary affection, treating with blood production herbs suitably to remission phase, cure proper Jian Pi benefit spirit ,soften the liver and tonify the kidney; the herbs in this category include astragalus, Rehmaniae, Caulis spatholobi, Barbary wolfberry fruit, Gelatin, Ligustrum lucidum ait, etc. The love of flesh and blood products like Tortoise shells, Turtle shell, Placenta hominis; For proteinuria and hematuria, Professor He was accomplished in treated with blood-activating and stasis-eliminating compound, like madder, Pollen typhae, Leech, etc. About testosterone-related aene and ulcer, Professor He emphasizes nourish Yin to ease dysphoria, the spleen Qi and aroma and damp elimination drugs include Radix fici hirtae, atractylodes macrocephala koidz, Poria, Rhizoma alismatis, Semen plantaginis, Coix seed, Bamboo shavings, amomum villosum, etc, eliminating dampness and avoiding deficiency of Yin, keeping moist and greaseless, The people who are unable to conceive, cure tonify kidney and regulate menstrual cycle with activate blood, Radix rehmanniae preparata, Caulis spatholobi, Cuscuta chinensis, Comus officinalis are always used to tonify kidney and essence replenishment, Angelica sinensis, Ligusticum wallichii, Salvia miltiorrhiza, Herba leonuri, Panax notoginseng,Gynostemma pentaphyllum can promotee blood circulation to remove blood stasis and promoting tissue regeneration, Epimedium, Eucommia ulmoides, Raspberries tonifying kidney-Yang as kidney-yang deficiency, Ligustrum lucidum Air, Herba Ecliptae, Mulberry tonifying kidney-Yin as kidney-Yin deficiency.