系统性红斑狼疮慎用“附桂”临床证治探析

Clinical Governance Analysis of Careful Use of Fugui on Systemic Lupus Erythematosus(SLE)

系统性红斑狼疮(SLE)是一种临床表现多样、病情复杂多变且迁延反复的自身免疫性疾病。临床多使用糖皮质激素和免疫制剂治疗,但副作用和并发症较为明显。近年来,中医药在控制和稳定SLE病情以及减少西药治疗毒副作用上,取得了较为显著的效果。但疾病不同时期的证候特点各有偏侧,且中药成分复杂、药用多样、配伍原则精细,故组方遣药对于SLE的治疗具有十分重要的意义。笔者从SLE之病机本质:"毒""瘀""虚"出发,结合附子、肉桂的药用特点,及其在SLE治疗中的功过分析,来探讨治疗初期、中期、后期不同阶段的SLE,应慎用附子、肉桂。

Systemic lupus erythematosus（SLE） is a complex autoimmune disease characterized by various immunological abnormalities. SLE can be treated with immunosuppressant drugs and corticosteroids. These medical treatments can alleviate inflammatory reaction,but a prolonged therapy may also cause systematic side effects. In the past few years,traditional Chinese medicine（TCM） has been proved to be effective in controlling and stabilizing SLE as well as reducing the side effects of Western medicine. However,since the manifestation of disease varies in different periods and the composition of TCM formulas is diversiform,it is important to realize the precision of prescription in different stage of SLE. Based on the pathogenesis essence of SLE,namely poison,blood stasis and virtual,and the herbal function of aconite,we discourage doctors from using aconite and cinnamon in whole stages of SLE.