基于阴阳毒理论探讨系统性红斑狼疮的预后及治疗

Prognosis and Treatment of Systemic Lupus Erythematosus Based on Yin-Yang Toxin Theory

基于《金匮要略》对阴阳毒的论述,探究系统性红斑狼疮与阴阳毒的关系。发现二者症状相似,预后不良因素存在潜在联系,且系统性红斑狼疮尽早治疗可改善预后的思想与中医学阴阳毒应早期诊治的观点不谋而合。故而提出以阴阳为总括、毒邪为致病关键阐述系统性红斑狼疮病机,以阴阳毒理论为指导,围绕病理要素“毒、热、瘀”论治系统性红斑狼疮,且治疗中应兼顾肾元。据此,提出以升麻鳖甲汤为基础方根据疾病不同证型与分期灵活治疗,为系统性红斑狼疮的临床诊疗提供参考。

This paper explored the relationship between systemic lupus erythematosus(SLE)and yin-yang toxins based on the discussion of yin-yang toxin in Synopsis of the Golden Chamber(《金匮要略》),and found that the two are similar in symptoms,and there is a potential relationship between adverse prognosis factors;and the idea that early treatment of SLE can improve prognosis is in accordance with the opinion in traditional Chinese medicine claiming that yin-yang toxin should be diagnosed and treated as soon as possible.Therefore,it is proposed to take yin-yang as general and toxin pathogen as key to explain the pathogenesis,use yin-yang toxin theory for guidance,discuss on the treatment of SLE around the pathological elements including“toxin,heat,stasis”,and take into account of the kidney essence.Accordingly,Shengma Biejia Decoction(升麻鳖甲汤)is recommended as the basic formula with modifications in accordance with different syndromes in staged treatment,providing reference for the clinical diagnosis and treatment of SLE.