The Clinical Study Of Systemic Lupus Erythematosus With Traditional Chinese Medicine And Western Medicine

ObjectivesThrough making a retrospective study of the data of hospitalized cases with systemic lupus erythematosus (SLE), to analyze its clinical features and summarize the treatment of traditional Chinese medicine and western medicine, which is in order to improve the diagnosis and treatment level of SLE and provide some models and the reference to its combination of traditional Chinese medicine and western medicine in standard treatment.MethodsMaking a retrospective study of the data of hospitalized SLE cases which were received by the main Branch of Guangdong Provincial Hospital of TCM from2006to2010, including general dates, original symptoms, clinical manifestations, complications, the tongue, pulse condition and symptom of TCM, diagnosis, traditional Chinese and western medicine and prognosis of diseases; analyzing death cases and conclude relevant experiences.Results292cases were collected in this study, the rate of gender composition is1:8.7,52.74%of patients were aged at21to40and half of them had course less than a year.63.01%of the cases were in a critical condition when they were hospitalized,98.29%of the cases were treated with combined traditional Chinese and western medicine, most of them had been better and discharged by the hospital, the total efficient of was92.82%; all of the6death cases were in co-infections or damaged in the important organs, one of them died from suicide and another one died because he didn’t get confirmed diagnosis which leading to delays in treatment. The average hospitalization charge cost12350.71±14069.28yuan, the mean hospital stay was19.55±10.82days in2006while the2010’s was14.84±11.02days, which had showed an obvious decrease tendency (P<0.05). First symptom to arthralgia, facial redness, fever and edema were the most common, the rate of misdiagnosis before admission was46.59%and97cases were diagnosed after admission. Lupus nephropathy and cytopenia were the most common complications of SLE,94.18%of patients were treated in the Nephrology Department, Dermatological Department and Hematology Department;189cases supervened with lupus nephropathy, which accounted for64.73%. There are ten symptoms of SLE:Weary, anorexie, edema of facial or limbs, erythema or rash on face, joint pain or fever, serous cavity effusion coughing, dizziness and headache, foamy urine and alopecia. And after treatment, fever was the most obvious symptom. The main character of SLE is deficiencyexcess mixing, the main symptoms showed after admission were Qi and Yin Deficiency, deficiency of spleen and kidney(Qi deficiency and Yang deficiency), Yin deficiency heat, hepatorenal Yin deficient, etc, and the first two had a high frequency. The accompanied symptoms were damp, hot and stasis, the rate of symptoms by leaving hospital didn’t change obviously. And according to the frequency of tongue’s pulse condition it could be ranked as follows:red, short dark, dull-red and light red in tongue; yellow greasy(pachy), yellow(thin), whitish and slimy(pachy) and whitish(thin) in tongue coating; thready pulse, taut pulse, rapid pulse and deep pulse. Glucocorticoid was the main drug used to treat SLE, cooperated with immunosuppressive and immunoglobulin was the common clinical treatment, PE was little application. Antimalarial drug, non—steroidal antiinflammatory drugs and immunomodulator were used; besides, Chinese decoction and Chinese patent medicine also helped a lot. As to Chinese decoction and Chinese patent medicine, supplementing qi and nourishing yin and invigorating the spleen and tonifying kidney were the main methods, which accompanied with clearing away heat and expelling dampness and promoting blood circulation to remove blood stasis. There were five medicines:heating-clearing herbs, qi-invigorating drugs, nourishing-yin drugs, dampnesseliminating medicinal materials and blood-activating drugs, and all of them made up a component.Conclusion1. Combination of TCM and WM is widely used in the treatment of SLE in our hospital; Our hospital’s measures in shortening average hospital stay time and containing the costs of treatment are desirable, the diagnosis and treatment of SLE patients are benchmarked gradually;2. The diagnosis of SLE is still a difficulty, some actions should be took to improve the diagnostic level in clinical, and try best to avoid mistakes in treatment;3."Hot" is its important feature, clearing heat’s flexible application is the major measure in TCM treatment. Heating-clearing herbs, qi-invigorating drugs, nourishing-yin drugs, dampness eliminating medicinal materials and blood-activating drugs are the five main medicines;4. The classical treatments of SLE, hormone and TCM, or hormone, immunosuppressive and TCM, are widely used in our hospital, some new measures are under trying, which are expected to provide more choices for SLE patients;5. Positive infection prevention and the delay of important organs’damages can be the important links in extending patients’ lives, make sure that every patient has a certain aware of SLE and can get psychological counseling;6. Benchmarking assessment and record of SLEDAI integral should be taken seriously by all kinds of clinicians;7. Electronic record system plays an important role in treatment and scientific research, which should be used widely in hospitals at all levels.