The Clinical Experience Research Of Professor Huang Shilin On Treating Lupus Nephritis

Objective:To summarize and inherit the academic thought and clinical experience on treating lupus nephritis(LN) of professor Huang Shilin. To observe the clinical effect of clearing away virulent heat pathogen, invigorating the spleen and tonifying the kidney therapy for LN, and the effect of Chinese herbs clearing away virulent heat pathogen by animal experiment.Methods:To study the clinical experience of professor Huang Shilin on treating LN with integration of traditional Chinese medicine and western medicine. The clinical data of LN patients were analyzed retrospectively. The therapeutic effect was studied in the treatment of Chinese herbs which clear away virulent heat pathogen or Chinese herbs which tonify the kidney and clear away virulent heat pathogen combining with immunosuppressive agents. The change of LN disease activity integral, urine protein, urine blood, serum albumin, serum creatinine and nephritis pathology were observed in patients before and after treatment. The effect of Chinese herbs clearing away virulent heat pathogen on New Zealand black x New Zealand white (NZB×NZW) F1 mice were studied through the change of urine protein, blood urea nitrogen and nephritis pathology.Results:It was proved that the deficiency of spleen and kidney is the internal condition and virulent heat pathogen is the key of LN occurrence. LN was treated according to the activation and remission duration. The clearing away virulent heat pathogen therapy was the mothods of treatment in the activation duration, the tonifying the kidney and clearing away virulent heat pathogen therapy was the mothods of treatment in the remission duration, meanwhile the immunosuppressive agents was applied in treating LN.42 patients with LN were involved in the retrospective clinical study including 3 male patients and 39 female patients. The age of 42 patients was 11-55 years, the mean age was 29.55±12.41 years. The improvement of LN disease activity integral, urine protein, urine blood, serum albumin, serum creatinine after treatment was more obvious than that before treatment(P< 0.05). The complete remission rate, total effective rate after treatment of 6 months,12 months,18 months, 24 months,36 months,48 months,60 months was 52.38%,69.05%,62.5%,80.77%, 85%,85.71%,87.5%(P<0.05); 92.86%,95.24%,93.75%,88.46%,90%,100%,100% respectively (P> 0.05).1,6,4,1 cases were the classⅤ,Ⅳ,Ⅲ,Ⅱof LN respectively before treatment.1 case was the class I of LN and 1 case was normal kidney after treatment. No serious adverse effects occurred during the treatment course, and there was no death in 42 patients during long term follow-up period for 5 years. The urine protein of lupus mice in the treatment group of Chinese herbs clearing away virulent heat pathogen and dexamethasone decreased gradually after treatment(P< 0.05). The blood urea nitrogen of lupus mice in the treatment group of Chinese herbs clearing away virulent heat pathogen and dexamethasone didn't increase after treatment(P> 0.05). The urine protein, blood urea nitrogen was significantly less than it in the control group after treatment(P< 0.05), and there was no remarkable difference between the group of Chinese herbs clearing away virulent heat pathogen and the group of dexamethasone(P> 0.05). The kidney pathology was obviously improved in the treatment group of Chinese herbs clearing away virulent heat pathogen and dexamethasone after treatment.Conclusion:Clearing away virulent heat pathogen, invigorating the spleen and tonifying the kidney therapy is the mothods of treatment. It is fund that Chinese herbs clearing away virulent heat pathogen or Chinese herbs tonifying the kidney and clearing away virulent heat pathogen are representative foundation through treatment based on differentiation of symptoms and signs according to the staging of LN. The new regimen with integration of traditional Chinese medicine and western medicine which Chinese herbs combine with immunosuppressive agents(CVMP) has exactive therapeutic effect, a less toxic and side-effect, a higher survival rate. It is hoped through these that the patients of LN can survive long time. The effect of Chinese herbs clearing away virulent heat pathogen which obviously reduce urine protein, improve blood urea nitrogen and kidney pathology of lupus mice is confirmed by the animal experiment.