Tcm Syndromes Of Systemic Lupus Erythematosus

[Objective]To investigate 103 hospitalized patients with systemic lupus erythematosus (SLE) received by Peking Union Medical College Hospital (PUMCH) from Oct 2010 to March 2011 on the characteristic of sex, age, beginning symptoms, course of disease, clinical symptoms, attack season, traditional Chinese medicine (TCM) pattern identification factors, pattern identification of SLE; To supply thoughts and methods for clinical diagnosis and treatment of SLE.[Methods]The standard of pattern of SLE was sketch up according to The Guidelines of Clinical Research on New Chinese Patent Drugs and TCM Pattern Identification Standard of Deficiency Patterns worked out by the Committee of Deficiency and Senile Disease of the National combination of TCM and Western medicine Association and The National Standard People's Republic of China-Clinic Terminology of TCM Diagnosis and Treatment—Syndrome. 103 patients were diagnosed in PUMCH as SLE. The characteristics of factors, including distribution of sex and age, attack symptoms, course of disease, clinical symptoms, TCM pattern identification factors and pattern identification, were observed in the method of questionnaire survey and computer centralized pattern identification. The data were analyzed and compared statistically.[Results]1. As for sex and age, there is obvious difference in the distribution of sex and age. The chi-square test showed it was statistically meaningful. Women were more vulnerable to be attacked, especially for women under 40 years old. The distribution of age in male group was similar to that in female group.2. As for the attack season and symptoms, the season order listed by the number of patients from the more to the less is summer (38.8%), winter (35.9%), spring (18.5%) and autumn (6.8%). The onset symptoms listed in the first five place swelling pain(39, 24.8%),stigmata(33,21.0%), fever(29,18.5%), edema(10,6.4%), Ranaud's phenomenon(9, 5.7%). In addition,12 patients (7.6%) were diagnosed as SLE in physical examination. The cause of SLE in 3 patients (1.9%) is pregnancy. The cause of SLE in 22 patients (14.0%) is caused by other symptoms.3. With reference to the distribution single pattern, patterns occurred from high frequency to low frequency are as follows:kidney deficiency pattern (61,19.1%),qi deficiency pattern(50,15.6%), dampness and heat pattern(47,14.7%), blood stagnation(44, 13.8%), yin deficiency(35,10.9%), spleen deficiency(28,8.8%), liver deficiency(26,8.1%), heart deficiency(10,3.1%), lung deficiency(10,3.1%), yang deficiency(7,2.2%), stomach deficiency(1,0.3%), blood deficiency(1,0.3%).4. The distribution of patterns are as follows:single pattern (5,4.9%), two-pattern (14, 13.6%),three-pattern (32,31.1%), four-pattern(27,26.2%), five- pattern(10,9.7%), six-pattern(4,3.9%), seven-pattern(5,4.9%), eight- pattern(3,2.9%),nine-pattern(1, 1.0%),11-pattern (1,1.0%), unknown pattern (1,1.0%).[Conclusions]1. It showed that most of patients with SLE were female youth, and that there was no obvious difference between men and women on the age attack.2. The attack season is mainly summer or winter. The attack symptoms are mainly swelling pain of joints, stigmata, fever, edema, and Ranaud's phenomenon. It is important to distinguish and diagnose in order to reduce misdiagnosis rate.3. As for single pattern,the following patterns, including kidney deficency pattern,qi deficency pattern, dampness and heat pattern,blood stagnation pattern and yin deficiency pattern, were common seen in clinical practice. The root cause of SLE belongs to deficiencyattern and the symptoms belong to excess pattern,which is the pathological mechanism of SLE in TCM.4. Multiple patterns are mostly seen in clinical practice,which reflected the clinical particularities of multi-system injury of SLE.