March 3, 2012

Hú Xī-Shù (胡希恕) -A Case of Systemic lupus erythematosus (SLE)

A 32-year-old female patient presented at the clinic on October 12, 1967. For the last year the patient has been experiencing feverishness along with red macules on her face and back. The origin of the feverishness and macules was unknown. At both the Běijīng Harmony hospital and the Běijīng University hospital she was diagnosed with Systemic lupus erythematosus. She was treated with hormone therapy, which offered no positive effects, and was then introduced to Dr. Hú for treatment.

Current symptoms: Irregular occurrences of feverishness, with red and swollen macules on the face and back occurring as patches or covering larger areas, with shedding scales resembling ox hide tinea. In addition she commonly experienced neck, nape, back and lumbar pain, dry throat, irritability, and also sweat easily from her head. Her tongue had a thin-white coating, and her pulse was thin, wiry, and rapid.

This is a pattern of pathogenic depression in the Jué Yīn, blood deficiency and exuberance of water. Treatment should involve warming the lower, clearing the upper, nourishing the blood, and disinhibiting water. chái hú guì zhī gān jiāng tāng (Bupleurum, Cinnamon Twig, and Ginger Decoction) with dāng guī sháo yào sǎn (Tangkuei and Peony Powder) is the appropriate formula.

chái hú (Bupleuri Radix) 5 qián 
huáng qín (Scutellariae Radix) 3 qián 
tiān huā fěn (Trichosanthis Radix) 4 qián 
mǔ lì (Ostreae Concha) 5 qián 
lóng gǔ (Fossilia Ossis Mastodi) 5 qián 
guì zhī (Cinnamomi Ramulus) 3 qián 
bái sháo (Paeoniae Radix alba) 3 qián 
dāng guī (Angelicae sinensis Radix) 3 qián 
chuān xiōng (Chuanxiong Rhizoma) 3 qián 
cāng zhú (Atractylodis Rhizoma) 3 qián 
fú líng (Poria) 3 qián 
gān jiāng (Zingiberis Rhizoma) 2 qián 
zé xiè (Alismatis Rhizoma) 5 qián 
zhì gān cǎo (Glycyrrhizae Radix preparata) 2 qián 
shí gāo (Gypsum fibrosum) 1 ½ liǎng

Results: After taking six packages of the above formula, she had started to notice some positive effects, and after thirty packages, she came in for a follow up consultation. By that point, the red macules on her face and back had basically disappeared, and all her blood tests were normal. Her body temperature had decreased and she no longer felt the irregular feverishness. In addition, her pain was no longer present. When she returned to the Běijīng University hospital for a follow up, her doctor was amazed and was completely satisfied with the treatment she had received. The doctor recapitulated her medical records and advised her that she no longer needed to take her herbs. However, approximately half a month after stopping the herbs, red macules reappeared on her face. Although the symptoms weren’t as bad as before, she returned to Dr. Hú for treatment. The above formula was prescribed again with the shí gāo (Gypsum fibrosum) removed.

Commentary: Systemic lupus erythematosus (SLE) is a difficult condition to treat with western medicine, and the same can be said about Chinese medicine. Using six-channel pattern identification in conjunction with classical formula theory, we are able to achieve good results with this condition, and Dr. Hú’s many years of clinical experience is definitely worth referencing.

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