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Lupus kidney

  Systemic lupus erythematosus (SLE) is an autoimmune disease that affects the connective tissue of the body. It often involves multiple systems and multiple organs.

  Disease Overview

  Lupus erythematosus is the most common systemic lupus erythematosus visceral damage, the severity of renal disease directly affect the prognosis of SLE. Chinese medicine is not the name of lupus nephritis. According to their clinical manifestations, the disease angelica in edema, low back pain, sunburn sun, yin and yang, temperature and toxic hair spots, Consumption, dizziness, palpitations and other areas of palpitations. Chinese medicine that the disease is due to lack of congenital deficiency, kidney essence deficiency or impassioned internal injuries, yin and yang disorders; or kidney essence loss, complex sense of cult poison, or taking toxic heat of the goods, causing blood block, Cheong, poisonous Jiuji Meridian due to blood.

  For many newly diagnosed patients with lupus kidney, many people there is such a question, that is what is lupus kidney. In fact, to explain clearly what is lupus kidney is not simple. As we all know, lupus kidney (LN) and systemic lupus erythematosus (SLE) has a great relationship.

  Systemic lupus erythematosus is the body there are a variety of autoantibodies, violations of the body connective tissue of a typical autoimmune disease, disease often involving multi-system multi-organ, many patients with systemic lupus erythematosus will always be their condition and Department of lupus erythematosus Kidney like to be confused. Lupus erythematosus is a systemic lupus erythematosus after a long period of disease development after the emergence of glomerular lesions. In a clearer understanding of what is the concept of lupus kidney, systemic lupus erythematosus patients on the typical symptoms of lupus kidney are more concerned about, to refer to their own existing disease is about to determine whether the development of the disease to lupus kidney. Systemic symptoms such as fever, rash, oral mucosal ulcers; systemic organ damage such as hematopoietic system, central nervous system, liver and multiple serositis; renal damage performance, hematuria, edema, proteinuria , Increased nocturia, hypertension, late uremia corresponding clinical manifestations.

  In addition, what is lupus kidney and lupus kidney symptoms have a general understanding, we must in-depth understanding of the etiology of lupus kidney in the end what is. The etiology of lupus kidney is unknown, the majority of that is genetic, viral infection, sun or ultraviolet radiation, the induction of certain drugs and the impact of estrogen and other factors interact with the body caused by cellular and humoral immune dysfunction. Immune disorder is the basis of the pathogenesis of lupus kidney, immune complex deposition is the main pathogenesis. Therefore, the immune complex lupus nephritis kidney, lupus nephritis caused by immune complexes mainly DNA-anti-DNA immune complexes.

  What is the lupus kidney, what is the most typical symptoms of lupus kidneys, lupus kidney what is the cause of the disease with a general understanding, you can better make people not lupus kidney kidney lupus knowledge to increase knowledge, more Good targeted prevention, treatment of lupus kidney, from the source to obtain the best treatment of lupus kidney. Systemic lupus erythematosus (SLE) is an autoimmune disease that affects the connective tissue of the body. It often involves multiple systems and multiple organs. Multiple clinical symptoms are: ① unexplained long-term fever; ② multiple joint pain; ③ skin damage; ④ multiple systems, multiple organ damage; ⑤ spontaneous remission or aggravating tendency; ⑥ hormone and cytotoxic drug therapy often effective; ⑦ blood γ-globulin increased; ⑧ ESR to speed up; ⑨ ANA can be used as screening test.

  Systemic lupus erythematosus is a common disease. US statistics show that the incidence of this disease was 50/10 million, accounting for about 0.7 of the population in China. The incidence of female patients with this disease is higher than that of men, and young women. SLE Where kidney damage, that is, lupus nephritis (LN). The incidence of lupus nephritis reported various results, we believe that in the diagnosis of SLE, about 70% of renal damage. If SLE patients do renal biopsy, with light microscopy, the renal damage of 90%, if coupled with immunofluorescence and electron microscopy, almost all patients have glomerular damage. Some patients with renal extracorporeal manifestations, and only mild renal damage, renal failure in patients with less of this; other patients with renal damage as the main external manifestations, such as can be expressed as nephrotic syndrome, extrarenal syndrome Performance is not obvious, easily misdiagnosed as primary glomerular disease.

  Clinical manifestations

  Renal damage performance: LN lesions can affect the glomerular, renal tubules and renal interstitium. Clinical manifestations can have the following:

  1. Hematuria and domain proteinuria patients without edema and hypertension, only mild to moderate proteinuria and hematuria domain.

  2. Nephritis syndrome often accompanied by edema or hypertension, proteinuria and hematuria. Acute onset of clinical manifestations similar to acute nephritis, renal dysfunction can be associated with. Some cases of rapid onset, rapid deterioration of renal function, short-term progress of renal failure, clinically was an urgent nephritis after, if no active and effective treatment, mortality is extremely high. There are some cases of onset can be no renal dysfunction, urinary changes are not significant, but after several years of progressive development of chronic renal failure.

  Cause of formation

  1, the basis of the incidence of lupus erythematosus - immune disorders

  Including lupus nephritis patients own immune tolerance, B cell hyperfunction, T cell dysfunction and cytokine abnormalities.

  2, the pathogenesis of lupus nephritis - immune complex deposition

  Lupus kidney disease process, will produce a variety of self-organization, including the nucleus, cell membrane, cytoplasm and various tissue components of autoantibodies. Among them, anti-nuclear antibody (ANA) is the most important, it is systemic lupus erythematosus the incidence, diagnosis and disease have played a key role. Systemic lupus erythematosus complicated by renal disease, the patient will have antigen-antibody complexes and immune complex deposition in the glomerular, causing kidney damage, that is, lupus nephritis.

  Treatment measures

  Lupus kidney according to the different disease progression, can be divided into the following treatment of lupus kidney several measures.

  First, the treatment of lupus kidney based on clinical manifestations, laboratory and renal biopsy data. For mild systemic lupus erythematosus (such as only a rash, fever or joint symptoms, etc.) and immune serological abnormalities, if normal urinalysis, renal biopsy showed normal or mild glomerular lesions, as appropriate, non-steroidal anti-inflammatory Drugs to improve symptoms, generally without the use of glucocorticoids or cytotoxic drugs, closely tracking the disease changes; if the urine abnormalities, renal biopsy showed glomerular focal mesangial hyperplasia with segmental necrosis, crescent formation and Focal glomerulosclerosis, with small and medium doses of glucocorticoids (such as prednisone 20 ~ 40mg / d), as appropriate, plus cytotoxic drugs or tripterygium preparations.

  Second, severe systemic lupus erythematosus (such as high fever, joint pain, weakness or lesions rapidly involving the serosa, heart, lung, liver, hematopoietic organs and other organs) with acute nephritic syndrome or rapid nephritis syndrome, renal biopsy Showed diffuse proliferative glomerulonephritis or crescentic glomerulonephritis, renal dysfunction, should be given standard hormone therapy plus CTX shock therapy; or methylprednisolone pulse therapy, daily 1.0g, static point 3 ~ 5 days for a course of treatment, followed by a moderate dose of prednisone to maintain, if necessary, after 7 to 10 days can be repeated once, generally not more than 3 courses. When the above method is ineffective or severe condition, can consider plasma replacement therapy; can not use CTX can try cyclosporine A, mycophenolate mofetil and so on. Associated with acute severe renal insufficiency, severe high blood volume, heart failure should be an emergency dialysis, so that through the dangerous period for drug treatment to create conditions and win time.

  Third, the performance of asymptomatic proteinuria (urine protein 2g / 24h) were available glucocorticoids, as appropriate, plus cytotoxic drugs, triptolide preparations and prednisone combination also have a certain effect; performance of asymptomatic hematuria, available Thunder Rattan preparation (conventional or double dose) or CTX. Conditions are the best choice according to renal pathological types of medication.

  Fourth, was nephrotic syndrome, but little red blood cells in urine, renal function and stability, or renal biopsy showed membranous lupus kidney should be preferred prednisone 0.8 ~ 1.0mg / kg.d, if 2 to 4 weeks after the effect is not When good, plus CTX, if associated with renal dysfunction, severe hypertension, renal biopsy showed significant glomerular hyperplasia or pathologic type of change should be given to standard hormone therapy plus CTX shock therapy.

  Fifth, for the fixed proteinuria without systemic lupus erythematosus performance, or azotemia and renal pathology with chronic lesions mainly, generally do not long-term use of prednisone and cytotoxic drugs.

  6, end-stage lupus kidney by chronic renal failure treatment.

  Seven general treatment: including rest, diet, diuretic, lowering blood pressure, anticoagulation and prevention of complications, should be based on the patient's condition with reference to primary glomerular disease treatment.

  Eight, Chinese medicine syndrome differentiation can improve the efficacy, reduce symptoms and reduce the side effects of Western medicine.

  Chinese medicine classification

  TCM treatment from the overall situation, according to the etiology of lupus kidney thorough treatment. Generally speaking, Chinese medicine for the treatment of lupus kidney is divided into five types, namely, heat poisoning type, Yin deficiency heat type, liver and kidney type, spleen and kidney yang deficiency type.

  Heat poison flaming lupus

  (1) heat poison flustered lupus kidney patients main symptoms are: persistent fever, or heat like thirst and cold drink disturbed disturbance disturbed, and even then coma delirium, facial symmetry of erythema, red or subcutaneous erythema, joint Pain, with lower extremity edema, or hematuria, urine turbidity, low back pain, dry stool, red or dark purple tongue, thin yellow coating, pulse and fine. This type is more common in acute exacerbation of lupus kidney.

  Chinese medicine treatment flaming lupus kidney focus: heat detoxification, cooling blood Sanbi.

  Yin internal heat lupus

  (2) yin deficiency heat lupus kidney patients main symptoms are: surface zygomatic flushing, hair spots, Yaoxisuanruan or pain, dizziness, fever, dry mouth and throat, five upset hot, hot flashes, night sweats, urinate red stools Dry, red tongue, little coating or light stripping, pulse breakdown. This type of lupus kidney more common in subacute or mild active period.

  Chinese medicine treatment of yin deficiency heat type lupus kidney focus: Ziyin heat.

  Liver and kidney yin deficiency type lupus

  (3) liver and kidney yin deficiency type of lupus kidney patients main symptoms are: facial erythema color is not fresh, dizziness, depending on the material dim, jaw tightness, Zha Jia dry, irritable, Yaoxisuanruan, men's nocturnal emission or woman After less, amenorrhea or menorrhagia, five upset hot, hot flashes, night sweats, insomnia, dry mouth and throat, sustained low fever, abdominal fullness, shortness of urine red or turbid as grease, even see hair off tooth shake. Red tongue, little moss or light stripping, pulse string breakdown. The disease more common in remission of lupus kidney, chronic inflammation, stable or partial occult nephritis period.

  Chinese medicine treatment of liver and kidney type of lupus kidney focus is nourishing liver and kidney.

  Spleen and kidney yang type lupus

  (4) Spleen and kidney yang type lupus kidney patients main symptoms are: two zygomatic red spot color dark, looking not Chinese, dizziness, aversion to cold, shortness of breath lazy words, eat less loose stools, limb weakness, pain, weak waist Or waist and knee Leng Tong, dysuria, white turbidity unhealed, limb edema, men impotence, irregular menstruation women, tongue fat side with tooth marks, dark purple or red tongue, or pale tongue, thin white fur , Pulse Shen weak. This type is more common in nephrotic syndrome type.

  Chinese medicine treatment of spleen and kidney yang type of lupus kidney focus is: Warming spleen and kidney, light penetration water.

  Qi and Yin Deficiency type lupus

  (5) Qi and Yin Deficiency type lupus kidney patients main symptoms are: Shenpi body tired, palpitations, shortness of breath, less gas lazy words, spontaneous sweating, dizziness, tinnitus, dry mouth and throat, five upset hot, pulse breakdown. This type is more common in the standard course of hormone therapy, the disease is basically no activity, the body is weaker.

  Chinese medicine treatment of Qi and Yin Deficiency type of lupus kidney focus: Qi and Yin.


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