Western Medical Diagnosis Systemic Lupus Erythematosus.

Formulas: San Xu Zeng Ye Tang with modifications: Yin Yang Huo 15g, Hu Zhang 10g, Si Zi 15g, Sheng Di 12g, Xuan Shen 10g, Mai Dong 10g, Chuan Xu Duan 10g, Han Lian Cao 15g, Cao Enzyme 10g, Dang Shen 10g, Huang Qi 20g, Dang Gui 10g, Bai Shao 15g, Tao Ren 10g, Hong Hua 6g, Jin Yin Hua 15g, Lian Qiao 15g, Bai Hua She She Cao 15g, Ban Zhi Lian 15g, Nu Zhen Zi 15g, Gou Qi Zi 15g, Fu Pen Zi 15g, Wu Wei Zi 3g. In addition, there are also less common syndromes: ① Spleen-Kidney Yang Deficiency Syndrome: Pale complexion, shortness of breath and reluctance to speak, dyspnea and spontaneous sweating, facial edema, abdominal distension and poor appetite, aversion to cold and cold limbs, difficulty urinating or clear and copious urine, thin stools or undigested food, a swollen tongue with faint tooth marks, thin white or moist white coating, and a deep or weak pulse. Treatment Principle: Warmly tonify the spleen and kidneys, unblock yang and promote diuresis. Formulas: Use Shi Pi Yin, Fang Ji Huang Qi Tang, Wei Ling San, Wu Ling San, Wu Pi Yin, Fang Ji Fu Ling Tang, etc., with modifications. ② Wind-Damp-Heat Arthropathy Syndrome: Joint pain, migratory and unpredictable, affecting multiple limbs and joints, local burning and redness, difficulty in flexion and extension, lower back pain, general fatigue, often accompanied by fever, thirst and irritability, red tongue with white or yellow greasy coating, and a slippery, rapid pulse. Treatment Principle: Clear heat, dispel wind, remove dampness, and unblock the meridians. Formulas: Use Jiu Wei Qiang Huo Tang, Gui Zhi Shao Yao Zhi Mu Tang, Da Qin Tang, etc., with modifications. 5. Analysis of Formulas Used by Professor Pei Zhengxue Professor Pei Zhengxue always conducts detailed syndrome differentiation and carefully adjusts treatment whenever he encounters systemic lupus erythematosus. After decades of theoretical research and clinical practice, he has summarized the main formulas for treating systemic lupus erythematosus as San Xu Zeng Ye Tang: Yin Yang Huo, Hu Zhang, Si Zi, Sheng Di, Xuan Shen, Mai Dong, Chuan Xu Duan, Han Lian Cao, Ge, Dang Shen, Huang Qi, Dang Gui, Bai Shao, Tao Ren, Hong Hua, Jin Yin Hua, Lian Qiao, Bai Hua She She Cao, Ban Zhi Lian. Among these, Professor Pei Zhengxue uses Yin Yang Huo, Chuan Xu Duan, Han Lian Cao, and Tu Si Zi to tonify the liver and kidneys; Sheng Di, Xuan Shen, and Mai Dong (Zeng Ye Tang) to nourish yin and fluids; Dang Shen and Huang Qi to tonify qi and reinforce the surface, protecting the middle jiao, thereby achieving the effect of reinforcing the innate endowment. This reflects Professor Pei Zhengxue's treatment philosophy of tonifying the liver and kidneys and nourishing yin and fluids to treat the root cause. Among them, Yin Yang Huo also has the function of dispelling wind and dampness, and with the addition of Jin Yin Hua, Lian Qiao, Hu Zhang, Bai Hua She She Cao, and Ban Zhi Lian to clear heat and resolve stasis, it effectively treats both the root and the manifestation. Thus, it forms an effective formula that takes both root and manifestation into account. In addition, Sheng Di, Dang Gui, Bai Shao, Tao Ren, and Hong Hua (Tao Hong Si Wu Tang) nourish the blood and activate blood circulation to dispel wind, which embodies the idea of "treating wind by first treating blood," further confirming that Professor Pei Zhengxue considers this disease (SLE) to fall within the scope of "wind" syndrome in TCM. Professor Pei Zhengxue says: Redness, swelling, heat, and pain are characteristic of patients with this type, and they are also the first symptoms seen in many newly diagnosed or recurrent patients, making the condition acute, severe, obvious, and easy to diagnose. Only clearing heat and detoxifying, cooling the blood and protecting yin to resolve the rash can be effective. Among them, Xijiao Dihuang Tang is not only representative but also directly targets the nutritive and blood layers, while adding Qingwen Baidu Yin, Huanglian Jiedu Tang, Wuwei Xiaodu Yin, and other formulas to eliminate wind-damp-heat pathogens from the wei qi, ying qi, and blood layers, thus controlling the condition in the short term. Since this disease is a chronic autoimmune disorder, in the later stages, liver and kidney deficiency and yin deficiency become increasingly prominent, but wind, dampness, and heat pathogens often remain unresolved, causing the condition to recur frequently or linger without healing. Therefore, while tonifying the liver and kidneys, it is necessary to clear heat and dispel wind to achieve long-term relief. San Xu Zeng Ye Tang, Zhi Bai Di Huang Wan, Er Zhi Wan, Wu Zi Yan Zong Wan, and Da Bu Yin Wan are commonly used as supplementary formulas. In addition, based on the above treatment, Professor Pei Zhengxue also emphasizes individualized treatment through syndrome differentiation, adjusting medications according to the specific clinical type: For lupus erythematosus with cutaneous erythema complicated by lower limb venous thrombosis, he prescribes Dang Chuan Liu Ling He Ji: (Dang Gui, Chuan Xiong, Wang Bu Liu Xing, Wei Ling Xian, Chuan Shan Jia—now banned, same below), Dan Shen, Yu Jin, Chishao, Xuan Shen, Xia Ku Cao, Fu Ling); For fever: Add Huang Qi, Bai Zhu, Dang Shen, etc. for qi deficiency-related fever; add Dang Gui, Sheng Di, A Jiao, Huang Jing, etc. for blood deficiency-related fever; add Jin Yin Hua, Pu Gong Ying, Chai Hu, Da Qing Ye, Ban Lan Gen, Bai Tou Weng, Di Gu Pi, etc. for viral infection-related fever; add Lian Qiao, Yu Xing Cao, Huang Lian, Yin Xing Ye, Ju Hua, etc. for bacterial infection-related fever; add Ling Yang Jiao (can use goat horn instead, increasing the dosage accordingly, same below), Xijiao powder, etc. for high fever that does not subside; add Yin Chai Hu, Di Gu Pi, etc. for low fever that does not subside; add Huang Qin, Fang Ji, Chen Pi, Ma Huang, etc. for allergic fever. For joint pain, add Fang Ji, Qin Rao, Hu Zhang, Wei Ling Xian, Yan Hu Suo, Luo Shi Teng, Qing Feng Teng, Hai Feng Teng, etc.; for edema, add Che Qian Zi, Bai Mao Gen, Fu Ling Pi; for dry cough or yin-deficiency cough, add Bei Sha Shen, Mai Dong, Bai He, Tian Dong, etc.; for palpitations, add Yuan Zhi, Fu Ling, Wu Wei Zi, Bai Zi Ren, Xuan Shen, Yu Zhu, etc.; for chest pain, add Chuan Xiong, Dan Shen, Chishao, San Qi, Shan Zha, Dong Qing, Yan Hu Suo, Yi Mu Cao, San Leng, E Shu, etc.; for arrhythmias such as pulse blockage or premature beats, add Zhi Gan Cao Tang, Xie Xin Tang, San Jia Fu Mai Tang, or Xian Ling Pi, Ku Shen, Dang Gui, Qing Hao, Xuan Shen, Fu Zi, Rou Gui, etc.; for insomnia, add Tian Wang Bu Xin Dan, Ye Jiao Teng, Suan Zao Ren, Sheng Long Gu, Sheng Mu Li, Zhen Zhu Mu, etc.; for liver pain, jaundice, and elevated transaminases, add Chai Hu, Long Dan Cao, Huang Qin, Ze Xie, Sheng Di, Yu Jin, Bai Zhu, Bai Hua She She Cao, Yin Chen, Pu Gong Ying, Yan Hu Suo; for Raynaud's phenomenon, cutaneous purpura, dark red tongue, and obvious blood stasis under the tongue, add Tao Ren, Hong Hua, Chishao, Dan Shen, Chuan Xiong, Shui Zhi, Da Huang, etc.; for bleeding or coagulation abnormalities, add Sheng Ce Bai Ye, Qian Cao Gen, Zi Zhu Cao, Xian He Cao, Bai Mao Gen, Da Ji, Xiao Ji, etc.; for leukopenia, add Nu Zhen Zi, Bai Zhu, Rou Gui, Ku Shen, Ji Xue Teng, Bu Gu Zhi, Zi He Che, Ren Shen, Fu Zi, Lu Jiao Jiao, etc.; for hypertension, add Niu Xi, Xia Ku Cao, Ju Hua, Shan Zha, Du Zhong, Huang Qin, Gou Teng, etc. For mental and neurological symptoms, add Tian Ma, Gou Teng, Tian Nan Xing, Shi Chang Pu, Bai Jiang Can, Fu Ling, Zhen Zhu Mu, Amber, etc.; for spleen deficiency, add Bai Zhu, Dang Shen, Chen Pi, Fu Ling, Shan Yao, etc.; for kidney deficiency, add Si Zi, Du Zhong, Sang Ji Sheng, Chuan Xu Duan, Nu Zhen Zi, Gou Qi Zi, Xian Ling Pi, etc.; for those with obvious joint pain, add Fu Fang Sang Zhi Tang, Chuan Wu, Cao Wu, Liao Xi Xin, Ma Qian Zi, Lei Gong Teng, etc.; for those with severe limb stiffness and difficulty in flexion and extension, add Gui Zhi Shao Yao Zhi Mu Tang, etc. In summary, Professor Pei Zhengxue bases his treatment of this disease on San Xu Zeng Ye Tang, with modifications such as Xijiao Dihuang Tang, Qingwen Baidu Yin, Huanglian Jiedu Tang, Wuwei Xiaodu Yin, Qinghao Bie Jia Tang, Qing Ying Tang, Liu Wei Di Huang Wan, Er Zhi Wan, Wu Zi Yan Zong Wan, Da Bu Yin Wan, Zhi Bai Di Huang Wan, Yiguang Jian, etc. He also uses Shi Pi Yin, Fang Ji Huang Qi Tang, Wei Ling San, Wu Ling San, Wu Pi Yin, Fang Ji Fu Ling Tang, Jiu Wei Qiang Huo Tang, Fu Fang Sang Zhi Tang, Gui Zhi Shao Yao Zhi Mu Tang, Da Qin Tang, Xue Fu Zhu Yu Tang, Zhi Gan Cao Tang, Xie Xin Tang, Tian Wang Bu Xin Dan, San Jia Fu Mai Tang, etc., according to different combined syndromes. It is particularly emphasized that chronic diseases, especially when treated for a long time, can easily damage the spleen and stomach, so during treatment, it is necessary to constantly protect them. "If there is stomach qi, there is life; if there is no stomach qi, there is death" is a famous saying often mentioned by Professor Pei Zhengxue, highlighting the importance of protecting the spleen and stomach. Professor Pei Zhengxue points out that Western medicine focuses on the pathogenicity of the disease, its microscopic manifestations, and local characteristics, using hormones and immunosuppressants to treat the symptoms quickly, but the efficacy is limited. In contrast, TCM focuses on overall regulation, emphasizing the body's reactivity, macroscopic manifestations, and overall characteristics, employing holistic regulation and syndrome differentiation to treat the root cause and restore immune function to a self-stabilizing state. Therefore, TCM treatment of this disease often shows great effectiveness, while also having significant advantages in reducing hormone side effects and preventing infections. "The superior physician treats disease before it occurs." For systemic lupus erythematosus, in addition to medication, one should avoid consuming foreign proteins in daily life and diet, avoid psychological stress, maintain a positive attitude, avoid exposure to sunlight and ultraviolet rays, strengthen nursing care during active phases of the disease, prevent infections, and guard against complications such as renal failure and central nervous system disorders. 6. Clinical Case Examples by Professor Pei Zhengxue Example 1: Ms. Liu, female, 34 years old, has had systemic lupus erythematosus (SLE) for 5 years, taking 12 tablets of prednisone (5mg each) for three months, with generalized edema and joint pain, and often experiencing afternoon fevers of 38°C to 40°C for more than ten days. Urinalysis: Proteinuria (3+), occult blood (3+), erythrocyte sedimentation rate 120mm/h. Pulse is large and rapid, tongue is red with purple streaks, and coating is thick and greasy. [Western Medical Diagnosis] Systemic Lupus Erythematosus. [TCM Syndrome Differentiation] Wind-damp-heat entering the interior, with blood stasis remaining inside. [Treatment Principle] Clear heat, dispel wind, remove dampness, activate blood circulation, and resolve stasis. [Formulas] Tao Hong Si Wu Tang, Huo Luo Xiao Ling Dan, Gui Zhi Fu Zi Tang with modifications: Dang Shen 10g, Huang Qi 20g, Gui Zhi 10g, Fu Pian 6g, Dan Shen 20g, Qi She 6g, Yi Mu Cao 20g, Water Buffalo Horn 10g, Sheng Di 12g, Wei Ling Xian 10g, Hong Hua 6g, Ji Xue Teng 20g, Bai Shao 20g, Dang Gui 10g, Ru Xiang 6g, Mo Yao 6g, San Leng 10g, E Shu 10g, Cang Shu 10g, Bai Zhu 10g, Ba Ji Tian 10g, Zicao 30g, Centipede 1 piece, Snake 9g. Decocted and taken orally; two doses every three days, totaling seven doses. During medication, combined with Xiao Feng II and Fu Zheng Chong Ji. After half a month of medication, the patient returned for follow-up, and the edema had completely subsided, prednisone had been reduced to two tablets, erythrocyte sedimentation rate was 45mm/h, and urinalysis showed proteinuria (2+) and occult blood (+), with good spirits, indicating that the disease had largely disappeared. Example 2: Ms. Tang, female, 30 years old, has had systemic lupus erythematosus for 10 years, previously taking large amounts of hormones and immunosuppressants, with repeated abnormalities in liver function, kidney function, and urinalysis, along with skin spots, joint pain, erythrocyte sedimentation rate of 56mm/h, dry stools, thin yellow coating, dark purple tongue, and a fine, slippery pulse. [Western Medical Diagnosis] Systemic Lupus Erythematosus. [TCM Syndrome Differentiation] Liver and kidney deficiency, with blood stasis blocking the channels. [Treatment Principle] Warmly tonify the liver and kidneys, activate blood circulation, and remove stasis. [Formulas] San Xu Zeng Ye Tang combined with Tao Hong Si Wu Tang with modifications: Yin Yang Huo 10g, Si Zi 10g, Hu Zhang 10g, Sheng Di 10g, Xuan Shen 10g, Mai Dong 10g, Chuan Xu Duan 10g, Han Lian Cao 10g, Ge 10g, Xian Mao 10g, Dang Shen 10g, Dan Shen 20g,

Yu Jin 6g, Gui Zhi 10g, Hong Hua 10g, Tao Ren 10g, Dang Gui 10g, Chuan Xiong 6g, Bai Shao 30g, Ji Xue Teng 10g, Zicao 30g, Snake 9g, Centipede 1 piece. Decocted and taken orally, two doses every three days, taken after meals. Given Xiao Feng I and Xie Huo Chong Ji, as well as Gu Sheng I, taken concurrently. After one month of medication, the patient returned for a follow-up, and all symptoms had subsided, liver and kidney functions were normal, urinalysis was negative, and erythrocyte sedimentation rate was 24mm/h. Example 3: Ms. Liu, female, 24 years old, initially presented with dark brown facial rash, intermittent low-grade fever, especially noticeable at night, lower back and leg pain, mild knee pain, accompanied by dizziness, fatigue, dry mouth and throat, slightly dry stools, yellow urine that was difficult to pass, red tongue with little fluid, thin yellow coating, and a fine, rapid pulse. Tests showed: proteinuria (+), occult blood (+), antinuclear antibody (+), and erythrocyte sedimentation rate of 76mm/h.

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[Western Medical Diagnosis] Systemic Lupus Erythematosus.
[Traditional Chinese Medicine Syndrome Differentiation] Liver and Kidney Yin Deficiency.
[Treatment Principle] Nourish the Liver and Kidneys, nourish Yin and clear Heat.
[Formula] Modified Compound Yishen Decoction: Peach Kernel 10g, Safflower 6g, Chuanxiong 6g, White Peony Root 15g, Dang Gui 10g, Rehmannia 12g, Cornus Fruit 6g, Chinese Yam 10g, Moutan Bark 6g, Poria 12g, Alisma 10g, Salvia 20g, Perilla Stem 20g, Cicada Slough 6g, Motherwort 15g, Honeysuckle 15g, Forsythia 15g, Isatis Root 15g, Licorice 6g. Total of 7 doses, one dose per day. At the same time, administer Xiaofeng No. 1, Fire-Purging Granules, and Gusheng No. 1 concurrently. After one week, the patient returned for follow-up; urine protein (-), urine occult blood (+), ESR 28 mm/h. Therefore, Ma Xing Shi Gan Tang combined with Erxian Tang, modified as needed, was prescribed for continued treatment.

Example 4: Zhang, female, 44 years old. Initial visit revealed bright red rashes on the face and limbs, high fever, irritability, flushed face, thirst, significant joint pain, skin purpura, yellow-red urine, constipation, red-dark tongue, greasy yellow coating, and wiry-rapid pulse.
[Western Medical Diagnosis] Systemic Lupus Erythematosus.
[Traditional Chinese Medicine Syndrome Differentiation] Exuberant Heat-Toxin Syndrome.
[Treatment Principle] Clear Heat and Cool Blood, Eliminate Rashes and Relieve Pain.
[Formula] Modified Huanglian Jiedu Tang combined with Xijiao Dihuang Tang: Rhinoceros Horn 15g, Codonopsis 10g, Ophiopogon 10g, Japonica Rice 30g, Rehmannia 12g, White Peony Root 12g, Moutan Bark 6g, Coptis 6g, Scutellaria 12g, Gardenia Fruit 15g (decocted first for 1 hour), Aconite 15g (decocted first for 1 hour), Aconite 15g (decocted first for 1 hour), Liaoxixin 15g (decocted first for 1 hour), Semen Strychni 1 piece (fried in oil), Artemisia 10g, Turtle Shell 15g, Anemarrhena 20g, Licorice 6g. Administer Xiaofeng No. 2, Fire-Purging Granules, and Gusheng No. 1 concurrently. Upon follow-up, all the above symptoms had significantly improved compared to before. After five courses of outpatient treatment, systemic discomfort had basically disappeared, and the patient was advised to take patent Chinese medicines to consolidate the effect. Follow-up for one year showed no recurrence of the disease.