Systemic lupus erythematosus (SLE) is an autoimmune disease, and its incidence is related to family inheritance, ultraviolet radiation, estrogen level in the body, certain drugs, food, infection and other factors. The manifestations of SLE are various: repeated high fever or long-term low fever, butterfly-shaped erythema or discoid erythema on both cheeks, punctate bleeding, erosion or ulcer on oral mucosa, swelling and soreness of joints. SLE also often invades pleura, pericardium, heart cavity and kidney, causing different degrees of damage to nervous system, blood system and digestive system. Another feature of SLE is that it is particularly prone to young adults, especially young women. Systemic lupus erythematosus is a common disease that seriously harms human health. Those who have the above performance should take the time to go to the hospital for examination so as to make a diagnosis as soon as possible. Once the diagnosis is made, it is necessary to cooperate with the doctor for active and effective treatment. While treating you, the doctor will remind you of ten points in particular: First, pay attention to aftercare and keep a positive and optimistic attitude. Traditional Chinese medicine believes that the pathogenesis of SLE is related to exogenous pathogens, diet and seven emotions injury. Melancholy, moodiness, and bad mood can all be turned into fire, and excessive fire will hurt the internal organs, induce and aggravate diseases. Therefore, keeping an open mind, eating moderately, living regularly, and coordinating the function of human viscera and qi and blood will be beneficial to the recovery of the disease. Second, pay attention to the combination of work and rest, exercise properly and control sexual life. SLE patients should stay in bed when their condition is active. After the illness is stable, you should take part in more social activities and do what you can, but you should not be overworked. Exercise properly, pay attention to controlling sexual life, strictly control contraception during the active period of illness, and consider pregnancy after the illness has stabilized for more than one year. Third, pay attention to prevent colds and actively prevent various infections. Cold, acute tonsillitis, lung infection, intestinal infection and other infections are easy to induce SLE and aggravate the condition. Fourth, pay attention to avoid direct exposure of the skin to the sun. SLE patients are particularly sensitive to ultraviolet rays (photosensitivity), so they should pay special attention when going out. In addition, some foods such as mushrooms, celery, grass head (southern alfalfa, Chinese milk vetch), and some drugs such as Psoralea corylifolia, Radix Angelicae Pubescentis, Radix Arnebiae, Chenopodium album, Radix Angelicae Dahuricae, etc. Can cause light sensitivity and should be avoided as much as possible. 5. Pay attention to quitting smoking and drinking. Harmful components such as nicotine in cigarettes will stimulate the blood vessel wall and aggravate vascular inflammation, and should be quit. Alcohol is warm and intense, which will aggravate the internal heat symptoms of SLE patients and is not suitable for drinking. Six, there are some western medicine can often cause or aggravate the condition, pay attention to avoid using. Such as hydralazine, propranolol, chlorpromazine, propyl or methyl thiouracil, gold preparation, D- penicillamine, phenytoin sodium, isoniazid, penicillin, streptomycin, sulfonamides and so on. Seven, pay attention to some health care products are not beneficial to SLE patients, but harmful. Such as ginseng, American ginseng, Gynostemma pentaphyllum and their compound preparations, because they contain ginsenoside, they can not only improve the cellular immune function of human body, but also improve the humoral immune function of human body, and indeed have the functions of strengthening the body and prolonging life for non-SLE people. However, for SLE patients, due to the increase of immunoglobulin, immune complexes are increased and antinuclear antibodies are activated, which can aggravate or induce SLE. Eight, pay attention to avoid the use of drugs and foods containing estrogen. Placenta Hominis (placenta), umbilical cord, royal jelly, oviductus ranae and some female contraceptives all contain estrogen, which is one of the important factors of SLE. 9. Be careful not to eat mutton, dog meat, horse meat, venison and donkey meat. This kind of meat food will not only aggravate the internal heat symptoms of SLE patients, but also aggravate the condition of some patients after eating this kind of meat, resulting in adverse consequences. Ten, pay attention to supplement high-quality protein and multivitamins, and eat less foods with high fat and cholesterol. Patients with lupus nephritis have lost protein from urine for a long time, so they should be supplemented in time. Protein sources with good quality include milk, eggs, lean meat and fish. Vitamins, especially B vitamins and vitamin C, are of great benefit to the prevention and treatment of some symptoms of SLE, and should be supplemented more.
How to judge whether SLE patients are active or not?
Systemic lupus erythematosus (SLE) is an autoimmune disease. According to the epidemiological survey in Shanghai, the prevalence rate is about 70/ 1o million, and the prevalence rate of women is about11o 00. It is estimated that there are about100000 SLE patients in China. Because the etiology of systemic lupus erythematosus is unknown, it is difficult to cure the disease radically. However, with the rapid development of modern immunology, the pathogenesis of the disease has been deeply understood. At the same time, the extensive application of advanced immunodiagnostic techniques, diagnostic criteria and immunotherapy measures in clinic has significantly improved the early diagnosis rate of SLE and improved the prognosis of the disease. 1963 Jessar and others reported that the 5-year survival rate of SLE was only 20%, while 10 reported by Dubois and others in 973 was 57%, and1990 Reville and Chen Shunle reported that 10 survival rate reached 84% respectively. As long as SLE patients get correct diagnosis and treatment in time, they can get better therapeutic effect. Most patients can be relieved for a long time and work and live like normal people. Patients with SLE should always pay attention to whether their condition is active after remission. Once the disease shows signs of activity, they should contact experts in time. So, how do you know if your illness is active? Knowing the following points is very helpful for self-judgment: 1. Do you feel tired? Under normal circumstances, if the patient is more prone to fatigue than usual and does not improve significantly after rest, it is necessary to think about the possibility of illness. 2. Joint pain and swelling (such as proximal interphalangeal joint, wrist joint, knee joint and ankle joint). ) may be accompanied by morning stiffness or joint effusion. 3. New rash (such as cheek erythema, discoid erythema, chilblain-like lesions, erythema multiforme-like lesions, inflammatory lesions, periungual erythema, etc. ) or aggravate the original rash. 4. No upper respiratory tract infection, diarrhea, frequent micturition, urgency, dysuria, unexplained fever or unexplained ESR increased significantly. 5. New or frequent oral or nasal ulcers. New or frequent plaque or diffuse alopecia. 6. Pleural inflammation is the most common lung lesion in SLE patients. Patients often complain of chest pain, which gets worse with respiratory movement or body position change. Pericarditis is the most common heart disease in systemic lupus erythematosus. The main manifestations are dull pain behind the sternum or precordial area, or severe chest pain, which is aggravated with breathing, coughing or swallowing, and the chest pain is relieved when the body leans forward. If the above situation occurs during the course of the disease, you should go to a doctor for examination. 7. If white blood cells, platelets and hemoglobin are found to be lower than normal in routine blood examination or urine protein and red blood cells appear in routine urine examination, whether there is disease activity should be considered. 8. Unexplained diarrhea, abdominal pain, nausea and vomiting have not improved after anti-infection and symptomatic treatment. Whether there is gastrointestinal activity in lupus should be considered. 9. If SLE patients have thinking disorders such as hallucination, delusion and sense of being controlled, mental symptoms such as hypomania and depression, organic encephalopathy syndrome such as consciousness disorder, orientation disorder and calculation disorder, and severe and persistent headache and convulsion, they should consider the central manifestations of SLE and see a doctor as soon as possible. In a word, it is a key part of SLE treatment strategy to comprehensively judge and understand the changes of one's condition, visit doctors regularly and cooperate with doctors for active treatment.
What are the common side effects of hormones?
Hormone is the most important anti-inflammatory and immunosuppressive drug for lupus erythematosus. Corticosteroids have been used to treat lupus erythematosus for more than 50 years. In this short history, there are both successful experiences and failed lessons. In the process of continuous exploration and intermittent discussion, people come to the conclusion that the application of any drug has both positive and negative effects. As far as hormones are concerned, good use can be said to be a life-saving medicine, and it is not too much to compare it to a bridge to health. However, if it is not used well, hormones may become poison and its side effects. 1, infection: Because it can inhibit the body's response to inflammation, the body's ability to resist infection is reduced. Therefore, superficial or slight infection may evolve into systemic infection, and static infection may turn into active infection, which may cause the migration and spread of purulent lesions, tuberculosis and other potential lesions. Therefore, we should pay attention to the prevention of infection, carefully observe the condition, reduce the dosage and stop taking drugs in time when necessary, and be sure to use drugs in combination when acute infection and poisoning occur. 2. Posture changes: Many patients receiving hormone therapy may have posture changes, which will affect their spirit and mood. Because long-term use of hormones can redistribute fat, patients may have posture changes such as full moon face, buffalo back, trunk obesity, skinny limbs, centripetal obesity, acne, hirsutism, purple skin, etc., which may affect their appearance. 3. Diabetes: Hormones can increase liver glycogen, supplement blood sugar and induce diabetes. When using glucocorticoid in large quantities, we should pay attention to the changes of blood sugar and urine sugar. If hyperglycemia occurs, hypoglycemic drugs and insulin treatment should be given when necessary. However, with the decrease of hormone dosage, the dosage of hypoglycemic agents or insulin can be reduced. 4. Osteoporosis: Hormones can decalcify bones and turn them into osteoporosis. Osteoporosis refers to the reduction of bone mass per unit volume, just like building a house reduces the amount of steel bars and is easy to cause fractures. Aseptic osteonecrosis, especially femoral head necrosis, is also a common complication, but its pathogenesis may be femoral head necrosis caused by blood circulation disorder and capillary inflammation of femoral head, which is also called aseptic necrosis of femoral head because it is not caused by bacterial infection. Therefore, patients who use hormones for a long time must make regular bone mineral density measurements to be aware of it. At the same time, taking vitamins and calcium preparations at the same time as taking hormones can reduce the decrease of bone mass caused by corticosteroids and prevent osteoporosis. Proper physical exercise can promote bone blood circulation and metabolism, and help to prevent osteoporosis and femoral head necrosis. Calcium supplementation is a long-term task, and patients must persist and persevere in order to achieve better curative effect. 5, peptic ulcer: hormones can stimulate gastric acid, pepsin secretion, too much digestive juice can often cause gastritis, gastric and duodenal ulcers, and even perforation and bleeding. If patients have digestive tract symptoms, they should be taken together with antacids when taking hormones to protect the gastric mucosa from damage. Ranitidine, Chen Bailu and others. Commonly used in clinic, it can be used as a synergistic drug for oral hormone drugs. 6. Electrolyte disorder and hypertension: Hormones can cause water and sodium retention and edema. Many patients have hypertension. Due to the increase of potassium excretion, patients often have low potassium. For patients with congestive heart failure or obvious peripheral edema, hormones with little influence on water and salt metabolism should be selected, and the electrolyte balance of patients should be checked regularly. Hormone drugs are often used to treat patients with hypertension, especially lupus nephropathy. At this time, on the one hand, we should minimize the dosage of hormones, on the other hand, we should use antihypertensive drugs appropriately, such as propranolol and captopril. Although some antihypertensive drugs may have side effects on lupus constitution, they still need to be used decisively after weighing the pros and cons. 7. Others: When a large number of corticosteroids are used, patients may obviously appear excitement, irritability, euphoria, mental irritability, insomnia, depression or psychosis. When a large number of corticosteroids are used for a long time, muscle weakness, muscle atrophy, even myositis, elevated intraocular pressure, even glaucoma and cortical gland dysfunction may occur. Irregular menstruation and even amenorrhea are also common.
How to use traditional Chinese medicine to combat the side effects of hormones?
(2002-0 1-25 10:04:50)
When hormone is used to treat lupus erythematosus, side effects often occur because of its large dose and long application time. However, the occurrence of side effects can be significantly reduced after adding traditional Chinese medicine. Common side effects include insomnia, Cushing's syndrome, osteonecrosis, hyperlipidemia, diabetes, stomachache and so on. The patient's excitement can reach sleepless all night, irritability, excitement, similar to mental illness and so on. It should be combined with traditional Chinese medicine to soothe the nerves and apply Suanzaoren Decoction. The main drugs are Ziziphus Spinosae Seed, Polygonum Multiflori Radix, Anemarrhena asphodeloides, Glycyrrhiza uralensis Fisch, Cinnabar, Coptidis Rhizoma, Amber Powder, Magnetite, etc. Cushing's sign appeared, showing centripetal obesity, full moon face, acne and hirsutism. , belonging to Chinese medicine. The main treatment is nourishing yin and clearing heat, eliminating dampness and promoting diuresis. Maidi Siling Powder is selected, with Radix Ophiopogonis, Poria, Rhizoma Alismatis, Polyporus, Atractylodis Rhizoma, etc. as the main drugs. Hormones can cause aseptic osteonecrosis, mostly in cuboid bones and joints, leading to traction pain. On the basis of stopping the decrease of hormones, it was treated by tonifying kidney and promoting blood circulation, and treated by Liuwei Dihuang Pill. Decoctions of Achyranthes bidentata, Scolopendra, Eucommia ulmoides, Dipsacus, Ilex pubescens, Sambucus williamsii, Ligusticum Chuanxiong, Salvia Miltiorrhiza and Glycyrrhiza uralensis should be taken. Another side effect of hormones is the increase of serum cholesterol and triglycerides. Traditional Chinese medicines for purging turbidity and lowering blood fat can be selected, mainly including Alisma orientale, Cassia seed, rhubarb, hawthorn, lotus plumule and medlar. Hormones can promote glycogen production and reduce the utilization of glucose by tissues. Some patients will have drug-induced diabetes, hyperglycemia, urine sugar positive, thirst, polyphagia, polydipsia and polyuria during hormone therapy, which belongs to yin deficiency and internal heat in traditional Chinese medicine. Traditional Chinese medicine is supplemented by drugs such as Radix Rehmanniae, Rhizoma Anemarrhenae, Gypsum Fibrosum and Pollen. Taking traditional Chinese medicine for a long time can also reduce the side effects of hormone-induced hyperglycemia. Hormones can induce and aggravate gastric and duodenal ulcers, and even lead to bleeding in severe cases. Drugs with pungent and bitter taste and regulating stomach and qi can neutralize and inhibit gastric acid, regulate gastrointestinal peristalsis, protect gastric mucosa, diminish inflammation and relieve pain. Commonly used drugs are Pinellia ternata, Wazi, Fingered Citron Tablets, Cardamom, Curcuma Rhizome, Fructus Aurantii and so on. In a word, the combination of hormone and traditional Chinese medicine can strengthen the therapeutic effect and obviously reduce the side effects.
How should patients with lupus erythematosus adjust their diet?
Systemic lupus erythematosus (SLE) is an autoimmune disease that damages many systems and organs. The onset is often accompanied by fever, which belongs to a chronic wasting disease. Therefore, in the treatment of this disease, it is necessary not only to use drugs correctly, but also to prepare the patient's diet, because there has been a saying that medicine and food are homologous since ancient times. Preparing the patient's diet can not only enhance the patient's physique, but also help the drug to play its best role. The principle of dietary distribution for patients with lupus erythematosus should be high protein, low fat, low salt, low sugar, and foods rich in vitamins and calcium. More than 50% patients with lupus erythematosus have obvious renal damage. Protein often loses a lot of urine, which leads to hypoproteinemia and edema, and causes various diseases in the body. Therefore, in order to replenish enough protein in time, protein should give priority to animal high-quality protein, such as milk, eggs and lean meat. The intake should be appropriate. No more than two ounces of lean meat and no more than two eggs per person per day. If the intake is too high, patients will not be able to fully absorb it, which will also increase the burden on the kidneys. Patients with proteinuria-positive nephropathy should eat less or no beans and bean products. Clinically, the energy metabolism of patients with lupus erythematosus is disordered, and at the same time, some patients also form hyperlipidemia, especially when patients are accompanied by fever, and their digestive function declines. It is advisable to eat more light and digestible food instead of big fish and meat rich in fat. Most patients with kidney invasion are accompanied by edema, which can lead to water and sodium retention when hormone therapy is used alone. Therefore, it is necessary to limit the salt intake of patients and give them a low-salt diet to avoid the aggravation of edema symptoms. Hormone is the first choice for treating lupus erythematosus. Long-term use of hormones in patients with lupus erythematosus can often affect the insulin secretion function of pancreas, reduce insulin secretion and disorder glucose metabolism, and even lead to diabetes in severe cases. Therefore, it is very necessary to advocate eating less high-sugar foods and limiting sugar intake among patients who use hormones for a long time. The pathological basis of lupus erythematosus is systemic vasculitis. At this time, vascular permeability increases, and visceral inflammation or Raynaud's syndrome appears. Therefore, we should eat more foods containing vitamin C. Patients who take hormone therapy for a long time can cause calcium and phosphorus metabolism disorder, bone calcium loss, osteoporosis and even bone necrosis in severe cases. Therefore, in addition to taking calcium supplements, we should eat more calcium-containing foods.
Dietary taboos in patients with lupus erythematosus
The taboo of lupus erythematosus is quite confusing among the people, even among different doctors, opinions are quite different. There is even a person who mystifies and lists all the taboo foods except white flour and a few vegetables, which makes people feel at a loss. This is unfounded and will affect the nutritional status of patients for a long time. Clinical observation shows that some foods can induce or aggravate lupus, which are arranged as follows for patients' reference: 1, seafood. The common people are commonly known as hair objects. Some patients with lupus erythematosus will have allergic reactions after eating seafood (most of them are allergic), which will induce or aggravate the condition. 2. Mutton, dog meat, venison and longan. The patients with lupus erythematosus are characterized by yin deficiency and internal heat. After eating, the symptoms of getting angry can be aggravated. 3, coriander, celery. Long-term consumption causes light sensitivity, aggravates erythema and skin lesions on patients' faces, and is not suitable for eating. 4. Spicy food. Such as pepper, raw onion, raw garlic, etc. It can aggravate the internal heat phenomenon of patients and is not suitable for eating. Smoking and drinking are absolutely forbidden. In fact, the taboo of lupus erythematosus is very complicated and varies from person to person. These taboos listed above are only general. Because of the great differences among individuals, individual problems should be treated individually. The principle of mastering is neither "choking on food" nor "reckless", and patients can master it appropriately according to their own personal experience.
Can lupus erythematosus be inherited?
Because lupus erythematosus patients are mostly women of childbearing age, whether lupus erythematosus is hereditary has naturally become a matter of great concern to patients and their families. A large number of genetic epidemiological investigations have proved that lupus erythematosus has a certain genetic tendency. It has been found that the incidence of close relatives of lupus erythematosus patients is 5~ 12%, and the incidence of fraternal twins is 23~69%, indicating that heredity is related to the occurrence of this disease. From the genetic point of view, there is something called human leukocyte antigen (HLA) on the short arm of human chromosome 6, which is composed of many genes and closely related to human heredity. HLA is divided into class I, class II and class III genes. It is found that HLA-II molecules are closely related to the susceptibility of lupus erythematosus and the formation of various autoantibodies in the pathogenesis of lupus erythematosus. Through testing, the incidence of lupus erythematosus in people with HLA-DR2 and HLA-DR3 genes is much higher than that in normal control population, which also proves the genetic tendency of the disease. But clinically, we also see that many children born to patients with lupus erythematosus are healthy and have no lupus erythematosus. In fact, the pathogenesis of lupus erythematosus is the result of a variety of comprehensive factors, including infection, endocrine and environmental effects. In particular, it should be pointed out that mental factors are a very important reason for inducing and aggravating this disease. According to this, we can only say that lupus erythematosus has a genetic tendency, not a genetic disease, so patients with lupus erythematosus don't have to worry too much about their illness being passed on to their children.
How to reduce hormone after lupus remission?
After lupus remission, hormones should be gradually reduced. Improper reduction method will cause lupus recurrence. There are two reduction methods that should be avoided. First, some patients live in remote areas and it is inconvenient to buy medicine. When you run out of hormones, you don't have to. Second, some patients, especially young women, are worried about body shape changes, and hormones often decrease too fast. Both of the above conditions may cause lupus recurrence. Most patients want doctors to tell them a specific method, such as how many days and how long it takes to reduce one tablet. In fact, every patient's condition is different, and everyone's reaction to drugs is different. It is hard to say that there is a fixed plan, but there are several principles to follow. After the disease is basically controlled, you can start to reduce the amount. When the daily dose is more than 40mg, it can be reduced by 10% each time, which is about one piece of prednisone. Once every one or two weeks. When the daily dose is 25mg, the reduction rate is gradually slow, with an interval of 4 ~ 8 weeks. Pay attention to whether there are any new changes such as low fever, burnout, rash, myalgia, joint pain, oral ulcer and hair loss before each reduction. , whether there is a decrease in complement, whether the anti-ds-DNA antibody turns negative or the titer increases, whether there is proteinuria and hemogram changes. If there are no problems with symptoms and tests, you can continue to reduce the amount. If the possibility of recurrence is suspected, the drug should be stopped and closely observed. Patients with nephritis, thrombocytopenia, interstitial pneumonia and other important organs often need a maintenance dose of 15 ~ 10mg/ day, which may not be completely reduced.