TCM FOR LUPUS: Eastern and Western Medicine Gets Different Outcomes

Since the protocols and scientific concepts that govern western medicine and traditional Chinese medicine vary greatly, I would like to introduce lupus erythematosus from two different viewpoints.

Western Medicine

Systemic lupus erythematosus, like rheumatoid arthritis, is an autoimmune disease in which the body’s disease-fighting mechanisms have somehow gone awry. With this disease, antibodies that should attack disease-causing agents such as viruses, bacteria, and allergens – instead attack the body’s own tissues, causing a wide variety of signs and symptoms.

General Symptoms – The symptoms of lupus vary greatly from patient to patient, the most common being joint inflammation, usually occurring in the knuckles, wrists, and knees. The arthritis of lupus is less severe than rheumatoid arthritis, and it seldom produces joint damage or deformity. Skin rashes also occur in a majority of patients; the ‘butterfly’ rash, which covers the nose and cheeks, is a particularly distinguishing sign, but both rashes and joint inflammation may appear in any part of the body.

Other signs and symptoms include low grade fever, fatigue, persistent swollen lymph nodes, unusual sensitivity to sunlight, loss of weight and appetite, loss of hair, and ulceration in the mouth and nose. The kidneys are affected in a majority of cases, but the severity of kidney involvement varies widely, from mild dysfunction apparent only in laboratory tests, to complete kidney failure requiring dialysis or transplant of a healthy kidney.

Lupus also causes pleurisy (inflammation of the pleura, the membrane that covers the lungs) and inflammation of both the inner and outer membranes of the heart (endocarditis and pericarditis). Lupus can affect the central nervous system, causing seizures and psychotic symptoms.

As the most common symptoms of lupus are similar to those of rheumatic fever or rheumatoid arthritis, a doctor will sometimes misdiagnose the condition.

Lupus runs an unpredictable course. In most patients, symptom-free periods alternate with periods when symptoms flare. These symptoms are often mild enough that many patients experience them for years without detecting a pattern or discovering their cause.

Western Medical Treatment – For mild symptoms, anti-inflammatory drugs such as aspirin are prescribed. Those who find aspirin hard to tolerate will take other nonsteroidal anti-inflammatory drugs. Both can reduce inflammation and ease joint pain, but both also have side effects.

If anti-inflammatory drugs fail to relieve symptoms, corticosteroids are used. Oral corticosteroids are often prescribed for arthritis and kidney problems, and corticosteroid ointments are applied topically to rashes. These medications have serious side effects. Antimalarial drugs, derived from quinine, are an alternative to steroids for patients who cannot tolerate or benefit from other anti-inflammatory durgs. Antimalarials are particularly effective against skin rashes, and can also relieve arthritis. Like steroids however, antimalarial drugs have serious side effects and so are reserved for more difficult cases.

Immunosuppressant drugs, which inhibit the immune response, are helpful for some patients. These drugs, which carry a risk of dangerous side effects, are commonly used to prevent rejection of transplanted organs; usually, they are reserved for patients who fail to respond to other treatments or who are experiencing intolerable steroid side effects.

Traditional Chinese Medicine

Since the science concepts  and special terminology used in Traditional Chinese Medicine are so different from western medicine, some concepts must be introduced. Below are listed the symptoms that show up for all six types of imbalance common to the condition of lupus:

1. Kidney yin deficiency: symptoms include night sweats, thinning or loss of hair, sore back, menstrual disorders. There is also ringing in the ears; tongue colour is red; the pulse is fine, hollow and rapid.
2. Kidney yang deficiency: symptoms include day sweats or automatic sweats; dislike of cold; weak back; no menstrual period or light period. As well, the tongue colour is light; the tongue shape is enlarged.
3. Lung yin deficiency: symptoms include dry cough, sore throat, afternoon fever; tongue and pulse symptoms are similar to kidney yin deficiency.  When the disease progresses, it will lead into kidney yin deficiency.
4. Liver deficiency: symptoms include headache, joint pain, numbness of the limbs, blurred vision, menstrual period could be light or the colour is light. As well, tongue colour is light; pulse is hollow.
5. Spleen deficiency: symptoms include lack of appetite, fullness of stomach, fatigue, swollen face, tongue colour is very light or white, tongue coating is thin, pulse is hollow.
6. Liver stagnation: symptoms include irritability, frustration, angers easily, menstrual period is usually heavy, tongue colour is dull, pulse is wiry or tight.

These six types of imbalance can show individually or in combination. For example, the symptoms of kidney yin deficiency can combine with those of spleen deficiency. (Note that people who suffer from lupus present the same general symptoms to both western modern medicine and TCM practitioners, the exception being there is no such term as ‘lupus’ in Chinese medicine.)

In Traditional Chinese Medicine, lupus is mainly viewed as stemming from internal injury, from the seven emotions; a simple term is ‘emotional distress.’ I use acupuncture and Chinese herbs to treat this disease with good results, but there is no standard formula. The treatment has to be based on which types of imbalance are present and must take into account the fact that a patient’s symptoms can change, and that each individual’s condition is unique and must be treated accordingly. In some cases the herbal dosage prescribed will be light; in others very heavy.

Caveat

A common misunderstanding is that all herbs are natural and so have no side effects. The truth is that the wrong formula applied to the wrong situation will adversely affect the course of the disease, and may actually harm the patient. When I was living in California, I had helped a patient who had ties to a pharmaceutical company. After treatment, the patient’s parents were so impressed with his recovery that they approached me with a proposal to mass produce what they called my “secret Chinese recipe” and sell it to the public. I refused the offer because it is against both my own personal philosophy and Chinese medical theory.