THE TCM MANAGEMENT

OF AUTOIMMUNE
DISORDERS – LUPUS
(PART I)
Baisong Zhong Ph.D, L.Ac, M.D (China)
Associate Prof. of ACAOM

Website: www.easternbalancetcm.com
E-mail: Bzhong@acaom.edu
Contents

 TCM Treatment of Systemic Lupus

Erythematosus (SLE)
 The Introduction of the Etiology,
Pathology Treatment of TCM on
Autoimmune Diseases (i.e. Lupus)
 TCM Prevention & Treatment of
the Chemo-therapeutic Side
Effects during Autoimmune
Disorders
 What is an Autoimmune
Disorder?
 An autoimmune disorder is a malfunction of
the body's immune system, causing the body
to attack its own tissues.
Normally, the immune system can distinguish what is self
from what is not self or foreign (see Biology of the Immune
System: Introduction) and reacts against foreign
substances called antigens. Antigens may be contained
within or on bacteria, viruses, other microorganisms, or
cancer cells. Antigens may exist on their own—for
example, as pollen or food molecules. Sometimes the
immune system malfunctions, interpreting the body's own
tissues as foreign and producing abnormal antibodies
(called autoantibodies) or immune cells that target and
attack particular cells or tissues of the body. This response
is called an autoimmune reaction. It results in inflammation
and tissue damage. Different cells or tissues are targeted
in the various autoimmune disorders.
What is an Autoimmune Disorder?
cont.
 The disorders include:
 Lupus,
 Hashimoto’s thyroiditis

 Myethenia Gravis

 Scleroderma

 Multiple Sclerosis

 Sjogren’s Syndrome

 Rheumatoid arthritis.
Introduction
 Systemic lupus erythematosus
(SLE,lupus) is a chronic inflammatory
connective tissue disorder that can
involve joints, kidneys, mucous
membranes, and blood vessel walls.

About 90% of people who have lupus
are young women in their late teens to
30s, but children (mostly girls) and
older men and women can also be
affected. Lupus occurs in all parts of
the world but may be more common in
Blacks and Asians.
Manifestations & Signs:
Symptoms vary greatly from person to
person, but can include:
 Fever: high fever or episodes (called flare-ups) of
fever
 Pain: headaches, arthralgias, chest pain
 Skin rashes: including a butterfly-like redness across
the
nose and cheeks (malar butterfly erythema)
 Other symptoms: cough, breathlessness and angina
Examples:
Etiology and Pathology
Congenital deficiency, external contraction
of the six environmental evils, unregulated
emotions and unregulated eating habits
and drinking alcohol, over-taxation are the
causes of SLE.
Etiology and Pathology, Chart 1

1. Sunshine
Wind, dampness & heat Cold damp Bi
2. Wind block channels Damp heat Bi
Exterior-6

3. Cold
4. Heat Excessive or deficient
Evils

heat (in five Zang

5. Dampness
organs)

Erythematous
6. Summer-heat causes reckless
movement
of blood
Weak constitution of

rash
Yin deficiency
body
Disorders

of
Interior-

Liver & Kidney

organs

Emotional Qi & Yang Deficiency Edema

disorders
Etiology and Pathology, Cont.
Generally speaking, the primary pathology
of SLE is Zong-organ deficiency, the
secondary pathology of SLE is excess
(heat, toxin, dampness, bloodstasis).
Principle of the Treatment
 Purging the excess evils for excess
pattern or an acute stage.
 Tonifying the deficiency for deficient

pattern or a chronic stage.

Pattern & Suggested Measures
1. Excessive heat toxicity
Symptoms/Signs:
 High fever that is temporarily reduced after
perspiration followed by immediate elevation of
temperature
 Red face with erythematous rash
 Soreness and pain of the muscles and joints
 Irritability
 Thirst with desire for cold beverages
 Dark red tongue
 Rapid, slippery or rapid flooding pulse
Pattern & Suggested Measures,
cont.
 Treatment Measures: clear heat & purge fire
Formula: Modified Qing Wen Bai Du Yin(clear epidemics
and overcome toxin decoction)
 Shi gao (Gypsum) 30g
 Zhi mu (Anemarrhena rhizome) 9g
 Shui niu jiao (Cornu Bubali) 15g
 Sheng di huang (Uncooked radix rehnanniae) 15g
 Xuan shen (Radix scrophulariae Ningpoensis) 10g
 Sheng di huang (Uncooked Radix Rehmanniae) 12g
 Jin yin hua (Honeysuckle flower) 9g
 Lian qiao (Forsythia fruit) 6g
 Huang lian (Coptis root) 9g
 Huang qin (Scutellaria root) 6g
 Huang bai (Phellodendron bark) 6g
 Zhi zi (Capejasmine fruit) 6g
Pattern & Suggested Measures,
cont.
 Acupuncture Points:
Shi Xuan (M-UE1) LI 4 (He Gu)
UB 40 (Wei Zhong) PC 3 (Qu Ze)
Du 10 (Ling Tai)
Modification:
 For dark, purple skin lesions: Sp10 (Xue
Hai)
LI 11 (Qu Chi)
 For spirit cloudy: Du 26 (Shui Gou)
Pattern & Suggested Measures,
cont.
2. Yin deficiency with empty heat
 Symptoms/Signs:
 Butterfly rash aggravated after exposure to sunlight, it is
bright red
 Low-grade fever
 Dry mouth
 Epistaxis
 Irritability
 Insomnia
 Red eyes
 Red tongue with no coating
 Rapid thready pulse
Pattern & Suggested Measures,
cont.
 Treatment Measures: Nourish Yin & clear
heat
Formula: Yu nu jian (Jade Woman decoction) & Zeng ye
tang (Increase Fluid Decoction)
 Shi gao (Gypsum) 15g
 Zhi mu (Anemarrhena rhizome 9g
 Shu di huang (Prepared rehmannia) 9g
 Mai men dong (Ophiopogon root) 6g
 Niu xi (Cyathula root) 6g
 Xuan shen (Radix Scrophulariae ningpoensis) 10g
 Sheng di huang (Uncooked Radix Rehmanniae) 12g
Pattern & Suggested Measures,
cont.
 Acupuncture Points:
Sp 6 (San Yin Jiao) LI 4 (He Gu)
Liv 3 (Tai Chong) GB34 (Yang Ling
Qiuan)
Modification:
 For severe stomach heat: St 44 (Nei Ting)
 For Kidney deficiency: Ki 3 (Tai Xi), Ki 6
(Zhao Hai)
Pattern & Suggested Measures,
cont.
3. Blood stasis with heat
 Symptoms/Signs:
 Rash in dark red color

 Petechiae spreading all over limbs

 Epistaxis
 Irritability
 Insomnia
 Dark scanty urination
 Deep red tongue with petechiae
 Thready, choppy pulse
Pattern & Suggested Measures,
cont.
 Treatment Measures: Cool & invigorate
blood, stop bleeding
Formula: Xi Jiao Di Huang Tang (Rhinoceros Horn
and Rehmannia Decoction)
 Shui niu jiao (Cornu Bubali) 20g
 Sheng di huang (Radix Rehmanniae Glutinosae)
30g
 Shao yao (Radix Paeoniae Lactiflorae) 9g
 Mu dan pi (Cortex Moutan Radixis) 6g
Pattern & Suggested Measures,
cont.
 Acupuncture Points:
Er Jian, LI 11 (Qu Chi)
St 44 (Nei Ting) UB 40 (Wei
Zhong)
Sp 10 (Xue Hai)
Pattern & Suggested Measures,
cont.
4. Spleen and Kidney Deficiency
 Symptoms/Signs:
 Malar flush
 Splinter hemorrhage
 Malaise
 Severe pitting edema in lower limbs
 Pale tongue with white coating
 Deep thready pulse
Pattern & Suggested Measures,
cont.
Treatment Measures: Tonify spleen and
kidney, promote urination
Formula: Ji Sheng Shen Qi Wan
 Shu Di Huang (Radix Rehmanniae Glutinosae Conquitae )10g
 Gou Qi Zi (Fructus Lycii )10g
 Fu Ling (Sclerotium Poriae Cocos )15g
 Shan Zhu Yu (Fructus Corni Officinalis )10g
 Fu Zi (Radix Lateralis Aconiti Carmichaeli Praeparata )10g
 Ze Xie (Rhizoma Alismatis Orientalis )12g
 Che Qian Zi (Semen Plantaginis )10g
Pattern & Suggested Measures,
cont.
 Acupuncture Points:
Du4 (Ming Men) BU 23 (Shen Shu)
St 36 (Zhu San Li) Sp 6 (San Yin
Jiao)
 Case Study – Ni Ya, Female, 37
April 20, 2006
 Facial pain for 9
months. It started from
temple and lower part
of face spreading to all
area around mouth.
Now on both sides
were 10/10 at
beginning-could not
chew and sleep. Right
3th,4th, and 5th fingers
cold, pale, purple and 6/29/2006
pain. Rashes of all
body, itching. Less
period. Deep and week
pulse. Tongue is the
following:
Case Study, cont.

6/1/2006
6/1/2006
Case Study, cont.
Lab Exam: 11/15/05
 ANA 1:10000(Normal <1:100)

 DNP(快速SLE因子) Positive

 U1RNP Positive

 RF 20.90(Normal <15)

 ALP 26(Normal 42-141)

 A/G 1.24(Normal1.5/2.5)

 TG1.98(Normal 0.56-1.70)

 HDL0.94(Normal 1.04-1.55)

 Apo-A163.40(Normal 100-160)

 ECG: deficient blood of Ht

Case Study, cont.

Western TCM Diagnosis:

Diagnosis: Bi syndrome due
to wind and
Raynaud’s dampness
disease blocking
Vasculitis meridians
Lupus
Rashes due to
Sjogren’s blood
disease deficiency and
stasis with
Fatty Liver internal wind
Ht blood
 Case Study, cont.
 EX: Acupuncture points:
GB20, LI11, SJ5, Lu10, Ren12,
Sp10,LI4,St36,Sp6,Lu3
 Herbal formula: Dang Gui Shao Yao Tang
(T23)
May 4th: Facial pain no change, Rash is less.
Fingers cold, pale and purple and pain is
gone.
 Acupuncture points:

Ren12,6, GB20,8, LI4, LI11, Liv3, Sp10, Sp6,

St36
 Case Study, cont.
Herbs:
 Shu Di 9g
11/05/06
 Dang Gui9g
+Ba Xie
 Bai Shao30g Si Wu Tang+Wu Pi Tang,
 Bai Xian Pi 9g Yi Yi Ren, Fang Feng,
 Fang Feng9g Gui Zhi, Yin Hua Teng
 Di Gu Pi 9g
 Dan Shen 9g

 Zhi Gan Cao9g

 Ju Hua 9g
 Di Fu Zhi 9g
 Case Study, cont.
05/25/06
TG166 (Normal <150)
HDL27 (Normal >39)
ANA 1:1280

10/12/2006
7/27/2006
10/12/2006
TCM PREVENTION &
TREATMENT OF THE
CHEMOTHERAPUTIC SIDE
EFFECTS DURING
AUTOIMMUNE DISORDERS OF
CONNECTIVE TISSUE – PART 2
Baisong Zhong Ph.D, L.Ac, M.D (China)
Associate Prof. of ACAOM

Website: www.easternbalancetcm.com
E-mail: Bzhong@acaom.edu
Treatment of Western Medicine &
Prognosis
 Lupus tends to be chronic and relapsing,
often with symptom-free periods that can
last for years. Flare-ups occur less often
after menopause. Because many people
are being diagnosed earlier than in the
past and because better treatment is
available, the prognosis has improved
markedly over the last two decades.
However, because the course of lupus is
unpredictable, the prognosis varies widely.
Usually, if the initial inflammation is
controlled, the long-term prognosis is
good.
Treatment of Western Medicine &
Prognosis
 Lupus tends to be chronic and relapsing,
often with symptom-free periods that can
last for years. Flare-ups occur less often
after menopause. Because many people
are being diagnosed earlier than in the
past and because better treatment is
available, the prognosis has improved
markedly over the last two decades.
However, because the course of lupus is
unpredictable, the prognosis varies widely.
Usually, if the initial inflammation is
controlled, the long-term prognosis is
good.
Treatment of Western Medicine &
Prognosis
Severe lupus is treated immediately with a
corticosteroid such as prednisone,
Sometimes an immunosuppressive drug
such as azathioprine, cyclophosphamide
is given to suppress the body's
autoimmune attack. Mycophenylate
mofetil is another new alternative
immunosuppressive drug.
Treatment of Western Medicine &
Prognosis
Generally speaking, these are the side
effects of Western Medicine for
autoimmune diseases:
 Side-effects on the endocrine system (sterol
affects on ACTH)
 Immuno–depression (sterol)

 Adrenal cortix addiction (sterol)

 Effects on hair, bone, digestive and

reproductive system (azathioprine,
cyclophosphamide).
Etiology and Pathology
Cause heat & Fever, anxiety,
toxins in the body constipation, sores, rash, bleeding,
etal.
Dampness inside the body acne, fatigue, full
abdomen, turbid urine

Injure Yin (Lu, Ht, Liv, St, Ki), Low grade fever, night
sweats,
deficiency of Zang fu organs rash, hot sensation, etal.
Chemicals:
Sweet, warm, hot, Injure Qi or Yang Fatigue, obesity, edema,
pungent and dry poor appetite, loose stool, sweating
susceptive, irregular
menstruation, infertility

Injure blood fatigue, palpitation, dizziness,

pale face &
lips
The Prevention of side-effects of
Prednisone
 Early stage: taking prednisone for the first
10 days around.
Treatment: treating primary differentiation of
syndrome.
 Middle stage: after taking high dosage of
prednisone for long period of time. The
hyperactivity of Yang due to Yin deficiency
becomes evident.
Manifestations: red face, overeating, thirsty,
red tongue with less coating, rapid pulse.
The Prevention of side-effects of
Prednisone
Treatment: nourishing Yin & clear fire
Formula: Zuo Gui Wan (restore the Left Pill) (T178)
 Shu Di Huang (Radix Rehmanniae Glutinosae
Conquitae)
 Shan Yao (Radix Dioscoreae Oppositae)
 Gou Qi Zi (Fructus Lycii)
 Shan Zhu Yu (Fructus Corni Officinalis)
 Niu Xi (Radix Achyranthis Bidentatae)
 Tu Si Zi (Semen Cuscutae Chinensis)
The Prevention of side-effects of
Prednisone
Acupuncture Points:
Sp6 (San Yin Jiao) Liv 3 (Tai Cong)
Ki3 (Tai Xi) Lu 5 (Chi Zhe)
 Taper off Dosage Stage: patient’s symptoms are
stable after taking the prednisone. The Yang deficiency
becomes evident. Use TCM to reduce dependence on
the prednisone and re-occurrence
Manifestations: fatigue, spontaneous sweating,
susceptive, poor appetite, obesity, profuse urine, pale
tongue with thick white coating, deep slow pulse.

Treatment: tonifying spleen & kidney Yang

The Prevention of side-effects of
Prednisone
 Formula: Jin Kui Shen Qi Wan (Kidney Qi Pill from
the Golden Cabinet) (T07)
 Shu Di Huang (Radix Rehmanniae Glutinosae
Conquitae)
 Shan Yao (Radix Dioscoreae Oppositae)
 Shan Zhu Yu (Fructus Corni Officinalis)
 Fu Ling (Sclerotium Poriae Cocos)
 Mu Dan Pi (Cortex Moutan Radixis)
 Ze Xie (Rhizoma Alismatis Orientalis)
 Fu Zi (Radix Lateralis Aconiti Carmichaeli
Praeparata)
 Gui Zhi (Ramulus Cinnamomi Cassiae)
The Prevention of side-effects of
Prednisone
Acupuncture Points:
Ming men (Du 4) Shen Shu (UB 23)
Zhu San Li (St 36) Qi Hai (Ren 6)
The Prevention of side-effects of an
Immunosuppressive Drug
(ISD, such as azathioprine, cyclophosphamide)
 The Prevention of side-effects of ISD on
digestive system: taking ISD for the first 10
days around.
Manifestations: nausea, vomiting, poor appetite,
abdominal pain, diarrhea or constipation,
fatigue, pale tongue with thin coating, weak
pulse

Treatment: tonifying spleen & stomach, regular

Qi
(Treating patients before the patients have been
The Prevention of side-effects of
an Immunosuppressive Drug, cont.

Formula: Xiang Sha Liu Jun Zi Tang (Six

Gentaleman Decoction with Aucklandia
and Amomun) (T169)

Acupuncture Points:
Nei Guan (PC6) Zhu San Li (St 36)
San Yin Jiao (Sp6) Zhong Wan (Ren 12)
The Prevention the side-effect of ISD
on Hematopietic System
The Prevention the side-effect of ISD
on hematopietic system: after being
treated by ISD one month around. The
liver & kidney essence deficiency
becomes evident.
Manifestations: lost hair, lower WBC,
fatigue,
pale face, insomnia, pale tongue, deep
weak pulse

Treatment: Tonifying kidney essence &

bone marrow.
The Prevention the side-effect of
ISD on Hematopietic System
Formula: Huang Jing Tang (Yellow golden
Decoction)
 Gou Qi Zi
 Sang Shen (Frucuts Mori Albae)
 Huang Jing (Rhizoma Polygonati)
 Huang Qi (Radix Astragali Membranacei)

Acupuncture Points:
San Yin Jiao (Sp 6) Jue Gu
(GB 39
Zhao Hai (Ki6) Xue Hai (Sp
10)
The Prevention of side-effects of
ISD on Gonads & Reproductive
System
 The Prevention of side-effects of ISD on
gonads & reproductive system: after being
treated by ISD six month around. The kidney
Yang deficiency becomes evident.
Manifestations: infertility, lower sex drive,
irregular menstruation, fatigue, pale tongue,
weak pulse
Treatment: tonifying Kidney Yin and Yang
 The Prevention of side-effects of
ISD on Gonads & Reproductive
system
Formula: Wu Zi Yan Zong Wan
Er Zhi Wan
 Fu Pen Zi (Fructus Rubi Chingii)
 Gou Qi Zi (Fructus Lycii)
 Tu Si Zi (Semen Cuscutae Chinensis)
 Wu Wei Zi (Fructus Schisandrae Chinensis)
 Che Qian Zi (Semen Plantaginis)
 Nu Zhen Zi (Fructus Ligustri Lucidi)
 Han Lian Cao (Herba Ecliptae Prostratae)
Acupuncture Points:
Ming Men (Du 4) Guan Yuan(Ren 3)
Shen Shui (UB 23) Tai Xi (Ki 3)
Notes
Notes:
 No sunshine.
 No spicy food.
 No seafood / greasy food.
References
1.Clinic Observation on Nephrotic Syndrome of Lupus Nephritis treated with Integrated
TCM. Wu Qiao, Ye Regao, Wu Kaimu,et al. Chinese J. of TCM & Western Medicine.
1998;(12) 718
2. Clinic Observation on SLE with Removing Blood Stasis. Wu Jialin, Bao Xiaohui, Zhuo
zhiling, et al. Chinese J. of TCM & Western Medicine. 2003;(11) 860.
3. On the Diagnosis and Treatment with TCM and Western Medicine. Chinese J. of TCM &
Western Medicine. 2000;(12): 883.
4. Therapeutic Effects of 138 Cases of Hyperthyroidism Treated wi thAcupoint Catgut
Embedding Therapy Combined with Chinese Drug.Tian YuanSheng; Yang WeiQian*;
Cao JinMei. Chinese Acupuncuture & Moxibustion 2002 , 22 ( 9 ): 585-586.
5. Effect of Xiaoying granule on heart rate,body temperature andserum T~3|,T~4| in
experimental hyperthyroidism model of rats. Jia XiLian; Li PeiLin; Xiong XiangMing; Qu
ZhuQiu. Hebei Journal of Traditional Chinese Medicine 2002 , 24 ( 8 ): 632-635
6. Association of the differentiating Zheng of TCM with thyroid hormone receptor mRNA in
patients with hyperthyroidism & hypothyroidism. Li XiaoMiao; Wang Li; Zhang NanYan; Li
Yuan; Li DeQiang. Journal of The Fourth Military Medical University 2001 , 22 ( 16 ):
1512-1514.
 Thank You!

Dr. Baisong Zhong’s final webinar:

 Thursday, July 12, 2012: The

Abdominal Nine Needles for

Improving the Side Effects of
HAART of HIV/AIDS
Questions/Discussions