Western medicine is effective, and treatment characteristics for patients
with kidney disease but the disadvantages of repeated illness, which bring great
harm to the patient's physical and mental, so choose Chinese medicine treatment
of kidney patientsin recent years more and more, Chinese medicine treatment of
lupus kidneyinflammationeffect how to? Effective treatment of lupus nephritis.
Lupus nephritis is an autoimmunedisease, its exact etiology is not entirely
clear. Also need long term follow up for Chinese medical treatment, regular
review to maintain the optimistic attitude, I would like todoctor's advice to
actively cooperate with the treatment.
1, lupus nephritis treatment is effective in reducing the recurrence of lupus
nephritis. Easyrecurrence of lupus nephritis, many kidney patients in the
overworked, due to decreased resistance to infection and other incentives under
the action of recurrent disease, lupus isactive again. Thus preventing the
recurrence of lupus is the key to improved patient outcomes.
2, Chinese medicine treatment can reduce the side effects of hormones and
immunosuppressive agents, and improve patients' quality of life. Variety of side
effectswill occur in a process using hormones and immunosuppressive agents. In
this process,and with the use of Chinese medicine can significantly reduce these
side effects,improve patient symptoms, improve the quality of life of patients
with lupus nephritis.Lupus nephritis, the best approach to Chinese medicine
treatment to avoid some side effects of Western medicine.
3, can also promote the remission of lupus nephritis. Syndrome
differentiation oftraditional Chinese medicine, Chinese medicine practitioners
believe that at this time of the pathogenesis of flaming toxic heat, blood
stasis obstructing the network-basedkidney disease treatment should be
Qingrejiedu Huoxuetongluo. The best of traditional Chinese medicine treatment
for lupus nephritis kidney disease treatment, more effective control of lupus nephritis
2012年4月20日星期五
2012年4月19日星期四
Lupus nephritis diet low pay attention to
Lupus nephritis has been no stranger to the people. Lupus nephritis diet low
pay attention!Lupus nephritis diet become an important means of adjuvant
therapy. Here wemake a simple introduction for lupus nephritis diet.
1, lupus nephritis should be low-fat diet: in patients with systemic lupus erythematosusactivity, poor digestive function, Yichi light digestible food unfit for human consumptioncontaining more fat greasy food.
2, lupus nephritis should be low-sugar diet: systemic lupus erythematosus patients with long-term use of glucocorticoid, could easily cause a steroid diabetes and Cushing's syndrome, it should be appropriate to control appetite, eat less sugar content of foods that are high.
3, lupus nephritis should be low-salt diet: corticosteroids, or patients with kidney damageeasily lead to water and sodium retention, causing edema, so the low-salt diet. Lupus nephritis in patients with eating three low pay attention to: the attention to low-fat, low sugar, low salt, so as to in the Oh options to ensure the treatment effect in the correct premise.
Need to be reminded fighter yes, some patients Yichi patients with lupus nephritiscauses and circumstances vary, and some food, some patients should not eat. Best toconsult a specialist before eating.
1, lupus nephritis should be low-fat diet: in patients with systemic lupus erythematosusactivity, poor digestive function, Yichi light digestible food unfit for human consumptioncontaining more fat greasy food.
2, lupus nephritis should be low-sugar diet: systemic lupus erythematosus patients with long-term use of glucocorticoid, could easily cause a steroid diabetes and Cushing's syndrome, it should be appropriate to control appetite, eat less sugar content of foods that are high.
3, lupus nephritis should be low-salt diet: corticosteroids, or patients with kidney damageeasily lead to water and sodium retention, causing edema, so the low-salt diet. Lupus nephritis in patients with eating three low pay attention to: the attention to low-fat, low sugar, low salt, so as to in the Oh options to ensure the treatment effect in the correct premise.
Need to be reminded fighter yes, some patients Yichi patients with lupus nephritiscauses and circumstances vary, and some food, some patients should not eat. Best toconsult a specialist before eating.
2012年4月15日星期日
Lupus nephritis treatment
Lupus nephritis treatment? Experts pointed out that in the course of treatment of lupus nephritis, regardless of the use of Chinese medicine for treatment, or the use of Western medicine to implement the treatment, treatment should be obtained through the followingways:
, Vasodilators: vasodilator purpose is to try to improve the state of the system of thekidney blood circulation blood to alleviate renal inherent cell ischemia and hypoxia,provide a good environment for the next repair of epithelial cells and mesangial cells.
2, anti-inflammatory: The aim is to reduce the infiltration of inflammatory cells, reducere-injury of glomerular epithelial cells.
3, anticoagulation: main in order to reduce the pressure of thrombosis, in order to lay the foundation for the repair of epithelial cells.
4, degradation: mainly excreted with the urine in order to make clear the immune complexes and the extracellular matrix.
Lupus nephritis treatment? Glomerular capillary epithelial cells will be fixed through the rational application of these four treatments, its normal physiological function of natural recovery. Epithelial barrier function will receive a reply, after the recovery of thesefunctions, protein and other clinical symptoms also vanish.
2012年4月13日星期五
Lupus nephritis, kidney damage manifested
About 70% of patients with varying degrees of renal damage in the clinical manifestations of varying degrees of proteinuria, microscopic hematuria is more common, often accompanied by tubular urine and renal function impairment. The majority of patients with renal impairment to a lesser degree. Some patients although the clinical symptoms, but are not the development of renal insufficiency. Only a small number of renal damage in patients with renal failure. Hypertension is often associated with renal failure extent, become an important factor affecting prognosis. (A) asymptomatic proteinuria and (or) the hematuria type: This type is more common.Mainly for light - moderate proteinuria (<2.5g or (and) hematuria. (B) type of acute nephritic syndrome: rare, clinical manifestations resembles a post-streptococcal acute nephritis. (C) rapidly progressive glomerulonephritis syndrome type: rare, clinically resembles rapidly progressive glomerulonephritis. Characterized by three months, serum creatinine increased by ≥ 1 times. Uremia occurred within weeks to months. (D) The nephrotic syndrome: This type is common, accounting for about 2/3, but not necessarily with hyperlipidemia. When not in treatment, the majority of 2 to 3 years to uremia. This type is often confused with primary nephrotic syndrome, it is noteworthy. (E) chronic nephritic syndrome: the performance of sustained proteinuria, hematuria, urinary tube, and varying degrees of edema, hypertension, anemia and renal insufficiency. Course of a long, delayed healing, and thus occurrence of uremia. (F) a small number of patients can be manifested as chronic tubule interstitial nephritis clinical manifestations of patients with clinical manifestations of the specific gravity and (or) reduce the osmotic pressure, nocturnal enuresis, high or hypokalemia and other electrolyte disorders. End-stage lupus nephritis uremia, the patient's clinical activities (including serology) may disappear or become typical.
Systemic manifestations of lupus nephritis
The most common systemic manifestations of lupus nephritis with unexplained
fever, arthritis, and skin and mucous membrane damage. The system is accompanied
by involvement of the liver, heart, central nervous system and blood-forming
organs, more than 1/3 of patients with polyserositis (pleural and
pericardial).
(A) General symptoms: Most patients showed generalized weakness, weight loss, 90% of patients have fever, some more than 39 ° C.
(B) of the skin, mucous membrane damage: The majority of patients the skin is exposed at the skin lesions, about half of patients with facial butterfly erythema, or hair loss.Visible urticaria in some patients, discoid erythema, the palm of your hand, refers to nail week erythema, purpura. Some patients with oral ulcers. These hair loss as the main indicators of the SLE disease activity.
(C) of the joints and muscles: 90% of patients with joint pain, common to the small joints in the limbs. About 30% of patients with muscle pain. Large quantities of irregular use of hormones can lead to some patients with aseptic necrosis of femoral head.
(D) cardiovascular: some patients can occur in pericarditis, generally short and mild, a few may occur in patients myocarditis performance. About 1/4 patients, there may be Raynaud's phenomenon.
(Five lung and pleura: Some patients may have pleurisy or lupus pneumonitis. But a common clinical SLE complicated infection caused by pneumonia, rather than lupus pneumonitis, should be noted.
(F) the blood system: ① red blood cells: 50% ~ 75% of patients showed positive pigment cell anemia; ② The white blood cells: 60% of the patients white blood cell count <4.5 x 109 / L, in particular, is the lymph decreased more significantly; ③ platelet: general slightly lower, a few can be severely reduced. Approximately 50% of patients with lymph node enlargement.
(G) the gastrointestinal tract: abdominal pain, may be associated with abdominal organ lesions caused by vasculitis. Liver, splenomegaly were found in 30%, 20% of patients.The small number of patients with ascites.
(H) of the nervous system: clinical manifestations of complex and diverse, of varying severity. Often show mental disorders such as depression, mental confusion, pay attention to the spirit and hormone-induced abnormal differentiated. The most notable is the epilepsy (15% ~ 50%), and the occasional migraine, peripheral neuritis.
(A) General symptoms: Most patients showed generalized weakness, weight loss, 90% of patients have fever, some more than 39 ° C.
(B) of the skin, mucous membrane damage: The majority of patients the skin is exposed at the skin lesions, about half of patients with facial butterfly erythema, or hair loss.Visible urticaria in some patients, discoid erythema, the palm of your hand, refers to nail week erythema, purpura. Some patients with oral ulcers. These hair loss as the main indicators of the SLE disease activity.
(C) of the joints and muscles: 90% of patients with joint pain, common to the small joints in the limbs. About 30% of patients with muscle pain. Large quantities of irregular use of hormones can lead to some patients with aseptic necrosis of femoral head.
(D) cardiovascular: some patients can occur in pericarditis, generally short and mild, a few may occur in patients myocarditis performance. About 1/4 patients, there may be Raynaud's phenomenon.
(Five lung and pleura: Some patients may have pleurisy or lupus pneumonitis. But a common clinical SLE complicated infection caused by pneumonia, rather than lupus pneumonitis, should be noted.
(F) the blood system: ① red blood cells: 50% ~ 75% of patients showed positive pigment cell anemia; ② The white blood cells: 60% of the patients white blood cell count <4.5 x 109 / L, in particular, is the lymph decreased more significantly; ③ platelet: general slightly lower, a few can be severely reduced. Approximately 50% of patients with lymph node enlargement.
(G) the gastrointestinal tract: abdominal pain, may be associated with abdominal organ lesions caused by vasculitis. Liver, splenomegaly were found in 30%, 20% of patients.The small number of patients with ascites.
(H) of the nervous system: clinical manifestations of complex and diverse, of varying severity. Often show mental disorders such as depression, mental confusion, pay attention to the spirit and hormone-induced abnormal differentiated. The most notable is the epilepsy (15% ~ 50%), and the occasional migraine, peripheral neuritis.
Lupus nephritis need chemotherapy?
Lupus nephritis in systemic lupus erythematosus renal different pathological
types ofimmune damage is accompanied by obvious clinical manifestations of a
disease ofkidney damage.
Lupus erythematosus is an autoimmune disease, the onset is slow, insidious occurrence of clinical manifestations are diverse and changeable. The disease can affect multiple systems of the body, multi-organ, can find a variety of autoantibodies in the patient's blood and organs. One of the autoimmune disease lupus erythematosus is a connective tissue disease range is divided into discoid lupus erythematosus (DLE), systemic lupus erythematosus (SLE), subacute cutaneous lupus erythematosus, lupus erythematosus and other types of deep.
Lupus nephritis need chemotherapy? How to be treated?
Lupus nephritis does not require chemotherapy medication principle is
1.Early oral steroid-based adjuvant drugs.
2.The standard amount of hormone invalid switch to the impact of hormone therapy.
3.The standard amount of hormone added azathioprine plus tripterygium film.
4.Infection with antibiotics.
5.Plasma exchange or dialysis therapy.
6. A kidney transplant.
7.Conditional should biopsy, pathological basis to guide therapy.
Lupus erythematosus is an autoimmune disease, the onset is slow, insidious occurrence of clinical manifestations are diverse and changeable. The disease can affect multiple systems of the body, multi-organ, can find a variety of autoantibodies in the patient's blood and organs. One of the autoimmune disease lupus erythematosus is a connective tissue disease range is divided into discoid lupus erythematosus (DLE), systemic lupus erythematosus (SLE), subacute cutaneous lupus erythematosus, lupus erythematosus and other types of deep.
Lupus nephritis need chemotherapy? How to be treated?
Lupus nephritis does not require chemotherapy medication principle is
1.Early oral steroid-based adjuvant drugs.
2.The standard amount of hormone invalid switch to the impact of hormone therapy.
3.The standard amount of hormone added azathioprine plus tripterygium film.
4.Infection with antibiotics.
5.Plasma exchange or dialysis therapy.
6. A kidney transplant.
7.Conditional should biopsy, pathological basis to guide therapy.
2012年4月10日星期二
Lupus nephritis kidney damage performance
Symptoms of lupus erythematosus kidney damage is almost a series of symptoms, including glomerular, tubulointerstitial, renal vascular disease, can also be abrupt onset can be insidious, the course is generally longer, with or without symptoms, can also be kidney damage as the only clinical manifestations. Edema is a common clinical manifestations tend to be the main reason for patients attending. The increase in nocturnal enuresis is one of the early symptoms often reflect the urinary concentration of dysfunction. About 1/6 patients with varying degrees of renal insufficiency at the time of diagnosis. According to its clinical manifestations can be divided into the following type:
Asymptomatic proteinuria (1) or (and) the hematuria type: This type is more common, edema, hypertension, mild to moderate proteinuria (<2.5g / d) or (and) hematuria.
(2) type of acute nephritic syndrome: rare, clinically resembles streptococcal infection, acute nephritis, acute onset of hematuria, proteinuria, urinary tube, may have edema, hypertension, and even acute renal decline.
(3) rapidly progressive glomerulonephritis syndrome, type: rare, clinically resembles rapidly progressive glomerulonephritis, abrupt onset and rapid development of oliguria or anuria, hematuria, proteinuria, urinary tube, can be edema, often without high blood pressure or mild hypertension, rapidly deteriorating rapidly and the development of anemia and hypoproteinemia, renal function, uremia in the weeks and months.
(4) nephrotic syndrome: This type is common, about 60% of patients with renal impairment performance for this type. The clinical manifestations of massive proteinuria (3.5g / d) and hypoproteinemia, severe edema, but not necessarily have high cholesterol.If not treated, the majority of 2 to 3 years, the development of uremia. This type is easy to be confused with primary nephrotic syndrome, it is noteworthy.
(5) type of chronic nephritic syndrome: the performance of persistent proteinuria, hematuria, urinary tube, and varying degrees of edema, hypertension, anemia and renal insufficiency. Course of a long, delayed healing and poor prognosis.
(6) The type of renal tubular syndrome: a rare renal tubular acidosis, nocturia, edema, hypertension, increased urine β2-microglobulin, half of the patients with renal dysfunction.
(7) clinical "silence": the clinical symptoms and signs had no kidney involvement, performance, urine tests negative, but the pathological examination (particularly in the electron microscopy and immunofluorescence) positive.
Asymptomatic proteinuria (1) or (and) the hematuria type: This type is more common, edema, hypertension, mild to moderate proteinuria (<2.5g / d) or (and) hematuria.
(2) type of acute nephritic syndrome: rare, clinically resembles streptococcal infection, acute nephritis, acute onset of hematuria, proteinuria, urinary tube, may have edema, hypertension, and even acute renal decline.
(3) rapidly progressive glomerulonephritis syndrome, type: rare, clinically resembles rapidly progressive glomerulonephritis, abrupt onset and rapid development of oliguria or anuria, hematuria, proteinuria, urinary tube, can be edema, often without high blood pressure or mild hypertension, rapidly deteriorating rapidly and the development of anemia and hypoproteinemia, renal function, uremia in the weeks and months.
(4) nephrotic syndrome: This type is common, about 60% of patients with renal impairment performance for this type. The clinical manifestations of massive proteinuria (3.5g / d) and hypoproteinemia, severe edema, but not necessarily have high cholesterol.If not treated, the majority of 2 to 3 years, the development of uremia. This type is easy to be confused with primary nephrotic syndrome, it is noteworthy.
(5) type of chronic nephritic syndrome: the performance of persistent proteinuria, hematuria, urinary tube, and varying degrees of edema, hypertension, anemia and renal insufficiency. Course of a long, delayed healing and poor prognosis.
(6) The type of renal tubular syndrome: a rare renal tubular acidosis, nocturia, edema, hypertension, increased urine β2-microglobulin, half of the patients with renal dysfunction.
(7) clinical "silence": the clinical symptoms and signs had no kidney involvement, performance, urine tests negative, but the pathological examination (particularly in the electron microscopy and immunofluorescence) positive.
What are the extra-renal manifestations of lupus nephritis?
Systemic lupus erythematosus is a common disease can occur at any age and
sex, is common in young women, the most common 20 to 30 years. Extrarenal
manifestations are:
(1) General symptoms: Most patients showed generalized weakness, weight loss, 90% of patients have fever, heat-type variable, 40% more than 39 ℃.
(2) skin and mucous membranes: 50% of patients, there may be facial butterfly erythema, lesions confined to the two cheeks and the nose bridge, was mild edema and erythema, telangiectasia and scaly blisters, severe exudative inflammation and crusts, erythema subsided in general does not leave scars and pigmentation. The hair loss seen in 50% of patients, is a sensitive indicator of lupus activity. Livedo reticularis is common, is a typical characteristic of vasculitis. Many symptoms of the nervous system. In addition, also visible urticaria, Discoid erythema, A Zhou erythema, purpura, crack haemorrhage, oral and nasal ulcers.
(3) joint and muscle: 90% of patients with joint pain, common in the limbs, joints, about 10% of patients may have mild joint deformity, but generally no bone erosion signs.Long-term, large, irregular use of hormones, can lead to some patients with aseptic necrosis of femoral head. 1/3 of patients with muscle pain, and some even appear obvious symptoms of muscle weakness or muscle atrophy.
(4) cardiovascular: up to 2/3 of patients with active lupus erythematosus pericarditis cases, usually short and mild clinical manifestations. 10% of patients with myocarditis.Mitral and aortic valve may also be involved, generally at the apex and the heart at the bottom of smell and systolic murmur, which may also be related to anemia, tachycardia, or fever, diastolic murmur rare. There is also the Raynaud's phenomenon (25%), pulmonary hypertension and recurrent thrombophlebitis, which can be lupus erythematosus in the first symptom.
(5), lung and pleura: 40% ~ 46% of patients can occur in pleurisy, it is a reliable indicator of lupus erythematosus forthcoming involving the kidneys. Acute lupus pneumonitis and rare, difficulty breathing, chest pain and cough, and severe cases, massive hemoptysis, and some patients present with recurrent pulmonary atelectasis, a few may develop as diffuse interstitial pulmonary fibrosis.
(6) the blood system: 50% ~ 75% of the patients showed positive pigment cell anemia; 60% of patients with white blood cells <4.5 × 109 / L; platelet is generally slightly lower, a small number of <30 × 109 / L (approximately 50% ).
(7) of the gastrointestinal tract: some patients have nausea, vomiting, abdominal pain is common (approximately 50%) may be associated with peritonitis and abdominal viscera. Liver, splenomegaly were found in 30% and 20% of patients.
(8) of the nervous system: the incidence of symptoms and signs of about 50% to 60%, complex and diverse clinical manifestations, and manifests itself as mental disorders such as depression, mental confusion. Or epilepsy, migraine, paralysis, chorea, peripheral neuropathy and retinopathy.
(9) Other: menstrual irregularity, premenstrual symptoms increased, especially migraine. Some patients may occur painless lymph nodes, parotid gland swelling, conjunctivitis.
(1) General symptoms: Most patients showed generalized weakness, weight loss, 90% of patients have fever, heat-type variable, 40% more than 39 ℃.
(2) skin and mucous membranes: 50% of patients, there may be facial butterfly erythema, lesions confined to the two cheeks and the nose bridge, was mild edema and erythema, telangiectasia and scaly blisters, severe exudative inflammation and crusts, erythema subsided in general does not leave scars and pigmentation. The hair loss seen in 50% of patients, is a sensitive indicator of lupus activity. Livedo reticularis is common, is a typical characteristic of vasculitis. Many symptoms of the nervous system. In addition, also visible urticaria, Discoid erythema, A Zhou erythema, purpura, crack haemorrhage, oral and nasal ulcers.
(3) joint and muscle: 90% of patients with joint pain, common in the limbs, joints, about 10% of patients may have mild joint deformity, but generally no bone erosion signs.Long-term, large, irregular use of hormones, can lead to some patients with aseptic necrosis of femoral head. 1/3 of patients with muscle pain, and some even appear obvious symptoms of muscle weakness or muscle atrophy.
(4) cardiovascular: up to 2/3 of patients with active lupus erythematosus pericarditis cases, usually short and mild clinical manifestations. 10% of patients with myocarditis.Mitral and aortic valve may also be involved, generally at the apex and the heart at the bottom of smell and systolic murmur, which may also be related to anemia, tachycardia, or fever, diastolic murmur rare. There is also the Raynaud's phenomenon (25%), pulmonary hypertension and recurrent thrombophlebitis, which can be lupus erythematosus in the first symptom.
(5), lung and pleura: 40% ~ 46% of patients can occur in pleurisy, it is a reliable indicator of lupus erythematosus forthcoming involving the kidneys. Acute lupus pneumonitis and rare, difficulty breathing, chest pain and cough, and severe cases, massive hemoptysis, and some patients present with recurrent pulmonary atelectasis, a few may develop as diffuse interstitial pulmonary fibrosis.
(6) the blood system: 50% ~ 75% of the patients showed positive pigment cell anemia; 60% of patients with white blood cells <4.5 × 109 / L; platelet is generally slightly lower, a small number of <30 × 109 / L (approximately 50% ).
(7) of the gastrointestinal tract: some patients have nausea, vomiting, abdominal pain is common (approximately 50%) may be associated with peritonitis and abdominal viscera. Liver, splenomegaly were found in 30% and 20% of patients.
(8) of the nervous system: the incidence of symptoms and signs of about 50% to 60%, complex and diverse clinical manifestations, and manifests itself as mental disorders such as depression, mental confusion. Or epilepsy, migraine, paralysis, chorea, peripheral neuropathy and retinopathy.
(9) Other: menstrual irregularity, premenstrual symptoms increased, especially migraine. Some patients may occur painless lymph nodes, parotid gland swelling, conjunctivitis.
No clinical manifestations of renal biopsy in lupus nephritis how to infer the pathological type?
A definite link between the clinical manifestations and pathological changes in lupus nephritis. In general, the clinical manifestations of the normal glomerular and Department of membranous glomerulonephritis lighter, no urine abnormalities, can also be expressed as a latent nephritis; focal segmental proliferative glomerulonephritis type more than to hide nephritis, or chronic nephritis, a few can be manifested as nephrotic syndrome; diffuse proliferative nephritis was manifested as nephrotic syndrome (about 75%) and chronic nephritic syndrome; membranous lupus nephritis more performance for the nephrotic syndrome, but generally no significant hypertension, slow deterioration of renal function. At present, most scholars believe that the WHO histological type of limited value in the treatment and prognosis of lupus nephritis. However, in recent years, some scholars believe that the renal activity index and the chronic index important guiding treatment and prognosis. The activity index is defined by the representative of the activity of (potentially reversible) damage the ratings of those items, the sum of the percent of the total number of these projects include capillary proliferation, leukocyte infiltration, capillary wall destruction, nuclear condensation, cell crescent, platinum ear, transparent thrombosis, fibrin thrombus and cellulose deposition, interstitial cellular infiltration, acute tubular necrosis, vasculitis, according to the light of the various lesions, weight rated as 1, 2, 3 . The chronic Index is a total number of chronic sclerosing, atrophic and / or fibrosis score together, these projects include glomerular sclerosis, cellulose crescents and adhesions, interstitial sclerosis, tubular atrophy, arterial and arteriosclerosis, the light, re-rated as 1, 2, 3. Chronic index with advanced kidney disease was positively correlated. Activity in mild to moderately elevated prompt condition reversible after appropriate treatment, renal function improved or stable.Chronic index moderately elevated activity index moderately elevated, and still is a strong indication of the treatment. Severe activity index increased, the indication for active treatment, but it reflects the glomerular structure of severe, active destruction, can often lead to scar formation.
2012年4月9日星期一
Lupus nephritis acupuncture
Acupoints are divided into two groups.
Group A: Wind pool, so Jiaji chest, chest, chest 11, the full three years;
Group B: Ojo, gu, Jiaji chest, chest 9, waist 1, multiple slip. Acupuncture three times aweek.
These two sets of acupuncture points are used interchangeably, 10
For a course of treatment, usually for three courses. For SIE therapy.
Lupus nephritis patients how to self-care?
(1) diet; patients with lupus nephritis adequate intake of nutrients such as protein, vitamins, mineral
Material, light is appropriate. Water, the salt should be moderate restrictions. Avoid a lot of tobacco, alcohol or irritating foods. Osteoporosis using vitamin D.
(2) Sports: Sports can promote blood circulation, improve heart and lung function,maintain muscle, bone toughness, have the benefit of any person, lupus patients is no exception. (Walking qigong) do not fatigue. Inflammation of the joints are not suitable foractivities.
(3) to avoid the sun: the lupus patients sensitive to the sun, caused by the wavelength ofultraviolet beta, should try to avoid sunshine.
(4) Prevention of infection: the impact of patients due to side effects of the impact of thedisease or steroids or immunosuppressive agents, a general decline in immunity is verysusceptible to bacterial violations caused by the infection of various organs. Commonrespiratory tract infections, urinary tract infections, gastrointestinal infections, and woundinfection.
(5) emotional adjustment: patients with sudden situations are diagnosed with lupus, is a heavy blow to the spiritual, often depression, anxiety, depression, anger, sin, denial,depression, and then the bell comes. But the emotions and disease has a close, mutualrelationship. Patients are faced with physical and mental challenges. To win the war, to maintain a pleasant mood, and contribute to the improvement of the disease. At the same time friends and family to give care and support.
Chinese medicine treatment of lupus nephritis
The ① toxic heat flaming: Zheng Jian fever subside, bleeding tendency, thirst
for cold drinks, and even the faint delirium convulsions, or see the joint
swelling and pain, redpurple, pulse loud or the number. The Expelling
detoxification, cooling Xiaoban, side withrhino
The angle Di Huang Tang flavors xiaoduyin addition and subtraction. See comadelirium, available Angongniuhuang, Zixue; convulsions plus the antelope powder, Uncaria, Scorpion; joint swelling and pain the available Xuanbi Decoction.
② liver and kidney: two eyes dry, dysphoria hot, dry mouth and throat, hair off teethshake, waist and knee pain, dry stool, or low-grade fever night sweats, red urine, burning, dizziness, tinnitus, red tongue, thin pulse number. Expelling nourish hepatorenal sideGuishao yellow soup or Qijudihuang, Decoction. Urine hot hematuria, can be used to know Bo Di Huang Tonga verbena, Biota orientalis, the size of thistle; if dizziness, ringing in the ears, and silkworm, chrysanthemum, magnets.
③ spleen deficiency: Zheng Jian malaise, less gas lazy words, aversion to cold, weak waist, heel pain, pay less bloating, loose stools, clear urine, or edema, pale tongue with teeth marks. white coating, pulse delay weakness. Expelling Warming spleen, in the absence of edema, available soup of Xiangsha Liujunzi or Buzhongyiqi Tonga aconite,cinnamon, Curculigo, Epimedium; if the edema, partial Spleen virtual real spleendecoction, partial deficiency Zhenwu Tonga Achyranthes, Plantago. Indulge in the spleen and kidney qi deficiency are Jianpiyishenfang mainly spleen deficiency obvious, Bu Zhong Yi Qi Tang or different power Powder Plus laevigata, dodder seed, psoralen;edema in serious cases, Fangjihuangqi Tang Chun Ze Tang; kidney deficiency obviouslycan be used to Wu Zi Yan Zong Wan Codonopsis, Astragalus.
The ④ Qiyinliangxu: Zheng Jian languid, less gas lazy words, spontaneous perspiration,fear the wind, common cold, fever night sweats, five upset hot, dry mouth and throat,tongue pink or reddish, with scalloped edges, moss thin white, thin veins or breakdown.Expelling Qi and yin, fried addition and subtraction with Shenqidihuang soup ornourishing. If you see the yin and yang can be used to Dihuangyinzi, or the Shenqi Guifuyellow Decoction.
The angle Di Huang Tang flavors xiaoduyin addition and subtraction. See comadelirium, available Angongniuhuang, Zixue; convulsions plus the antelope powder, Uncaria, Scorpion; joint swelling and pain the available Xuanbi Decoction.
② liver and kidney: two eyes dry, dysphoria hot, dry mouth and throat, hair off teethshake, waist and knee pain, dry stool, or low-grade fever night sweats, red urine, burning, dizziness, tinnitus, red tongue, thin pulse number. Expelling nourish hepatorenal sideGuishao yellow soup or Qijudihuang, Decoction. Urine hot hematuria, can be used to know Bo Di Huang Tonga verbena, Biota orientalis, the size of thistle; if dizziness, ringing in the ears, and silkworm, chrysanthemum, magnets.
③ spleen deficiency: Zheng Jian malaise, less gas lazy words, aversion to cold, weak waist, heel pain, pay less bloating, loose stools, clear urine, or edema, pale tongue with teeth marks. white coating, pulse delay weakness. Expelling Warming spleen, in the absence of edema, available soup of Xiangsha Liujunzi or Buzhongyiqi Tonga aconite,cinnamon, Curculigo, Epimedium; if the edema, partial Spleen virtual real spleendecoction, partial deficiency Zhenwu Tonga Achyranthes, Plantago. Indulge in the spleen and kidney qi deficiency are Jianpiyishenfang mainly spleen deficiency obvious, Bu Zhong Yi Qi Tang or different power Powder Plus laevigata, dodder seed, psoralen;edema in serious cases, Fangjihuangqi Tang Chun Ze Tang; kidney deficiency obviouslycan be used to Wu Zi Yan Zong Wan Codonopsis, Astragalus.
The ④ Qiyinliangxu: Zheng Jian languid, less gas lazy words, spontaneous perspiration,fear the wind, common cold, fever night sweats, five upset hot, dry mouth and throat,tongue pink or reddish, with scalloped edges, moss thin white, thin veins or breakdown.Expelling Qi and yin, fried addition and subtraction with Shenqidihuang soup ornourishing. If you see the yin and yang can be used to Dihuangyinzi, or the Shenqi Guifuyellow Decoction.
2012年4月8日星期日
Pathology of lupus nephritis
1 pathogenesis
Pathogenesis of lupus nephritis there is no affirmative, can be replicated, animal experiments and clinical results are consistent conclusion. At present, most scholars believe that some foreign antigen (eg, retrovirus) and endogenous antigen (such as DNA immunization needed protein, lymphocyte surface antigen) role in immune regulation dysfunction in patients with highly active proliferation of B lymphocytes to produce a large number of autoantibodies, and combined with the corresponding antigen to form immune complex deposition in the glomerulus is the main pathogenesis of lupus nephritis. DNA and glomerular basement membrane binding, and the cycle of anti-DNA antibodies in situ formation of immune complexes can also be involved in lupus nephritis. Complement component defects in red blood cells and phagocytosis of FC or C3b receptor density on the cell to reduce the clearance of immune complexes decreased ability to increase immune complex deposition in the tissues, increased tissue damage. Complement activation, chemokine formation, leukocyte aggregation, and then released a series of inflammatory mediators and cytokines, leading to inflammation and glomerular damage of small blood vessels. At the same time, the renal interstitial obvious leukocyte and macrophage infiltration, with intercellular adhesion molecule (ICAM) and MHC antigen.The severity of renal interstitial lesion is usually associated with glomerular lesions.Some patients mild glomerular lesions, mainly interstitial vascular disease.
(2) pathological changes
Due to the complexity of the pathogenesis of lupus nephritis, renal pathological changes also showed the diversity and varied, each patient's glomerular, tubulointerstitial and small blood vessels may appear different changes. Lupus nephritis histological changes in glomerular, tubulointerstitial and vascular changes also determine the prognosis of patients. Renal histopathological damage, depends largely on the number of antibody deposition and the intensity of the inflammatory response induced. Persistent antibody deposition, and continue to cause inflammation, eventually leading to irreversible damage. Pathological changes characterized by: wire ring lesions: electron microscopy and immunofluorescence under the sediments of a large number of endothelial endothelial sediment leaving the basement membrane thickening, is an important feature of lupus nephritis kidney damage; Hematoxylin bodies: the general anti-nuclear body in place to cause cell damage caused by the nuclear chromatin gathered together; necrotizing vasculitis: the arterioles and capillaries were cellulose necrosis; electron microscope, electron dense deposits, nuclear fragmentation, virus-like particles and inclusions; immunofluorescence: diffuse granular sediments, mainly IgG, C3.
Pathogenesis of lupus nephritis there is no affirmative, can be replicated, animal experiments and clinical results are consistent conclusion. At present, most scholars believe that some foreign antigen (eg, retrovirus) and endogenous antigen (such as DNA immunization needed protein, lymphocyte surface antigen) role in immune regulation dysfunction in patients with highly active proliferation of B lymphocytes to produce a large number of autoantibodies, and combined with the corresponding antigen to form immune complex deposition in the glomerulus is the main pathogenesis of lupus nephritis. DNA and glomerular basement membrane binding, and the cycle of anti-DNA antibodies in situ formation of immune complexes can also be involved in lupus nephritis. Complement component defects in red blood cells and phagocytosis of FC or C3b receptor density on the cell to reduce the clearance of immune complexes decreased ability to increase immune complex deposition in the tissues, increased tissue damage. Complement activation, chemokine formation, leukocyte aggregation, and then released a series of inflammatory mediators and cytokines, leading to inflammation and glomerular damage of small blood vessels. At the same time, the renal interstitial obvious leukocyte and macrophage infiltration, with intercellular adhesion molecule (ICAM) and MHC antigen.The severity of renal interstitial lesion is usually associated with glomerular lesions.Some patients mild glomerular lesions, mainly interstitial vascular disease.
(2) pathological changes
Due to the complexity of the pathogenesis of lupus nephritis, renal pathological changes also showed the diversity and varied, each patient's glomerular, tubulointerstitial and small blood vessels may appear different changes. Lupus nephritis histological changes in glomerular, tubulointerstitial and vascular changes also determine the prognosis of patients. Renal histopathological damage, depends largely on the number of antibody deposition and the intensity of the inflammatory response induced. Persistent antibody deposition, and continue to cause inflammation, eventually leading to irreversible damage. Pathological changes characterized by: wire ring lesions: electron microscopy and immunofluorescence under the sediments of a large number of endothelial endothelial sediment leaving the basement membrane thickening, is an important feature of lupus nephritis kidney damage; Hematoxylin bodies: the general anti-nuclear body in place to cause cell damage caused by the nuclear chromatin gathered together; necrotizing vasculitis: the arterioles and capillaries were cellulose necrosis; electron microscope, electron dense deposits, nuclear fragmentation, virus-like particles and inclusions; immunofluorescence: diffuse granular sediments, mainly IgG, C3.
The cause of lupus nephritis
Lupus nephritis cause of so far is difficult to determine, lupus nephritis, and genetic, viral infections, sex hormones and stress factors have great relevance.
1. genetic factors
Recent studies show that genetic factors play a decisive role in the pathogenesis of lupus nephritis. Patients with lupus nephritis may have a family history, and close relatives of high prevalence. HLA-DR2 positive rate was significantly higher than normal high the HLA the-DQW1, HLA-DQW2, HLA-B8 Proof of, but also more common. In addition, C2, C4, Clr, and Cls lack of susceptibility to lupus nephritis. In recent years, the development of the theory and technology of molecular biology, and deepen the lupus nephritis study of immunogenetics, suggesting that other than the MHC genes and other "autoimmune genes" may have a crucial role in lupus nephritis.
2. Sex hormones
In view of this disease women significantly outnumber men, and more in the incidence of reproductive age, suggesting that the estrogen and Benbingfasheng. Pregnancy can make half of the patients deteriorate. Lupus nephritis in experimental animals given estrogen made it worse, such as give androgen to reduce disease. Has been found that the patients both men and women, estrone hydroxylation products were increased, while testosterone decrease.
3. psychological factors
Some studies reveal that psychological stress can trigger lupus nephritis disease activity, but also may be caused by lupus nephritis. However, personality characteristics and stressful life events, intensity, duration, frequency and degree of the impact of stress on the responses of the individual by the individual quality.
4. environmental factors
(1) virus infection
Many scholars believe that this disease and slow virus (C-type RNA virus). Detection of type C RNA virus in New Zealand hybrid mice NZB/NAWF1 of organizations suffering from lupus nephritis, although the patient groups has not yet proven the existence of such viruses, but can be detected to engage in the RNA-DNA antibodies in serum.
(2) sunlight or ultraviolet radiation
Horn cells of the skin by ultraviolet light to stimulate the secretion of interleukins to stimulate B cells and induce T cells to produce interleukin-2 stimulates the immune system to disease progression. Some people think that the UV DNA is converted to thymine dimer, so that the antigen enhanced. Sunlight allergy seen in 40% of patients with lupus nephritis. Cold or strong electro-optical radiation can also induce or aggravate the disease.
In addition, certain drugs and food change and the occurrence of lupus nephritis.
The cause of lupus nephritis
This disease is the body's endogenous (self) antigen by the immune complex diseases and disorders associated with T cell function. To be investigated in the patients serum antibodies have a variety of anti-autologous tissue composition, including anti-DNA antibodies, especially anti-double stranded DNA (natural DNA) antibody is more effective than positive, patients with circulating immune complexes separable into natural and single-stranded DNA antibodies and antigens; eluted from glomerular immunoglobulin antibody combined with natural and single-stranded DNA antigen. A humoral immune changes in which DNA and anti-DNA antibodies form immune complexes play a major role. (1) virus triggering factors: more studies confirm the disease is an RNA virus - type C virus. C-type virus on the one hand may damage the cells, so that the release of DNA was highly immunogenic; the other hand, may be due to this virus reverse transcriptase, RNA replication of the virus itself into DNA, leaving the body to produce anti-DNA antibodies both anti-viral replication generated by DNA, but also anti-human DNA. (2) Bacterial toxins and lipopolysaccharide trigger factors: Some bacterial lipopolysaccharide composition injected into mice and observed that can contribute to the DNA of mouse tissue release to the blood circulation and the role of mitogen to promote the activation of B lymphocytes to produce antibodies, so that these substances promote the role of DNA antigen-antibody complex to generate. (3) release of DNA from tissue damage: the patients in vivo lymphocyte cytotoxic antibodies.Medium molecular weight soluble DNA immune complexes through the blood circulation to the kidneys (or other organs) and deposited in the glomerulus.
Cellular immunity: the suppressor T cell function and decline in the number. The reason is that serum cytotoxic antibody (anti-lymphocyte or thymocyte antibody), thereby undermining the T cells, suppressor T cells down the one hand, can directly reduce the inhibition of antibody formation, on the other hand may be due to the release of The lymphokines declined to inactivate the ability of helper T cells, helper T cells promote the ability to increase antibody production, total humoral immune (antibody formation) strong.
(3) genetic factors, family history of the same disease accounted for 0.4% to 3.4% in the patients.
Cellular immunity: the suppressor T cell function and decline in the number. The reason is that serum cytotoxic antibody (anti-lymphocyte or thymocyte antibody), thereby undermining the T cells, suppressor T cells down the one hand, can directly reduce the inhibition of antibody formation, on the other hand may be due to the release of The lymphokines declined to inactivate the ability of helper T cells, helper T cells promote the ability to increase antibody production, total humoral immune (antibody formation) strong.
(3) genetic factors, family history of the same disease accounted for 0.4% to 3.4% in the patients.
Gender difference of lupus nephritis
Kidney disease and many aspects of our life, such as age, gender, race,
occupation, genetic, environmental, infections, drugs, etc., which have a
certain tendency of gender on the occurrence of some kidney disease.
Female patients more susceptible to lupus nephritis (male to female ratio of approximately 1:9), pyelonephritis (male to female ratio of approximately 1:8), male patients more susceptible to acute nephritis and nephrotic syndrome.
Why kidney disease showed that men and women do not?
This mainly involves two characteristics:
Physiological characteristics such as sex hormone differences; anatomical characteristics, such as urinary tract structural difference, but the exact cause is not entirely clear. In outpatient visits, pyelonephritis, acute nephritis and nephrotic syndrome are easily diagnosed, lupus nephritis and nephritis and nephrotic syndrome susceptible to wrong diagnosis or missed diagnosis, and ultimately lead to delays in treatment.Therefore, female patients with nephritis or nephrotic syndrome, should be noted that the presence of lupus nephritis.
Lupus nephritis
Lupus nephritis is the result of invasion of kidneys of systemic lupus erythematosus. All likelihood occur in young women. The incidence of familial tendency in some patients, some patients by ultraviolet radiation, viral infection or pregnancy and after childbirth the body's immune dysfunction, resulting in a series of autoantibodies caused by the occurrence of the disease. Its symptoms in three aspects:
Systemic manifestations: intermittent fever; malar rash shaped like a butterfly, also known as the butterfly erythema; painless oral ulcers; multiple joint swelling and pain; epilepsy or mental disorders; hand, foot and cold become pale, warm turned purple, followed by recovery of the regular color, also known as Raynaud's phenomenon.
Renal manifestations: hematuria or proteinuria; hematuria, proteinuria, with edema, backache, or high blood pressure, nephritis-like performance; massive proteinuria, hypoalbuminemia, edema, nephrotic syndrome-like performance; hematuria. proteinuria with renal sharp decline, showing a rapidly progressive glomerulonephritis performance; performance of chronic renal failure. Life can be expressed as one of the cases.
3 laboratory abnormalities: blood leukopenia (<4 × 109 / L), or anemia, or thrombocytopenia (<100 × 109 / L,); rapid erythrocyte sedimentation rate; complement C3 low; antinuclear antibodies and antibody-positive . Renal biopsy is not only helpful in diagnosis of lupus nephritis, the more clear the severity of kidney damage, to determine the condition and the correct treatment.
Sometimes it is not typical symptoms of lupus nephritis, only kidney abnormalities are often misdiagnosed as nephritis, nephrotic syndrome or chronic renal failure, missed the best timing of treatment, the disease can not be improved in time to bring uremia, heart failure or sepsis and other adverse consequences. Therefore, early diagnosis and early treatment is very important. Female kidney disease patients should self-examination whether the above-mentioned systemic symptoms, if present, should further the appropriate laboratory tests.
Female patients more susceptible to lupus nephritis (male to female ratio of approximately 1:9), pyelonephritis (male to female ratio of approximately 1:8), male patients more susceptible to acute nephritis and nephrotic syndrome.
Why kidney disease showed that men and women do not?
This mainly involves two characteristics:
Physiological characteristics such as sex hormone differences; anatomical characteristics, such as urinary tract structural difference, but the exact cause is not entirely clear. In outpatient visits, pyelonephritis, acute nephritis and nephrotic syndrome are easily diagnosed, lupus nephritis and nephritis and nephrotic syndrome susceptible to wrong diagnosis or missed diagnosis, and ultimately lead to delays in treatment.Therefore, female patients with nephritis or nephrotic syndrome, should be noted that the presence of lupus nephritis.
Lupus nephritis
Lupus nephritis is the result of invasion of kidneys of systemic lupus erythematosus. All likelihood occur in young women. The incidence of familial tendency in some patients, some patients by ultraviolet radiation, viral infection or pregnancy and after childbirth the body's immune dysfunction, resulting in a series of autoantibodies caused by the occurrence of the disease. Its symptoms in three aspects:
Systemic manifestations: intermittent fever; malar rash shaped like a butterfly, also known as the butterfly erythema; painless oral ulcers; multiple joint swelling and pain; epilepsy or mental disorders; hand, foot and cold become pale, warm turned purple, followed by recovery of the regular color, also known as Raynaud's phenomenon.
Renal manifestations: hematuria or proteinuria; hematuria, proteinuria, with edema, backache, or high blood pressure, nephritis-like performance; massive proteinuria, hypoalbuminemia, edema, nephrotic syndrome-like performance; hematuria. proteinuria with renal sharp decline, showing a rapidly progressive glomerulonephritis performance; performance of chronic renal failure. Life can be expressed as one of the cases.
3 laboratory abnormalities: blood leukopenia (<4 × 109 / L), or anemia, or thrombocytopenia (<100 × 109 / L,); rapid erythrocyte sedimentation rate; complement C3 low; antinuclear antibodies and antibody-positive . Renal biopsy is not only helpful in diagnosis of lupus nephritis, the more clear the severity of kidney damage, to determine the condition and the correct treatment.
Sometimes it is not typical symptoms of lupus nephritis, only kidney abnormalities are often misdiagnosed as nephritis, nephrotic syndrome or chronic renal failure, missed the best timing of treatment, the disease can not be improved in time to bring uremia, heart failure or sepsis and other adverse consequences. Therefore, early diagnosis and early treatment is very important. Female kidney disease patients should self-examination whether the above-mentioned systemic symptoms, if present, should further the appropriate laboratory tests.
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