浙江中医药大学学报2025，Vol.49Issue(12)：1572-1576,5.DOI:10.16466/j.issn1005-5509.2025.12.009
二型九证法辨治系统性红斑狼疮的中西医结合方案构建探讨
Construction and Clinical Application of A Combination of Traditional Chinese and Western Medicine in the Treatment of Sys-temic Lupus Erythematosus by Two-Type and Nine-Syndrome
摘要
Abstract
[Objective]To clarify the necessity and the entire process of formulating a combined traditional Chinese and western medicine treatment plan for systemic lupus erythematosus(SLE)by using the two-type nine-syndrome method,and provide reliable and standardized theoretical guidance for clinical application.[Methods]This article systematically summarizes and elaborates the two-type nine-syndrome differentiation and treatment method from three aspects:the entire process of scheme construction,the specific connotation interpretation and clinical application.And two test cases were exemplified for proof.[Results]A total of 725 articles were initially included,and 11 common syndrome types of SLE were summarized,namely,intense heat-toxin syndrome,deficiency of both spleen and kidney(Yang)syndrome,deficiency of Yin with internal heat(excess fire)syndrome,deficiency of both liver and kidney(Yin)syndrome,and deficiency of both Qi and Yin syndrome,etc.Then,a multicenter cross-sectional study was conducted in 17 hospitals in China,involving 445 SLE patients.The main syndromes were Yin deficiency with internal heat syndrome,Qi and blood deficiency syndrome,spleen-kidney Yang deficiency syndrome,rheumatic heat arthralgia syndrome and intense heat-toxin syndrome,etc.Based on literature mining and cross-sectional studies,nine syndromes were proposed.After three rounds of expert discussions,a combination of traditional Chinese and western medicine treatment for SLE was finally completed by using the two-type and nine-syndrome differentiation method,and the"Guideline for the Diagnosis and Treatment of Systemic Lupus Erythematosus with Integrated Chinese and Western Medicine"was formed.The specific connotation of this method was to firsly divide SLE into mild and severe types based on the presence or absence of organ damage,and then further classified according to different clinical manifestations.The mild type included rheumatic heat arthralgia syndrome,Yin deficiency with internal heat syndrome and Qi and blood deficiency syndrome.The severe type included intense heat-toxin syndrome,liver depression with blood stasis syndrome,phlegm-dampness invading the heart syndrome,spleen-kidney Yang deficiency syndrome,wind-phlegm internal movement syndrome and phlegm-stasis blocking the lung syndrome.The first case was a mild case of SLE with Qi and blood deficiency,and the treatment was the modified Danggui Buxue Decoction;the second case was a severe case of SLE with intense heat-toxin,and was treated with the modified Xijiao Dihuang Decoction.[Conclusion]The two-type and nine-syndrome differentiation treatment method integrates the advantages of western medicine's disease stratification and traditional Chinese medicine's individualized syndrome differentiation.It has high clinical discrimination and promotion value.The stratified diagnosis and treatment strategy provides a standardized framework for the combined Chinese and western medicine treatment of SLE.In the future,it will be further verified for its long-term benefits through multi-center prospective studies.关键词
系统性红斑狼疮/中西医结合/二型九证/方案构建/诊疗指南/病证结合/分层治疗/临床应用Key words
systemic lupus erythematosus/the combination of traditional Chinese and western medicine/two-type and nine-syndrome/scheme construction/diagnosis and treatment guidelines/integration of disease and syndrome/stratified treatment/clinical application分类
医药卫生引用本文复制引用
包洁,李霄鹏,谢志敏,吴德鸿,谢冠群,李正富,杨科朋,王新昌,范永升..二型九证法辨治系统性红斑狼疮的中西医结合方案构建探讨[J].浙江中医药大学学报,2025,49(12):1572-1576,5.基金项目
国家重点研发计划中医药现代化专项项目(2024YFC3506100) （2024YFC3506100）
浙江省中医药现代化专项项目(2020ZX008) National Key R&D Program of China(2024YFC3506100) （2020ZX008）
Zhejiang Provincial Traditional Chinese Medicine Modernization Special Project(2020ZX008) （2020ZX008）
