CLINICAL APPLICATIONS

* Systemic lupus erythematosus (SLE) 

§ Lupus with inflammation in joints, tendons, and other connective tissues and organs

§ Lupus with arthritis, mouth sores, skin rash, facial rash, hair loss, depression, fever, sunlight sensitivity, extreme fatigue, joint pain, muscle pain and weakness, anemia, malar flush, headache, general malaise, and in severe cases, destruction of vital organs.

* Autoimmune diseases with manifestations of heat and fire

 

WESTERN THERAPEUTIC ACTIONS

* Inhibits and suppresses the growth and multiplications of cells

* Anti-inflammatory effect to reduce swelling and inflammation

 

CHINESE THERAPEUTIC ACTIONS

* Clears heat

* Eliminates toxins

* Nourishes yin, tonifies blood, and generates body fluids

 

DOSAGE

Take 4 to 6 capsules three times daily. For acute recurrences, the dosage may be increased to 6 capsules four times daily.

 

INGREDIENTS

Bai Hua She She Cao (Herba Hedyotis)

Ban Zhi Lian (Herba Scutellariae Barbatae)

Chi Shao (Radix Paeoniae Rubrae)

Di Huang (Radix Rehmanniae)

Hong Hua (Flos Carthami)

Hu Zhang (Rhizoma et Radix Polygoni Cuspidati)

Ji Xiang Teng (Caulis Paederiae)

Jin Yin Hua (Flos Lonicerae Japonicae)

Lian Qiao (Fructus Forsythiae)

Mo Han Lian (Herba Ecliptae)

Mu Dan Pi (Cortex Moutan)

Tao Ren (Semen Persicae)

Xuan Shen (Radix Scrophulariae)

Ye Ju Hua (Flos Chrysanthemi Indici)

Zhi Mu (Rhizoma Anemarrhenae)

 

BACKGROUND

Systemic lupus erythematosus (SLE) is an autoimmune disorder in which the immune system attacks many parts of the body, such as the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system, resulting in inflammation and tissue damage. Clinical signs and symptoms of lupus include, but are not limited to, malar rash, discoid rash, photosensitivity, oral ulcers, arthritis, serositis, leukopenia, renal disorder, and neurological disorder. The exact cause of lupus is unknown in Western medicine. Therefore, treatment is mainly focused on relieving the symptoms and preventing the relapse.

 

FORMULA EXPLANATION

From a traditional Chinese medicine perspective, lupus is a condition characterized by both excess and deficiency. Excess represents the inflammatory conditions of the body, with such symptoms as arthritis, mouth sores, skin rash, facial rash, and sunlight sensitivity. Deficiency represents the fundamental and underlying weakness, such as anemia, and dysfunction of the kidney, nerves or brain.

        Most young girls suffering from lupus will show signs of excess heat in the blood level. Middle-aged women with lupus exhibit symptoms of chronic low-grade fever with exacerbation of symptoms upon exertion and tidal fever, flushed cheeks, petechiae spots on the skin, leg and heel pain, weakness of the limbs, night sweats, hair loss and thready and rapid pulse. Therefore, optimal treatment of lupus requires use of herbs to treat both the excess and the deficiency.

        Di Huang (Radix Rehmanniae), Chi Shao (Radix Paeoniae Rubrae), Mu Dan Pi (Cortex Moutan), Zhi Mu (Rhizoma Anemarrhenae) and Xuan Shen (Radix Scrophulariae) clear heat and cool the blood to treat the fever, mouth sores and skin lesions. Jin Yin Hua (Flos Lonicerae Japonicae), Lian Qiao (Fructus Forsythiae), Hu Zhang (Rhizoma et Radix Polygoni Cuspidati), Ye Ju Hua (Flos Chrysanthemi Indici), Bai Hua She She Cao (Herba Hedyotis) and Ban Zhi Lian (Herba Scutellariae Barbatae) are added to clear heat, eliminate toxins and relieve inflammation. Tao Ren (Semen Persicae) and Hong Hua (Flos Carthami) activate blood circulation and eliminate blood stasis to relieve pain, and deliver the formula to the affected parts of the body. To nourish yin, tonify blood and promote the generation of body fluids, herbs such as Di Huang (Radix Rehmanniae), Mo Han Lian (Herba Ecliptae), Xuan Shen (Radix Scrophulariae), and Mu Dan Pi (Cortex Moutan) are used. Ji Xiang Teng (Caulis Paederiae) is used to relieve pain. By nourishing the body, symptoms of extreme fatigue, joint pain, muscle aches, anemia, and general malaise can be alleviated.

        Overall, LPS Support is a balanced formula to address both the excess and the deficiency aspects of lupus. However, lupus is a complicated disorder with a wide variety of symptoms and severities. Therefore, additional formulas are often needed to address related symptoms and complications, as stated below in the Supplementary Formulas section.

 

CAUTIONS & CONTRAINDICATIONS

* The main emphasis of this formula is to use herbs to clear heat, eliminate toxins, and control the autoimmune and inflammatory conditions of lupus. Therefore, it contains many bitter and cold herbs, which may consume qi and yin. If the patient shows more signs and symptoms of such deficiencies, additional herbs and formulas should be given to strengthen the underlying constitutions. See Supplementary Formula section for details.

* Systemic lupus erythematosus is an autoimmune disorder. In theory, qi tonic herbs that stimulate the immune system, such as Huang Qi (Radix Astragali) and Ren Shen (Radix et Rhizoma Ginseng), should be used with caution. However, in clinical practice, these herbs may still be indicated based on differential diagnosis.

 

CLINICAL NOTES

* Lupus may develop after taking certain prescription medications. Symptoms generally disappear after the drug is discontinued. According to New England Journal of Medicine, up to 10% of lupus cases are related to drug reactions. Therefore, drugs that are most likely to cause lupus should be avoided, such as Apresoline (hydralazine), Procan (procainamide), and isoniazid. Certain birth control pills may also cause lupus to flare-up.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Inflammation: big pulse, a thick, forceful, expanding pulse on all levels, in all three pulse positions

 

SUPPLEMENTARY FORMULAS

* With facial or skin rash, add Silerex or Dermatrol (PS).

* With mouth sores, use Lonicera Complex as a mouthwash and gargle with it for 5 minutes three times daily.

* With arthritis, combine with Flex (Heat) or Flex (CD).

* With nerve dysfunction, combine with Flex (NP) .

* With kidney dysfunction or scanty yellow urination, combine with Kidney DTX .

* With low white or red blood cell count, combine with Imperial Tonic.

* With exterior wind-heat condition, add Lonicera Complex.

* With cough, add Respitrol (CF).

* With constipation, add Gentle Lax (Excess) or Gentle Lax (Deficient).

* With high fever, add Gardenia Complex.

* With thirst, dry eyes and mouth, add Nourish (Fluids).

* With Kidney yin deficiency manifesting chronic low-grade fever, flushed cheeks, body pain, purpura, add Balance (Heat) and Nourish.

* With intermittent pulse, palpitation, anemia, and pale complexion, add Schisandra ZZZ.

* With Kidney yang deficiency, add Kidney Tonic (Yang).

* With Kidney yin deficiency, add Kidney Tonic (Yin).

* With back pain, add Back Support (AC) or Back Support (CR).

* With jaundice, add Yin Chen Hao Tang (Artemisia Scoparia Decoction).

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Fengchi (GB 20), Jianshi (PC 5), Zusanli (ST 36), Dazhui (GV 14), Hegu (LI 4), Fuliu (KI 7)

§ For heat and toxins: Dazhui (GV 14), Weizhong (BL 40), Xiangu (ST 43), Daling (PC 7), Yanglingquan (GB 34)

§ For yin and blood deficiencies: Quchi (LI 11), Hegu (LI 4), Yingxiang (LI 20), Fengchi (GB 20), Laogong (PC 8), Yongquan (KI 1)

§ For yang qi deficiency: Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36), Shangqiu (SP 5), Mingmen (GV 4)

§ For qi stagnation and blood stasis: Shanzhong (CV 17), Qihai (CV 6), Hegu (LI 4), Taichong (LR 3), Zhangmen (LR 13), Neiguan (PC 6), Yintang

 

Classic Master Tung's Points:

* Minghuang (T 88.12), Qihuang (T 88.14), Simazhong (T 88.17), Simashang (T 88.18)

 

Master Tung’s Points by Dr. Chuan-Min Wang:

* Lupus: Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Simazhong (T 88.17), Simashang (T 88.18), Simaxia (T 88.19), Zhongjiuli (T 88.25), Qili (T 88.51)*

 

Balance Method by Dr. Richard Tan:

* Treatment Plan One:

§ Right side: Hegu (LI 4), Houxi (SI 3), Zhongzhu (TH 3), Sanyinjiao (SP 6), Zhongfeng (LR 4), Taixi (KI 3)

§ Left side: Shaoshang (LU 11), Zhongchong (PC 9), Shaochong (HT 9), Zusanli (ST 36), Yanglingquan (GB 34), Weizhong (BL 40)

* Treatment Plan Two:

§ Right side: Shaoshang (LU 11), Zhongchong (PC 9), Shaochong (HT 9), Zusanli (ST 36), Yanglingquan (GB 34), Weizhong (BL 40)

§ Left side: Hegu (LI 4), Houxi (SI 3), Zhongzhu (TH 3), Sanyinjiao (SP 6), Zhongfeng (LR 4)

 

Auricular Medicine by Dr. Li-Chun Huang:

* Lupus erythematosus: corresponding point (to the affected area), Kidney, Liver, Spleen, Lung, Endocrine, Allergic Area, San Jiao, Adrenal Gland. Bleed Ear Apex.

 

NUTRITION

* Adequate intake of calcium and magnesium is important, as they are necessary for pH balance and protection against bone loss.

* L-cysteine, L-methionine and L-lysine are important in skin formation and cellular protection and preservation.

* Diet low in fat, salt, and animal protein is less stressful to the kidneys. It also keeps the immune system from becoming overly reactive.

* Foods that contain sulfur, such as eggs, garlic and onions are essential for the repair and rebuilding of bones, cartilages, and connective tissues.

* Avoid caffeine, citrus fruits, salt, tobacco and foods that contain sugar.

* Raw, cold, greasy and salty foods are contraindicated.

* Barley, mung bean, mushrooms, lotus nodes, honey, soybeans and soy products, and duck are recommended.

 

LIFESTYLE INSTRUCTIONS

* Get an adequate amount of rest and exercise regularly to promote muscle tone and fitness.

* Use hypoallergenic soaps, lotions, and cosmetics.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Systemic lupus erythematosus (SLE), simply referred to as lupus, is a complicated autoimmune disorder that results in episodes of inflammation in joints, tendons, and other connective tissues and organs. It is complicated because the symptoms and their severity can differ drastically from person to person, ranging from mild to disabling to fatal. LPS Support contains many herbs with various actions: some address the autoimmune aspect of lupus by suppressing the multiplication of cells; others alleviate the symptoms of inflammation, rash, and dysfunction of the organs.

        LPS Support incorporates many herbs that inhibit and suppress the growth and multiplication of cells to address the autoimmune aspect of lupus. Herbs with this therapeutic effect include Bai Hua She She Cao (Herba Hedyotis) and Ban Zhi Lian (Herba Scutellariae Barbatae).[1]^,[2] By controlling the autoimmune aspect of lupus, these herbs help to control the underlying cause of the illness.

        LPS Support has many herbs specifically to control the inflammatory symptoms of lupus. Many herbs in this formula have marked anti-inflammatory effects with multiple mechanisms of actions. Jin Yin Hua (Flos Lonicerae Japonicae) and Lian Qiao (Fructus Forsythiae) both have significant anti-inflammatory effects.[3],[4] The mechanisms of action include inhibition of cylcooxygenase-2, inducible nitric oxide synthase, and 5-lipoxyfenase activities.[5] In addition, Ye Ju Hua (Flos Chrysanthemi Indici) has a marked anti-inflammatory effect to treat a variety of acute and chronic immune-related cutaneous inflammations. The anti-inflammatory properties of Ye Ju Hua (Flos Chrysanthemi Indici) are attributed to the inhibition of inflammatory mediators, such as nitric oxide, prostaglandin E(2), TNF-α, and IL-1beta.[6] Another study showed that Ye Ju Hua (Flos Chrysanthemi Indici) has immunomodulatory properties on humoral and cellular immunity.[7] Furthermore, Tao Ren (Semen Persicae) and Hong Hua (Flos Carthami) both have anti-inflammatory functions. Tao Ren (Semen Persicae) exerts its anti-inflammatory and antiallergic effects via reduction of histamine release from mast cells. Hong Hua (Flos Carthami) exerts its anti-inflammatory action via induction of heme oxygenase-1 expression.[8] Mu Dan Pi (Cortex Moutan) demonstrates a significant anti-inflammatory effect by suppressing histamine release and prostaglandin D(2) synthesis from mast cells.[9] Lastly, Di Huang (Radix Rehmanniae) has both anti-inflammatory and antiallergic effects by suppressing the expression of cytokines, chemokines, and adhesion molecules.[10]

        With regards to clinical applications, many herbs in this formula have shown excellent results to treat related signs and symptoms of lupus, including but not limited to arthritis, skin disorders, and dysfunction of the internal organs. Clinically, Di Huang (Radix Rehmanniae) has been used to successfully treat 23 patients with rheumatoid arthritis in one study, and 37 patients with skin disorders (rashes, urticaria, and contact dermatitis) in another study.[11],[12] Zhi Mu (Rhizoma Anemarrhenae) was used in one herbal formula to treat 56 patients with acute-onset rheumatism with 71.4% effectiveness.[13] Lastly, use of Lian Qiao (Fructus Forsythiae) in herbal formulas has been shown to be effective to treat nephropathy.[14]

        In summary, lupus is a complicated disorder, as it is an autoimmune disorder that affects multiple areas of the body, leading to different symptoms of various severities. LPS Support integrates principles of traditional Chinese medicine and Western medicine, to address both the cause and the main symptoms of lupus.

 

COMPARATIVE ANALYSIS

Systemic lupus erythematosus (SLE) is an illness that poses great challenge for both Western and traditional Chinese medicines. It is quite challenging to manage lupus because the cause of the disease has not yet been clearly identified, and the illness may be complicated by its effect on tissues and organs in the body.

        Drug treatments for lupus focus mainly on relieving the symptoms. Mild to moderate lupus is managed by use of non-steroidal anti-inflammatory agents (NSAIDs) to relieve pain and reduce inflammation. However, these drugs may cause such serious side effects as gastric ulcer, duodenal ulcer, gastrointestinal bleeding, tinnitus, blurred vision, dizziness and headache. Severe lupus is treated with corticosteroids, such as prednisone and immunosuppressant drugs. However, both of these types of medication have very serious side effects and must be used with extreme caution.

        Heat-clearing herbs manage both the symptoms and the cause of lupus. These herbs have been shown to have an analgesic effect to relieve pain and an anti-inflammatory effect to reduce swelling and inflammation. Furthermore, certain herbs are also effective to suppress the immune system and help to control the autoimmune aspect of lupus.

        Lupus is a challenging illness that has no cure at the present time, but may be managed with drugs and/or herbs. Drugs effectively suppress symptoms, but do not change the progress of illness or the underlying condition of the patients. Herbs help to manage symptoms and control the underlying cause of the illness. Both options should be explored to identify the most effective treatment.