Systemic Lupus Erythematosus Nephritis

|Common Symptoms

Clinical Description:

短气乏力,汗出恶风,食少便溏,颜面浮肿,汗出恶风,舌淡苔薄白,脉浮虚

Plain-Language Explanation:

  • Breathing tends to be short and weak; even slight activity causes fatigue, and the whole body feels drained.
  • Spontaneous sweating easily occurs; after sweating, one becomes more sensitive to wind, and exposure to wind causes discomfort.
  • Poor appetite with reduced food intake; stools are loose and unformed, appearing soft and mushy.
  • Facial swelling is present, appearing puffy and tight, with obvious pitting on pressure.
  • Still fearful of wind after sweating, and feels uncomfortable and eager to avoid drafts.
  • The tongue body is pale in color; the tongue coating is thin and white, giving a light, clear appearance.
  • The pulse is palpable at the superficial level but lacks strength; it feels empty and weak upon pressure.

|TCM Approach

Clinical Description:

益气健脾,补肺固表

Plain-Language Explanation:

  • Strengthens the spleen’s function so that food and drink are better absorbed and utilized, gradually building physical strength.
  • Tonifies lung qi to make breathing smooth and strong, reducing shortness of breath and fatigue.
  • Secures the exterior and astringes sweat to reduce recurrent sweating and vulnerability to wind invasion.

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|Common Symptoms

Clinical Description:

神疲乏力,腰膝酸软,四肢水肿,月经不调,舌淡胖,苔白

Plain-Language Explanation:

  • Easily feels mentally tired and physically weak, lacks motivation, and does not recover well even after rest.
  • The lower back and knees feel sore, weak, and unsteady, with a sense of powerlessness when walking or sitting for long periods.
  • Edema develops in the limbs; the swelling is obvious on pressure and can be felt during movement.
  • Menstruation may be irregular, with variations in cycle length and flow volume.
  • The tongue is pale and enlarged, appearing puffy when extended.
  • The tongue coating is white, visible as a pale layer.

|TCM Approach

Clinical Description:

补益肺肾,泌精益气

Plain-Language Explanation:

  • Tonifies lung qi to make breathing smoother and stronger, reducing shortness of breath and fatigue.
  • Nourishes the kidneys to replenish essence, alleviating lower back and knee soreness and tiredness.
  • Secures and regulates essence to gradually reduce issues such as seminal emission or spermatorrhea.
  • Boosts qi and generates strength, enhancing mental and physical energy for a more stable overall condition.

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|Common Symptoms

Clinical Description:

两目干涩,咽干口燥,发脱齿摇,腰膝酸软,舌嫩红,苔少或光剥,脉细数

Plain-Language Explanation:

  • The eyes feel dry and gritty, with easy soreness or strain when looking at things, worsening with prolonged use.
  • The throat and mouth are dry and parched, feeling rough when speaking or swallowing.
  • Hair tends to fall out easily; teeth feel loose and shaky, unstable when biting.
  • The lower back and knees feel sore, weak, and unsteady, with a sense of powerlessness when walking or sitting for long periods.
  • The tongue appears vivid and red, looking bright and tender.
  • The tongue coating is scanty or absent, appearing glossy as if peeled.
  • The pulse is thin and rapid, with a quick rhythm and fine force.

|TCM Approach

Clinical Description:

滋补肝肾,养阴清热

Plain-Language Explanation:

  • Nourishes the liver and kidneys to enrich essence and blood, reducing blurred vision, tinnitus, and soreness of the lower back and knees.
  • Replenishes yin fluid to balance yin and yang, relieving deficiency heat, restlessness, and night sweats.
  • Clears deficiency heat to gradually ease thirst, tidal fever, and insomnia.

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|Common Symptoms

Clinical Description:

全身水肿,倦怠懒言,形寒肢冷,舌体淡胖有齿痕,苔白腻,脉沉迟细

Plain-Language Explanation:

  • Generalized edema occurs, with a puffy and tight appearance; pitting is obvious and slow to resolve.
  • The body tires easily, with a reluctance to speak and lack of motivation.
  • Marked aversion to cold; hands and feet feel cold and are slow to warm, with discomfort worsening on exposure to cold.
  • The tongue is pale and enlarged, with tooth marks visible along the edges.
  • The tongue coating is white, slimy, and greasy, appearing unclean.
  • The pulse is felt only at a deeper level, being slow and thin.

|TCM Approach

Clinical Description:

温补脾肾,通阳利水

Plain-Language Explanation:

  • Warms and tonifies spleen yang to enhance digestion and absorption, gradually restoring physical strength.
  • Tonifies kidney qi to strengthen the body, improving lower back and knee soreness and aversion to cold.
  • Promotes the smooth flow of yang qi to drive water metabolism.
  • Promotes diuresis and drains dampness to smooth urination and gradually reduce edema.

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|Common Symptoms

Clinical Description:

面浮身肿,腰以下为甚,腰部冷痛酸重,舌质淡胖,苔白,脉沉细或沉迟无力

Plain-Language Explanation:

  • Swelling appears on the face and body, with a clearly puffy appearance.
  • Edema is more pronounced below the waist, with the lower limbs more severely swollen and obvious pitting.
  • The lower back feels cold, painful, and heavy; discomfort is present during activity or prolonged sitting.
  • The tongue is pale and enlarged, appearing puffy.
  • The tongue coating is white.
  • The pulse is only perceptible with deep pressure; it may be thin, slow, and forceless.

|TCM Approach

Clinical Description:

温补肾阳,运化水湿

Plain-Language Explanation:

  • Warms and tonifies kidney yang to reduce aversion to cold and gradually alleviate lower back and knee soreness and fatigue.
  • Enhances kidney qi transformation to promote smoother fluid circulation.
  • Assists in transforming and transporting water-dampness to promote urination and reduce edema.
  • Relieves heaviness and tiredness caused by dampness retention.

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|Common Symptoms

Clinical Description:

眩晕,耳鸣,腰酸,口干,舌质红,少苔,脉细数

Plain-Language Explanation:

  • Dizziness and blurred vision, more noticeable when standing or walking, with a sensation of floating and unsteadiness.
  • Tinnitus with ringing in the ears, audible even in quiet, affecting concentration and rest.
  • Soreness and discomfort in the lower back, more pronounced during activity or prolonged sitting.
  • Dry mouth and throat, feeling rough when talking or swallowing.
  • The tongue is red, with a clear reddish appearance.
  • The tongue coating is scanty, with almost no visible thick coating.
  • The pulse is thin and rapid.

|TCM Approach

Clinical Description:

平肝息风,清热安神

Plain-Language Explanation:

  • Calms excessive liver qi to gradually reduce dizziness, headaches, and irritability.
  • Expels wind pathogens to relieve tremors, numbness, and vertigo.
  • Clears heat to ease thirst, restlessness, and insomnia.
  • Calms the mind to stabilize emotions, improve sleep quality, and promote mental tranquility.

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|Common Symptoms

Clinical Description:

口渴,气短,倦怠乏力,腰膝酸软,舌质红或淡,脉细弱

Plain-Language Explanation:

  • Persistent thirst, with drinking providing only temporary relief from dryness.
  • Easily becomes short of breath; slight exertion causes a feeling of insufficient air and weakness.
  • Easily tired and weak, with low motivation and incomplete recovery after rest.
  • Soreness and weakness in the lower back and knees, feeling unsupported when walking or sitting.
  • The tongue may be red or pale; when extended, it appears either more red or pale.
  • The pulse is thin and weak, perceptible only with steady pressure.

|TCM Approach

Clinical Description:

益气养阴,补肾健脾,清除余毒

Plain-Language Explanation:

  • Boosts qi and nourishes yin fluid so one is less prone to fatigue and weakness.
  • Tonifies kidney and spleen-stomach functions to improve nutrient absorption and reduce lower back/knee soreness and weakness.
  • Clears residual pathogenic qi to gradually relieve dry mouth, sore throat, or sores.

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|Common Symptoms

Clinical Description:

腰酸膝冷,完谷不化,舌质淡,苔薄黄,脉细数

Plain-Language Explanation:

  • The lower back feels sore and weak; the knees are cold, with an overall cold sensation.
  • Undigested food particles are often visible in the stool.
  • The tongue is pale, lacking in color.
  • The tongue coating is thin and yellow.
  • The pulse is thin and rapid.

|TCM Approach

Clinical Description:

健脾益肾,清热利湿

Plain-Language Explanation:

  • Strengthens spleen function to improve absorption and gradually build physical strength.
  • Nourishes the kidneys to replenish essence, reducing lower back and knee soreness and fatigue.
  • Clears heat to relieve thirst, restlessness, and throat discomfort.
  • Eliminates excess dampness to promote urination and gradually resolve edema and heaviness.

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|Common Symptoms

Clinical Description:

小便热涩刺痛,尿色深红,或夹有血块,舌苔黄,脉滑数

Plain-Language Explanation:

  • Urination is accompanied by a burning sensation and is not smooth, with stinging pain and obvious discomfort during voiding.
  • The urine is dark red or contains visible blood clots, appearing markedly bloody.
  • The tongue coating is yellow.
  • The pulse feels slippery and rapid.

|TCM Approach

Clinical Description:

清热利湿,凉血止血

Plain-Language Explanation:

  • Clears internal heat to reduce fever, thirst, and restlessness.
  • Drains excess dampness to relieve heaviness, edema, and difficult urination.
  • Cools the blood to calm blood flow and reduce bleeding due to blood heat.
  • Stops bleeding, gradually reducing hemoptysis, epistaxis, or hematochezia.

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|Common Symptoms

Clinical Description:

小便不利,尿频,尿急,尿痛,舌质红,苔薄黄或腻,脉浮数或滑数

Plain-Language Explanation:

  • Urination is not smooth; voiding feels labored and incomplete with poor flow.
  • Urinary frequency increases, with frequent urges to urinate.
  • Urinary urgency, with a sudden, compelling need to urinate.
  • Pain during urination, with urethral discomfort that worsens when passing urine.
  • The tongue is red.
  • The tongue coating is thin and yellow, or may be greasy and unclean.
  • The pulse is easily palpable at the superficial level and tends to be rapid, or is slippery and rapid.

|TCM Approach

Clinical Description:

清热燥湿,利尿通淋

Plain-Language Explanation:

  • Clears internal heat to ease thirst, restlessness, and burning urination.
  • Dries excess dampness to gradually relieve heaviness and stickiness.
  • Promotes smooth urination, improving difficult urination, frequency, and urgency.
  • Unblocks strangury to gradually reduce scanty, dark, or painful urination.

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|Common Symptoms

Clinical Description:

关节游走性疼痛,屈伸不利,舌红,苔黄腻,脉多滑数

Plain-Language Explanation:

  • Migratory joint pain that shifts from one joint to another, worsening with movement or pressure.
  • Joint flexion and extension are not smooth; bending or straightening feels restricted and clumsy.
  • The tongue is red.
  • The tongue coating is yellow, slimy, and greasy, appearing thick and unclean.
  • The pulse feels slippery and rapid.

|TCM Approach

Clinical Description:

祛风通络,清热和营

Plain-Language Explanation:

  • Expels wind pathogens to gradually relieve numbness, itching, and joint difficulties.
  • Unblocks the meridians to promote smooth flow of qi and blood, reducing pain and restricted movement.
  • Clears internal heat to ease thirst, restlessness, and sore throat.
  • Harmonizes nutrient-blood to stabilize qi and blood circulation and support overall recovery.

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|Common Symptoms

Clinical Description:

神疲乏力,身体消瘦,青筋暴露,身体瘀斑,腰酸腿软,血尿,舌红苔少,脉细数或涩

Plain-Language Explanation:

  • Mental and physical fatigue, lack of drive, and an emaciated appearance from depletion.
  • Visible superficial veins, with prominent venous markings clearly seen.
  • Purple-dark ecchymoses or petechiae are present, appearing as spots or patches of subcutaneous bleeding.
  • Lower back soreness and leg weakness, with legs feeling powerless, especially when walking or sitting for long.
  • Blood in the urine, with noticeable redness or blood streaks during urination.
  • The tongue is red with a scanty coating, almost no thick coating visible.
  • The pulse is thin and rapid, or rough and not smooth; it feels hurried or choppy.

|TCM Approach

Clinical Description:

补肺益肾,活血化瘀

Plain-Language Explanation:

  • Tonifies lung qi to improve breathing and reduce shortness of breath and fatigue.
  • Nourishes the kidneys to replenish essence, relieving lower back and knee soreness and weakness.
  • Activates blood circulation to smooth flow and reduce pain or numbness from stasis.
  • Dispels stasis to resolve bruising, masses, and blood flow obstruction.

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|Common Symptoms

Clinical Description:

胁肋疼痛,腹胀纳呆,或见黄疸,头晕失眠,月经不调,皮肤红斑色暗,舌红少苔,舌质紫暗,或有瘀点,脉细弦

Plain-Language Explanation:

  • Pain in the hypochondriac regions, more pronounced with movement or pressure, causing persistent discomfort.
  • Abdominal distension and fullness, with poor appetite and reduced food intake.
  • Occasionally the skin or eyes may appear yellowish.
  • Dizziness and a floating sensation; restless sleep with easy insomnia and vivid dreams.
  • Menstrual irregularities, with cycles and flow varying in amount.
  • Red patches on the skin that are darkish, not bright.
  • The tongue is red with very little coating.
  • The tongue body is purple-dark, or there may be petechial dots.
  • The pulse is thin and wiry, like a taut string.

|TCM Approach

Clinical Description:

活血化瘀,柔肝理气

Plain-Language Explanation:

  • Promotes blood circulation to help disperse stasis, reducing pain, numbness, and bruising.
  • After activating blood and resolving stasis, local masses or hardenings will gradually subside.
  • Soothes liver qi to improve mood, reducing chest tightness, hypochondriac distension, and irritability.
  • Regulates qi movement to harmonize qi and blood, bringing greater overall comfort.

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|Common Symptoms

Clinical Description:

小便浑浊如米汁水,置之沉淀如絮状,上有浮油如脂,舌红,苔黄腻,脉濡数

Plain-Language Explanation:

  • The urine appears cloudy like rice-washing water; upon standing, flocculent sediment sinks and an oily film floats on the surface.
  • The tongue is red.
  • The tongue coating is yellow, slimy, greasy, and unclean.
  • The pulse is soft and somewhat rapid; it is gentle but quickened.

|TCM Approach

Clinical Description:

分清化浊,温肾利湿

Plain-Language Explanation:

  • Assists the body in separating clear from turbid in the urine, promoting more normal and smooth excretion.
  • Dissolves turbid qi to relieve sticky mouth, heavy head, and bodily heaviness.
  • Warms and tonifies kidney qi to strengthen yang, reducing aversion to cold and lower back/knee soreness.
  • Promotes diuresis and drains dampness to smooth urination and gradually resolve edema and dampness.

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|Common Symptoms

Clinical Description:

关节酸痛,颜面红斑,浮肿,舌淡胖,苔白,脉沉

Plain-Language Explanation:

  • Joints feel sore and achy, with pain more noticeable on movement or pressure.
  • Red patches appear on the face, looking distinctly red.
  • General body swelling occurs, with skin appearing puffy and tight; pitting is clearly visible.
  • The tongue is pale and enlarged, appearing puffy.
  • The tongue coating is white.
  • The pulse is palpable only at a deep level, being deep and hard to pinpoint.

|TCM Approach

Clinical Description:

祛风解毒,除湿消肿,舒筋通络

Plain-Language Explanation:

  • Expels wind pathogens to gradually ease dizziness, itching, and joint stiffness.
  • Clears toxins to relieve sore throat, sores, and heat-toxin symptoms.
  • Drains excess dampness to reduce heaviness and edema.
  • Relaxes the sinews and unblocks meridians to improve joint mobility and gradually reduce pain and numbness.

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|Common Symptoms

Clinical Description:

恶心,呕吐,纳差,身重困倦,苔厚腻,脉濡或沉

Plain-Language Explanation:

  • Nausea and a churning sensation in the stomach, worsened by speaking or smelling odors.
  • Frequent vomiting, with lingering discomfort and poor appetite afterward.
  • Poor appetite with little interest in food and markedly reduced intake.
  • The body feels heavy and weary, with limbs lacking strength and fatigue worsening with activity.
  • The tongue coating is thick and greasy, appearing like a layer of oily fur.
  • The pulse is soft and slippery, or deep and only felt with firm pressure.

|TCM Approach

Clinical Description:

化浊祛湿,健脾补肾

Plain-Language Explanation:

  • Dissolves turbid qi to relieve dizziness, sticky mouth, and bodily heaviness.
  • Eliminates excess dampness to promote smooth urination and gradually resolve edema and heaviness.
  • Strengthens spleen function to improve digestion and absorption and boost physical strength.
  • Nourishes the kidneys to replenish essence, gradually improving lower back and knee soreness and fatigue.

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|Common Symptoms

Clinical Description:

神识昏迷,或有癫痫样发作,四肢抽搐,周身肢节疼痛或红肿,舌红或绛或紫黯,脉沉虚数

Plain-Language Explanation:

  • Altered consciousness or even coma may occur, with reduced responsiveness or inability to communicate normally.
  • Epileptiform seizures may appear, with convulsive jerking of the limbs that is difficult to control.
  • Joints in the limbs or whole body are painful; in severe cases, redness and swelling may occur.
  • The tongue is red, or a deeper crimson, or purplish-dark; its color change is evident when extended.
  • The pulse is deep and must be felt with pressure; it is somewhat weak and slightly rapid.

|TCM Approach

Clinical Description:

清营滋阴,宁心开窍

Plain-Language Explanation:

  • Clears heat from the ying (nutritive) level to gradually reduce high fever, restlessness, and red tongue.
  • Nourishes yin fluid to balance yin and yang, relieving deficiency heat, thirst, and night sweats.
  • Calms the mind to stabilize mood and ease irritability and insomnia.
  • Opens the heart orifices to restore consciousness and gradually improve mental clouding or confusion.

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|Common Symptoms

Clinical Description:

壮热口渴,肌肤发斑,出血证候,舌红绛,脉弦数

Plain-Language Explanation:

  • Persistent high fever with a sensation of intense heat and constant thirst.
  • Spots or rashes appear on the skin, scattered over the body surface.
  • Bleeding manifestations occur, with a tendency for bleeding that is hard to stop.
  • The tongue is deep red or crimson, intensely red when extended.
  • The pulse is wiry and tight, and rapid.

|TCM Approach

Clinical Description:

清热解毒,舒筋活络

Plain-Language Explanation:

  • Clears internal heat to gradually relieve fever, thirst, and sore throat.
  • Resolves toxins to reduce sores, redness, swelling, and heat-toxin manifestations.
  • Relaxes sinews and joints to improve flexibility and reduce stiffness.
  • Unblocks the meridians to promote smooth flow of qi and blood, gradually reducing pain and numbness.

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|Common Symptoms

Clinical Description:

忽起发病,热势不高,面部、手臂、胸腹可见红疹散发,肌肤瘙痒,关节疼痛,苔薄,质黯红少津,脉浮数,重按无力

Plain-Language Explanation:

  • Symptoms come on suddenly with mild fever; the fever is low-grade and not severe.
  • Scattered red rashes appear on the face, arms, chest, and abdomen, appearing in patches.
  • Intense skin itching, with a constant urge to scratch; scratching does not provide complete relief.
  • Joint pain occurs, worsening with movement or pressure and affecting daily activities.
  • The tongue coating is very thin, appearing as a light layer.
  • The tongue is dark red with reduced moisture, looking dry and not well-moistened.
  • The pulse is easily palpable at the superficial level and rapid, but becomes weak when pressed deeply.

|TCM Approach

Clinical Description:

祛风解毒

Plain-Language Explanation:

  • Expels wind pathogens to reduce dizziness, itching, and joint mobility issues.
  • Clears toxins to relieve sore throat, sores, and red, swollen, hot, painful lesions.

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