The Treatment of Rheumatology Immunology

Definition of Rheumatology Immunology Disease

Six Clarifications on Bi Syndrome (Arthralgia Syndrome) in Traditional Chinese Medicine

I. What is Bi Syndrome?

According to Traditional Chinese Medicine (TCM) theory, Bi Syndrome is primarily caused by a deficiency of kidney qi, disharmony between defensive (wei) and nutritive (ying) qi, which allows wind, cold, and damp pathogenic factors to lodge in the moyuan (pleuro-diaphragmatic space or source of qi). These pathogens stagnate, disrupting the qi mechanism in the moyuan. Repeated exposure to pathogens causes them to condense into toxins, which then travel with blood and qi, damaging the skin, muscles, tendons, bones, viscera, and the moyuan itself, thus forming Bi Syndrome.

The disease location of Bi Syndrome is the moyuan, and its root cause lies in the liver and kidney channels. In TCM, Bi Syndrome is classified into Cold-Damp Bi Syndrome and Damp-Heat Bi Syndrome.

• Cold-Damp Bi Syndrome is mainly characterized by pain and stiffness in the limbs and joints, which worsens with cold exposure. Symptoms may include aversion to cold, chills, clear urine, and frequent urination at night.
• Damp-Heat Bi Syndrome is mainly characterized by redness, swelling, heat, and pain in the limbs and joints, which worsens with heat exposure. Symptoms may include aversion to heat, sweating, thirst, and scanty, dark urine.
• When pathogenic factors lurk in the moyuan, the condition becomes lingering and difficult to cure. Over time, this leads to the consumption of qi and blood, deficiency of the liver and kidneys, progressing into Deficiency Bi Syndrome.
• The lurking pathogens in the moyuan lead to chronic, unhealing conditions. Prolonged Bi Syndrome results in blood stasis due to chronic illness, phlegm accumulation due to dampness, and kidney involvement due to chronic illness. If the chest is obstructed, it manifests as Chest Bi (Xiong Bi); if phlegm-fluid retains in the chest and hypochondrium, it manifests as Suspended Fluid (Xuan Yin); the kidneys govern the bones, so kidney deficiency with bone damage manifests as Bone Wilting (Gu Wei); if kidney qi declines, qi movement is reversed, leading to inability to eat and difficulty with urination and defecation, which manifests as Obstruction and Rejection (Guan Ge).

II. Why do people get Bi Syndrome?

TCM believes that irregular daily routines, uncontrolled diet, and prolonged emotional stress can lead to disharmony of the defensive and nutritive qi—essentially, a decline in resistance (weakened vital/righteous qi, zheng qi). This allows wind, cold, and damp pathogens to invade the body and lodge in the moyuan. These pathogens stagnate and condense into toxins, penetrating deep into the moyuan, obstructing the liver and kidney channels, and destroying the筋骨 (tendons and bones), thus developing into Bi Syndrome.

III. How is Bi Syndrome currently treated in TCM?

Current TCM treatments primarily focus on oral administration of Chinese herbal medicine, herbal fumigation and hot compresses, and small-needle knife therapy. The main actions are invigorating blood to unblock channels and dispelling wind and dampness.

However, these TCM treatments mainly aim to alleviate symptoms and do not necessarily expel the lurking pathogens from the moyuan. Although they have fewer toxic side effects, they can be slow to take effect, and the condition may persist without complete recovery.

IV. Why is Bi Syndrome often stubborn and difficult to cure?

Conventional TCM treatments may not adequately address the functional abnormality of the moyuan, the lurking pathogens within it, or the disharmony of defensive and nutritive qi. Consequently, the body cannot properly distribute nutrients or clear toxins and pathogens. As long as the lurking pathogens remain in the moyuan, the condition will be difficult to cure completely.

V. How does our hospital treat Bi Syndrome?

Our hospital adopts a comprehensive treatment strategy:

1. Local External TCM Therapies: We utilize techniques such as herbal fumigation, steam therapy, moxibustion, acupuncture, and herbal compresses. These methods accelerate local blood circulation and metabolism, help clear local immune complexes and inflammatory factors, and provide rapid pain relief and swelling reduction.
2. Immunoadsorption and Plasma Exchange: These techniques directly remove antibodies, antigens, immune complexes, and inflammatory factors from the blood. This blocks the re-deposition of toxins onto muscles, bones, and joints, preventing recurrence or further aggravation of the condition.
3. Systemic Immunomodulation: We use oral Chinese herbal medicine and patented formulas, combined with whole-body fumigation, umbilical therapy, meridian-specific moxibustion, acupressure massage, and field therapy (e.g., magnetic or electric field). These methods aim to regulate the body's immune function, balance antibodies, antigens, immune complexes, and abnormally expressed cytokines, thereby preventing relapse.

VI. What treatment outcomes can our hospital achieve?

1. If there is no bone damage yet and only swelling and pain in muscles and tendons, satisfactory results can be achieved relatively quickly.
2. If there is no joint deformity, we can rapidly relieve pain and reduce swelling, helping patients regain self-care ability.
3. For patients with existing joint deformities, we can delay disease progression, protect heart and kidney function, and prevent severe complications.

VII. What precautions should be taken during treatment?

1. Early Detection, Early Treatment: This is fundamental for achieving better therapeutic results.
2. Follow Medical Advice, Do Not Stop Medication: This is crucial for ensuring stable and positive progress in treatment.
3. Frequent Follow-ups and Re-examinations: Adhere to the doctor's schedule for follow-ups and re-examinations to effectively work towards establishing immune tolerance.