2.TCM key specialty institution of Hebei Province
3.Clinical and Research Base for Rheumatism and Immune Diseases of Chinese Medical Association.

1. Introduction

Rheumatology and Autoimmune Diseases Department of Hebei Yiling Hospital, is a member institution of International Network of Scleroderma Clinical and Research (InSCAR), key TCM specialty department of Hebei Province, the Clinical and Research Base of Rheumatoid and Autoimmune Diseases of Chinese Medical Association, and the largest and earliest established scleroderma treatment center in China. With over twenty years of development, the department has become a significant characteristic specialty both at home and abroad, and developed 34 TCM preparations which have been approved by Hebei Food and Drugs Administration, and mainly treated scleroderma, multiple myositis, ankylosing spondylitis, rheumatoid diseases, Sjögren's syndrome, Behcet's syndrome, etc. Particularly, the department is in a leading position for treating scleroderma, and has the largest number of inpatients with scleroderma throughout the world with over 12000 cases of scleroderma.

On the basis of fully tapping TCM traditional theories, the department established for scleroderma and its complications a scleroderma research lab which has innovated many treatment theories and methods, such as diagnosis and treatment from the perspective of collateral pathology, softening scleroderma with TCM medication in three phases, treating scleroderma pulmonary fibrosis with three differentiations and three combinations according to different phases, treating systematic scleroderma with the combination of TCM and thoracic duct drainage, and also conducted clinical researches on treating systematic scleroderma esophageal lesion with Shenzhe Zhuyun mixture, treating scleroderma pulmonary fibrosis with combination of Shenmai Kaifei powder and pirfenidone and treating scleroderma with mesenchymal stem cell, etc.

While conducting substantial clinical practice, the department has also attached the same importance to scientific research, carried out cooperation on scleroderma with medical institutions like UT Health, Fudan University, Shanghai Huashan Hospital, taken on one international cooperation project (NIH-UO1) of the National Institution of Health of the United States, one special international cooperation project of the Ministry of Science and Technology, one project of the National Natural Science Foundation of China and four project of provincial science and research, published over 20 professional papers on scleroderma, and related research results have been shared many times at professional conferences both at home and abroad. The clinical efficacy and research competence of the department has been highly appreciated by the general patients and professionals both at home and abroad.

2. TCM Characteristic Therapy

(1) Applying TCM ointment. It is used for scleroderma skin lesion. It might be prepared in two dosage forms of vanishing cream and cold cream according to dermatological symptoms of patients.



(2) Iontophoresis of TCM. It is used for scleroderma skin lesion, parotid gland disease of Sjögren's syndrome, and rheumatic arthropathy, etc.

(3) Chinese medicine bath (including local medicine bath and systematic bath). It is used for scleroderma, and other skin and joint lesion of rheumatic and autoimmune diseases.

(4) TCM steam bath (TCM fumigation treatment). It is used for scleroderma, and other skin and joint lesion of rheumatic and autoimmune diseases.

(5) TCM drug-wax therapy. It is used for scleroderma, other skin and joint lesions of rheumatic and autoimmune diseases, and Raynaud phenomenon, etc.

(6)Acupuncture therapy. It could be used for nearly all symptoms according to different conditions.

(7) Grand moxibustion therapy. It is used for scleroderma and other rheumatic diseases of insufficiency of both the spleen and the kidney in the diagnostic perspective of TCM.

(8) TCM alcohol therapy. It is used for scleroderma, other skin and joint lesions of rheumatic and autoimmune diseases, and Raynaud phenomenon, etc.

(9) TCM packet therapy. It is used for various arthritis, neck shoulder pain or lumbocrural pain, skin sclerosis and joint contracture, etc.


3. Initiation of a series of effective TCM preparations:

(1) Xianling Huoluo Powder: It warms to dissipate the congealed cold, detoxifies and removes stasis. It is used for scleroderma diagnosed with cold coagulation and blood stasis, manifesting stiff, thick and edematous skin with gloss of wax, muscle atrophy, limited motor function, paucity of facial expressions, loss of the ability to close eyes, acrocyanosis, arthralgia and squamous and dry skin, etc.

(2) Dangui Huoluo Powder: It clears the heat and toxic materials.  It is used for stiff, thick, swollen and hard skin caused by scleroderma with toxic heat and blood stasis resistance, when pressed it will locally warm up, shiny like wax, with limited motor function, difficult in opening mouth, with even dysphagia, etc.



(3) Shenmai Kaifei Powder: It supplements qi and nourishes yin, detoxifies and promotes blood circulation. It is used for chest distress, shortness of breath, and weak coughing sound etc. caused scleroderma diagnosed with insufficiency of qi and yin, blood stasis and toxic accumulation.

(4) Shenxiang Zhuyun Powder: It invigorates the spleen and supplement qi, harmonizes stomach for descending adverse qi. It is used for scleroderma gastrointestinal lesions diagnosed with  deficient spleen and weak vital

energy, stomach qi rising that cause coughing when drinking water, dysphagia, abdominal distension, stomachache, alternating diarrhea and constipation, etc.

(5) Shenqi Yiqi Capsule: It benefits qi, invigorates the spleen, activates blood circulation. It is used for scleroderma patients diagnosed with qi deficiency and blood stasis, manifesting that the patients are in poor health, lassitude, short of breath, abdominal fullness and distention, decline in diet and hypoimmunity, etc.

(6) Shenling Fuyuan Capsule: It invigorates the spleen and the kidney, invigorates qi and warming yang. It is used for scleroderma diagnosed with loss of Zhenyuan and weak warmth that cause insufficiency with chills, vertigo, tinnitus, soreness and weakness of waist and knees, impotence nocturnal emission.

(7) Guishao Tongluo Powder: It warms yang and promotes blood circulation, removes spasmolysis, and dredges collaterals. It is used for scleroderma with stagnant coldness in meridian and vessels, and manifestations are cold limbs, acrocyanosis, changing colors from white, cyanosis to red when distally exposed to coldness, possible aggravating emotion changes, and severe patients may manifest microdactyly, inhibited bending and stretching, ulcers and gangrene, etc.

(8) Shenjing Yangrong Capsule: It reinforces the vital essence and strengthening the primordial qi, nourishes and promotes tissue regeneration. It is used for scleroderma in the phase of dermatrophia with asthenia of qi and blood, and manifestations are subcutaneous tissue and muscle atrophy, skin shriveling on bones forming board like rigidity.

4. Having effectively treated a number of patients both at home and abroad:

(1) ArgentineanMs. Cecilia Tkacz, got systematic scleroderma relapsing multiple myositis. After 3 months oftreatment with oral TCM decoction, TCM  bath and external application of TCM ointment, her symptoms of skin tightening and induration, hyperpigmentation and hypopigmentation were remarkably relieved, skin metabolism was improved, joints were capable of moving with ease, ulcerations of interphalangeal and  metacarpophalangeal joints were healed, arthralgia and pruritus disappeared, myodynamia and myocardial enzymes was basically restored to normal level, which was a clinical recovery.



(2) Madam Lin Huanxia, from Bologna, Italy, had been diagnosed with systemic scleroderma for7 years. When she was just admitted to the hospital, her skin was tight and thick with minor gloss of wax, hyperpigmentation with occasional hypopigmentation, dermal atrophy, reduction of rhicnosis, loss of the ability to make skin fold, loss of sweat glands and part of body hair, acral arthralgia and stiffness, and loss of the ability to make a fist and to squat. After 3 months of treatment, the skin of the patient was obviously softened and became white, hyperpigmentation was alleviated, skin metabolism was improved, body hair started to grow, sweating became normal, acral arthralgia disappeared, and flexibility of joints increased and capable of making a fist and squatting. When first admitted to the hospital, she was helped into ward by her husband, and for the following 2 consolidation treatments, she came to the hospital from Italy all by herself. She said, "Right now I could independently manage my life, shopping and walking just like able-bodied person without feeling tired!"



(3) Hanako, a Japanese patient diagnosed with systemic sclerosis, when admitted to the hospital, her whole skin was tight, hard, dark with pruritus, partial hypopigmentation at face, anterior chest and the backs of both hands, and her face showed gloss of wax, the skin of both upper limbs appears swollen and hard, both elbow joints presented with stiffness, lack of flexibility, both hands presented with deformation of digital joints and flexion contracture, difficulty of tongue extension and opening mouth. After two treatments in the hospital with combined therapy of thoracic duct drainage and TCM, the symptoms of tight, stiff, edema and darkened skin were obviously on the mend, pruritus disappeared, facial gloss of wax was greatly improved, the flexibility of hands and digital joints got better, the extents of opening mouth and extending tongue increased, and the patient condition is relatively stable, and lives her life just like common people.

(4) Madam Ni Peizhen, a Chinese Indonesian,  had suffered from scleroderma adultorum for 11 years, when admitted to the hospital, the patient presented with diffuse swelling, thickening, tightening and induration in the skin and subcutaneous tissues of her neck, back, face, shoulders, upper arms, anterior chest, non-pitting-edema, limited ability to make skin fold, darkened skin, masklike face, paucity of wrinkles. When the patient was 
discharged from the hospital after 42 days of treatment, the edema, tightening, induration and hyperpigmentation of the diseased skin and subcutaneous tissues were relieved, skin metabolism was improved, no loss of body hair, perspiration was normal, the expressions was richer, motion ranges of neck and upper limbs increased.

(5) Ailikemujiang from Kazakhstan, had been diagnosed with systemic scleroderma for 2 years, accompanied by acute interstitial pulmonary fibrosis, and the disease appeared progressive despite of treatments by doctors in many places, with coughing,  expectoration, chest distress and shortness of breath, tight, hard, thick and darkened skin, soreness and weakness of muscles and arthralgia. When the patient was initially admitted to the hospital, climbing one storey or walking 500 meters would cause unbearable chest distress and shortness of breath. After 2 months of combined TCM and western medicine of  TCM decoction, TCM preparations of Shenmai Kaifei powder, acupuncture, aerosol inhalation, and anticoagulant therapy, immunosuppressive agents, anti-fibrosis and anti-inflammatory, arthralgia disappeared, and symptoms of coughing, asthma and shortness of breath were obviously relieved. The skin became soft, the strength was improved. The patient was capable of climbing four storeys, feeling a slight shortness of breath, and of walking 3 kilometers without obvious discomfort. Rales of pulmonary diagnosis were reduced, respiratory activities increased. Pulmonary function and pulmonary HRCT were obviously improved.



Professor Maureen Mayes, an international scleroderma specialist from UT Health and Professor John Reveille, former President of the Pan American League of Associations of Rheumatology(PANLAR) were delivering the plaque of InSCAR in 2012.

Both foreign and Chinese specialists held a major scleroderma joint consultation at Hebei Yiling Hospital in 2014.

A souvenir picture of experts and professionals at the Fourth Annual Conference of InSCAR and the Second Scleroderma Summit Forum of Hebei Yiling Hospital in March 2014.