The Role of Traditional Chinese Medicine in the Treatment of Lupus Nephritis.

Abstract

Lupus nephritis (LN) represents one of the most severe organ manifestations of systemic lupus erythematosus and remains a leading cause of morbidity and mortality in affected patients. Its pathogenesis is highly complex, involving multifaceted immune dysregulation and posing substantial challenges for clinical management. According to Traditional Chinese Medicine (TCM), LN is characterized by root deficiency and branch excess, with kidney deficiency as the base and heat-toxins combined with blood stasis driving disease progression. Furthermore, clinical manifestations of LN vary significantly across disease stages and are often complicated by conventional pharmacotherapies. Accumulating clinical evidence increasingly supports the therapeutic efficacy of TCM intervention in LN management. Pharmacologic investigations have further elucidated their multi-target, pleiotropic actions, including modulating immune responses and regulating critical molecular pathways implicated in the pathogenesis of LN. This review systematically outlines the TCM conceptualization of LN pathogenesis; catalogs commonly employed compound formulas, single herbs, and bioactive extracts used in clinical practice; and delineates their underlying pharmacologic mechanisms, thereby providing a rigorous scientific foundation for rational TCM formulation design and facilitating the development of integrated, evidence-informed, and optimized therapeutic strategies for LN.