Traditional Chinese Medicine Syndrome of Primary Sjögren's Syndrome Patients with Interstitial Lung Disease

CHEN Jiaqi; YANG Jianying; WU Zihua; ZHANG Lining; ZHANG Yan; HU Qi; HE Qian; HUANG Ziwei; YU Xinbo; LUO Jing; TAO Qingwen

doi:10.13422/j.cnki.syfjx.20231490

您当前的位置：

首页 >

文章列表页 >

Traditional Chinese Medicine Syndrome of Primary Sjögren's Syndrome Patients with Interstitial Lung Disease

更新时间：2023-05-17

- Traditional Chinese Medicine Syndrome of Primary Sjögren's Syndrome Patients with Interstitial Lung Disease
  增强出版
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 29, Issue 8, Pages: 66-72(2023)
- 作者机构：
  
  1.北京中医药大学，北京 100029
  2.中日友好医院，免疫炎性疾病北京市重点实验室，北京 100029
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20231490
  CLC： R242;R2-0;R2-031;R593;R24;R285
- Published：20 April 2023，
  
  Published Online：27 October 2022，
  
  Received：17 August 2022，
- 稿件说明：
扫描看全文
陈嘉琪,杨建英,吴子华等.原发性干燥综合征合并间质性肺病的中医证候特点及相关因素分析[J].中国实验方剂学杂志,2023,29(08):66-72.

CHEN Jiaqi,YANG Jianying,WU Zihua,et al.Traditional Chinese Medicine Syndrome of Primary Sjögren's Syndrome Patients with Interstitial Lung Disease[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(08):66-72.
陈嘉琪,杨建英,吴子华等.原发性干燥综合征合并间质性肺病的中医证候特点及相关因素分析[J].中国实验方剂学杂志,2023,29(08):66-72. DOI： 10.13422/j.cnki.syfjx.20231490.

CHEN Jiaqi,YANG Jianying,WU Zihua,et al.Traditional Chinese Medicine Syndrome of Primary Sjögren's Syndrome Patients with Interstitial Lung Disease[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(08):66-72. DOI： 10.13422/j.cnki.syfjx.20231490.

摘要

目的

总结原发性干燥综合征（pSS）合并间质性肺病（ILD）患者的中医证候特点，探索相关因素。

方法

采用调查研究的方法，纳入2018年12月至2022年4月于中日友好医院中医风湿病科就诊的pSS患者，统一采集舌象和证候，依据是否合并ILD进行分组（pSS-ILD与pSS-非ILD组）。比较两组患者舌象、证候及实验室指标的差异，采用Logistic回归探索pSS-ILD的相关影响因素。

结果

共纳入pSS患者200例，女性186（93.0%）例，中位年龄57岁，中位病程60月，其中pSS-ILD患者44例（22%）。在舌象上，pSS-ILD组患者常见暗/紫/瘀舌、裂纹舌、少津舌、厚苔、黄苔、腻苔。与pSS-非ILD组患者比较，pSS-ILD组患者黄苔比例更高（

=4.799，

0.05）。在证候上，超过40% pSS-ILD组患者存在气虚、阴虚、痰湿、气滞和（或）血瘀证。阴虚中以肝肾阴虚证最多见，气虚中以肺气虚证最多见。与pSS-非ILD组患者比较，pSS-ILD组患者肺气虚比例更高（

=18.667，

0.01）。在实验室指标上，与pSS-非ILD组患者比较，pSS-ILD组患者抗SSA抗体阳性比例更高（

=4.332，

0.05），C反应蛋白（

0.01）、补体C3（

0.05）、补体C4（

0.05）水平更高。Logistic回归分析显示，黄苔［比值比（OR）=5.260，95%置信区间（CI） 1.337~20.692，

0.05］、肺气虚（OR=6.079，95% CI 2.585~14.298，

0.01）是pSS-ILD的独立危险因素，补体C4降低（OR=0.199，95% CI 0.070~0.564，

0.01）是pSS-ILD的独立保护因素。

结论

约22%的pSS患者合并ILD，此类患者常见气虚、阴虚、痰湿、气滞、和（或）血瘀证。黄苔、肺气虚和C4水平是pSS合并ILD的相关因素。

Abstract

Objective

To summarize the characteristics of traditional Chinese medicine （TCM） syndrome in primary Sjögren's syndrome （pSS） patients with interstitial lung disease （ILD） and to explore associated factors.

Method

A survey was conducted and pSS patients who were treated in TCM department of rheumatism at China-Japan Friendship Hospital from December 2018 to April 2022 were included. Tongue manifestations and syndromes of patients were recorded. pSS patients with ILD were classified into the pSS-ILD group and those without the ILD were included in the pSS-non-ILD group. The tongue manifestations， syndromes， and laboratory indexes were compared between the two groups， and logistic regression was used to explore the factors associated with pSS-ILD.

Result

A total of 200 pSS patients were included， with 186 （93.0%） females， median age of 57 years， and median disease course of 60 months， of which 44 （22%） had pSS-ILD. In terms of tongue manifestations， pSS-ILD patients generally had dark/purple/stasis tongue， fissured tongue， and tongue with little fluid， thick coating， yellow coating， and greasy coating. The proportion patients with yellow coating was higher in pSS-ILD group than in the pSS-non-ILD group （

=4.799，

0.05）. In terms of syndrome， more than 40% of pSS-ILD patients had Qi deficiency， Yin deficiency， phlegm-dampness， Qi stagnation， and/or blood stasis syndrome. As for Yin deficiency， liver-kidney Yin deficiency syndrome ranked the first. For Qi deficiency， lung Qi deficiency syndrome was most commonly seen. The proportion of patients with lung Qi deficiency was higher in the pSS-ILD group than in the pSS-non-ILD group （

=18.667，

0.01）. As to laboratory indexes， compared with the pSS-non-ILD group， pSS-ILD group had high proportion of anti-SSA-positive patients （

0.05） and high levels of C-reactive protein （CRP）（

0.01）， complement C3 （

=4.332，

0.05）， and complement C4 （

0.05）. Logistic regression analysis showed that pSS with ILD was positively associated with lung Qi deficiency ［odds ratio （OR）=6.079， 95% confidence interval （CI） 2.585-14.298，

0.01）］ and yellow coating （OR=5.260， 95% CI 1.337-20.692，

0.05） and negatively associated with low C4 （OR=0.199， 95% CI 0.070-0.564，

0.01）.

Conclusion

About 22% of pSS patients had ILD， and patients with pSS-ILD generally have Qi deficiency， Yin deficiency， phlegm-dampness， Qi stagnation， and/or blood stasis syndrome. Yellow coating， lung Qi deficiency and C4 level are factors associated with pSS combined with ILD.

关键词

干燥综合征间质性肺疾病证候舌象免疫炎症

Keywords

Sjögren's syndromeinterstitial lung diseasesyndrometongueimmune inflammation

references

MARIETTE X，CRISWELL L A.Primary Sjögren's syndrome［J］.N Engl J Med，2018，378（10）：931-939.

PALM O，GAREN T，BERGE ENGER T，et al.Clinical pulmonary involvement in primary Sjogren's syndrome：Prevalence，quality of life and mortality-A retrospective study based on registry data［J］.Rheumatology （Oxford），2013，52（1）：173-179.

GUPTA S，FERRADA M A，HASNI S A.Pulmonary manifestations of primary Sjögren's syndrome：Underlying immunological mechanisms，clinical presentation，and management［J］.Front Immunol，2019，10：1327.

陈宏道，丁一帆，谢师旅，等.中医药治疗干燥综合征干眼疗效的Meta分析［J］.亚太传统医药，2022，18（5）：179-184.

周娜，黄传兵，陈君洁，等.健脾养阴法治疗气阴两虚型干燥综合征临床疗效及安全性Meta分析［J］.光明中医，2022，37（7）：1130-1134.

黄淑霞，曹天雨，肖战说，等.中药联合硫酸羟氯喹治疗干燥综合征疗效和安全性的Meta分析［J］.海南医学院学报，2022，28（9）：685-693.

焦以庆，王玉光，郭丽娅，等.干燥综合征继发肺间质疾病45例的中西医临床特点分析［J］.中华中医药杂志，2020，35（2）：876-879.

刘洋，董振华，郝伟欣.原发性干燥综合征合并肺间质病变中医证候与高分辨CT特征的研究［J］.北京中医药大学学报，2016，39（7）：610-613.

张丽宁，陈嘉琪，胡琪，等.不同舌象原发性干燥综合征患者的免疫炎症特点［J］.世界中西医结合杂志，2021，16（9）：1710-1713.

SHIBOSKI C H，SHIBOSKI S C，SEROR R，et al.2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjögren's syndrome：A consensus and data-driven methodology involving three international patient cohorts［J］.Ann Rheum Dis，2017，76（1）：9-16.

中华中医药学会.中医内科常见病诊疗指南：西医疾病部分［M］.北京：中国中医药出版社，2008：234-236.

李灿东.中医诊断学［M］.北京：中国中医药出版社，2016：43-46.

SAMBATARO G，FERRO F，ORLANDI M，et al.Clinical，morphological features and prognostic factors associated with interstitial lung disease in primary Sjögren's syndrome：A systematic review from the Italian Society of Rheumatology［J］.Autoimmun Rev，2020，19（2）：102447.

QIAN J，HE C，LI Y，et al.Ten-year survival analysis of patients with primary Sjögren's syndrome in China：A national prospective cohort study［J］.Ther Adv Musculoskelet Dis，2021，doi：10.1177/1759720X211020179http://dx.doi.org/10.1177/1759720X211020179.

NANNINI C，JEBAKUMAR A J，CROWSON C S，et al.Primary Sjogren's syndrome 1976-2005 and associated interstitial lung disease：A population-based study of incidence and mortality［J］.BMJ Open，2013，3（11）：e003569.

WANG Y，HOU Z，QIU M，et al.Risk factors for primary Sjögren syndrome-associated interstitial lung disease［J］.J Thorac Dis，2018，10（4）：2108-2117.

LI X，XU B，MA Y，et al.Clinical and laboratory profiles of primary Sjogren's syndrome in a Chinese population：A retrospective analysis of 315 patients［J］.Int J Rheum Dis，2015，18（4）：439-446.

LIN W，XIN Z，ZHANG J，et al.Interstitial lung disease in Primary Sjögren's syndrome［J］.BMC Pulm Med，2022，22（1）：73.

GAO H，ZHANG X，HE J，et al.Prevalence，risk factors，and prognosis of interstitial lung disease in a large cohort of Chinese primary Sjögren syndrome patients：A case-control study［J］.Medicine，2018，97（24）：e11003.

HE S H，HE Y J，GUO K J，et al.Risk factors for progression of interstitial lung disease in Sjögren's syndrome：A single-centered，retrospective study［J］.Clin Rheumatol，2022，41（4）：1153-1161.

高鑫，郑雅文，赵志远，等.原发性干燥综合征合并间质性肺疾病的临床特点及影响因素分析［J］.河南医学研究，2021，30（5）：784-787.

吴晓丹，龙武彬.原发性干燥综合征间质性肺疾病与临床免疫学指标的关系［J］.四川医学，2009，30（7）：1017-1018.

ROCA F，DOMINIQUE S，CHMIDT J，et al.Interstitial lung disease in primary Sjögren's syndrome［J］.Autoimmun Rev，2017，16（1）：48-54.

张科，何雪春，陈超，等.原发性干燥综合征相关间质性肺疾病的发生率及危险因素分析［J］.实用临床医药杂志，2021，25（18）：10-14.

陈秀英，刘佩玲，赵金霞.原发性干燥综合征合并肺间质病变的临床特点分析［J］.中华风湿病学杂志，2020，24（11）：761-766.

LUPPI F，SEBASTIANI M，SILVA M，et al.Interstitial lung disease in Sjögren's syndrome：A clinical review［J］.Clin Exp Rheumatol，2020，126（4）：291-300.

石宇红，周润华，莫汉有，等.145例原发性干燥综合征肺间质病变的危险因素分析［J］.重庆医学，2012，41（11）：1111-1113.

路武杰，冯志军，郭俊华，等.原发性干燥综合征合并间质性肺疾病的临床、化验及检查特征［J］.国际呼吸杂志，2015，35（2）：114-116.

GAO H，SUN Y，ZHANG X Y，et al.Characteristics and mortality in primary Sjögren syndrome-related interstitial lung disease［J］.Medicine （Baltimore），2021，100（35）：e26777.

MANFREDI A，VACCHI C，DELLACASA G，et al.Fibrosing interstitial lung disease in primary Sjogren syndrome［J］.Joint Bone Spine，2021，88（6）：105237.

KAKUGAWA T，SAKAMOTO N，ISHIMOTO H，et al.Lymphocytic focus score is positively related to airway and interstitial lung diseases in primary Sjögren's syndrome［J］.Respir Med，2018，137：95-102.

DECKER P，MOULINET T，PONTILLE F，et al.An updated review of anti-Ro52 （TRIM21） antibodies impact in connective tissue diseases clinical management［J］.Autoimmun Rev，2022，21（3）：103013.

HE C，CHEN Z，LIU S，et al.Prevalence and risk factors of interstitial lung disease in patients with primary Sjögren's syndrome：A systematic review and Meta-analysis［J］.Int J Rheum Dis，2020，23（8）：1009-1018.

李娅，李小峰，黄慈波，等.原发性干燥综合征患者继发间质性肺病的临床特点［J］.中华风湿病学杂志，2013，17（10）：667-671.

LUO J，SONG W J，CHEN J Q，et al.Factors associated with secondary immune thrombocytopenia in patients with primary Sjögren's syndrome：A retrospective study of 639 cases［J］.Clin Exp Rheumatol，2022，40（12）：2245-2252.

周瑾，殷松楼.干燥综合征并发间质性肺疾病与临床免疫学指标的关系［J］.中国实用医药，2020，15（25）：38-39.

冯秀媛，庞春艳，王永福.干燥综合征合并间质性肺病临床特点分析［J］.中国临床研究，2018，31（1）：125-127.

ZHANG T，YUAN F，XU L，et al.Characteristics of patients with primary Sjögren's syndrome associated interstitial lung disease and relevant features of disease progression［J］.Clin Rheumatol，2020，39（5）：1561-1568.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Characteristics of Tongue Manifestations and Syndromes of Patients with Primary Sjögren's Syndrome of Different Time

Sishenwan Combined with Tongxie Yaofang Treats Ulcerative Colitis with Spleen-kidney Yang Deficiency and Liver Depression

Methodological Evaluation of Advantages of Traditional Chinese Medicine Treatment of Sjögren's Syndrome

Guidelines for TCM Intervention After Conventional Western Medicine Treatment for Stage Ⅰ-Ⅲ Colorectal Cancer

Immunoregulatory Effect of Jiedu Tongluo Shengjin Prescription on Sjögren's Syndrome Mice Based on Stability of Treg Cells

Related Author

ZHANG Yan

CHEN Jiaqi

LUO Jing

TAO Qingwen

LIU Yaqing

LIU Haifan

LIU Bin

FENG Xue

Related Institution

Beijing Key Lab for Immune-Mediated Inflammatory Diseases， China-Japan Friendship Hospital

Heilongjiang University of Chinese Medicine

Institute of Chinese Materia Medica，China Academy of Chinese Medical Sciences

Hospital of PLA Joint Logistics Support Force

The First Affiliated Hospital of Heilongjiang University of Chinese Medicine

Postal code：100700
Tel：010-84076882 Email：syfjx_2010@188.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备11006657号-10 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰