浏览全部资源
扫码关注微信
1.中日友好医院,北京 100029
2.中国中医科学院 广安门医院,北京 100053
3.中国医学科学院 北京协和医院,北京 100730
4.北京中医药大学 东方医院,北京 100078
5.北京中医药大学 东直门医院,北京 100700
6.首都医科大学 附属北京中医医院,北京 100010
7.北京大学 第一医院,北京 100034
8.北京大学 第三医院,北京 100191
9.首都医科大学 北京宣武医院,北京 100053
10.首都医科大学 北京世纪坛医院,北京 100038
11.首都医科大学 中医药学院,北京 100013
12.北京中医药大学 中医学院,北京 100029
13.中华中医药学会,北京 100029
Published:20 April 2023,
Published Online:16 February 2023,
Received:09 December 2022,
扫 描 看 全 文
罗静,徐愿,周新尧等.中医临床优势病种探讨——干燥综合征[J].中国实验方剂学杂志,2023,29(08):73-79.
LUO Jing,XU Yuan,ZHOU Xinyao,et al.Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine: Sjögren's Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(08):73-79.
罗静,徐愿,周新尧等.中医临床优势病种探讨——干燥综合征[J].中国实验方剂学杂志,2023,29(08):73-79. DOI: 10.13422/j.cnki.syfjx.20231691.
LUO Jing,XU Yuan,ZHOU Xinyao,et al.Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine: Sjögren's Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(08):73-79. DOI: 10.13422/j.cnki.syfjx.20231691.
干燥综合征(SS)是常见的风湿免疫病,是中医药治疗的优势病种之一。中华中医药学会组织中医风湿、西医风湿及药学领域专家,深入探讨SS的中医药治疗优势及优选方案。与会专家充分讨论后认为,SS早期诊断率低,缺乏针对性的治疗药物;自身免疫异常是SS发病的关键因素,气阴两虚是核心病机;SS的舌象极具特点,可能成为本病早期诊断及中西医结合诊疗的突破口;中医药治疗SS在改善临床症状和系统受累、个体化治疗、缓解睡眠和情志障碍、疾病早期发挥“治未病”功效及中西药联用增效减毒等方面具有优势,在SS不同阶段均有优势点;中药内服、外治、针刺和针刀均是可选的治疗手段;优选方案应在辨证基础上,结合病情阶段、中医药优势综合制订。应深入研究SS的临床特点和生物标记物对本病患者进行分层,探索建立基于循证证据的SS中医精准治疗方案。基于SS舌象的独特表现,建立疾病早期诊断和不良预后识别模型,实现早期防治,改善预后。未来应大力开展中医、中西医结合治疗SS的高质量循证医学研究,制定相关指南,优化和规范当前的诊疗,为说明白、讲清楚中医药治疗SS的优势提供依据。
Sjögren's syndrome (SS), a disorder of immune system, is one of the dominant diseases treated by traditional Chinese medicine (TCM). China Association of Chinese Medicine organized experts in the field of TCM and western medicine rheumatology and pharmacology to discuss the advantages and optimal regimens of TCM for the treatment of SS. The experts generally agreed on the low early diagnosis rate of SS and the lack of targeted therapeutic drugs. In addition, autoimmune abnormality is the key factor in the occurrence of SS and deficiency of both Qi and Yin is the core pathogenesis. SS has unique tongue manifestations, which is expected to allow for the early diagnosis and treatment with integrated traditional Chinese and western medicine. TCM has advantages in treating SS in terms of alleviating clinical symptoms and systemic involvement, individualized treatment, relieving sleep and mood disorders, preventing the occurrence in the early stage, and enhancing the effectiveness and reducing toxicity in the treatment by integrated TCM and western medicine. In general, TCM has advantages in different stages of SS. Internal and external use of TCM, acupuncture, and acupotome are all available options. The optimal regimens should be determined on the basis of pattern identification, stage of disease, and the advantages of TCM. Clinical characteristics and biomarkers of SS should be studied to classify patients, so as to design precision evidence-based TCM regimens for SS. On the basis of unique tongue manifestations of SS, models for early diagnosis and poor prognosis identification of SS should also be established to achieve early prevention and treatment and to improve the prognosis. In the future, we should vigorously carry out high-quality evidence-based medical research on the treatment of SS by TCM and integrated traditional Chinese and western medicine and develop relevant guidelines to optimize and standardize current diagnosis and treatment, thereby laying a basis for clarifying and explaining the advantages of TCM in treating SS.
干燥综合征优势病种中西医结合专家指导建议
Sjögren's syndromedominant diseaseintegrated Chinese and western medicineexpert advice
刘莉莉,刘大新,刘锦峰,等.中医药临床优势病种探讨——变应性鼻炎[J].中国实验方剂学杂志,2023,29(2):203-211.
闫占峰,孔令博,王景尚,等.中医药临床优势病种的探索与认识——中华中医药学会临床优势病种研讨系列青年沙龙[J].中国实验方剂学杂志,2023,29(1):202-208.
祝雨田,王彬,李卫,等.中医药治疗男性不育症临床优势病种的探讨[J].中国实验方剂学杂志,2023,29(5):223-228.
邱文然,徐榛敏,申伟,等.中医药治疗缺血性脑卒中优势定位评价情况概述[J].中国实验方剂学杂志,2022,28(12):225-232.
徐愿,罗静,韩曼,等.中医药治疗风湿免疫领域临床优势病种的探讨[J].中国实验方剂学杂志,2022,28(9):198-204.
孔令博,晏军,张迪,等.中医药治疗脓毒症领域临床优势的探讨[J].中国实验方剂学杂志,2022,28(5):211-218.
沈建武,王彬,林生,等.中医药临床优势病种——良性前列腺增生[J].中国实验方剂学杂志,2022,28(2):220-226.
王景尚,刘晓巍,王昕,等. 中医药治疗产科领域临床优势病种的探讨[J].中国实验方剂学杂志,2021,27(20):206-218.
唐璇,席玉婕,郭非非,等.“心梗-心衰”疾病演变过程概述与疾病动态分子网络研究进展[J].中国实验方剂学杂志,2022,28(8):255-264.
刘宝利,钟逸斐,刘伟敬,等.中医药临床优势病种探讨——膜性肾病[J].中国实验方剂学杂志,2021,27(16):185-190.
吴薇,孙永章,刘大新,等.中医药治疗耳鼻咽喉头颈外科领域临床优势病种的探讨[J].中国实验方剂学杂志,2021,27(14):208-214.
孔令博,王淑燕,廖晓凌,等.中医药治疗神经内科领域临床优势病种的探讨[J].中国实验方剂学杂志,2021,27(13):172-178.
李曰庆,李海松,孙永章,等.中医药治疗男科领域临床优势病种的探讨[J].中国实验方剂学杂志,2021,27(12):182-188.
MARIETTE X,CRISWELL L A.Primary Sjögren's syndrome[J].N Engl J Med,2018,378(10):931-939.
张乃峥,施全胜,要庆平,等.原发性干燥综合征的流行病学调查[J].中华内科杂志,1993,32(8):522-524.
XU D,ZHAO S,LI Q,et al.Characteristics of Chinese patients with primary Sjögren's syndrome:Preliminary report of a multi-centre registration study[J].Lupus,2020,29(1):45-51.
GOULES A V,ARGYROPOULOU O D,PEZOULAS V C,et al.Primary Sjögren's syndrome of early and late onset:Distinct clinical phenotypes and lymphoma development[J].Front Immunol,2020,11:594096.
WANG B,CHEN S,ZHENG Q,et al.Early diagnosis and treatment for Sjögren's syndrome:Current challenges,redefined disease stages and future prospects[J].J Autoimmun,2021,117:102590.
KABASAKAL Y,KITAPÇIOĞLU G,KARABULUT G,et al.Criteria sets for primary Sjogren's syndrome are not adequate for those presenting with extraglandular organ involvements as their dominant clinical features[J].Rheumatol Int,2017,37(5):675-684.
JONSSON R,THEANDER E,SJÖSTRÖM B,et al.Autoantibodies present before symptom onset in primary Sjögren syndrome[J].JAMA,2013,310(17):1854-1855.
LIN D F,YAN S M,ZHAO Y,et al.Clinical and prognostic characteristics of 573 cases of primary Sjögren's syndrome[J].Chin Med J (Engl),2010,123(22):3252-3257.
杜梦梦,罗静,周丽,等.基于“内燥”理论探讨原发性干燥综合征的病因病机及治疗[J].中华中医药杂志,2021,36(1):250-252.
CHEN J,HE Q,JIANG B,et al.Research on primary Sjögren's syndrome in 2004-2021:A web of science-based cross-sectional bibliometric analysis[J].Rheumatol Int,2022,42(12):2221-2229.
张文,厉小梅,徐东,等.原发性干燥综合征诊疗规范[J].中华内科杂志,2020,59(4):269-276.
BJÖRK A,MOFORS J,WAHREN-HERLENIUS M.Environmental factors in the pathogenesis of primary Sjögren's syndrome[J].J Intern Med,2020,287(5):475-492.
CAFARO G,BURSI R,CHATZIS L G,et al.One year in review 2021:Sjögren's syndrome[J].Clin Exp Rheumatol,2021,133(6):3-13.
TRIANTAFYLLOPOULOU A,MOUTSOPOULOS H.Persistent viral infection in primary Sjogren's syndrome:Review and perspectives[J].Clin Rev Allergy Immunol,2007,32(3):210-214.
MAŚLIŃSKA M.The role of Epstein-Barr virus infection in primary Sjögren's syndrome[J].Curr Opin Rheumatol,2019,31(5):475-483.
MAVRAGANI C P,FRAGOULIS G E,MOUTSOPOULOS H M.Endocrine alterations in primary Sjogren's syndrome:An overview[J].J Autoimmun,2012,39(4):354-358.
张丽宁,姚传辉,罗静,等.原发性干燥综合征中医治疗经验荟萃[J].中华中医药杂志,2021,36(5):2588-2592.
姜泉,张华东,陈祎,等.路志正治疗干燥综合征经验[J].中医杂志,2016,57(6):463-465.
阎小萍.“辨五液,调五脏”论治干燥综合征[J].中医杂志,2017,58(22):1906-1910.
崔向宁.冯兴华辨治干燥综合征经验[J].中医杂志,2017,58(3):200-202,211.
罗静,张丽宁,陈嘉琪,等.原发性干燥综合征患者舌象特点及其与证候的相关性研究[J].中华中医药杂志,2021,36(6):3653-3656.
马武开,唐芳,王莹,等.干燥综合征中医证候分类临床文献研究[J].中华中医药杂志,2013,28(2):482-485.
宣磊,董振华,梁晓春,等.原发性干燥综合征中医证型特点的研究[J].世界中西医结合杂志,2012,7(11):975-977,989.
刘维,张磊,刘晓亚,等.干燥综合征中医证候规律探讨[J].中华中医药杂志,2010,25(9):1374-1376.
宋威江,罗静,申洪波,等.原发性干燥综合征中医证候分布及诊断标准研究进展[J].中华中医药杂志,2020,35(1):380-382.
张绪磊.40例干燥综合征的阴虚舌象分析[J].江苏中医杂志,1982(1):28-29.
杨梅,董振华.干燥综合征患者80例舌象观察与分析[J].中国全科医学,2011,14(7):804-805.
胡琪,罗静,张丽宁,等.原发性干燥综合征舌诊研究的现状与展望[J].时珍国医国药,2020,31(7):1677-1679.
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.
罗静,张丽宁,陈嘉琪,等.原发性干燥综合征中医证候特点及其与疾病活动指数的相关性[J].中国中西医结合杂志,2021,41(6):674-679.
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.
SEROR R,BOOTSMA H,SARAUX A,et al.Defining disease activity states and clinically meaningful improvement in primary Sjögren's syndrome with EULAR primary Sjögren's syndrome disease activity (ESSDAI) and patient-reported indexes (ESSPRI)[J].Ann Rheum Dis,2016,75(2):382-389.
LIU J,ZHOU H,LI Y,et al.Meta-analysis of the efficacy in treatment of primary sjögren's syndrome:Traditional Chinese medicine vs western medicine[J].J Tradit Chin Med,2016,36(5):596-605.
HOU J Q,XUE L.Challenges in Treatment of primary Sjögren's syndrome and opportunities for Chinese medicine[J].Chin J Integr Med,2020,26(7):483-485.
丁洋,韩建民,韩梅,等. 中医药治疗口腔干燥综合征疗效的meta分析[J].世界中西医结合杂志,2017,12(9):1213-1220.
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.
侯佳奇,杨月,薛鸾,等.解毒通络生津方治疗原发性干燥综合征血液系统损害的临床研究[J].风湿病与关节炎,2016,5(5):13-17.
赵浩,王丹,薛鸾,等.桑珠滋阴口服液治疗干燥综合征合并间质性肺炎的疗效及机制研究[J].世界临床药物,2018,39(4):253-258.
钟钊,王新昌.自拟养阴柔肝方联合羟氯喹治疗阴虚肝郁型原发性干燥综合征合并焦虑32例[J].浙江中医杂志,2019,54(4):281.
CHEN H H,LAI J N,YU M C,et al.Traditional Chinese medicine in patients with primary Sjogren's syndrome:A randomized,double-blind,placebo-controlled clinical trial[J].Front Med (Lausanne),2021,8:744194.
唐镕,唐卷壹,孙香娟,等.中药分阶段治疗小儿肾病综合征研究近况[J].陕西中医药大学学报,2022,45(4):162-166.
张丽宁,陈嘉琪,罗静,等.燥漱方联合羟氯喹治疗原发性干燥综合征60例疗效观察[J].北京中医药,2021,40(4):342-344.
贾蝉忆,张霞,谢华灵,等.润燥解毒液漱口缓解干燥综合征口干的疗效研究[J].现代医药卫生,2021,37(17):2905-2908.
王北,顾文,马丛,等.益气生津散治疗干燥综合征气阴两虚证临床观察[J].北京中医药,2018,37(11):1036-1038,1042.
LIU Z,JIN M,LI Y,et al.Efficacy and safety of houttuynia eye drops atomization treatment for meibomian gland dysfunction-related dry eye disease:A randomized,double-blinded,placebo-controlled clinical trial[J].J Clin Med,2020,9(12):4022.
项承荣.中药熏眼治疗干燥综合征干眼症随机平行对照研究[J].实用中医内科杂志,2013,27(9):23-24.
韦尼,陈自佳,翟瑶瑶,等.中药雾化吸入治疗干燥综合征口干燥症的临床研究[J].西部中医药,2016,29(5):5-8.
王慧娟,王俊丽.中药内服联合穴位贴敷治疗干燥综合征的疗效[J].深圳中西医结合杂志,2021,31(6):75-77.
周新尧,张华东,刘志顺,等.针灸干预原发性干燥综合征临床研究现状与思考[J].中华中医药杂志,2016,31(11):4629-4633.
刘永进,杜博,邵江健,等.针刺治疗干燥综合征临床疗效的Meta分析[J].风湿病与关节炎,2017,6(8):41-45,50.
张娟,王海东,杨会军.针刀治疗原发性干燥综合征口眼干燥症状疗效观察[J].中国针灸,2019,39(11):1173-1176.
杨梅,董振华.干燥综合征患者80例舌象观察与分析[J].中国全科医学,2011,14(7):804-805.
0
Views
30
下载量
3
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution