| Objective:To explore the TCM syndrome characteristics of primary Sj o gren syndrome(PSS)with blood system involvement.To explore the relationship between the blood system involvement of PSS and TCM syndromes,laboratory indexes and disease activity score,so as to guide the early treatment and intervention of TCM.Methods:From January 1,2018 to January 1,2020,the data of 100 patients with PSS associated with blood system in outpatient and ward of primary Sjogren’s syndrome were included into the affected group,and the data of 100 patients without PSS were included into the affected group No affected group.According to the diagnosis standard of dryness syndrome in practical rheumatology of traditional Chinese medicine(2nd Edition),the patients with PSS were divided into dryness pathogen attacking lung syndrome,yin deficiency and internal heat syndrome,Qi and yin deficiency syndrome,Yang deficiency and Jin coagulation syndrome,Qi and blood stasis syndrome.The data of patients were input into Microsoft Excel to establish database,and spss22.0 was used for stati stical analysis.Results:①① There was no significant difference in gender,age and course between the two groups(P>0.05).② The most common symptoms were dry mouth(184 cases,92%)and dry eye(144 cases,72%).The frequency of symptoms in the non affected group was:dry mouth(96 cases,96%)>dry eye(74 cases,74%)>insomnia(44 cases,44%)asthenia(36 cases,36%)>arthralgia(29 cases,29%)>fear of cool body(28 cases,28%);the frequency of symptoms in the affected group was:dry mouth(88 cases,88%)>dry eye(70 cases,70%)>asthenia(54 cases,54%)>insomnia(36 cases,36%)>Joint pain(35 cases,35%)was more than eating less and staying in the same place(33 cases,33%).Asthenia accounted for 36 cases(36%)in the non affected group,54 cases(54%)in the affected group,the difference between the two groups was statistically significant(P<0.05);skin purpura accounted for 2 cases(2%)in the non affected group,16 cases(16%)in the affected group,the difference between the two groups was statistically significant(P<0.05).There was no significant difference in other symptoms between the two groups(P>0.05).③ In the distribution of syndrome types,the distribution of the non affected group was as follows:32 cases of dryness pathogen attacking lung syndrome(32%);30 cases of Qi and yin deficiency syndrome(30%);18 cases of yin deficiency and internal heat syndrome(18%);12 cases of Qi and blood stasis syndrome(12%);8 cases of Yang deficiency and Tianjin coagulation syndrome(8%);34 cases of Qi and yin deficiency syndrome(34%);30 cases of Qi and blood stasis syndrome(30%);20 cases of dryness pathogen attacking lung syndrome(20%);12 cases of Yin deficiency and internal heat syndrome(12%)There were 4 cases(4%)with syndrome of deficiency of Yang and coagulation of Jin.There were 12 cases(12%)of Qi blood stasis syndrome in the non affected group and 30 cases(30%)in the affected group,the difference was statistically significant(P<0.05).There was no significant difference between the two groups(P>0.05).④In laboratory examination,the ESR and CRP of the affected group were higher than those of the non affected group(P<0.05).Compared with the same syndrome type,ESR and CRP of Qi and blood stasis syndrome in the affected group were higher than those in the non affected group,the difference was statistically significant(P<0.05),and CRP level of Qi and yin deficiency syndrome in the affected group was higher than that in the non affected group,the difference was statistically significant(P<0.05).There were 25 cases(45.4%)of Qi Yin deficiency syndrome in the affected group.Compared with other syndrome types,the difference was statistically significant(P There was no statistical significance in the difference(P>0.05);in the aspect of thrombocytopenia,there were 12 cases of Qi blood stasis syndrome(57.1%).Compared with other syndrome types,the difference was statistically significant(P<0.05),and there was no statistical significance in the other syndrome types(P>0.05).⑤In the immunologic indexes,66(66%)of the patients in the affected group had positive SSA,which was higher than 46(46%)of the patients in the non affected group,the difference was statistically significant(P<0.05);IgG in the affected group was higher than that in the non affected group and C4 was lower than that in the non affected group,which was statistically significant(P<0.05).There was no significant difference in SSB,Ana,IgA,IgM and C3 between the two groups(P>0.05);compared with the same syndrome type between the two groups,the number of positive SSA of Qi blood stasis syndrome in the non affected group was 4(33.3%),the number of positive SSA in the affected group was 26(86.70%),the difference was statistically significant(P<0.05);the IgG of Qi blood stasis syndrome in the affected group was higher than that in the non affected group,and the C4 was lower than that in the non affected group The difference was statistically significant(P<0.05),but there was no signi ficant difference between the two groups(P>0.05).⑥ In terms of disease activity score,esspri score(severity of dryness,pain and fatigue)and essdai score(disease activity index)were selected.The scores of esspri and essdai in the affected group were higher than those in the uninjured group(P<0.05).The difference between the two groups was statistically significant(P<0.05),and the difference between the two groups was not statistically significant(P>0.05).Conclusion:① the incidence of asthenia and skin purpura in PSS patients with blood system involvement is higher than that in PSS patients without blood system involvement,and the number of patients with Qi blood stasis syndrome is significantly increased.The patients with leukopenia and hemoglobin were mainly Qi Yin deficiency,while the patients with thrombocytopenia were mainly Qi blood stasis.②The patients with Qi and blood stasis syndrome in the blood system were associated with higher ESR,CRP,IgG,lower complement C4,more anti SSA antibody positive rate,and higher esspri score and essdai score. |
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