Study On The Evolution Of Syndromes And The Distribution Of Syndrome Elements In Patients With Sj(?)gren’s Syndrome

Objective:To investigate the evolution of syndromes and the distribution of syndrome elements in patients with primary Sjogren’s syndrome(pSS),and to provide theoretical basis for the standardized treatment of pSS with traditional Chinese medicine.Methods:An observational study method was used to analyze and collect patients‘ general conditions,relevant laboratory indices,EULAR Sjogren’s Syndrome Disease Activity Index(ESSDAI),EULAR Sjogren’s Syndrome Patient Reported Index(ESSPRI),TCM syndrome elements,and related TCM syndrome data of patients in the 6th,12 th,and 24 th weeks.The 299 pSS patients who met the inclusion criteria were established as a database,and the statistical software SPSS 25.0 was used to statistically analyze the relevant information of pSS patients.Results:(1)The syndromes on the first day,the sixth week ± 3 days,the 12 th week ± 5 days,and the 24 th week ± 5 days were counted for 4 time nodes.In the 4time points,the TCM syndromes was dominated by the syndrome of yin deficiency and fluid deficiency and the syndrome of both qi and yin deficiency.The distribution of symptoms on the 1st day and 6th week ±3 are as follows:Qi and Yin deficiency >Yin deficiency and fluid deficiency > Yin deficiency and heat toxicity > Yin deficiency and blood stasis.The distribution of syndromes in the 12 th week ± 5 days and the 24 th week ± 5 days are as follows: Qi-yin deficiency syndrome >Yin-deficiency Jin Deficiency syndrome>Yin deficiency and blood stasis syndrome>Yin deficiency and heat toxicity syndrome.In the four time points,Qi and Yin deficiency syndromes are the most distributed syndrome types,and show a gradual upward trend.The proportion of Yin deficiency and Jin deficiency syndrome is second only to that qi and yin deficiency syndrome,with little change and a slight increase.Yin deficiency and blood stasis syndrome showed a slightly increasing trend in the late 12 th week ± 5 days and 24 th week ± 5 days.Yin deficiency and heat toxicity syndrome showed a significant downward trend at each time point.(2)The symptoms and signs of 299 patients with pSS were extracted and summarized into 8 categories: dryness,fire,blood stasis,phlegm-dampness,qi deficiency,yin deficiency,blood deficiency,and yang deficiency.Among them,there are 134 cases of dryness,accounting for 44.8%,130 cases of qi deficiency,accounting for 43.5%,129 cases of yin deficiency,accounting for 43.1%,94 cases of fire,accounting for 31.4%,50 cases of phlegm-dampness,accounting for 16.7%,37 cases of blood stasis,accounting for 12.4%,17 cases of yang deficiency,accounting for5.7%,and 15 cases of blood deficiency,accounting for 5%;(3)The current study found that ANA in pSS patients was an independent influencing factor for the appearance of dryness,ESR was an independent risk factor for the appearance of fire(heat)and blood stasis,Ig M was an independent influencing factor for the appearance of phlegm-dampness,and SSA was an independent risk factor for the appearance of yin deficiency.Conclusion: 1.The TCM syndromes of pSS patients are mainly qi and yin deficiency syndrome and yin deficiency and fluid deficiency syndrome.The proportion of yin deficiency and heat toxicity syndrome gradually decreases after a period of treatment.A slight upward trend of Qi and Yin deficiency evidence and Yin deficiency and blood stasis evidence in the later stage;2.The most common TCM syndromes in pSS patients is dryness,followed by Qi deficiency,Yin deficiency,fire,phlegm-dampness,blood stasis,Yang deficiency,and blood deficiency.In addition,due to the complexity of the patient’s condition,there are often multiple syndromes in combination,among which the double syndrome is the most,followed by the single syndrome,the three syndromes,and the four syndromes.The combination of each syndrome element is counted,and the syndrome element combination is mainly yin deficiency,dryness,qi deficiency + yin deficiency,dryness + qi deficiency,qi deficiency,dryness + fire,dryness + yin deficiency,dryness + qi deficiency + yin deficiency and fire..3.The present study found that ANA in pSS patients was an independent influencing factor for the appearance of dryness,ESR was an independent risk factor for the appearance of fire(heat)and blood stasis,Ig M was an independent influencing factor for the appearance of phlegm-dampness and SSA was an independent risk factor for the appearance of yin deficiency;4.The gender,age,disease duration,BMI(Body Mass Index),CRP(C-reactive protein),RF(rheumatoid factor),WBC(white blood cell),RBC(red blood cell),Hb(hemoglobin),PLT(platelet),Ig G,Ig A,and SSB of the pSS patients in this study did not correlate with TCM evidence.