Sjogren's Syndrome Intervened By HuoXueJieDuYangYinSheng Jin Compound And The Cytokines Profile Of Sjogren's Syndrome Intervened By HuoXueJieDuYangYinShengJin Compound

Sjogren's Syndrome is considered a chronic autoimmune disease characterized by the inflammation involving the exocrine glands. The most common clinical manifestations include Xerostomia, xerophthalmia. And respiratory system, digestive system, nervous system, urinary system, hematologic system, cardiovascular system also involved. SS can't be cured till today but there is way to Improve Symptoms, control secondary infections, slow the progress of the autoimmune destruction of multi-systems.The fist part of the paper is literature review on the pathogenesis, pathology, clinical manifestations, management of SS from traditional chinese medicine and modern medicine.The second part of the paper is clinical studyPurpose:to observe the effect of HuoXueJieDuYangYinShengJin Compound on SS patients.Method:in the randomized controlled trial,40 SS patients were divided into HXJD group (treatment), Tripterygium Wilfordii group (control), by randomized block design,20 patients each group. We use symptom integral, ESSDAI and laboratory indexes as evaluation indexes. Result:17/20 were involved in the analysis of results and 3 fell off in HXJD group; 18/20 were involved in the analysis of results and 2 fell off in Tripterygium Wilfordii group.①Efficacy on symptom integral index:15/17 (88.2%) were effective in HXJD group; 15/18 (83.3%) were effective in Tripterygium Wilfordii group. The ranked data had been tested by Ridit analysis, showedthat:R1=0.49 (HXJD group), R2=0.51 (Tripterygium Wilfordii group), u=0.68, P> 0.05. That means the efficacy was no difference between two groups. Further analysis discovered the association between the efficacy and the improvement of Xerostomia, xerophthalmia, dryness of skin, arthralgia, constipation of both groups. There was a greater improvement of HXJD group than that of Tripterygium Wilfordii group.②ESSDAI index improvement: both scores of two groups were improved by self-comparison before and after treatment and significant differences were observed (P<0.01). But there was no significant differences between two groups.③Compare of serology indexes after treatment:positive ratio of Anti-SSA(Ro),Anti-SSB (La) and RF in two groups were not significantly improved by self-comparison before and after treatment (P>0.05). The scores of ESR, CRP and Igs (IgA,IgG,IgM) in two groups were improved by self-comparison before and after treatment and significant differences were observed (P<0.01)Conclusion:HuoXueJieDuYangYinShengJin Compound can improve symptoms and serology indexes of SS patients effectively and improve ESSDAI also.The third part ofthe paper is experimental studies.Purpose:to explor the theraprutic mechanism of HuoXueJieDuYangYinShengJin Compound on SS.Method:NOD mice were randomly divided into three groups for the experiments:model group, TGPC group and HXJD group, we took BABL/C mice as normal control group. After treatment, we examined the function and morphology of salivary glands. We also determined IL-2, IFN-γlevels in serum by ELISA and IL-2mRNA, IFN-γmRNA levels in salivary glands by RealTime RT-PCR.Result:①8 weeks after treatment, improvements of salivary glands funct ion and decreased lymphocy tic infiltration into salivary glands were observed.②Compare with normal group, IL-2 level in serum of model group decreased markedly (P< 0.05) but not of TGPC group nor that of HXJD group. There was no marked difference of serum IL-2 between normal group and the rests. Compare with normal group, IFN-y level in serum of model group increased markedly(P<0.05). Compare with model group, IFN-γlevel in serum of HXJD group decreased markedly (P<0.05).③Compare with model group, IFN-γmRNA level in salivary glands of HXJD group and TGPC group decreased markedly (P< 0.05). Compare with normal group, IFN-γmRNA level in salivary glands of HXJD group decreased markedly (P<0.05). There was no marked difference of IL-2mRNA level in salivary glands of all groups.Conclusion:①HuoXueJieDuYangYinShengJin Compound can improve symptoms as well as the ESSDAI of SS patients.②HuoXueJieDuYangYinShengJin Compound can down-regulate IFN y mRNA expression in salivary glands as well as IFN-γin serum.③The posable theraprutic mechanism of HuoXueJieDuYangYinShengJin Compound on SS might be connected with regulation of IFN-γwhich decreasing Thl effect.