The Clinical Research Of Primary Sjogren's Syndrome Symptoms Of Fatigue

Objective: To investigate the prevalence and severity of fatigue in primary Sjogren’s syndrome, and explore the relationship of fatigue severity to other clinical feature in primary Sjogren’s syndrome.Methods:87patients fulfilling the American-European consensus criteria of pSS was undertaken in the period May2012to April2013. Demographic characteristic,clinical features, laboratory indexes were collected. Sicca symptom was assessed by the Visual Analogue Scale(VAS).Fatigue was assessed by VAS, fatigue severity scale(FSS),the Profile of Fatigue(ProF). Traditional Chinese medicine (TCM) syndrome was collected to identify the syndrome differentiation.. Subjects are classified into two main syndromes: Qi and yin Deficiency syndrome. Heat-dampness and Yin Deficiency syndrome. Subsidiary syndromes include Heat-toxin syndrome and Blood stasis syndrome. The abnormal fatigue was defined as an FSS score≥4. The data were analyzed by SPSS18.0. Associations with fatigue were compared using bivariatc correlation.Outcomes: Abnormal fatigue, defined as an FSS≥4,was present in64.37%. According to FSS,56patients(64.37%) experienced significant fatigue and31patients(35.63%) not. fatigued group presents higher score in VAS, FSS. ProF-S and ProF-M(p＜0.01). Physical fatigue was associated with sicca symptom, years with diagnose, neutrophils percentage and hemoglobin. Meanwhile, mental fatigue was associated with xerophthalmia(dry eyes), years with diagnose, red blood cell count and hemoglobin. Qi and yin Deficiency have higher scoresin VAS, FSS. ProF-S than Heat-dampness and Yin Deficiency syndrome, indicating Qi and yin Deficiency syndrome correlated significantly with Physical fatigue (p＜0.01). Meanwhile, there is no statistic difference in mental fatigue between the two main syndrome. Blood stasis syndrome is likely to has higher score in somatic and mental fatigue than Heat-toxin syndrome, but there is no statistic difference between the two subsidiary syndromes.Conclusion: Fatigue is prevalent among the pSS as a primary symptom. There are64.37%of the subjects experiencing significant fatigue. Fatigue deserves more recognition as a treatment target in pSS. Standard assessment tools to evaluate the fatigue in pSS are needed in the clinical research. Fatigue correlates with sicca severity and years with diagnose, as the mark of the disease severity. The correlations with neutrophils percentage and hemoglobin need further exploration. Physical fatigue correlates significantly with Qi and yin Deficiency syndrome indicating that Qi and yin Deficiency is the primary pathogenesis of pSS in TCM. Supplementing qi and nourishing yin should be taken through all stages of pSS.