Study Of The Distribution Of Damp-type And Dry-type Primary Sjogren's Syndrome

Objective:To investigate the clinical proportion of patients with primary Sjogren's syndrome(p SS)with or without dry complaint at first visit,and to analyze the proportion of dry syndrome and dampness syndrome in current symptoms and their correlation,and to further analyze the clinical proportion of Yangming dampness-heat syndrome and Taiyin cold-dampness syndrome in dampness syndrome,so as to guide clinical diagnosis and treatment.Method:A total of 124 patients with primary Sjogren's syndrome(PSS)who were admitted to the specialist clinic of director Gu Junhua,Department of Rheumatology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine before January 2019 were collected.Their first onset and current general information,chief complaint and current history,treatment process of Western medicine,information of four diagnostic methods of traditional Chinese medicine and laboratory indicators were checked by questionnaire.And the first prescription.According to the symptoms and tongue veins at the first diagnosis,the attributes of dryness and dampness were judged,and were related to the first complaint of dryness.At the same time,the dampness syndrome was further divided into Taiyin cold-dampness syndrome and Yangming dampness-heat syndrome,and its proportion and correlation were analyzed and compared.Result:1.A total of 199 cases were included,to comply with a Dry syndrome and Damp syndrome 124 cases,of which 119 were female,accounting for 96.0% of the total;5 were male,accounting for 4.0% of the total,and the ratio of male to female was 1:29.The youngest age recorded at the first visit was 28 years old and the oldest age was 75 years old,with an average age of 51.31±10.8 years.The minimum duration of the disease was 1 month,and the longest duration was 20 years,with an average duration of 3.9 ± 0.36 years.2.Among 124 patients,79(63.7%)had dry complaints and 45(36.2%)had non-dry complaints.The order of symptoms of non-drying complaints from high to low was descending of blood cells > joint pain > fever > cough,etc.There was significant difference in the course of disease between the two groups(P<0.05),suggesting that the course of disease in the non-drying group was shorter than that in the drying group.Compared with the age distribution of the two groups,51.9% of the people over 55 years old complained of dryness,48.1% of the people under 55 years old complained of dryness,and there was significant difference between the two groups(P<0.05).3.Distribution of dryness syndrome and dampness syndrome in 124 cases: 99 cases of dampness syndrome,accounting for 79.8% of the total;25 cases of dryness syndrome,accounting for 20.2% of the total.The average course of disease of dry syndrome(5.74±5.55 years)was longer than that of wet syndrome(3.49±3.38 years),and the difference was statistically significant(P<0.05).The average age of dry syndrome patients(58.92±11.34 years old)was higher than that of wet syndrome patients(51.65±10.22 years old),the difference was statistically significant(P<0.05).4.Among the 99 cases in the wet syndrome group,39 cases had no dry complaint,60 cases had dry complaint,6 cases had no dry complaint,24.0% had dry complaint and 19 cases had dry complaint,76.0% had dry complaint.There was no significant difference in the distribution of dry complaints between the two syndromes(P>0.05),suggesting that dry complaints can be found in both dry and wet syndromes.5.Distribution analysis of dry symptoms found that dry mouth,dry skin and dry lips had significant difference between dry and wet syndrome groups(P<0.05).Dry mouth,dry skin and dry lips in dry syndrome group were higher than those in wet syndrome group.There was no significant difference in the distribution of other dry symptoms between the two syndromes(P>0.05).6.From the analysis of the attributes of Yangming and Taiyin in 99 cases of damp syndrome,23 cases(38.7%)of damp-heat syndrome of Yangming and 76 cases(61.3%)of cold-damp syndrome of Taiyin were found.There was no significant difference in course and age distribution between the two syndromes(P>0.05).7.There was significant difference in dry skin between Yangming dampness-heat syndrome and Taiyin cold-dampness syndrome(P<0.05).Dry skin distribution in Taiyin cold-dampness syndrome group was higher than that in Yangming dampness-heat syndrome group.There was no significant difference in the distribution of other dry symptoms between the two syndromes(P>0.05).8.The frequency of main symptoms in patients with different syndromes ranged from high to low.Dry syndrome: dry mouth and throat(25 cases)> dry eyes(20 cases)> thirsty and liking drink(18 cases)> itchy skin,dry stool(13 cases each)> fatigue,joint constriction,cramp,flexion and extension(7 cases each)> dry lips,difficult to swallow and dry food(5 cases each)> upset and sleepless(4 cases)> other dryness(4 cases of dry nose,1 case of vaginal dryness,1 case of anal cleft)> dry cough and less phlegm(2 cases).Thirteen cases of glossal red dry fissure were smooth.Damp syndrome: body fatigue and fatigue(57 cases)> epigastric discomfort(43 cases)>chest tightness and phlegm,joint swelling and pain(38 cases each)> loose stool(37 cases)> eczema(20 cases)> constipation(17cases)> dry and greasy mouth(11 cases)> leucorrhea(7 cases).There were 62 cases of greasy fur,including 30 cases of dry and greasy fur and 14 cases of thick and greasy fur.Yangming damp-heat syndrome: dry mouth and throat in 17 cases > hot image in 16 cases(nausea,burning,hot flashes,etc.)> abdominal pain in 14 cases > dry eyes in 12 cases > restless sleep in 9 cases > joint swelling and pain,bad breath in gums in 8 cases > chest tightness and phlegm in 7 cases > perspiration in 6 cases > loose stool,constipation such as sheep feces,sore eyes,itching and headache in 5 cases > purgative acid,sore throat,itchy phlegm,eczema and blister,dry lips There were 4 cases in each group > 2 cases in leucorrhea with yellow consistency.There were 15 cases of greasy fur,9 cases of dry fur and 9 cases of red tongue.Taiyin cold-dampness syndrome: 47 cases of mental fatigue,low voice and sluggishness,38 cases of warm-like drink,32 cases of loose stool,30 cases of joint swelling,30 cases of aversion to cold or cold hands and feet,29 cases of stupor,appetite and abdominal distention,25 cases of chest tightness,21 cases of spontaneous sweating,20 cases of cough and asthma,18 cases of body fatigue,17 cases of phlegm-prone cough,12 cases of constipation,5 cases of white belt,34 cases of fat teeth scars and 47 cases of greasy moss.Conclusion:First,the proportion of non-drying complaints reached 36.2% at the first onset of the disease;second,the proportion of wet syndrome in the first-visit patients who did not use traditional Chinese medicine intervention was quite large;third,the proportion of damp syndrome in the first-visit patients was too Yin-cold-dampness,which greatly overturned our original clinical impression that Sjogren's syndrome often had dry complaints,and the idea of clinical excessive Yin-deficiency and excessive heat syndrome,so we should consider the aspect of spleen-deficiency and dampness obstruction more in guiding It is possible that the adverse effects of Sanjiao waterway lead to inadequate Jin,stop drinking for phlegm,Jin does not dissolve Qi,and therefore the vicious cycle is the cause of most Sjogren's syndrome.Therefore,we can not ignore the treatment of Warming Yang and removing dampness,Tongli waterway,the middle and late stages of disease,as the age rises,Yin and blood are insufficient,and the original dampness obstruction further depletion of body fluid will cause more dryness syndrome manifestations.