Study On TCM Syndrome And Medication Rules Of Sjögren's Syndrome Combined With Perimenopausal Syndrom

Purpose:By collecting the syndrome differentiation and prescription drug use of patients with Primary Sjogren’s syndrome(pSS)combined with Perimenopausal syndrome(PMS),the distribution characteristics of TCM syndrome and drug use rule of this disease were analyzed.To provide reference for clinical treatment based on syndrome differentiation.Material and method:Cases of patients with pSS combined with PMS admitted to the rheumatology Department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from March 2012 to February 2022 were collected according to the layout standard.Patient data were collected and a patient case information database was established with the WPSOffice form.SPSS26.0 and SPSSModeler18.0 software were used to compare the clinical manifestations,syndrome differentiation,laboratory examination,basic prescriptions and other aspects of patients with pSS combined with PMS,explore the TCM syndrome and clinical characteristics of patients with pSS combined with PMS,and draw conclusions.Results:1.General situation,syndrome type distributionA total of 140 cases were collected in this study,all of which were female.The distribution results of syndrome types were as follows: Qi and Yin deficiency syndrome(44.3%)> Yin deficiency syndrome of liver and kidney Yin deficiency syndrome(27.9%)> Yin deficiency syndrome of blood stasis(13.6%)> Yin deficiency syndrome of heat and poison syndrome(7.8%)> syndrome of dryness and evil attacking lung syndrome(6.4%).2.The course of disease,clinical symptoms and laboratory tests were compared among the syndrome types(1)The length of the disease course was statistically different among the syndrome types(P < 0.05),among which the syndrome of dryness and evil affecting lung was shorter than the syndrome of Qi and Yin deficiency and the syndrome of liver and kidney Yin deficiency,and the difference was statistically significant(P < 0.05).(2)Clinical symptoms with frequency >10% were analyzed:Dry mouth(98.6%)> dry eyes(94.3%)> arthralgia(82.1%)> fatigue(76.4%)> insomnia(47.9%)> shortness of breath(37.9%)> night sweats(27.1%)> rampant teeth(26.4%)> spontaneous sweating(25.0%)> purpura rash(19.3%)> dry skin(12.9%).Except for arthralgia and sweating symptoms,there was no statistical difference among the other symptoms(P>0.05).(3)The comparison of IgG and HGB levels among different syndrome types had statistical differences(P < 0.05),and the difference of IgG between liver-kidney Yin deficiency syndrome and Qi and Yin deficiency syndrome was statistically significant(P < 0.05),and the difference of HGB between Yin deficiency and blood stasis syndrome and liver-kidney Yin deficiency syndrome was statistically significant(P <0.05).There were no significant differences in SSA,SSB,Ro-52,RF,ESR,CRP,IgM,IgA,C3,C4,WBC and PLT among all syndrome types(P > 0.05).3.Drug frequency and drug category123 prescriptions were collected in this study,involving a total of 170 traditional Chinese medicines,with a total frequency of 1884 times and 16 drug categories.29 traditional Chinese medicines(frequency ≥20)such as ophiopogon ophiopogon and glycyrrhiza were commonly used in the treatment of pSS combined with PMS.Among them,tonifying deficiency drugs,clearing heat drugs,promoting blood circulation and removing blood stasis drugs,and relieving surface drugs are the main drugs for the treatment of pSS complicated with PMS.4.Cluster analysisCluster analysis was performed on 17 Chinese medicines with ≥30 drug frequency,and three groups of cluster drugs were obtained: Class 1 ophiopogonis ophiopogonis,Panax chinensis,smallpox,Dendrobium and Yam.Class 2: Atractylodes atractylodes,Schisandra chinensis,Angelica sinensis,poria cocos,licorice,Radix astragalus and Paeoniae alba;Class 3: Ligusticum Chuanxiong,Wolfberry,Achyranthes bidentata,cooked Rehmannia,raw Rehmannia Rehmannia.5.Correlation analysisA total of 466 association rules were obtained from the association analysis of 29 herbs with ≥20 drug frequency.In the second-order association analysis,the confidence of achyranthosa bidentata + Eucommia ulmoides was the highest(100.0%).In the third-order correlation analysis,the support degree of ophiopogon ophiopogon,Radix panax chinensis + Angelica sinensis was the highest(32.52%).In the fourth order association analysis,the drug combination of ophiopogon ophiopogon,schisandra chinensis,atractylodes atractylodes and glycyrrhiza were stable.Conclusion:1.Qi-yin deficiency syndrome is most common in pSS patients with PMS.2.Patients with liver-kidney Yin deficiency syndrome are more likely to have symptoms of joint pain than those with Qi-yin deficiency syndrome,and patients with Qi-yin deficiency syndrome are more likely to have symptoms of spontaneous sweating than those with liver-kidney Yin deficiency syndrome.3.The IgG level of patients with liver-kidney Yin deficiency syndrome is lower than that of other syndrome types,and patients with Yin deficiency and blood stasis syndrome are more likely to be complicated with blood system damage.4.High frequency drugs for pSS combined with PMS include ophiopogon ophiopogon,glycyrrhiza,angelica sinensis,Paeonia lactiflora,poria cocos,Radix Rehmanniae and atractylodes atractylodes.Commonly used drugs include tonifying deficiency drugs,clearing heat drugs,promoting blood circulation and removing blood stasis drugs,relieving surface drugs,etc.Common drug combinations were achyranthes bidentata and Eucommia ulmoides;Ophiopogon ophiopogon,Radix japonicae rhizome,Angelica sinensis;Ophiopogon ophiopogon,Schisandra chinensis,Atractylode and licorice.