Professor Wang Weigang 's Clinical Experience In Treating Sjogren' S Syndrome And Preliminary Study On The Clinical Efficacy Of Total Glucosides In Treatment Of Sjogren 's Syndrome

The thesis is divided into three parts. The first part is literature review. The second part is professor Wang’s clinical experience. And the third part is clinical research.Part1.Literature reviewThis part is mainly to discuss the research progress of the diagnosis and treatment of Sjogren’s Syndrome from the aspects of both Traditional Chinese medicine and Western medicine recent years.The progress of Traditional Chinese medicine is targeted to the name of the disease, etiology and pathogenesis, syndrome differentiation and treatment of Sjogren’s Syndrome. Traditional Chinese medicine holds the view that Sjogren’s Syndrome belongs to the disease of "ZaoBi".The main etiology and pathogenesis is that dryness evil invades or wind and cold evils change into dryness and hurt the yin fluids of human body;or it is congential yin deficiency leading to blood and qi deficiency that causes stasis of blood and blockage of meridians.The pathomechanism is mostly related to unbalance of yin and yang of liver, spleen and kidneys.The key of pathogenis is that yin deficiency and dryness-heat. It will hurt the yin of lungs and stomach,sometimes even the liver and kidneys.Generations of doctors holds views of syndrome differentiation and treatment from kinds of theroies like pathological changes of viscera and their interrelations or three-jiao theory or the qi and yin deficiency,dryness-heat, blood stasis and so on.Therapeutic method varies from different patterns of syndrome,aimed to nourish liver and kidneys,or reinforce qi and nourish blood,or nourish blood and promote blood circulation,or disperse blood stasis and dredge collaterals.Acupuncture and moxibustion are also recommended as assisting therapies.The research progress of Western medicine ncludes pathogenic factors,pathogenesis,clinicopathologic analysis,clinical manifestation,differential diagnosis, diagnostic criteria,western drug therapy and nursing and precautions of Sjogren’s Syndrome. Studies show that the pathogenic factors of this disease contain genetic factors,virus infection and endocrine factors.Clinicopathologic analysis shows exocrine glands inflammation and vasculitis. It usually hurts the salivary glands and lacrimal gland, however, any organ could be involved.Clinical symptoms manifest as dry mouth,dry eyes.Apart from local symptoms,dermal system,musculoskeletal system, urinary system, respiratory system, digestive system, nervous system and blood system will be affected. Diagnostic criteria follows the international classification(diagnosis) criteria(2002) for primary Sjogren’s Syndrome.Sjogren’s Syndrome should be differentiated from swollen parotid glands caused by other diseases, rheumatoid arthritis, systemic lupus erythematosus, dry mouth and eyes not caused by autoimmune diseases. Treatment of Sjogren’s Syndrome is targeted to different clinical stages, and to control the progression of disease,and to avoid or reduce multisystem damage. The purpose of treatment is to alleviate the symptoms of dry mouth and dry eyes, and to prevent the organ damage caused by long-term dryness.Symptomatic treatment should be applied.Critical patients could be treated by suppressing autoimmune reaction.Glucocorticoids and immunosuppressant would be used if necessary.Nursing and precautions are also very important.Multisystem and multiple organ damage play a key role in causing unfavorable prognosis.Combination of Traditional Chinese Medicine and Western Medicine should be explored further for the precaution and treatment of Sjogren’s Syndrome.Part 2:The clinical experience of Professor Wang Weigang in treating Sjogren’s Syndrome disease.Dr Wang claims that figuring out the etiology and pathogenesis of Sjogren’s Syndrome disease is very important in treatment,as well as whether it is exterior or interior syndrome,deficiency or excess syndrome.Dr Wang appreciates Dr Jiao’s Traditional Chinese Medicine theory and uses the method of activating blood and replenishing yin to relieve dryness in the treatment og Sjogren’s Syndrome disease.Also Dr Wang thinks it is a good idea to apply Chinese Medicine and Western Medicine at the same time when necessary. This part summarizes the experience of Dr Wang in using White Paeony Root and Total Glucosides of Paeony.Sydrome discrimination is the soul of Traditional Chinese Medicine theory.Part 3.Clinical researchClinical research is mainly to discuss the efficiency and security of Total Glucosides of Paeony (TGP)in treating Sjogren’s Syndrome.30 primary Sjogren’s Syndrome patients were recruited for the experiment. All patients were divided into two groups randomly, TGP treatment group and placebo control group. Follow-up period was 24 weeks,and efficiency index and security index were collected during the follow-up. Experiment results shows that ESSDAI grades, ESSPRI grades, salivary gland flow rate,schirmer I test results of TGP treatment group were better than placebo control group. Noticeable influence to HGB, WBC,AST, ALT, BUN, Cr were not found.In 15 patients who took TGP,2 patients developed light-headedness,5 patients developed diarrhea with different degrees and change of stool property. Because of limitation of time and small size of samples,effects of TGP to autoimmune antibodies could not be evaluated accurately.Animal experiments study or collecting large samples should be done further.Experiment conclusion:TGP could improve the symptoms of dry mouth and eyes in Sjogren’s Syndrome patients. Also TGP could improve the function of salivary glands and lacrimal glands and control the progression of disease. Effects of TGP to autoimmune antibodies have not been demonstrated yet. Security of TGP will be proved by further pharmacology experiment and clinical research.