Study On The Correlation Factors Between TCM Syndrome Of Primary Sjögren's Syndrome And Salivary Gland Ultrasound And ESSDAI Scor

BackgroundPrimary Sjogren’s syndrome is an autoimmune disease mainly involving exocrine glands such as salivary glands and lacrimal glands.With the rapid development of imaging in recent years,ultrasound has played an increasingly important role in the examination and diagnosis of this disease.Salivary gland ultrasound is not only simple,non-invasive and reproducible,but also has a variety of imaging modes,which can evaluate the morphological and structural changes of parotid gland and submandibular gland and the damage of gland function in pSS patients from multiple angles.Chinese medicine has been quite effective in the exploration of pathogenesis differentiation and treatment of Sjogren’s syndrome,but different doctors have their own roles,and have different understandings of the syndromes and prescriptions.In order to provide more elements of syndrome differentiation,the characteristics of syndrome types were further summarized.The exocrine gland,which is the earliest and mainly involved in this disease,was taken as the entry point.Through imaging studies on the exocrine glands mainly involved in salivary glands,the changes of ESSDAI were combined.It is of significance to discuss the difference of syndrome differentiation and legislative prescription in different groups of primary Sjogren’s syndrome.The first part is literature reviewReviewl:The research progress of ultrasonic diagnosis of primary Sjogren’s syndrome at home and abroad was summarized and analyzed.The role of ultrasonic scoring of salivary glands combined with shear wave elastic imaging and serological indexes in the diagnosis of this disease was summarized and analyzed.Review2:This paper summarizes the treatment and legislative prescription of Sjogren’s syndrome and analyzes the progress of different treatment and treatment methods of Sjogren’s syndrome.The second part is clinical studyObjective:1.To explore the difference of ultrasonic imaging among different TCM syndrome groups in patients with primary Sjogren’s syndrome.2.To investigate the difference of ESSDAI among different TCM syndrome groups in patients with primary Sjogren’s syndrome.Methods:Eighty patients with primary Sjogren’s syndrome who met the inclusion criteria were included and divided into deficiency syndrome group and deficiency syndrome mixed syndrome group according to the requirements.The ultrasonic score data of three saliatic glands,parotid gland typing,shear wave elasticity and blood flow imaging information,and ESSDAI score related information of patients were collected and included.A database was established,and SPSS20.0 software was used for statistical analysis.Results:1.There was no statistical difference in the distribution of the five syndrome types in pSS patients(P>0.05),which was reflected in the two groups of syndrome types of deficiency syndrome and deficiency and accumulation syndrome.There was no statistical difference in the distribution of gender,age of onset,age of seeking medical treatment and season(P>0.05).There was statistical difference between the two syndrome groups(P=0.047).The course of disease in the mixed syndrome group was longer than that in the deficiency syndrome group.2.There was statistical significance in the comparison of 0-4 score method,0-16 score method,0-48 score method,parotid gland classification and bilateral parotid gland elasticity between the two syndrome types(P<0.001).In terms of specific classification,in the 0-4 scoring method,the following groups were significant:Yin and jin deficiency syndrome and dryness and dampness mutual syndrome(adjusted P=0.001);Yin and jin deficiency syndrome and dryness stasis interjunction syndrome(adjusted P<0.001);Qi Yin deficiency syndrome and dryness dampness interjunction syndrome(adjusted P=0.031);Qi Yin deficiency syndrome and dryness and stasis interjunction syndrome(adjusted P=0.001);Yin deficiency internal heat syndrome and dryness and stasis interjunction syndrome(adjusted P=0.047).In the 0-16 scoring method,the following groups were significant:Yin and jin deficiency syndrome and Yin deficiency internal heat syndrome(adjusted P=0.021);Yin and jin deficiency syndrome and dryness and dampness mutual syndrome(adjusted P<0.001);Yin and jin deficiency syndrome and dryness stasis interjunction syndrome(adjusted P<0,001);Qi Yin deficiency syndrome and dryness dampness interjunction syndrome(adjusted P<0.001);Qi Yin deficiency syndrome and dryness and stasis interjunction syndrome(adjusted P<0.001).In the 0-48 scoring method,the following groups were significant:Yin and jin deficiency syndrome and dryness and dampness mutual syndrome(adjusted P<0.001);Yin and jin deficiency syndrome and dryness stasis interjunction syndrome(adjusted P<0.001);Qi Yin deficiency syndrome and dryness dampness interjunction syndrome(adjusted P<0.001);Qi Yin deficiency syndrome and dryness and stasis interjunction syndrome(adjusted P<0.001);Yin deficiency internal heat and dryness syndrome and dampness interknot syndrome(adjusted P=0.022)and Yin deficiency internal heat syndrome and dryness stasis interjunction syndrome(adjusted P<0.001).There were no significant differences in CDFI scores and bilateral submandibular gland elasticity among different groups of included patients(P>0.05).There was statistical significance in ESSDAI score distribution and disease activity level between the two syndrome types(P<0.001),while there was no statistical significance in the number of involved fields between the two groups of syndrome types(P>0.05).In the specific fields of ESSDAI,the lesions between the two syndrome types were statistically significant in joint lesions and kidney lesions(P<0.05).There was no statistical significance in lung disease,lymph node disease,systemic symptoms,skin disease,glandular disease,blood system disease and serological changes(P>0.05).Conclusion:1.The five syndromes are common witness of pSS,and the classified syndromes can all appear in patients of different ages and genders,and they may all take dry mouth,dry eyes,fatigue or oral ulcers as the first symptoms of medical treatment.2.The course of disease in the mixed syndrome group may be longer than that in the deficiency syndrome group as a whole;In the specific ultrasonic score,the score may be higher;Parotid gland typing and elastic Young’s modulus values may also be more serious.The ESSDAI score in the mixed syndrome group may be higher than that in the deficiency syndrome group;They are also more likely to have high levels of disease activity.