Analysis Of The Relationship Between Secondary Interstitial Lung Disease Of Sjogren Syndrome And TCM Syndrome Type

Objective:To investigate the relationship between the secondary pulmonary interstitial lesions of Sjogren's syndrome and the TCM syndrome type.To investigate the relationship between TCM syndromes and clinical examination results.To find the possible risk factors of SS-ILD.By combining SS-ILD related examinations to find effective ways for diagnosing SS-ILD,so as to detect SS-ILD in clinic early.Methods:Analyzing the collected data through a retrospective study.According to the diagnostic criteria of TCM syndromes of Sjogren's syndrome,159 cases of Sjogren's syndrome patients were divided into five categories:Qi and Yin deficiency syndrome,syndrome of dryness invading lung,syndrome of endogenous heat due to Yin deficiency,Qi and Blood stasis syndrome,and Yang Xu Jin Ning syndrome.According to the SS-ILD clinical diagnostic criteria,patients were divided into SS group and SS-ILD group.To observe the differences of the two groups in TCM syndromes,clinical symptoms,and examination results.To observe the differences of different TCM syndrome types in symptoms and clinical indicators.To observe the clinical manifestations,pulmonary function,and HRCT performance in the SS-ILD group.Results:(1)The secondary rate of ILD of five syndromes:Qi and Blood stasis syndrome(59.09%),Yang Xu Jin Ning syndrome(57.14%),syndrome of endogenous heat due to Yin deficiency(42.86%),syndrome of dryness invading lung(26.53%),Qi and Yin deficiency syndrome(26.32%).There was a significant difference in the secondary rate of ILD among the five syndromes(P<0.01).Qi and Blood stasis syndrome had higher secondary rate of ILD than syndrome of dryness invading lung and Qi and Yin deficiency syndrome(P<0.01).There was no statistical difference between the remaining syndromes(P>0.05).(2)Compared SS-ILD group with SS group,SS-ILD group was older and had longer duration.And it's degree of dry mouth,dry eyes,constipation,TCM syndrome scores,ESR,CRP,IgA,IgG,positive rate of saliva flow test was higher.SS-ILD group had lower level of RBC,HGB and PLT(P<0.01).SS-ILD group also had higher degree of skin dryness,fatigue,ANA positive rate and ECT positive rate(P<0.05).There was no significant difference in gender,smoking history,feverish palms and soles,swelling of parotid gland,joint pain,WBC,IgM,complement C3,complement C4,positive rate of Anti-SSA,positive rate of anti-SSB,positive rate of anti-Ro-52 and positive rate of Schirmer test(P>0.05).(3)To compare the two groups in Qi and Yin deficiency syndrome:SS-ILD group had higher degree of eye dryness,dry mouth,TCM syndrome scores,ESR,CRP,IgG,IgA,positive rate of salivary flow rate(P<0.01)and constipation(P<0.05)than SS group.(4)To compare the two groups in syndrome of dryness invading lung:SS-ILD group was older and had longer duration(P<0.01).SS-ILD group also had higher degree of dry mouth,dry eyes,TCM syndrome scores,CRP,IgA(P<0.01),constipation,ESR and lower level of HGB(P<0.05)than SS group.(5)To compare the two groups in syndrome of endogenous heat due to Yin deficiency:SS-ILD group was older(P<0.01)and had longer duration(P<0.05).It also had higher degree of constipation,TCM syndrome scores,CRP(P<0.01),fatigue,dry mouth(P<0.05)and lower level of HGB?RBC(P<0.01),WBC(P<0.05)than SS group.(6)To compare the two groups in Qi and Blood stasis syndrome:SS-ILD group was older and had higher degree of dry mouth,TCM syndrome scores,CRP,IgA(P<0.01),constipation,IgM,ESR(P<0.05)and lower level of RBC(P<0.01),PLT(P<0.05)than SS group.(7)To compare the two groups in Yang Xu Jin Ning syndrome:SS-ILD group was older and had higher degree of IgA(P<0.05)than SS group.(8)There was no significant difference in other indicators between the two groups in the five TCM syndrome type(P>0.05).(9)The positive rate of the clinical manifestation in SS-ILD was 92.06%.The main symptoms were cough,expectoration and chest tightness.The positive rate of pulmonary function was 89.36%.The main performances are restrictive ventilation dysfunction and diffusion dysfunction.The positive rate of HRCT was 100%,and the top three performances were mainly mesh shadow(47.62%),cellular shadow(25.4%),and ground glass(22.22%).Conclusions:(1)The posible high risk groups of SS-ILD are those patients whose age,duration of illness,degree of dry mouth,dry eyes,constipation,dry skin,fatigue,TCM syndromes scores,ESR,CRP,IgA and IgG are higher,the counts of RBC,HGB and PLT are reduced,the results of ANA,saliva flow rate test and salivary gland ECT are positive.Qi and blood stasis syndrome is also the posible high risk factor of SS-ILD.(2)Risk factors of different TCM syndrome types:In Qi and Yin deficiency syndrome:higher degree of dry mouth,dry eyes and constipation;higher scores of TCM syndromes;higher level of CRP,ESR,IgA,and IgG;the positive result of flow rate of saliva.In syndrome of dryness invading lung:older;longer duration;higher degree of dry mouth,dry eyes and constipation;higher scores of TCM syndrome;higher level of ESR,CRP and IgA;lower level of HGB.In syndrome of endogenous heat due to Yin deficiency:older;longer duration;higher degree of dry mouth,fatigue,constipation,scores of TCM syndrome;higher level of CRP;lower level of WBC?RBC and HGB.In Qi and Blood stasis syndrome:older;higher degree of dry mouth,constipation and scores of TCM syndromes;higher level of CRP,ESR,IgA and IgM;lower level of RBC and PLT.In Yang Xu Jin Ning syndrome:older;higher level of IgA.(3)The sensitivity of HRCT is higher than that of clinical manifestations and pulmonary function.HRCT can help diagnose and predict early.