Evaluation Of The Curative Effect Of Huoxue Jiedu Recipe In Treating Primary Sjogren’s Syndrome With Blood Stasis Syndrome

Background:primary Sjogren’s Syndrome(pSS)is a chronic inflammatory autoimmune disease which mainly invades human exocrine glands.With the progress of the disease,it can cause multiple organ system involvement.At present,the pathogenesis of Sjogren’s syndrome is not entirely clear.There are many defects in the treatment of Western medicine,and the treatment of traditional Chinese medicine has certain advantages.Sjogren’s syndrome belongs to the category of dryness and arthralgia in traditional Chinese medicine.Clinical observation shows that there are a large number of patients with stasis and toxin syndrome.The method of activating blood circulation,removing blood stasis and detoxifying,nourishing yin,promoting body fluid and moiste-ning dryness has achieved good therapeutic effect.Previous experiments showed that BAFF,CXCL13 and IRF4 were involved in the pathogenesis of Sjogren’s syndrome with stasis and toxin.The good therapeutic effect of Huoxue Jiedu recipe may be related to the inhibition of the overexpression of BAFF and CXCL13 in Sjogren’s syndrome.In addition,in recent years,salivary gland ultrasound has increasingly become a reliable tool for evaluating the gland function of Sjogren’s syndrome,with high diagnostic and other clinical value.The differentiation of symptoms and signs in traditional Chinese medicine has certain subjectivity,and the effectiveness of traditional Chinese medicine treatment is closely related to the accuracy of differentiation of symptoms and signs.Therefore,the application of modern medical technology salivary gland ultrasound in the exploration of Sjogren’s syndrome may become a more objective and accurate method of differentiation of symptoms and signs in traditional Chinese medicine.Objective:The purpose of this study is to explore the clinical manifestations and changes of BAFF,CXCL13,IRF4,salivary gland ultrasound and other indicators of Sjogren’s syndrome patients with stasis-toxin syndrome after treatment with Huoxue Jiedu recipe,to further clarify the curative effect of Huoxue Jiedu Recipe on Sjogren’s syndrome patients with stasis-toxin syndrome,and to explore its possible mechanism of action.According to the changes of salivary gland ultrasound before and after treatment,the objective evaluation basis for syndrome differentiation of Sj ogren’s syndrome with stasis and toxin was found.Methods:According to the discharge standard,60 cases of Sjogren’s syndrome with stasis and toxin syndrome were included in the outpatient and ward of our hospital.They were randomly divided into two groups,30 cases in the control group and 30 cases in the treatment group.The treatment group was treated with total paeony glycol-side capsule and self-made Huoxue Jiedu recipe and total paeony glycoside capsule,0.6g(two capsules)each time,three times a day.The control group was routinely given total glucosides of paeony capsules,0.6g(2 capsules)each time,three times a day,for 12 weeks.The indexes were tested before and after treatment.Including electrocardiogram,hematuria and stool routine,liver and kidney function,creactive protein,erythrocyte sedimentation rate,immunoglobulin,serum BAFF,CXCL13,IRF4,ESSDAI score,TCM syndrome score and salivary gland ultrasound.RESULTS:Sixty Sjogren’s syndrome patients with stasis and toxin syndrome were included,3 cases in the control group dropped out,60 cases completed the experiment,30 cases in the treatment group and 30 cases in the control group.Before treatment,the two groups of Sjogren’s syndrome patients with stasis-toxin syndrome had no comparability in gender,age and course of disease.Compared with before treatment,ESR,IgG,ESDDAI,BAFF,CXCL13,TCM syndrome score and salivary gland ultrasound score were improved in both groups after treatment(P<0.05).The improvement of each index in the treatment group was better than that in the control group,and there was no significant difference between the two groups.The treatment group had definite effect in improving dry mouth,dry eyes and dry skin,which was better than the control group.There were no obvious abnormalities in the safety indexes before and after treatment in the treatment group and the stomach control group.There were 6 cases of diarrhea in the control group,which were relieved by self-relief or drug reduction.There was no adverse reaction in the treatment group.Conclusion:Huoxue Jiedu Decoction can improve the clinical manifestations,lab-oratory and scoring indexes of Sjogren’s syndrome with stasis and toxin,without obvious adverse reactions.Its mechanism may be to inhibit the overexpression of BAFF and CXCL13 in the pathogenesis of Sjogren’s syndrome.Salivary gland ultrasound can visually show the gland manifestations of patients,which has guiding significance for clinical differentiation of symptoms and signs,and can improve the objectivity and accuracy of differentiation of symptoms and signs.