Study On TCM Syndromes And Related Factors Of Primary Sjögren's Syndrome Complicated With Renal Damage

BackgroundPrimary Sjogren's syndrome(pSS)is one of the common diseases in rheumatology.Patients will suffer from dry mouth,dry eyes,fatigue and other symptoms,while the etiology and mechanism is not clear.Further studies have found that it not only affects the exocrine glands of the body,but also affects multiple systems,which is a systemic autoimmune disease.The incidence rate of renal damage in pSS is high and the onset is insidious,so there is a lack of clinical attention to it.Therefore,early detection and early intervention of renal damage is of great significance for the treatment and improvement of prognosis of pSS.Traditional Chinese medicine(TCM)is an important means for the treatment of pSS.However,because of its many involved systems and complex etiology and pathogenesis,it is difficult to form a unified guide recommendation on TCM syndromes.Renal damage is an important part of the development of pSS.Therefore,the summary of its TCM syndrome will contribute to the full understanding of the disease,which will achieve greater results in the clinical treatment of pSS.ObjectiveBy reviewing and collecting the hospitalized medical records of patients with primary Sjogren's syndrome,extracting the clinical characteristics and TCM syndrome information of patients with primary Sjogren's syndrome,in order to obtain the TCM syndrome characteristics and related factors of pSS patients with renal damage,provide a basis for the diagnosis and treatment of clinical pSS patients with renal damage,and provide clinical data support for further study of the mechanism of pSS renal damage and improving the effect of traditional Chinese medicine treatment.MethodsBy using the method of retrospective analysis,the medical records of patients with primary Sjogren's syndrome hospitalized in Dongfang Hospital of Beijing University of traditional Chinese Medicine in recent 5 years were collected and divided into renal damage group and control group according to the occurrence of renal damage.the basic information,clinical symptoms,laboratory examination and diagnostic results of the patients in the medical records were extracted,and the database was established.Through the analysis of the data to obtain the TCM syndrome characteristics and related factors of primary Sjogren's syndrome complicated with renal damage.Results1.A total of 153 medical records were collected,including 81 in renal damage group and 72 in control group.There was no significant difference in sex ratio between the two groups The age of onset and the duration of the disease were higher in the renal damage group,but there was no statistical difference(P>0.05).2.In the past medical history statistics,the top 5 diseases were osteoporosis,hypertension,osteoarthritis,hyperlipidemia and pulmonary interstitial fibrosis.There were significant differences in the incidence of hypokalemia,hyperuricemia and cataract between the two groups(P<0.01).Only 37 cases(45.68%)of renal damage were concerned.3.The most frequency symptoms were dry mouth,dry eyes and joint symptoms,and the constituent ratios of frequent urination,fatigue,shortness of breath and diarrhea in the kidney damage group were significantly higher than those in control group(P<0.05).Tongue pulse statistics showed that there were significant differences in the frequency of pale red tongue,less Jin fur and white fur between the two groups(P<0.05).4.In laboratory examination,there were significant differences in albumin concentration,sodium ion level,urea,?2-microglobulin,creatinine clearance rate and glomerular filtration rate between the two groups(P<0.05).14 cases(18.18%)in the renal damage group had proteinuria.No significant differences were found in immune related indexes between the two groups(P>0.05)5.According to the statistics of TCM syndromes,Qi-Yin deficiency syndrome was the most in general,and there was significant difference between the two groups(P<0.01).After statistical analysis of the syndrome in medical records using single factor syndromes,it is found that the constituent ratio of Qi deficiency syndrome in renal damage group was significantly higher than that in the control group(P<0.01).6.The disease site analysis showed that the spleen system was the most in the whole group The disease site in the kidney system of the renal damage group was increased compared with the control group,but there was no statistical difference(P>0.05).Deficiency-excess syndrome is the main disease.Conclusion1.The positive rate of pSS complicated with renal damage is high,while lack of attention was paid to it.2.Among pSS patients,the patients with renal damage have different characteristics in clinical symptoms and laboratory examination.?2-MG may have certain diagnostic value for early renal damage in pSS,but further studies are needed to confirm it.3.Qi-Yin deficiency syndrome and Qi deficiency syndrome in pSS patients with renal damage are significantly increased,and its pathogenesis may be related to the Qi deficiency.