Study On The Distribution Of TCM Syndromes And Related Factors Of Sj(?)gren’s Syndrome-interstitial Lung Disease

Objective: Based on the statistical analysis of the relevant data of Sjogren’s syndrome patients with lung interstitial disease in the rheumatology department of Yunnan Hospital of Traditional Chinese Medicine,the distribution characteristics and related factors of TCM syndromes of SS-ILD were preliminarily discussed,so as to provide reference for the standardized syndrome differentiation and early prevention and treatment of the disease.Methods: Data of 282 inpatients in the rheumatology department of Yunnan Hospital of Traditional Chinese Medicine from January 2016 to November 2021 who metthe clinical diagnostic criteria of SS-ILD and case selection criteria were collected,including general information,related medical history,information of four diagnoses,auxiliary examination and other relevant information,and case data of 282 patients with simple SS during the same period were collected as controls.SPSS26.0 software was used to analyze the data by frequency analysis,cluster analysis,Chi-square test,non-parametric rank sum test and other statistical methods,so as to explore the distribution characteristics and related factors of TCM syndrome in SS-ILD patients.Results: 1.282 TCM syndroms of SS-ILD patients were: 78 cases(27.7%)of Qi and Yin deficiency,58 cases(20.6%)of phlegm and turbidity-blocking lung,54 cases(19.1%)of liver and kidney Yin deficiency,47 cases(16.7%)of wind-cold-dampness obstruction,and 45 cases(16%)of lung Yin deficiency.2.General data of SS-ILD group and SS group were compared.The results showed that there were statistical differences in gender,age,smoking history,use history of Methotrexate tablets and leflunomide tablets between the two groups(P<0.05).There was no statistical difference in the course of disease(P>0.05).The laboratory examination comparison between SS-ILD group and SS group showed that: WBC,ESR,CRP,D-dimer,immunoglobulin Ig A,Ig G,RF-Ig A titer,RF-Ig G titer,RF-Ig M titer,and IL-1β,IL-6,IL-8,IL-10,TNF-α,anti-Ro-52 antibody,anti-SSA antibody,anti-SSB antibody,and 25-OH-D between the two groups There were statisticaldifferences(P<0.05).There were no significant differences in RBC,PLT,HGB,C3,C4,Ig M,Ig E and CCP between the two groups(P>0.05).All 282 cases of SS-ILDshowed different degrees of pulmonary interstitial lesions,including early stage imaging in 117 cases(41.4%),fibrotic stage in 134 cases(47.6%),and honeycomb stage in 31 cases(11%).3.Analysis of TCM syndrome types and related factors showed that: In the course of the disease,the elders were characterized as liver and kidney deficiency,lung-yin deficiency and qi-yin deficiency.The smoking history of the patients with phlegm-turbidity syndrome was longer,which was significantly different from that ofthe four types(P<0.05),but there was no statistical difference between the four types.The CRP of phlegm-turbid obstruction of lung syndrome was higher than that of lung-yin deficiency syndrome(P<0.05),but there was no difference between othersyndromes(P>0.05).The PLT of the patients with lung-yin deficiency syndrome was lower than that of the other four types(P<0.05).The Ig A of liver-kidney-yin deficiency syndrome was higher than that of Qi-yin deficiency syndrome(P<0.05),and there was no difference between the residual syndrome types.The IL-6 of Qi-Yin deficiency syndrome,liver-kidney-Yin deficiency syndrome and lung-Yin deficiency syndrome were higher than that of phlegm-turbidity of lung(P<0.05),but therewas no statistical difference in the rest syndrome.HRCT statistics showed that in the early stage,wind-cold-dampness Bi syndrome was more common,and there were statistical differences with Qi and Yin deficiency syndrome,phlegm turbidity obstructivelung syndrome,liver and kidney Yin deficiency syndrome,lung Yin deficiency syndrome(P<0.05),and there were no statistical differences among other syndrome types.There was no statistical difference in the other indicators among the fivesyndrome types(P>0.05).Conclusion: 1.The TCM syndromes in SS-ILD : Qi and Yin deficiency syndrome,phlegmturbidity obstructive lung syndrome,liver and kidney Yin deficiency syndrome,wind-cold-dampness Bi syndrome,lung Yin deficiency syndrome.2.SS-ILD related factors: General data related: male,older,history of smoking,history of methotrexate and leflunomide tablets.Related to laboratory tests: Increased WBC,ESR,CRP,D-2 polymer,high titer of immunoglobulin Ig A,Ig G,RF-Ig A,RF-Ig G,RF-Ig M and high positive rate of IL-1β,IL-6,IL-8,IL-10,TNF-α,anti-Ro-52,anti-SSA and anti-SSB may be associated with secondary ILD There is a correlation.3.TCM syndrome types and related factors of SS-ILD: deficiency of liver andkidney,deficiency of lung and Yin,deficiency of qi and Yin were more common in elderly patients with disease course;Smoking patients are more likely to have phlegm-turbidity obstructive pulmonary syndrome,and patients with phlegm-turbidity obstructive pulmonary syndrome have higher CRP level.Lung Yin deficiency syndrome is more prone to thrombocytopenia;High Ig A level in liver-kidney Yin deficiency syndrome;IL-6 of Qi and Yin deficiency syndrome,liver and kidney Yin deficiency syndrome and lung Yin deficiency syndrome was higher than that of phlegm and turbidity-blocking lung syndrome.HRCT showed that ILD was positive in the early stage,and wind-cold-dampness arthralgia was more common.Fibrosis stage ofdeficiency and accumulation mixed with wind,cold and dampness syndrome,lung Yin deficiency syndrome;Honeycomb lung stage partial deficiency syndrome,lung Yin deficiency syndrome,liver and kidney Yin deficiency syndrome in the majority.