益气消毒方对干燥综合征患者腮腺超声病变影响的研究

Effect of Yiqi Xiaodu Decoction on Ultrasound Lesions of Parotid Gland in Patients with Sj?rgen’s Syndrome

[目的]回顾性分析存在腮腺病变的干燥综合征患者的超声特征,并探究益气消毒方对其腮腺病变的影响。[方法]收集2015年1月1日至2018年1月1日就诊我院的195例干燥综合征患者,分析其中有腮腺超声改变的患者的临床特征,进一步筛选出持续以益气消毒方加减治疗3个月以上,并在治疗前后复查腮腺超声者85例,进行治疗前后的腮腺超声指标比较,并与未使用该方剂治疗的患者(包括未服中药,以及服用其他非益气消毒方加减中药制剂者)的腮腺超声指标进行比较。[结果]原发性干燥综合征患者出现腮腺超声改变的比例显著高于继发性干燥综合征,且与口干量表(xerostomia inventory,XI)评分、抗干燥综合征A(anti-Sj gren’s syndrome A,anti-SSA)抗体阳性强度、高IgG血症、唇腺灶性指数(salivary gland focus score,FS)高度相关(P<0.05);益气消毒方可减轻或延缓干燥综合征患者超声下的腮腺病变,从而改善口干症状(P<0.01)。[结论]腮腺超声在诊断干燥综合征及评价益气消毒方对干燥综合征的治疗效果方面均有价值。

[Objective]To retrospectively analyze the ultrasound features of Sjogren’s syndrome patients with parotid gland lesions,and subsequent study the effect of Yiqi Xiaodu decoction on its parotid gland lesions.[Methods]One hundred and ninety five patients with Sjogren’s syndrome from Jan 1st 2015 to Jan 1st 2018 were collected,and the clinical features of patients with parotid gland changes under ultrasound were analyzed.Furtherly,eighty five patients who both received continuous treatment with Yiqi Xiaodu decoction for more than 3 months,and parotid gland ultrasound examination before and after treatment were selected.The parameters of parotid gland ultrasound were compared before and after treatment,and compared with patients who didn’t receive Yiqi Xiaodu decoction,or received other herb prescriptions.[Results]The proportion of parotid ultrasound changes in patients with primary Sjogren’s syndrome was higher than that of secondary Sjogren’s syndrome,and it was highly correlated with xerostomia inventory(XI)score,anti-Sjogren syndrome(anti-SSA)antibody positive intensity,hyperimmunoglobulinemia,and salivary gland focus score(FS),all indexes were statistically significant(P<0.05).Yiqi Xiaodu decoction can alleviate or delay the parotid lesion under ultrasound in patients with Sjogren’s syndrome,thus improve the oral symptoms(P<0.01).[Conclusion]Parotid gland ultrasound is valuable in diagnosis of Sjogren syndrome and evaluation of effect of Yiqi Xiaodu decoction on the treatment of Sjogren’s syndrome.