从中焦湿热论治原发性干燥综合征

Treatment of Primary Sjogren's Syndrome From the Perspective of Damp Heat in the Middle Jiao

原发性干燥综合征(primary Sjogren's syndrome,pSS)是一种常见的慢性自身免疫性疾病,主要累及唾液腺和泪腺,临床表现为眼、口干燥以及疲劳、关节痛等全身症状。pSS患者的治疗涉及多个不同的专业领域,治疗复杂,且缺乏特异性药物,疗效欠佳。中医将pSS归属于“燥痹”范畴,多数医家认为该病基本病机为阴液亏损、津液枯涸,治疗亦多以滋阴润燥,养阴生津法为主,但部分患者疗效不尽如人意。笔者在此领域积累了丰富的临证经验,发现pSS属中焦湿热证者占较大比例,从中焦湿热论治,采用健脾化湿,清热润燥法取得了良好效果。

Primary Sjogren's syndrome(pSS)is a common chronic autoimmune disease that mainly affects the salivary and lacrimal glands.Its clinical manifestations include dry eyes and mouth,as well as systemic symptoms such as fatigue and joint pain.The treatment of PSS patients involves multiple different professional fields,with complex treatment and a lack of specific drugs,resulting in poor efficacy.Traditional Chinese medicine categorizes pSS as"dry bi",and most doctors believe that the basic pathogenesis of this disease is the loss of yin fluid and the drying up of body fluid.The treatment is mainly based on nourishing Yin and moistening dryness,nourishing Yin and promoting fluid production,but some patients have unsatisfactory therapeutic effects.The author has accumulated rich clinical experience in this field and found that pSS belongs to the middle jiao dampness heat syndrome,which accounts for a large proportion.From the perspective of middle jiao dampness heat treatment,the method of strengthening the spleen to dissipate dampness and clearing heat and moistening dryness has achieved good results.