原发性干燥综合征住院患者的中医证素研究

Study on Traditional Chinese Medicine Syndrome Elements of Inpatients with Primary Sjogren’s Syndrome

【目的】探究原发性干燥综合征(燥痹)住院患者的中医证素分布规律。【方法】以2012年1月至2022年12月期间在广东省中医院接受治疗的符合纳入、排除标准的240例原发性干燥综合征住院患者为研究对象,对证素信息进行数据挖掘。【结果】(1)240例患者中,男21例(占8.75%),女219例(占91.25%),以女性患者居多;年龄方面,青年患者(18~45岁)33例(占13.75%),中年患者(46~69岁)148例(占61.67%),老年患者(70岁~)59例(24.58%),以中年患者居多。(2)240例患者中,有4例无证素诊断成立,236例统计到证素诊断,共得到38个证素,其中病位证素15个,病性证素23个,证素总频次为1142例次。频数最多的病位证素为肝(6.04%)、肺(4.99%)、筋骨(4.20%);频数最多的病性证素为阴虚(13.75%)、气虚(9.37%)、痰(6.57%)。病位证素中,以单病位证素为主(42.92%);病性证素中,以5个以上病性证素为主(25.83%)。不同性别的脾、阴虚证素分布比较,差异有统计学意义(P<0.05);不同年龄段的气虚、饮证素分布比较,差异有统计学意义(P<0.05)。频数最高的证素组合为气虚+阴虚(72次,30%)、痰湿+阴虚(72次,30%),其次为热+阴虚(59次,24.58%)。根据证素组合得到240例原发性干燥综合征的常见中医证型为气阴两虚、阴虚痰湿、阴虚火旺等。【结论】原发性干燥综合征常累及肝、肺等,以阴虚、气虚多见,证素混杂,以气阴两虚为常见证型,提示从证素出发对原发性干燥综合征进行辨治更具有针对性。

Objective To investigate the distribution patterns of traditional Chinese medicine(TCM)syndrome elements in patients with primary Sjogren’s syndrome(pSS;dryness blockage syndrome in TCM).Methods A total of 240 inpatients with pSS who met the inclusion and exclusion criteria and were treated in Guangdong Provincial Hospital of Chinese Medicine from January 2012 to December 2022 were selected as the research objects,and data mining was performed on the information of syndrome elements.Results(1)Among the 240 patients,there were 21 males(accounting for 8.75%)and 219 females(accounting for 91.25%),indicating that most of which were female patients.In terms of the age,33(13.75%)patients were young(18-45 years old),148(61.67%)patients were middle-aged(46-69 years old),and 59(24.58%)patients were elderly(being or over 70 years old),indicating that most of the patients were middle-aged.(2)Among 240 patients,4 cases had no manifestations of any syndrome elements,and a total of 38 syndrome elements were obtained from the 236 cases of patients,including 15 diseases-location syndrome elements and 23 diseases-nature syndrome elements.The total frequency of syndrome elements was 1142 times.The leading diseases-location syndrome elements with high frequency were liver(6.04%),lung(4.99%)and bones(4.20%),and the leading diseases-nature syndrome elements with high frequency were yin deficiency(13.75%),qi deficiency(9.37%)and phlegm(6.57%).The diseases-location syndrome elements were predominated by the single syndrome elements of diseaselocation(42.92%),and the diseases-nature syndrome elements were predominated by the complex syndrome elements of over five kinds of diseases-nature(25.83%).There were significant differences in the distribution of spleen and yin deficiency syndrome elements between the males and the females(P<0.05),and statistically significant differences were shown in the distribution of qi deficiency and fluid retention syndrome elements among various age groups(P<0.05).The syndrome-element combinations with high frequency were qi deficiency+yin deficiency(72 times,30%)and phlegm-damp+yin deficiency(72 times,30%),and then came heat+yin deficiency(59 times,24.58%).The analysis of the combination of syndrome elements showed that the common TCM syndrome types of 240 cases of pSS were deficiency of qi and yin,yin deficiency and phlegm-damp,and yin deficiency with flaring of fire.Conclusion The affection of pSS often involves the liver and lung.In the patients with pSS,yin deficiency and qi deficiency are the most common syndrome elements,and the syndrome elements are usually complex;deficiency of qi and yin is the common type of syndrome.The results indicated that the differentiation and treatment of pSS starting from the syndrome elements will be more targeted.