| 束开艳,曹云祥,刘健,徐昌萍,付皖兰.原发性干燥综合征合并血液系统损害患者的中西医临床特征及危险因素分析[J].中国临床保健杂志,2023,26(4):540-544. |
| 原发性干燥综合征合并血液系统损害患者的中西医临床特征及危险因素分析 |
| The clinical characteristics and risk factors of Chinese and western medicine in patients with primary Sjgren′s syndrome complicated with blood damage |
| 投稿时间：2023-04-26 |
| DOI：10.3969/J.issn.1672-6790.2023.04.024 |
| 中文关键词: 干燥综合征 血液和免疫系统 危险因素 中草药 回顾性研究 |
| 英文关键词: Sjgren′s syndrome Hemic and immune systems Risk factors Drugs,Chinese herbal Retrospective studies 〖FL |
| 基金项目:国家自然科学基金面上项目(82074090)；安徽省自然科学基金面上项目(2208085MH267)；安徽省高校自然科学研究重点项目(KJ2020A0403)；第七批全国老中医药专家学术经验继承项目(国中医药人教函〔2022〕76号) |
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| 中文摘要: |
| 目的 研究原发性干燥综合征(pSS)合并血液系统损害患者的中西医临床特征及危险因素。方法 收集2019年11月至2022年6月安徽中医药大学第一附属医院风湿免疫科收治的pSS患者临床资料156例,依据是否合并白细胞、淋巴细胞、中性粒细胞减少,分为血液损害组(68例)和非血液损害组(88例),采用回顾性分析对纳入患者的一般资料、临床症状、并发疾病、实验室检查及中医证型、舌脉进行统计分析,并回归分析疾病危险因素。结果 (1)156例pSS患者中68例pSS合并白细胞、中性粒细胞减少、淋巴细胞减少为血液损害组占43.6%,白细胞减少52例(76.5%),淋巴细胞减少26例(38.2%),中性粒细胞减少32例(47.1%),两系及两系以上减少31例(45.6％)。(2)血液损害组女性发病率更高；更易出现多关节疼痛及乏力症状(P＜0.05)。(3)原发病和合并疾病统计发现脾大、甲状腺功能减退症的发病率更高(P＜0.05)。(4)实验室检查表现为抗SSA抗体阳性率更高,肌酐、红细胞沉降率升高,白蛋白/球蛋白降低(P＜0.05)。(5)中医证型以气阴两虚等虚证为主,舌脉排名前3的舌质为:红、淡红、暗红；脉象:细、沉细、濡。(6)logistic回归分析提示多关节疼痛(OR=4.048)、乏力(OR=3.655)、甲减(OR=6.032)、抗SSA抗体阳性(OR=4.482)及红细胞沉降率升高(OR=4.619)可能为pSS合并血液损害的危险因素。结论 红细胞沉降率、抗SSA抗体、甲状腺功能减退可明显增加pSS合并血液系统损害的风险,其中医病机以脾虚为本。 |
| 英文摘要: |
| Objective To study the clinical characteristics and risk factors of Chinese and western medicine in patients with primary Sjgren′s syndrome (pSS) complicated with blood damage.Methods The clinical data of 156 patients with SS from November 2019 to June 2022 were collected from the Department of Rheumatology and Immunology,the First Affiliated Hospital of Anhui University of traditional Chinese medicine,according to whether there is a combination of leukopenia,lymphopenia,and neutropenia,they are divided into a blood damage group (68 cases) and a non blood damage group (88 cases),retrospective analysis was used to analyze the general data,clinical symptoms,complications,laboratory examination,TCM syndrome types,tongue and pulse of the patients,and to analyze the risk factors of the disease.Results (1)Among 156 pSS patients,68 pSS patients with leukopenia,neutropenia and lymphopenia accounted for 43.6%,52 SS patients with leukopenia (76.5%),26 SS patients with lymphopenia (38.2%),there were 32 cases (47.1%) of neutropenia,31 cases (45.6%) of 2-line and more than 2-line reduction.(2) The incidence of polyarticular pain and fatigue was higher in the women with blood damage (P<0.05).(3) The incidence of splenomegaly and hypothyroidism was higher in the patients with primary and complicated diseases (P<0.05).(4)The positive rate of anti-SSA antibody was higher,CREA,ESR increased,A/G decreased (P<0.05).(5)Deficiency of both qi and yin is the main syndrome types of traditional traditonal medicine,top three tongue:red,light red,dark red;top three pulse:thin,thin,wet.(6)Logistic regression analysis showed that multiple joint pain (OR=4.048),fatigue (OR=3.655),hypothyroidism (OR=6.032),anti-SSA antibody (OR=4.482) and increased ESR (OR=4.619) might be the risk factors of blood damage in patients with pSS.Conclusions Hypothyroidism,ESR and anti-SSA antibodies can increase the risk of pSS complicated with hematological system damage,and the main pathogenesis of traditional Chinese medicine is spleen deficiency. |
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