原发性干燥综合征合并血细胞减少患者中医证候特点及相关因素分析  

Characteristics of Chinese Medical Syndromes and Associated Factors of Primary Sjögren'sSyndrome Patients with Hemocytopenia

作　　者：杨建英 罗静[2] 陈嘉琪 张丽宁 吴子华 张燕 贺倩 黄子玮 余新波 陶庆文[2] YANG Jian-ying;LUO Jing;CHEN Jia-qi;ZHANG Lining;WU Zi-hua;ZHANG Yan;HE Qian;HUANG Zi-wei;YU Xin-bo;TAO Qing-wen(Graduate School,Beijing University of Chinese Medicine,Beijing,100029;Department of Rheumatology,China-Japan Friendship Hospital,Beijing Key Laboratory of Immuno-Inflammatory Diseases,Beijing,100029)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中日友好医院中医风湿病科,免疫炎性疾病北京市重点实验室,北京100029

出　　处：《中国中西医结合杂志》2023年第8期937-942,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：首都卫生发展科研专项青年优才项目(No.2020-4-40610);中日友好医院“菁英计划”人才培育工程(No.ZRJY2021-QM14);中央高水平医院临床科研业务费资助(No.2022-NHLHCRF-LX-02)。

摘　　要：目的 分析原发性干燥综合征(p SS)合并血细胞减少患者的舌象与中医证候特点,并探索其相关因素。方法 243例均为2018年12月—2022年5月于中日友好医院中医风湿病科就诊的p SS患者,符合纳入标准210例,依据是否合并血细胞减少分为A、B两组,观察两组舌象、中医证候及免疫炎症指标的差异,采用Logistic回归分析方法分析p SS合并血细胞减少患者的相关因素。结果 合并血细胞减少86例(40.95%,A组),无血细胞减少124例(59.05%,B组)。A组患者常见舌体裂纹、少津,舌苔白,常见脾气虚证和肝肾阴虚证。与B组比较,A组患者舌体少津、舌苔薄及脾气虚证的比例更高(P<0.05)。Logistic回归分析发现,舌体少津[OR=2.197, 95%CI (1.128, 4.280), P=0.021]、脾气虚证[OR=2.861, 95%CI(1.340, 6.106), P=0.007]、抗SSA抗体阳性[OR=3.051, 95%CI (1.168, 7.966),P=0.023]及补体3(C3)降低[OR=2.992, 95%CI (1.404, 6.374), P=0.005]与p SS合并血细胞减少呈正相关。结论 p SS合并血细胞减少患者常见脾气虚证和肝肾阴虚证;p SS合并血细胞减少与舌体少津、脾气虚证、抗SSA抗体阳性、C3降低正相关。Objective To analyze the characteristics of tongue images and Chinese medical syndromes in primary Sjögren's syndrome(pSS)patients with hemocytopenia,and to study its related factors.Methods Totally 210 pSS patients in line with the inclusion criteria were enrolled from 243 patients who visited Department of Chinese Medical Rheumatism,China-Japan Friendship Hospital from December 2018 to May 2022.They were assigned to group A and B according the presence or absence of hemocytopenia.The differences in tongue images,Chinese medical syndromes,and immune inflammation indices were analyzed.Logistic regression analysis was used to analyze the factors associated with hemocytopenia in pSS patients.Results Totally 86(40.95%)patients with hemocytopenia in group A and 124(59.05%)patients without hemocytopenia in group B.pSS patients in group A commonly had cracked tongue,less tongue fluid,and white tongue coating.Pi-qi deficiency syndrome and Gan-Shen yin deficiency syndrome were more often seen.Compared with group B,pSS patients in group A had a higher proportion of less tongue fluid,thin tongue coating,and Pi-qi deficiency syndrome(P<0.05).Logistic regression analysis showed that less tongue fluid[OR=2.197,95%CI(1.128,4.280),P=0.021],Pi-qi deficiency syndrome [OR=2.861, 95%CI (1.340, 6.106), P =0.007], positive anti-SSA antibody [OR=3.051, 95%CI (1.168,7.966), P=0.023], and decreased level of complement 3( C3) [OR=2.992, 95%CI( 1.404, 6.374), P=0.005]were positively correlated with hemocytopenia in pSS patients. Conclusions Pi-qi deficiency syndrome andGan-Shen yin deficiency syndrome were more often seen in pSS hemocytopenia patients. Less tongue fluid,Pi-qi deficiency syndrome, positive anti-SSA antibody, and lowered C3 were positively correlated with pSSpatients with hemocytopenia.

关 键 词：干燥综合征 血细胞减少 舌象 中医证候 

分 类 号：R259[医药卫生—中西医结合]