养阴清肺汤治疗干燥综合征腮腺肿大探讨  

Treating Sjogren’s syndrome parotid gland swelling with the Yangyin Qingfei decoction

作　　者：周晓妍[1] 汪元元 邓玉甲 ZHOU Xiaoyan

机构地区：[1]济宁市中医院,山东济宁272000 [2]济宁市市直机关医院,山东济宁272000

出　　处：《中医临床研究》2023年第28期111-115,共5页Clinical Journal Of Chinese Medicine

摘　　要：干燥综合征是一种以侵犯泪腺、唾液腺等外分泌腺体,伴或不伴多系统损害的,具有淋巴细胞浸润和特异性自身抗体为特征的弥漫性结缔组织病。是风湿科中的常见病和多发病。腮腺受累在临床中十分常见,患者腮腺硬肿疼痛极为痛苦。腮腺肿大及腮腺造影在该病的诊断中具有重要的意义,如果不能及时有效的治疗将会对患者造成永久性的损伤,且容易继发感染而迁延不愈。干燥综合征中医称为“燥痹”,是病因病机均较复杂的一种风湿病,涉及到多脏器、多系统的病理变化。中医学对其病因病机有着重要的论述,中医药治疗该病具有其独特的优势,不仅能够缓解患者病情,而且无长期口服激素及免疫抑制剂造成的不良反应,对患者长期的预后而言具有很好的安全性。通过辨证和辨病相结合,调节异常的免疫功能,不仅能降低涎腺肿大的复发,而且可以对肺间质病变、肾脏病变、肝功能异常、血液系统损害、血管炎等均有一定的治疗作用,并能提高患者的生活质量。本文从肺及腮腺病变这一中西医共同关注的热点入手,从中医理论、方药研究、现代医学机制研究并结合临床案例进行探讨,肺肾阴虚、燥毒为患为其发病的重要病机,临床中治以滋肾润肺、解毒凉血,方选养阴清肺汤加减效果明显,具有借鉴价值及意义。Sjogren’s syndrome is a diffuse connective tissue disease characterized by lymphocyte infiltration and specific autoantibodies that invade exocrine glands such as lacrimal and salivary glands,with or without multisystem damage.It is a common and frequent disease in rheumatology.Parotid gland involvement is very common in clinical practice,and patients with hard andS painful parotid gland swelling are extremely painful.Parotid gland enlargement and parotid glandography are of great significance in the diagnosis of this disease,and if not treated in a timely and effective manner,it will cause permanent damage to the patient,and it is easy to prolong secondary infection.Sjogren’s syndrome,known as dryness in TCM,is a rheumatic disease with complex etiology and pathogenesis,involving pathological changes of multiple organs and systems.TCM has an important discussion on its etiology and pathogenesis,and the treatment of this disease has its unique advantages,which can not only alleviate the patient's condition,but also have no adverse reactions caused by long-term oral hormones and immunosuppressants,and has a good safety for the long-term prognosis of patients.Through the combination of syndrome differentiation and disease differentiation,the abnormal immune function can not only reduce the recurrence of salivary gland enlargement,but also have a certain therapeutic effect on pulmonary interstitial lesions,kidney lesions,liver function abnormalities,hematologic damage,vasculitis,etc.,and can improve the quality of life of patients.Starting from the hot spot of lung and parotid gland lesions,which is a common concern of TCM and Western medicine,this paper discusses the theory of TCM,prescription research,modern medical mechanism research and combined with clinical cases.Yin(阴)deficiency in the lungs and kidneys,dryness and toxins are important pathogenesis for its pathogenesis,and the clinical treatment is to nourish the kidneys and moisten the lungs,detoxify and cool the blood,and the Yangyin Qingfei decoction(

关 键 词：养阴清肺汤 干燥综合征 腮腺肿大 

分 类 号：R25[医药卫生—中医内科学]