不同自身抗体阳性原发性干燥综合征患者的舌象特点  

Tongue appearances characteristics of patients with primary Sjogren's syndrome with different positive autoantibodies

作　　者：黄子玮 吴子华 杨建英 张燕 张丽宁[1,2] 胡琪 罗静 陶庆文[2] HUANG Ziwei;WU Zihua;YANG Jianying;ZHANG Yan;ZHANG Lining;HU Qi;LUO Jing;TAO Qingwen(Graduate School of Beijing University of Chinese Medicine,Bejing 100029,China;Department of TCM Rheumatology,China-Japan Friendship Hospital,Beijing Key Laboratory of Immune Inflammatory Disease,Beijing 100029,China)

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：《中华中医药杂志》2023年第11期5514-5518,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中央高水平医院临床科研业务费资助(No.2022-NHLHCRF-LX-02-0301);中日友好医院“菁英计划”人才培育工程(No.ZRJY2021-QM14);首都卫生发展科研专项青年优才项目(No.2020-4-40610)。

摘　　要：目的:探索不同自身抗体阳性原发性干燥综合征(pSS)患者舌象特点。方法:纳入2018年12月至2021年9月于中日友好医院中医风湿病科就诊的pSS患者,统一采集舌象和自身抗体。χ^(2)检验比较不同自身抗体阳性患者舌象特点,phi相关分析自身抗体与舌象相关性。结果:共纳入pSS患者173例,抗核抗体(ANA)滴度≥1∶160较滴度<1∶160患者存在舌体裂纹、少津,舌色红绛,剥脱苔比例更高(P<0.05,P<0.01),舌苔厚、腻比例更低(P<0.05)。抗着丝点蛋白B(CENP-B)抗体阳性较阴性患者舌体裂纹比例更高(P<0.01),舌苔厚、腻比例更低(P<0.05)。类风湿因子(RF)阳性较阴性患者舌苔燥、剥脱苔比例更高(P<0.05)。部分自身抗体与舌象间均呈弱相关(φ<0.4)。结论:ANA滴度≥1∶160、抗CENP-B抗体及RF阳性pSS患者易见气阴两虚舌象,且前两种少见痰湿舌象,可为pSS中医现代化研究提供参考。Objective:To explore the characteristics of tongue appearances in patients with primary Sjogren's syndrome(pSS)with different positive autoantibodies.Methods:Patients with pSS who were treated in the Department of TCM Rheumatology,China-Japan Friendship Hospital,from December 2018 to September 2021 were enrolled,tongue appearances and autoantibodies were collected uniformly.Chi-square test were used to analyze the features of tongue appearances for patients with different positive autoantibodies,phi correlation analysis were used to test the correlation between autoantibodies and tongue appearances.Results:A total of 173 patients with pSS were included in this study,patients with pSS with ANA titer≥l:160 presented with cracked tongue,less fluid tongue,deep-red tongue,and a high proportion of exfoliation(P<0.05,P<0.01),a lower proportion of thick coating,and greasy coating(P<0.05);Patients with positive for anti-centromere protein B(CENP-B)antibodies had a higher proportion of cracked tongue(P<0.01),and a lower proportion of thick coating,and greasy coating(P<0.05);Patients with pSS who were positive for rheumatoid factor(RF)had a higher proportion of dry coating,and exfoliation(P<0.05).There was a weak correlation between part of autoantibodies and tongue appearances(<0.4).Conclusion:Patients with pSS with ANA titer≥1:160,positive for anti-CENP-B antibodies or positive for RF are more likely to appear a tongue appearances with qi and yin deficiency.And the first two kinds of patients are more rarely to appear tongue appearances with phlegm-damp syndrome.This study can provide reference for pSS TCM modernization research.

关 键 词：原发性干燥综合征 舌象 自身抗体 着丝点蛋白B 类风湿因子 

分 类 号：R259[医药卫生—中西医结合]