摘要
目的探讨原发性干燥综合征(primary Sjogren's syndrome,PSS)患者涎腺超声(SGU)与外周血T细胞亚群及中医舌象、证型之间的关联,为临床诊疗和基础研究提供依据。方法选取2022年6月至12月就诊于广安门医院风湿病科的PSS患者,采集其SGU回报、外周血T淋巴细胞水平及中医舌象,借助统计学方法探究PSS患者SGU评分与上述指标的相关性,并根据舌象特点归纳中医证型,分析不同证型患者的差异性。结果共筛选PSS患者205例,最终纳入48例,其中涎腺轻度损伤组6例,中度损伤组38例,重度损伤组4例。随着涎腺损伤程度增加,3组患者的滤泡辅助性T细胞(Tfh),以及细胞因子辅助性T细胞(Th)1、Th2、Th17、Tfh17比例逐渐升高,调节性T细胞(Treg)、Tfh1、Tfh2比例逐渐降低。Tfh、Th1、Th2、Th17、Tfh17水平与SGU评分呈正相关,Treg、Tfh1、Tfh2水平与SGU评分呈负相关。舌象方面,轻度损伤组患者以淡舌、少津或齿痕、薄苔为主,中度损伤组以红舌、少津、无苔/少苔为主,重度损伤组以暗舌、裂纹、厚苔/腻苔为主。轻度损伤组患者以阴虚津亏证为主,中度损伤组以阴虚内热证为主,重度损伤组以燥瘀互结证为主。以上差异均无统计学意义(P>0.05)。结论涎腺损伤程度、T细胞亚群及中医舌象、证型均为PSS诊疗要素;患者涎腺损伤程度与T细胞亚群失衡状态存在正相关趋势;涎腺损伤加重时,舌象、证型向热、瘀、虚方向演变。
Objective To explore the correlation between salivary gland ultrasound(SGU)and peripheral blood T cell subsets,as well as traditional Chinese medicine(TCM)tongue images and syndrome types in patients with primary Sjogren's syndrome(PSS),to provide a basis for clinical diagnosis and basic research.Methods PSS patients who visited the Rheumatology Department of Guang'anmen Hospital from June to December,2022 were selected.Their SGU report,peripheral blood T lymphocyte levels,and TCM tongue images were collected.Statistical methods were used to explore the correlation between SGU scores of PSS patients and the above indicators.TCM syndrome types were summarized based on the characteristics of tongue images,and the differences among patients with different syndrome types were analyzed.Results A total of 205 patients with PSS were screened,and 48 cases were ultimately included,including 6 cases in the mild salivary gland injury group,38 cases in the moderate injury group,and 4 cases in the severe injury group.As the degree of salivary gland injury increased,the proportions of Tfh,Th1,Th2,Th17,and Tfh17 in the three groups of patients gradually increased,while the proportions of Treg,Tfh1,and Tfh2 gradually decreased.The levels of Tfh,Th1,Th2,Th17,and Tfh17 were positively correlated with SGU scores,while the levels of Treg,Tfh1,and Tfh2 cells were negatively correlated with SGU scores.Mild injury group patients were mainly characterized by a pale tongue,less body fluid or tooth marks,and a thin coating.Moderate injury group patients were mainly characterized by a red tongue,less body fluid,and no or little coating.Severe injury patients were mainly characterized by a dark tongue,cracks,and a thick or greasy coating.The patients in the mild injury group were mainly characterized by Yin deficiency and body fluid deficiency syndrome.The moderate injury group was mainly characterized by Yin deficiency and internal heat syndrome.And the severe injury group was mainly characterized by the combination of dryness and blood stasis syndrome.The above differences were not statistically significant(P>0.05).Conclusion The degree of salivary gland damage,T cell subsets,TCM tongue images,and syndrome types are all diagnostic and therapeutic factors for PSS.There is a positive correlation between the degree of salivary gland injury in patients and the imbalance of T cell subsets.When salivary gland damage worsens,TCM tongue images and syndrome types evolve towards heat,stasis,and deficiency.
作者
郭子琳
周新尧
刘瑞华
刘文靖
何加乐
单雪燕
姜泉
唐晓颇
GUO Zilin;ZHOU Xinyao;LIU Ruihua;LIU Wenjing;HE Jiale;SHAN Xueyan;JIANG Quan;TANG Xiaopo(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《中国中医基础医学杂志》
2025年第2期247-251,共5页
JOURNAL OF BASIC CHINESE MEDICINE
基金
中国中医科学院科技创新工程项目(CI2021A01502,CI2021A01510)
国家自然科学基金面上项目(82374285)
中央级公益性科研院所基本科研业务费专项(ZZ15-XY-PT-11,ZZ15-YQ-023)
中央高水平中医医院临床研究和成果转化能力提升项目——临床科研一体化人才专项(创新团队培育项目)(HLCMHPP2023002)
中央高水平中医医院临床研究和成果转化能力提升项目——中医药临床循证研究专项(HLCMHPP2023087)。
关键词
原发性干燥综合征
涎腺超声
T淋巴细胞亚群
中医舌象
中医证型
Primary Sjogren's syndrome
Salivary gland ultrasonography
T lymphocyte subsets
TCM tongue image
TCM syndrome type
