摘要
干燥综合征(SS)是以侵犯泪腺、唾液腺等为主的自身免疫疾病,具有高度淋巴细胞浸润特征。以口、眼干燥为常见症状同时又伴有多系统损害症状。SS在风湿免疫病中发病率位居第二,流行病学调查显示,该病在我国患病率为0. 29%~0. 77%,而其中老年人患病率为3%~4%。多见于女性患者,发病率约为90%,发病年龄大多在30~60岁。西医从如何规范化治疗本病以及治疗原则、药物、方法等方面进行了总结。例如,全身应用糖皮质激素、免疫抑制剂以及以B细胞清除为主的生物制剂在临床上的使用。现代中医认为SS属"燥痹"范畴。从病名、病因病机、辨证论治、单方验方、针灸等方面介绍SS的中医药研究概况。常用处方核心药物:党参、茯苓、白术、甘草、丹参、玉竹、熟地黄、淡竹叶、麦冬、玄参、生地黄;常用核心针灸穴位包括:攒竹、合谷、颊车、承浆、廉泉、肝俞、肾俞、足三里、三阴交、太溪、金津、玉液、梁丘、血海、睛明、阳白。临床上应该针药结合治疗SS眼干症,不仅可以提高疗效,同时副作用小、安全可靠、又减少患者长期用药经济负担,值得广泛推广。并且研究重点回顾SS规范化治疗现状和近年来在治疗学上取得的进展,以期能够指导SS的临床实践。
Sjogren’s syndrome (SS) is an autoimmune disease mainly involving salivary glands of the lacrimal glands,with a high degree of lymphocytic infiltration. Dry mouth and eyes are the common symptoms,but they are accompanied by multiple system damage. SS has the second highest incidence of rheumatic immunity diseases. Epidemiological investigation shows that the prevalence rate of SS in China is 0. 29%-0. 77%,and the prevalence rate in the elderly is 3%-4%. This disease is more common in women whose prevalence rate is 90% at the age of 30-60 years old. Western medicine summarized from how to standardize the treatmentand medication principlesand other aspects,for example,the therapy of glucocorticoid and immunosuppressoragent,the using of the biological agentfocusing on the depletion of B-cell. Traditional Chinese medicine doctors think it belongs to Chinese medicine " dry Bi syndrome". Traditional Chinese medicineintroduces name,etiology and pathogenesis,treatment based on syndrome differentiation and acupuncture of SS. The key drugs include Dangshen (Codonopsis pilosula),Fuling (Poria cocos),Gancao (liquorice),Danshen (Salviae Miltiorrhizae Radix et Rhizoma),Yuzhu (radix polygonati officinalis),Shudi (prepared rehmannia root),Danzhuye (lophatherum gracile),Maidong (Liriope graminifolia),Xuanshen (radix scrophulariae) and Shengdi (dried rhizome of rehmannia). The key acupoints include Cuanzhu (BL2),Hegu (LI4),Jiache (ST6),Chengjiang (RN24),Lianquan (RN23),Ganshu (BL18),Shenshu (BL23),Zusanli (ST36),Sanyinjiao (SP6),Taixi (KI3),Jinjin (EX-HN12),Liangqiu (RN23),Xuehai (SP10),Jingming (BL1) and Yangbai (GB14). The combination of acupuncture with medicine in the treatment of SScan improve the curative effect. At the same time,it has few side effects. It is safe and reliable,and can reducelong-term economic burden. And so it is worthy of popularizing widely.And this review focused on the major therapeutic discoveries of the last few years to offer practical methods for the treatment of patients with SS.
作者
徐洋
高明利
XU Yang;GAO Mingli(School of Graduate Studies,Liaoning University of Traditional Chinese Medicin,Shenyang 110847,Liaoning,China;Rheumatism Immunity Department,The Affiliated Hospital of Liaoning University of traditional Chinese Medicine,Shenyang 110034,Liaoning,China)
出处
《实用中医内科杂志》
2020年第4期17-20,共4页
Journal of Practical Traditional Chinese Internal Medicine
基金
国家中医药管理局[SATCM-2015-BZ(292)]。
关键词
干燥综合征
西医治疗
中药
针灸
综述
激素
免疫抑制剂
生物制剂
Sjogren’s syndrome
western medicine treatment
traditional Chinese medicine
acupuncture
review
hormone
immunosuppressant
biological agents
