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以舌统证辨治干燥综合征OA

Treating Sjogren syndrome based on tongue-guided syndrome differentiation

中文摘要英文摘要

干燥综合征是一种以淋巴细胞浸润外分泌腺为主要特征的慢性炎症性自身免疫病,早期诊断率低,且缺乏针对性的治疗药物.干燥综合征的舌象表现具有明显的特点和规律,且随病情发展呈动态变化,能够直观反映本病的潜在病机、病情特点及演变规律.本团队提出以舌统证辨治干燥综合征:将舌象作为核心依据应用于干燥综合征的早期筛查诊断、辨证分型、病情评估、治疗与预后判断等全程管理中,构建"舌象-证候-治法"诊疗体系.干燥综合征患者舌象可主要分为阴虚舌象及痰湿舌象两大类,又可兼见气虚、燥热、血瘀等表现,结合其他四诊信息,有助于把握本病两大核心病机——气阴两虚与燥湿互结.针对气阴两虚证患者以益气养阴润燥为主要治法,燥湿互结证患者则以健脾化湿润燥为主要治法,并可根据患者舌象特征性表现及其动态变化判断疗效、随症加减药物.以舌统证辨治干燥综合征,有利于提升本病辨治的客观化程度,推动干燥综合征精准辨治.

Sjogren syndrome is a chronic inflammatory autoimmune disorder primarily characterized by lymphocytic infiltration of the exocrine glands.It has a low early diagnosis rate and lacks targeted therapeutic drugs.Tongue manifestations in Sjogren syndrome exhibit distinct features and patterns,which change dynamically with disease progression.These manifestations can reflect the underlying pathogenesis,clinical features,and evolutionary patterns of the disease.Therefore,we proposed a tongue-guided approach to syndrome differentiation and treatment for Sjogren syndrome.By using tongue manifestations as the core basis for managing Sjogren syndrome,including early screening and diagnosis,syndrome differentiation,disease assessment,treatment,and prognosis evaluation,a"tongue manifestation-syndrome-treatment"diagnostic and therapeutic system can be established.Tongue manifestations of patients with Sjogren syndrome can be primarily classified into two major categories:yin deficiency and phlegm-damp tongue manifestations,which may also be accompanied by qi deficiency,dryness-heat,and blood stasis.Integrating these with other information from the four diagnostic methods helps identify the two core pathological mechanisms of this disease—qi and yin deficiency,as well as intermingled dryness and dampness.For patients with both qi and yin deficiency,the primary treatment method is to benefit qi,nourish yin,and moisturize dryness;for patients with intermingled dryness and dampness,the primary treatment approach is to invigorate the spleen to eliminate dampness and moisturize dryness.Furthermore,the characteristic manifestations and dynamic changes of the patient's tongue can be used to evaluate therapeutic efficacy and adjust medications accordingly.Adopting a tongue-guided syndrome differentiation approach for treating Sjogren syndrome enhances objectivity of syndrome differentiation and treatment,thereby promoting the precise diagnosis and treatment for this condition.

张燕;罗静;陶庆文

中日友好医院中医风湿病科 北京 100029中日友好医院中医风湿病科 北京 100029中日友好医院中医风湿病科 北京 100029

医药卫生

干燥综合征以舌统证舌象辨证论治

Sjogren syndrometongue-guided syndrome differentiationtongue manifestationtreatment based on syndrome differentiation

《北京中医药大学学报》 2026 (3)

377-383,7

首都卫生发展科研专项(No.2024-1-4065)中日友好医院"菁英计划"人才培育工程资助项目(No.ZRJY2024-GG08)中华中医药学会青年求实项目(No.2024-QNQS-07)中日友好医院高水平医院临床科研业务费专项项目(No.2025-NHLHCRF-JBGS-A-YNZJ-03,No.2025-NHLHCRF-PY-36) Capital Health Development Research Special Project(No.2024-1-4065)

10.3969/j.issn.1006-2157.2026.03.009

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