Treatment of Sjogren's syndrome with traditional Chinese medicine
Sjogren's syndrome is a chronic autoimmune disease that invades exocrine glands, especially salivary glands and lacrimal glands. If only exocrine glands are involved, it is called primary Sjogren's syndrome; At the same time, if it is accompanied by other connective tissue injuries or autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis, it is called secondary Sjogren's syndrome. Dry mouth and dry eyes are the main symptoms in clinic.
This disease is a global disease, mainly occurring in women. More than 90% of the patients are 30-40 years old, and the youngest is 9 years old. The ratio of male to female is 1: 9- 17. According to foreign data, the prevalence rate of the elderly is 3-4%, second only to rheumatoid arthritis. China has investigated 1 10,000 people, and the prevalence rate is 0.77-0.29%. Early xerostomia is not easy to be taken seriously and easily misdiagnosed. Its course of disease is long and its prognosis is generally good. Most patients with visceral injury can be relieved by proper treatment. Patients with severe organ diseases, malignant lymphoma, secondary Sjogren's syndrome and severe connective tissue diseases have poor prognosis.
The etiology of this disease is not clear, which may be related to heredity, immunity, sex hormones, virus infection and other factors. 1. Genetic basis: family history. The frequency of HLAB8 and DR3 genes in primary patients is very high, and the frequency of HLAR2 in secondary patients is very high. 2. Virus infection: At present, it is believed that EB virus, cytomegalovirus and HIV virus are related to Sjogren's syndrome, among which EB virus is particularly valued. 3, sex hormones: more common in women, may be related to the ability of sex hormones to regulate immune response, estrogen makes immune activity too strong. 4. Immune abnormality: There are complex humoral and cellular immune abnormalities, and many autoantibodies often appear in patients' serum, such as antinuclear antibody, anti-SS-A antibody, anti-SS-B antibody and anti-salivary gland antibody. It often coexists with some autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, chronic active hepatitis, Hashimoto's thyroiditis and so on. The application of adrenocortical hormone or other immunosuppressants can alleviate the disease. The basic pathological changes are that there are a large number of lymphocytes infiltrating into exocrine glands such as lacrimal gland, submandibular gland and parotid gland, the glands are obviously atrophied, and the glandular ducts are narrowed and expanded. In later cases, it can be seen that all glands were replaced by connective tissue.
Traditional Chinese medicine's understanding of this disease began in Neijing, and there is a saying that dryness is better than dryness and dryness is dampness. In the Jin and Yuan Dynasties, Liu added: "Everything is dry and dry, and enthusiasm is dry". From the analysis of its onset and clinical characteristics, it can be classified as "dryness syndrome" in traditional Chinese medicine, and those with joint pain can be called "peripheral arthralgia" and "dryness arthralgia", because of congenital deficiency, yin deficiency and dryness and heat; Tired the day after tomorrow, long illness and loss of support; Exogenous wind, summer heat, dryness and fire are four evils, and excessive yang heat leads to consumption of body fluid, deficiency of yin and blood, loss of vision, long-term blood stasis, obstruction of collaterals, involvement of skin, bones and muscles, and deep penetration into viscera, resulting in disease. The basic pathogenesis is yin deficiency and body fluid deficiency, and the main pathological factors are dryness of blood and blood stasis. Pathological nature belongs to substance deficiency and excess. At first, the location of the disease was the clearing of the mouth, eyes, nose and pharynx, and later it involved the whole body and five internal organs.
【 Syndrome Differentiation and Treatment 】
1, deficiency of both qi and yin
Symptoms: dry mouth and throat, fatigue, shortness of breath, laziness, loss of appetite, false stool, red tongue with little coating and thready pulse.
Treatment: invigorating qi and spleen, nourishing yin and promoting fluid production.
Prescription: Buzhong Yiqi Decoction.
Commonly used drugs: Radix Astragali, Rhizoma Cimicifugae, Radix Glycyrrhizae, Radix Trichosanthis, Radix Pseudostellariae, Radix Rehmanniae, Radix Ophiopogonis, Pericarpium Citri Tangerinae, Mume Fructus, and Radix Glehniae.
Dry eyes, adding Fructus Lycii and Herba Dendrobii; Fake stool, yam, kudzu root; Loss of appetite, epigastric discomfort, stir-fried cereal malt, raw meat and green plum.
This type is more common in patients with Sjogren's syndrome with a long course of disease. It is caused by long-term illness, lung and kidney yin deficiency and spleen deficiency. Spleen and stomach are the foundation of the day after tomorrow, so it is very important to treat and protect them.
2. Blood deficiency and dryness-heat type
Symptoms: dry mouth and throat, dry nose and dark eyes, pale face, dizziness and fatigue, scanty menstrual blood, anxiety and irritability, insomnia and dreaminess, dull skin and hair, tender red tongue, less fur and thready pulse.
Treatment: nourishing blood and softening liver, promoting fluid production and moistening dryness.
Prescription: Siwu Decoction and Guan Yi Decoction.
Commonly used drugs: Radix Rehmanniae, Radix Angelicae Sinensis, Radix Paeoniae Alba, Rhizoma Chuanxiong, Fructus Lycii, Radix Glehniae, Radix Ophiopogonis, Radix Salviae Miltiorrhizae, and Lily.
For dizziness and headache, Rhizoma Gastrodiae, Fructus Tribuli, and Kudingcha are added; Anxiety and irritability, dreaminess at night, adding Coptidis Rhizoma, Colla Corii Asini and cooked jujube kernels; For dull skin and hair, Rhizoma Polygonati and Polygoni Multiflori Radix are added; When the red face gets angry, add Cynanchum atratum and Mahonia leaf; For blurred vision, Fructus Ligustri Lucidi and Fructus Mori are added.
This syndrome type is more common in middle-aged women and menopausal women. Female over 40 years old, gradually exhausted, lack of essence and blood. Women are born with liver, yin and blood are insufficient, and blood does not nourish the liver, which leads to blood deficiency and liver flourishing, and dryness and heat are endogenous. The disease is in the liver, mainly due to insufficient essence. Treatment should pay attention to nourishing the liver and softening the liver in order to achieve the purpose of promoting fluid production and moistening dryness.
3. Type of blood stasis blocking collaterals
Symptoms: dry mouth and throat, dry eyes, rough skin with dark spots, brown hair, pain in limbs and joints, unfavorable flexion and extension, deformity, dull fingertips, dark menstruation, dark tongue, ecchymosis and thready pulse.
Treatment: promoting blood circulation, removing blood stasis and dredging collaterals.
Prescription: Taohong Siwu Decoction.
Commonly used drugs: peach kernel, safflower, angelica, Ligusticum chuanxiong, Paeonia lactiflora, Spatholobus suberectus, pangolin, Salvia miltiorrhiza, Radix Rehmanniae and Buxus macrophylla.
Fingertips are dark and cold, and Herba Epimedii, cornu Cervi Degelatinatum and Fructus Lipuidambaris are added; Less menstrual flow, dark color, and Herba Leonuri and Herba Lycopi; Joint deformity, rough skin, Eupolyphaga Seu Steleophaga, Leech, Carapax Trionycis, Camptotheca acuminata; Dry mouth and throat are obvious, and Trichosanthes root and Scrophularia root are added.
This syndrome is found in patients with a long course of disease or scleroderma, and often appears at the same time as the above syndrome. Insufficient body fluid leads to stagnant blood circulation, while weak qi leads to weak blood circulation, so that blood stasis blocks collaterals and blood vessels, further aggravating the obstacle of body fluid use. The treatment is mainly to promote blood circulation and remove blood stasis, and the clinical symptoms need careful analysis.
4. Excessive heat and dryness
Symptoms: dry mouth, dry lips, dry throat and nose, cracked tongue, red eyes and less tears, red eyes, short and red urine, dry stool, red face and fever, or low fever, dry and red tongue without body fluid or cracks, little or yellow fur, and thready pulse.
Treatment: clearing heat and cooling blood, nourishing yin and moistening bath.
Prescription: Jiawei Rhinoceros Horn Dihuang Decoction.
Commonly used drugs: buffalo horn, Radix Rehmanniae, Cortex Moutan, Radix Paeoniae Rubra, Radix Scrophulariae, Radix Salviae Miltiorrhizae, Radix Ophiopogonis, Colla Corii Asini, Rhizoma Anemarrhenae and Rhizoma Coptidis.
For the pain caused by tongue ulceration, yellow and white residual flowers, indigo naturalis and gypsum are added; Eyes are red and swollen, and gardenia and lophatherum gracile are added; Dry stool, add Fructus Cannabis and Fructus Trichosanthis; Low fever persists, and Cortex Lycii and Radix Bupleuri are added; The tongue is red and dry with no body fluid. Adding Mume Fructus, Radix Paeoniae Alba and Glycyrrhrizae Radix. Rhizoma Polygoni Cuspidati, Caulis Lonicerae and Ramulus Mori are added for arthralgia; It is also characterized by damp-heat and excessive internal heat, bitter and sticky mouth, thin and yellow fur, and patchouli and Eupatorium odoratum are added.
This is a serious syndrome of Sjogren's syndrome, which is caused by exogenous wind-heat, summer heat and dry fire, excessive yang heat, dry heat and toxic substances, and fluid injury to yin and blood. The main manifestations are excessive dryness and heat and inflammation of fire, so the treatment should be clearing away heat and purging fire, cooling blood and detoxifying, nourishing yin and moistening dryness. If the disease is difficult to control, low-dose tripterygium wilfordii can be added as appropriate.
5. Yin deficiency and internal heat type
Symptoms: dry mouth and throat, especially at night, chapped lips, thirst or inability to quench thirst, dry eyes, little or no tears, blurred vision, dizziness and tinnitus, hoarseness, fever, constipation, red tongue with little or no fur, and rapid pulse.
Treatment: nourishing yin and promoting fluid production, clearing away heat and removing annoyance.
Prescription: Qijudihuang Decoction and Guan Yi Decoction.
Commonly used drugs: Radix Glehniae, Radix Ophiopogonis, Radix Rehmanniae, Fructus Lycii, Fructus Ligustri Lucidi, Flos Chrysanthemi, Fructus Corni, Cortex Moutan, Eclipta prostrata and Trichosanthis Radix.
Cortex Lycii, Rhizoma Atractylodis Macrocephalae, Folium Mahoniae and Carapax Trionycis are added for patients with yin deficiency and internal heat; If you are restless at night, upset and hot palms, add Schisandra chinensis, Anemarrhena asphodeloides and Lily; Blurred vision, adding Herba Dendrobii, Herba Eriocauli, and Semen Cassiae; Constipation, Scrophularia and Polygonum Multiflori Radix; Joint pain with papaya, heather, sinomenine.
This type of Sjogren's syndrome is the most common, which is caused by body yin deficiency or various reasons. The main pathogenesis is yin deficiency of liver and kidney, endogenous dryness and heat, which belongs to deficiency heat and deficiency fire, and bitter cold is not suitable for clinical medication.
Dry and itchy skin is common in autumn and winter. If you or your family and friends have this problem, don't worry, let alone take it lightly. Just buy an ointment at the drugstore and apply it. We suggest to find a reliable local Chinese medicine practitioner to adjust diet and daily life through syndrome differentiation and treatment. Use some Chinese medicine if necessary, and you will soon be able to please this trouble.