Expert consensus on multidisciplinary diagnosis and treatment of primary Sjögren syndrome (2024 edition)

doi:10.16138/j.1673-6087.2024.06.01

Abstract

Abstract:

Primary Sjögren syndrome (PSS) is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands and other organs. PSS shows strong clinical heterogeneity, presents different degrees of topical and systemic damage, and multidisciplinary collaboration are required to develop PSS treatment strategies. However, our country currently has not unified diagnosis and treatment consensus for PSS. Based on domestic and foreign diagnosis and treatment experience, consensus and guideline, experts from multiple related disciplines achieved consensus using the nominal group technique, providing guidance and reference for standardized diagnosis and treatment of PSS.

Key words: Sjögren syndrome, Multiple-disciplinary team, Diagnosis, Treatment

CLC Number:

R593.2

CHENG Fang, ZHAO Futao, SHEN Xuemin, LI Jin, CHEN Xiangjun, WANG Guifang, LI Huilin, XUE Luan, QI Junyuan. Expert consensus on multidisciplinary diagnosis and treatment of primary Sjögren syndrome (2024 edition)[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(06): 357-362.

Figures/Tables 1

Table 1

Differential diagnosis and treatment of Sjögren syndrome

辨证分型	证候特点及舌脉	治则治法	推荐方剂	常用中药
阴虚津亏证	口干舌燥，眼干无泪，咽干，鼻干，皮肤干燥，大便干或数日一行。舌红，少苔或无苔，或舌有裂纹，脉细、沉细或细弱。	养阴增液，生津润燥。	沙参麦冬汤合六味地黄丸，或增液汤加减。	沙参、麦冬、玉竹、玄参、生地黄、熟地黄、山药、山萸肉、茯苓、泽泻、牡丹皮等。
气阴两虚证	口眼干燥，神疲乏力，动则心悸，气短懒言，干咳少痰，夜尿频，便溏。舌红，苔少而干或有裂纹，脉细弱或细数。	益气养阴，润燥通络。	生脉饮合沙参麦冬汤，或四君子汤合益胃汤加减。	沙参、玉竹、麦冬、天花粉、石斛、葛根、生地黄、太子参、南沙参、五味子、白术、茯苓、山药、赤芍、大血藤、乌梢蛇等。
阴虚内热证	口干咽痛，眼干目赤，烦渴多饮，口角干裂，鼻干鼻衄，干咳，手足心热，盗汗，午后热甚，心烦失眠，小便短赤，大便干结。舌红或红绛，有裂纹，苔干燥少津，或少苔、无苔，脉细数。	养阴清热，润燥生津。	一贯煎合青蒿鳖甲汤，或清燥救肺汤加减。	北沙参、麦冬、当归、生地黄、枸杞子、川楝子、青蒿、鳖甲、知母、牡丹皮、桑叶、石膏、甘草、胡麻仁、苦杏仁、枇杷叶等。
燥瘀互结证	口干不欲饮，眼干少泪，鼻干，咽干，肌肤甲错或有瘀斑瘀点，关节肌肉疼痛，肢端皮肤变白、变紫，颐肿不消或瘰疬。舌质暗或有瘀斑、瘀点，或舌下脉络迂曲青紫，苔少且干，脉涩或细涩。	滋阴润燥，活血通络。	活血润燥生津汤加减。	当归、白芍、天冬、麦冬、天花粉、桃仁、红花、忍冬藤、络石藤、鸡血藤等。
燥湿互结证	口渴不欲饮，目涩多眵，口中黏腻，脘痞腹胀，肢体沉重、周身倦怠，咳嗽、痰黏难出，关节肿胀疼痛，尿频，大便黏滞不爽。舌淡红，苔白腻，脉濡滑。	润燥祛湿、行气散结。	甘露饮，或乌梅丸，或知柏地黄丸加减。	生地黄、熟地黄、山药、茯苓、泽泻、桔梗、枳实、香橼、佩兰、青蒿、黄芩、黄连、黄柏、天冬、麦冬、乌梅、当归、连翘、浙贝母、路路通等。

Table 1

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