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Article(id=1322923991450657002, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.025, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339258301, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339258301, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339258301, creator=13701087609, updateTime=1793339258301, updator=13701087609, issue=Issue{id=1322923782029062261, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='6', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339208371, creator='13701087609', updateTime=1793340556755, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929437859258468, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929437859258469, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=130, endPage=133, ext={EN=ArticleExt(id=1322923991643594987, articleId=1322923991450657002, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Yiqi Yangyin Quyu Decoction（益气养阴祛瘀汤）on Dynamic Imaging Index and Immune Function of Parotid Gland in Patients with Sjögren's Syndrome, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To study the effect of Yiqi Yangyin Quyu Decoction（益气养阴祛瘀汤）on parotid radionuclide dynamic imaging index and immune function in patients with Sjogren's syndrome.

Methods

Eighty-four patients with Sjogren's syndrome treated in the hospital from January 2022 to January 2023 were selected and randomly divided into two groups according to the random number table method，with 42 cases in each group.The patients in the control group were treated with conventional western medicine and those in the observation group were treated with Yiqi Yangyin Quyu Decoction on the basis of the control group.The treatment course of the two groups was3 months.The quantitative scores of TCM symptoms，changes in disease activity［Sjgren's syndrome disease activity index（ESSDAI）and EULAR Sjgren's syndrome patient reporting index（ESSPRI）］，parotid radionuclide dynamic imaging indicators［uptake fraction（IF），excretion fraction（EF）］，immune function indicators［erythrocyte sedimentation rate（ESR），C-reactive protein（CRP），immunoglobulin G（IgG），anti-Sjgren's syndrome antigen A（SSA）antibody，anti-Sjögren's syndrome antigen B（SSB）antibody］and adverse reactions were compared between the two groups.

Results

Before treatment，there was no significant difference in the observation indexes between the two groups（P>0.05）.After treatment，the scores of TCM symptoms such as red tongue and less body fluid，no coating/less coating/peeling，dry mouth and desire to drink，dry eyes and less tears in the observation group were significantly lower than those in the control group［（1.72±0.53）points，（1.96±0.70）points，（2.03±0.91）points，（1.70±0.84）points vs（1.98±0.61）points，（2.36±0.59）points，（2.89±0.72）points，（2.13±0.77）points］（P<0.05）.The ESSDAI and EULAR scores of the observation group were significantly higher than those of the control group［（5.92±1.60）points，（4.36±1.02）points vs（6.87±1.54）points，（5.39±0.96）points］（P<0.05）.The levels of IF and EF of parotid radionuclide dynamic imaging were significantly higher than those of the control group［（1.87±0.26）%，（21.07±4.20）% vs（1.74±0.19）%，（17.96±3.75）%］.The immune function indexes（ESR，IgG，positive rate of anti-SSA antibody and positive rate of anti-SSB antibody）were significantly better than those of the control group［（19.83±1.84）mm/h，（6.90±1.37）g/L，（41.28±5.69）%，（28.91±4.03）% vs（21.05±1.69）mm/h，（8.81±1.19）g/L，（53.47±5.18）%，（6.28±3.71）%］（P<0.05）.There was no significant difference in the incidence of adverse reactions between the observation group（7.14%）and the control group（11.90%）（P>0.05）.

Conclusion

Yiqi Yangyin Quyu Decoction is effective in the treatment of Sjogren's syndrome.It can relieve the symptoms of patients more effectively，improve the body's immune function and parotid radionuclide dynamic imaging indicators.It is safe and reliable，and has application value.

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目的

研究益气养阴祛瘀汤治疗干燥综合征对患者腮腺核素动态显像指标、免疫功能的影响。

方法

选取2022年1月—2023年1月医院治疗的干燥综合征患者84例，根据随机数表法随机均分为两组，观察组、对照组各42例。对照组患者采用常规西药治疗，观察组在对照组基础上采用益气养阴祛瘀汤治疗，两组用药疗程3个月。比较两组的中医症状量化评分，疾病活动度改变［干燥综合征疾病活动指数（European League Against Rheumatism SSdisease activity index，ESSDAI）和EULAR干燥综合征患者报告指数（EULAR SSPatient Reported Index，ESSPRI）］，腮腺核素动态显像指标［摄取分数（intake fraction，IF）、排泌分数（excretion fraction，EF）］，免疫功能指标［血沉（erythrocyte sedimentation Rate，ESR）、C反应蛋白（C-reactive protein，CRP）、免疫球蛋白G（immunoglobulin G，IgG）、抗干燥综合征抗原A（Sjögren's syndrome type A，SSA）抗体、抗干燥综合征抗原B（Sjögren's syndrome type B，SSB）抗体］及不良反应发生情况。

结果

治疗前，两组患者的各项观察指标差异无统计学意义（P>0.05）。治疗后，观察组中医症状舌红津少、无苔/少苔/花剥、口干欲饮、眼干少泪评分均显著低于对照组［（1.72±0.53）（1.96±0.70）（2.03±0.91）（1.70±0.84）分vs（1.98±0.61）（2.36±0.59）（2.89±0.72）（2.13±0.77）分］（P<0.05），观察组ESSDAI、EULAR评分均显著高于对照组［（5.92±1.60）（4.36±1.02）分vs（6.87±1.54）（5.39±0.96）分］（P<0.05），腮腺核素动态显像IF、EF均显著高于对照组［（1.87±0.26）%、（21.07±4.20）% vs（1.74±0.19）%、（17.96±3.75）%］，免疫功能指标ESR、IgG、抗SSA抗体阳性率、抗SSB抗体阳性率均显著优于对照组［（19.83±1.84）mm/h、（6.90±1.37）g/L、（41.28±5.69）%、（28.91±4.03）% vs（21.05±1.69）mm/h、（8.81±1.19）g/L、（53.47±5.18）%、（36.28±3.71）%］（P<0.05）。观察组不良反应发生率7.14%与对照组11.90%比较，差异无统计学意义（P>0.05）。

结论

益气养阴祛瘀汤治疗干燥综合征效果满意，其能够更有效地缓解患者症状，改善机体免疫功能和腮腺核素动态显像指标，且用药安全性可靠，具有应用价值。

, authors=徐杨杨, 谢海, 刘元奎, authorsList=徐杨杨, 谢海, 刘元奎, authorCompany=null, correspAuthors=null, authorNote=

徐杨杨（1987-），女，山东潍坊人，主治医师，硕士，研究方向：SPECT/CT、PET/CT的诊断，放射性核素的治疗。

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徐杨杨（1987-），女，山东潍坊人，主治医师，硕士，研究方向：SPECT/CT、PET/CT的诊断，放射性核素的治疗。

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徐杨杨（1987-），女，山东潍坊人，主治医师，硕士，研究方向：SPECT/CT、PET/CT的诊断，放射性核素的治疗。

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组别例数舌红津少无苔/少苔/花剥口干欲饮眼干少泪
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组424.03±1.291.72±0.53a3.92±1.801.96±0.70a4.12±1.472.03±0.91a3.42±1.251.70±0.84a
对照组423.97±1.181.98±0.61a3.87±1.652.36±0.59a4.08±1.522.89±0.72a3.61±1.302.13±0.77a
t值0.2222.0850.1332.8320.1234.8030.6832.446
P值0.8250.0400.8950.0060.903<0.0010.4970.017
), ArticleFig(id=1322923997331071255, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923991450657002, language=CN, label=表1, caption=

两组干燥综合征患者中医症状评分比较（±s）

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组别例数舌红津少无苔/少苔/花剥口干欲饮眼干少泪
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组424.03±1.291.72±0.53a3.92±1.801.96±0.70a4.12±1.472.03±0.91a3.42±1.251.70±0.84a
对照组423.97±1.181.98±0.61a3.87±1.652.36±0.59a4.08±1.522.89±0.72a3.61±1.302.13±0.77a
t值0.2222.0850.1332.8320.1234.8030.6832.446
P值0.8250.0400.8950.0060.903<0.0010.4970.017
), ArticleFig(id=1322923997402374424, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923991450657002, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数ESSDAI评分EULAR评分
治疗前治疗后治疗前治疗后
观察组4212.29±3.205.92±1.60a9.95±2.104.36±1.02a
对照组4211.93±2.376.87±1.54a10.03±1.955.39±0.96a
t值0.5862.7720.1814.766
P值0.5600.0070.8570.001
), ArticleFig(id=1322923997465288985, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923991450657002, language=CN, label=表2, caption=

两组干燥综合征患者ESSDAI、EULAR评分比较（±s）

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组别例数ESSDAI评分EULAR评分
治疗前治疗后治疗前治疗后
观察组4212.29±3.205.92±1.60a9.95±2.104.36±1.02a
对照组4211.93±2.376.87±1.54a10.03±1.955.39±0.96a
t值0.5862.7720.1814.766
P值0.5600.0070.8570.001
), ArticleFig(id=1322923997528203546, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923991450657002, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IFEF
治疗前治疗后治疗前治疗后
观察组421.49±0.381.87±0.26a10.18±2.3421.07±4.20a
对照组421.50±0.411.74±0.19a9.97±2.8617.96±3.75a
t值0.1162.6160.3683.983
P值0.9080.0110.7140.001
), ArticleFig(id=1322923997595312411, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923991450657002, language=CN, label=表3, caption=

两组干燥综合征患者腮腺核素动态显像IF、EF比较（±s）

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组别例数IFEF
治疗前治疗后治疗前治疗后
观察组421.49±0.381.87±0.26a10.18±2.3421.07±4.20a
对照组421.50±0.411.74±0.19a9.97±2.8617.96±3.75a
t值0.1162.6160.3683.983
P值0.9080.0110.7140.001
), ArticleFig(id=1322923997670809884, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923991450657002, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数ESR/（mm/h）CRP/（mg/L）IgG/（g/L）抗SSA抗体阳性率/（%）抗SSB抗体阳性率/（%）
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组4224.06±5.2819.83±1.84a9.08±1.225.25±0.94a18.40±3.266.90±1.37a72.36±8.4041.28±5.69a54.20±6.3528.91±4.03a
对照组4223.94±4.9021.05±1.69a8.95±1.305.41±0.89a17.21±3.178.81±1.19a71.28±9.0653.47±5.18a55.06±7.1536.28±3.71a
t值0.1083.1650.4730.8011.6966.8210.56710.2670.58330.939
P值0.9140.0020.6380.4250.094<0.0010.573<0.0010.562<0.001
), ArticleFig(id=1322923997733724445, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923991450657002, language=CN, label=表4, caption=

两组干燥综合征患者免疫功能指标比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数ESR/（mm/h）CRP/（mg/L）IgG/（g/L）抗SSA抗体阳性率/（%）抗SSB抗体阳性率/（%）
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组4224.06±5.2819.83±1.84a9.08±1.225.25±0.94a18.40±3.266.90±1.37a72.36±8.4041.28±5.69a54.20±6.3528.91±4.03a
对照组4223.94±4.9021.05±1.69a8.95±1.305.41±0.89a17.21±3.178.81±1.19a71.28±9.0653.47±5.18a55.06±7.1536.28±3.71a
t值0.1083.1650.4730.8011.6966.8210.56710.2670.58330.939
P值0.9140.0020.6380.4250.094<0.0010.573<0.0010.562<0.001
), ArticleFig(id=1322923997817610526, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923991450657002, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数皮疹恶心呕吐腹泻合计
观察组420（0.00）2（4.76）1（2.38）3（7.14）
对照组422（4.76）1（2.38）2（4.76）5（11.90）
t值0.138
P值0.710
), ArticleFig(id=1322923997901496607, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923991450657002, language=CN, label=表5, caption=

两组干燥综合征患者不良反应情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数皮疹恶心呕吐腹泻合计
观察组420（0.00）2（4.76）1（2.38）3（7.14）
对照组422（4.76）1（2.38）2（4.76）5（11.90）
t值0.138
P值0.710
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益气养阴祛瘀汤治疗干燥综合征对患者腮腺核素动态显像指标、免疫功能的影响研究
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徐杨杨 , 谢海 , 刘元奎
中华中医药学刊 | 国家项目点击 2025,43(6): 130-133
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中华中医药学刊 |国家项目点击 2025 , 43 (6) : 130 -133
益气养阴祛瘀汤治疗干燥综合征对患者腮腺核素动态显像指标、免疫功能的影响研究
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徐杨杨（1987-），女，山东潍坊人，主治医师，硕士，研究方向：SPECT/CT、PET/CT的诊断，放射性核素的治疗。

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徐杨杨（1987-），女，山东潍坊人，主治医师，硕士，研究方向：SPECT/CT、PET/CT的诊断，放射性核素的治疗。

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徐杨杨, 谢海, 刘元奎
作者信息
  • 潍坊医学院附属医院，山东 潍坊 261000
作者简介:

徐杨杨（1987-），女，山东潍坊人，主治医师，硕士，研究方向：SPECT/CT、PET/CT的诊断，放射性核素的治疗。

Effect of Yiqi Yangyin Quyu Decoction（益气养阴祛瘀汤）on Dynamic Imaging Index and Immune Function of Parotid Gland in Patients with Sjögren's Syndrome
Yangyang XU, Hai XIE, Yuankui LIU
Affiliations
  • Department of Nuclear Medicine，Affiliated Hospital of Weifang Medical College，Weifang 261000，Shandong，China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.025
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摘要
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目的

研究益气养阴祛瘀汤治疗干燥综合征对患者腮腺核素动态显像指标、免疫功能的影响。

方法

选取2022年1月—2023年1月医院治疗的干燥综合征患者84例，根据随机数表法随机均分为两组，观察组、对照组各42例。对照组患者采用常规西药治疗，观察组在对照组基础上采用益气养阴祛瘀汤治疗，两组用药疗程3个月。比较两组的中医症状量化评分，疾病活动度改变［干燥综合征疾病活动指数（European League Against Rheumatism SSdisease activity index，ESSDAI）和EULAR干燥综合征患者报告指数（EULAR SSPatient Reported Index，ESSPRI）］，腮腺核素动态显像指标［摄取分数（intake fraction，IF）、排泌分数（excretion fraction，EF）］，免疫功能指标［血沉（erythrocyte sedimentation Rate，ESR）、C反应蛋白（C-reactive protein，CRP）、免疫球蛋白G（immunoglobulin G，IgG）、抗干燥综合征抗原A（Sjögren's syndrome type A，SSA）抗体、抗干燥综合征抗原B（Sjögren's syndrome type B，SSB）抗体］及不良反应发生情况。

结果

治疗前，两组患者的各项观察指标差异无统计学意义（P>0.05）。治疗后，观察组中医症状舌红津少、无苔/少苔/花剥、口干欲饮、眼干少泪评分均显著低于对照组［（1.72±0.53）（1.96±0.70）（2.03±0.91）（1.70±0.84）分vs（1.98±0.61）（2.36±0.59）（2.89±0.72）（2.13±0.77）分］（P<0.05），观察组ESSDAI、EULAR评分均显著高于对照组［（5.92±1.60）（4.36±1.02）分vs（6.87±1.54）（5.39±0.96）分］（P<0.05），腮腺核素动态显像IF、EF均显著高于对照组［（1.87±0.26）%、（21.07±4.20）% vs（1.74±0.19）%、（17.96±3.75）%］，免疫功能指标ESR、IgG、抗SSA抗体阳性率、抗SSB抗体阳性率均显著优于对照组［（19.83±1.84）mm/h、（6.90±1.37）g/L、（41.28±5.69）%、（28.91±4.03）% vs（21.05±1.69）mm/h、（8.81±1.19）g/L、（53.47±5.18）%、（36.28±3.71）%］（P<0.05）。观察组不良反应发生率7.14%与对照组11.90%比较，差异无统计学意义（P>0.05）。

结论

益气养阴祛瘀汤治疗干燥综合征效果满意，其能够更有效地缓解患者症状，改善机体免疫功能和腮腺核素动态显像指标，且用药安全性可靠，具有应用价值。

干燥综合征  /  益气养阴祛瘀汤  /  硫酸羟氯喹片  /  腮腺核素动态显像  /  免疫功能
Objective

To study the effect of Yiqi Yangyin Quyu Decoction（益气养阴祛瘀汤）on parotid radionuclide dynamic imaging index and immune function in patients with Sjogren's syndrome.

Methods

Eighty-four patients with Sjogren's syndrome treated in the hospital from January 2022 to January 2023 were selected and randomly divided into two groups according to the random number table method，with 42 cases in each group.The patients in the control group were treated with conventional western medicine and those in the observation group were treated with Yiqi Yangyin Quyu Decoction on the basis of the control group.The treatment course of the two groups was3 months.The quantitative scores of TCM symptoms，changes in disease activity［Sjgren's syndrome disease activity index（ESSDAI）and EULAR Sjgren's syndrome patient reporting index（ESSPRI）］，parotid radionuclide dynamic imaging indicators［uptake fraction（IF），excretion fraction（EF）］，immune function indicators［erythrocyte sedimentation rate（ESR），C-reactive protein（CRP），immunoglobulin G（IgG），anti-Sjgren's syndrome antigen A（SSA）antibody，anti-Sjögren's syndrome antigen B（SSB）antibody］and adverse reactions were compared between the two groups.

Results

Before treatment，there was no significant difference in the observation indexes between the two groups（P>0.05）.After treatment，the scores of TCM symptoms such as red tongue and less body fluid，no coating/less coating/peeling，dry mouth and desire to drink，dry eyes and less tears in the observation group were significantly lower than those in the control group［（1.72±0.53）points，（1.96±0.70）points，（2.03±0.91）points，（1.70±0.84）points vs（1.98±0.61）points，（2.36±0.59）points，（2.89±0.72）points，（2.13±0.77）points］（P<0.05）.The ESSDAI and EULAR scores of the observation group were significantly higher than those of the control group［（5.92±1.60）points，（4.36±1.02）points vs（6.87±1.54）points，（5.39±0.96）points］（P<0.05）.The levels of IF and EF of parotid radionuclide dynamic imaging were significantly higher than those of the control group［（1.87±0.26）%，（21.07±4.20）% vs（1.74±0.19）%，（17.96±3.75）%］.The immune function indexes（ESR，IgG，positive rate of anti-SSA antibody and positive rate of anti-SSB antibody）were significantly better than those of the control group［（19.83±1.84）mm/h，（6.90±1.37）g/L，（41.28±5.69）%，（28.91±4.03）% vs（21.05±1.69）mm/h，（8.81±1.19）g/L，（53.47±5.18）%，（6.28±3.71）%］（P<0.05）.There was no significant difference in the incidence of adverse reactions between the observation group（7.14%）and the control group（11.90%）（P>0.05）.

Conclusion

Yiqi Yangyin Quyu Decoction is effective in the treatment of Sjogren's syndrome.It can relieve the symptoms of patients more effectively，improve the body's immune function and parotid radionuclide dynamic imaging indicators.It is safe and reliable，and has application value.

Sjogren's syndrome  /  Yiqi Yangyin Quyu Decoction（益气养阴祛瘀汤）  /  hydroxychloroquine sulfate tablets  /  parotid radionuclide dynamic imaging  /  immune function
徐杨杨, 谢海, 刘元奎. 益气养阴祛瘀汤治疗干燥综合征对患者腮腺核素动态显像指标、免疫功能的影响研究. 中华中医药学刊, 2025 , 43 (6) : 130 -133 . DOI: 10.13193/j.issn.1673-7717.2025.06.025
Yangyang XU, Hai XIE, Yuankui LIU. Effect of Yiqi Yangyin Quyu Decoction（益气养阴祛瘀汤）on Dynamic Imaging Index and Immune Function of Parotid Gland in Patients with Sjögren's Syndrome[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 130 -133 . DOI: 10.13193/j.issn.1673-7717.2025.06.025
正文
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干燥综合征是一种以侵犯泪腺、唾液腺等外分泌腺为主的慢性自身免疫性疾病，又称为自身免疫性外分泌腺体病。患者临床主要表现为眼、鼻、口、咽、皮肤等部分干燥，会有眼泪分泌减少、眼部磨砂感、异物感，口干，同时还可能有腮腺肿大、舌头有疼痛、皲裂等情况，甚至可能肺、肾、血液系统以及神经系统等多种系统受累的情况，严重影响患者生活质量[1-3]。该疾病治疗方法大多以免疫抑制剂、糖皮质激素、生物制剂等为主，以达到控制病情发展、降低疾病活动度的治疗目标，但是西药治疗在局部症状及病情进展方面尚无高质量证据支持，且治疗安全性也需关注[4-5]。近年来中医药在干燥综合征治疗中取得确切疗效，该疾病归属于中医学“燥证”“燥痹”范畴，可从脏腑、三焦、卫气营血、六经辨证以及气血津液辨证入手，调节各脏腑间的功能及机体免疫力，显著改善干燥综合征的临床症状[6-7]。本研究分析益气养阴祛瘀汤治疗干燥综合征对患者腮腺核素动态显像指标、免疫功能的影响，现对相关病例资料进行总结并报道如下。
1　资料与方法
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1.1　一般资料
将2022年1月—2023年1月医院治疗的干燥综合征患者84例，按照随机数表法分为观察组和对照组，每组42例患者。对照组中，男13例，女29例；年龄26～71岁，平均（46.1±7.8）岁；病程1～18年，平均（5.9±2.2）年。观察组中，男15例，女27例；年龄24～70岁，平均（45.8±8.1）岁；病程1～19年，平均（6.0±2.5）年。两组患者以上性别、年龄、病程资料比较差异无统计学意义（P>0.05），具有可比性。本研究经本院伦理委员会批准通过。
1.2　纳入与排除标准
纳入标准：均符合中国医师协会风湿免疫科医师分会干燥综合征学组制定的干燥综合征诊断标准[8]及原发性干燥综合征中医证候分布及诊断标准[9]；年龄≥18周岁；意识清楚、能够无障碍交流；近1个月未接受其他相关治疗干预；患者知情同意并自愿参与研究内容。
排除标准：严重心肝肾功能不全者；合并系统性红斑狼疮、类风湿关节炎等风湿免疫疾病患者；妊娠及哺乳期女性；研究所用药物过敏史患者；因其他各种原因无法完成研究试验的患者。
1.3　方法
对照组患者采用常规西药治疗，硫酸羟氯喹片（0.1 g/片）每次0.2 g，每日2次；醋酸泼尼松片（每片10 mg）每次30 mg，每日2次。观察组在对照组基础上采用益气养阴祛瘀汤治疗，药物组分：黄芪30 g，生地15 g，石斛15 g，赤芍15 g，五爪龙15 g，黄精12 g，防风12 g，当归10 g，知母9 g，石膏9 g，每日1剂，以水煎煮取汤300 mL，分早晚2次服用。
1.4　观察指标
（1）中医症状量化评分：将症状舌红津少、无苔/少苔/花剥、口干欲饮、眼干少泪依据《中药新药临床研究指导原则》[10]中症状严重程度无、轻、中、重依次对应0、2、4、6分。（2）疾病活动度改变：采用干燥综合征疾病活动指数（European League Against Rheumatism SSdisease activity index，ESSDAI）和EULAR干燥综合征患者报告指数（EULAR SS Patient Reported Index，ESSPRI）评估，ESSDAI评分按照患者受累部位全身症状（权重3）、淋巴结病（权重4）、腺体病变（权重2）、关节病变（权重2）、皮肤病变（权重3）、肺部病变（权重5）、肾脏病变（权重5）、肌肉病变（权重6）、外周神经（权重5）、中枢神经（权重5）、血液系统（权重2）及血清学变化（权重1）疾病活动水平对应0、1、2、3分，评分＝各项积分（活动水平×权重）的和，评分越高疾病活动度越严重；ESSPRI由干燥症状、疲乏和肢体痛三项组成，每项单独评分，依据症状的严重程度从无症状至最重范围为0～10分，ESSPRI评分为三项评分的均值，评分越高、疾病症状越严重[11]。（3）腮腺核素动态显像指标：受检者仰卧位平躺在检查床上，采用GE公司Infinia双探头SPECT检测，静脉弹丸式注射高锝酸盐（99mTcO4-）注射液10 mCi，注射后即可行前位头面部动态显像，1 min/帧，连续采集至第20帧时，受检者口腔内注入维生素C400 mg溶液，再继续采集10 min至结束，共采集30 min。仪器对应计算机软件处理后获得曲线和图像，根据判读数据计算摄取分数（intake fraction，IF）、排泌分数（excretion fraction，EF），IF＝峰值放射性计数/5 min放射性计数，EF＝（放射性曲线峰值计数-排泌最低点放射性计数）/放射性曲线峰值计数。（4）免疫功能指标：取患者晨起空腹肘静脉血4 mL进行常规离心处理，分离血清获得检测样本，全自动生化分析仪检测血沉（erythrocyte sedimentation Rate，ESR）、C反应蛋白（C-reactive protein，CRP）、免疫球蛋白G（immunoglobulin G，IgG）、抗干燥综合征抗原A（Sjögren's syndrome type A，SSA）抗体、抗干燥综合征抗原B（Sjögren's syndrome type B，SSB）抗体。（5）不良反应发生情况：记录治疗期间患者有无皮疹、恶心呕吐、腹泻等不良反应发生。
1.5　统计学分析
统计学分析工具SPSS 23.0软件，计数资料用［例（%）］表示，行χ2检验，计量资料经Shapiro-wilk检验呈正态分布，用（）表示，行t检验，P<0.05表示差异有统计学意义。
2　结果
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2.1　中医症状评分分析
治疗前，两组患者的各项中医症状评分差异无统计学意义（P>0.05）。治疗后，观察组舌红津少、无苔/少苔/花剥、口干欲饮、眼干少泪评分均显著低于对照组（P<0.05）。见表1。
2.2　疾病活动度改变情况分析
治疗前两组患者疾病活动度ESSDAI、EULAR评分差异均无统计学意义（P>0.05）。治疗后，观察组ESSDAI、EULAR评分均显著高于对照组（P<0.05）。见表2。
2.3　腮腺核素动态显像IF、EF分析
治疗前，两组患者腮腺核素动态显像IF、EF差异无统计学意义（P>0.05）。治疗后，观察组腮腺核素动态显像IF、EF均显著高于对照组。见表3。
2.4　免疫功能指标分析
治疗前，两组患者的免疫功能指标ESR、CRP、IgG、抗SSA抗体阳性率、抗SSB抗体阳性率差异无统计学意义（P>0.05）。治疗后，观察组ESR、IgG、抗SSA抗体阳性率、抗SSB抗体阳性率均显著优于对照组（P<0.05），两组CRP水平均降低，但组间差异仍无统计学意义（P>0.05）。见表4。
2.5　不良反应分析
观察组不良反应发生率7.14%与对照组11.90%比较，差异无统计学意义（P>0.05），见表5。两组中出现的不良反应症状均较轻微，可自行缓解。
3　讨论
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中医典籍中无干燥综合征记载，根据其病因病机及临床表现，多属“燥痹”范畴。《素问·阴阳应象大论篇》提出“燥胜则干”，提示疾病的内质为津枯液涸。《黄帝内经》云：“正气存内，邪不可干。”据报道，林昌松教授认为干燥综合征病机以脏腑真阴亏虚为本，燥象为标，津亏不能濡润脏腑而致脏腑功能紊乱，治则培补脏腑真阴，兼以滋阴润燥，辅以活血通络、清热祛湿解毒[12]；也有研究主张干燥综合征病程漫长、经久难愈，属“痼疾”，由虚、燥、毒、瘀相互胶着，致机体正虚外感、阴虚津亏、燥盛化毒、气滞血瘀等，临证以扶正祛邪、分解主客为基本治法[13]。以上提示了中医药治疗干燥综合征因人而异、辨证论治的特点。
岳佳书等[14]检索SinoMed、CNKI、WanFang Data、VIP数据库中关于中药复方治疗原发性干燥综合征的文献，筛选得到121首治疗原发性干燥综合征的处方，提示中药复方以益气养阴润燥、清热凉血活血为主。《血证论》云：“有瘀血，则气为血阻，不得上升，水津因不得随气上升。”提示血瘀内停，气机受阻而津液运行失常。益气养阴祛瘀汤中，黄芪具有补气升阳、固表止汗、利水消肿、生津养血、行滞通痹、托毒排脓、敛疮生肌的功效，生地滋阴润燥、凉血止血，石斛益胃生津、滋阴清热，赤芍清热凉血、散瘀止痛，五爪龙清热解毒、利水通淋，黄精补气养阴、健脾、润肺、益肾，防风祛风解表、胜湿止痛、止痉，当归补血活血、调经止痛、润肠通便，知母清热泻火、滋阴润燥，石膏清热泻火、除烦止渴，诸药合用发挥益气养阴、活血祛瘀作用[15-17]。因此，本研究中观察组在西医常规用药基础上用药益气养阴祛瘀汤，在改善患者症状、降低疾病活动度、提高机体免疫功能等各个方面均具有更佳效果。
腮腺核素动态显像技术原理是通过静脉注射高锝酸盐99mTcO4-，被小叶细胞从周围毛细血管中摄取并积聚于腺体内，并在一定的刺激下分泌出来，随后通过唾液腺导管排到口腔，进而获得唾液腺核医学影像和时间-放射性活度曲线，从而了解唾液腺位置、大小、形态和摄取功能、分泌功能以及导管通畅情况[18-19]。研究中观察组患者腮腺核素动态显像IF、EF改善情况显著优于对照组，考虑益气养阴祛瘀汤的应用能够通络活血，利于腮腺血供恢复有关。现代药理学研究也提示，黄芪的皂苷类成分[20]、石斛茎中联苄类化合物[21]等均具有抗炎作用，减轻了炎症破坏，有利于腮腺功能恢复。干燥综合征是自身免疫性疾病，其发生与机体免疫功能异常有关，在组织水平上，典型的特征是B细胞、T细胞和抗原呈递细胞对唾液腺的淋巴细胞浸润[22]。ESR、CRP、IgG、抗SSA抗体阳性率、抗SSB抗体阳性率异常均与干燥综合征免疫机制失调有关，益气养阴祛瘀汤有利于更好地改善机体免疫功能，与其养血益气、祛瘀通络、清热解毒等作用有关。现代药理研究也提示，黄芪的化学成分多糖、黄酮类化合物，三萜类化合物等具有增强免疫功能、调节机体代谢等作用[23-24]；黄精含有多糖、甾体皂苷、植物甾醇、黄酮、三萜、生物碱等活性成分，具有抗炎、免疫调节等药理作用[25]；中药生石膏的主要成分包括石膏素、石膏纤维素、微量元素和其他活性物质等多种成分，有清热泻火、抗炎、免疫等药理作用[26]。
综上所述表明，益气养阴祛瘀汤治疗干燥综合征效果满意，其能够更有效地缓解患者症状，改善机体免疫功能和腮腺核素动态显像指标，且用药安全性可靠，具有应用价值。
基金
收起
  • 国家中医药管理局项目(201920879)
  • 潍坊医学院附属医院种子基金项目(2021wyfyzzjj09)
文献
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2025年第43卷第6期
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doi: 10.13193/j.issn.1673-7717.2025.06.025
  • 首发时间：2026-10-30
  • 出版时间：2025-06-10
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国家中医药管理局项目(201920879)
潍坊医学院附属医院种子基金项目(2021wyfyzzjj09)
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    潍坊医学院附属医院，山东 潍坊 261000
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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