【目的】 探讨原发性干燥综合征（primary Sjögren􀆳s syndrome，PSS）患者的中医证型分布及其与免疫学及炎症细胞因子等 实验室检测指标之间的相关性。【方法】 回顾性研究2018年1月～2022 年12月在上海中医药大学附属岳阳中西医结合医院风 湿病科就诊的 PSS患者 326例。分析 PSS 患者的中医证型分布规律（具体分阴虚血燥证、气阴两亏证、湿热内蕴证、瘀热入 络证4型），比较不同中医证型PSS患者的性别、发病年龄、病程情况，探讨不同中医证型与抗干燥综合征抗原A抗体（抗SSA）、 抗干燥综合征抗原B抗体（抗SSB）、C反应蛋白（CRP）、红细胞沉降率（ESR）、免疫球蛋白G（IgG）、免疫球蛋白A（IgA）、白 细胞介素6（IL-6）、补体3（C3）和补体4（C4）等实验室检测指标之间的相关性。【结果】（1）中医证型分布方面，326例患者中， 以湿热内蕴证最多见，共106例（占32.5%），其他中医证型分布频次由高到低依次为阴虚血燥证[84例（占25.8%）]、瘀热入络 证[78例（占23.9%）]、气阴两亏证[58例（占17.8%）]。（2）不同中医证型PSS患者的性别、发病年龄、病程方面，不同中医证型 的性别比较，差异无统计学意义（P > 0.05）；而不同中医证型的病程和发病年龄比较，差异均有统计学意义（P < 0.05），患者 的病程和发病年龄由高到低均依次为阴虚血燥证、气阴两亏证、瘀热入络证、湿热内蕴证。（3）不同中医证型与实验室检测 指标的相关性方面，阴虚血燥证与抗SSB、IgA、IgG、C4等呈正相关，气阴两亏证与抗SSB、IgG、C4等呈正相关，湿热内 蕴证与CRP、ESR、IL-6、抗SSA、IgA等呈正相关，瘀热入络证与CRP、ESR、IL-6、抗SSA等呈正相关，差异均有统计学 意义（P < 0.05或P < 0.01）。【结论】 PSS患者以湿热内蕴证最多见，以阴虚血燥证和气阴两亏证患者的病程相对较长、发病年 龄相对较大，以湿热内蕴证和瘀热入络证患者的病程相对较短、发病年龄相对较小；不同中医证型的免疫学及炎症细胞因 子等实验室检测指标间有一定的相关性，该研究结果对中医临床辨证有一定的指导意义。

Objective To investigate the distribution of traditional Chinese medicine（TCM）syndrome types in patients with primary Sjögren􀆳s syndrome（PSS），and to explore the correlation between TCM syndrome types and laboratory findings of immunological parameters and inflammatory cytokines. Methods A retrospective study was conducted on 326 patients with PSS who attended the Department of Rheumatology of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine，Shanghai University of Traditional Chinese Medicine，from January 2018 to December 2022. Analysis was carried out for the distribution of TCM syndrome types，namely yin deficiency and blood dryness syndrome， deficiency of qi and yin syndrome， internal retention of damp-heat syndrome，and stagnant heat in the collateral syndrome，in PSS patients. The gender，age of onset，and duration of disease of PSS patients with different TCM syndrome types were compared. And then an exploration was performed in the correlation between TCM syndrome types and laboratory findings of Sjögren􀆳s syndrome antigen A antibody（anti-SSA），Sjögren􀆳s syndrome antigen B antibody（anti-SSB），C-reactive protein（CRP），erythrocyte sedimentation rate（ESR），immunoglobulin G（IgG），immunoglobulin A（IgA），interleukin 6（IL-6），complement 3（C3）and complement 4（C4）. Results（1）The analysis of the distribution of TCM syndrome types showed that among the 326 patients， 106 cases（32.5%）were differentiated as internal retention of damp-heat syndrome， which accounted for the most，and then came yin deficiency and blood dryness syndrome（84 cases，25.8%），stagnant heat in the collateral syndrome（78 cases，23.9%），and deficiency of qi and yin syndrome（58 cases，17.8%） in descending order.（2）There was no statistically significant difference in the gender among the PSS patients with different TCM syndrome types（P > 0.05），but the differences of age of onset and the duration of disease among the PSS patients with different TCM syndrome types were statistically significant（P < 0.05）. The distribution of duration of disease and age of onset in the PSS patients with yin deficiency and blood dryness syndrome，deficiency of qi and yin syndrome，and stagnant heat in the collateral syndrome，internal retention of damp-heat syndrome was in descending order.（3）The analysis of the correlation between TCM syndrome types and laboratory findings showed that yin deficiency and blood dryness syndrome was positively correlated with anti-SSB，IgA，IgG，and C4；deficiency of qi and yin syndrome was positively correlated with anti-SSB，IgG，and C4；internal retention of damp-heat syndrome was positively correlated with CRP，ESR，IL-6，anti-SSA，and IgA；stagnant heat in the collateral syndrome was positively correlated with CRP，ESR，IL-6，and anti-SSA. The differences were all statistically significant（P < 0.05 or P < 0.01）. Conclusion The patients with PSS are usually differentiated as internal retention of damp-heat syndrome，patients with yin deficiency and blood dryness syndrome and deficiency of qi and yin syndrome usually have longer duration of disease and older age of onset，and the patients with internal retention of damp-heat syndrome and stagnant heat in the collateral syndrome usually have shorter duration of disease and younger age of onset. The laboratory findings such as immunological parameters and inflammatory cytokine are correlated with TCM syndrome types of PSS patients to some extent，which will supply guidance for the clinical differentiation of TCM syndromes of PSS.

R259.932

国家自然科学基金资助项目（编号：82374342）；上海市“国医强优”三年行动计划建设项目（编号：HKGYQYXM-2022-02）