Sjögren’s Syndrome

Sjögren's syndrome is a chronic inflammatory autoimmune disease characterized by lymphocyte proliferation and progressive damage to the exocrine glands. Beyond the hallmark symptoms of dry mouth and dry eyes — caused by impaired salivary and lacrimal gland function — it can also lead to multi-system and multi-organ damage through involvement of other exocrine glands and extra-glandular organs, as well as the presence of autoantibodies and hyperimmunoglobulinemia in the serum.

Symptoms and characteristics:

Sjögren's syndrome has an insidious onset, with an average of 5–10 years elapsing between the first symptoms of dry mouth and dry eyes and a formal diagnosis. Some patients experience only localized symptoms, while others present primarily with systemic manifestations:

• Dry mouth
• Dry eyes
• Dry skin
• Muscle and joint pain
• Dry cough due to airway dryness
• Tubulointerstitial nephritis

Western Medicine Treatment:

Commonly used Western medicines for Sjögren's syndrome include glucocorticoids, immunosuppressants, and biologics. Frequently prescribed immunosuppressants include hydroxychloroquine sulfate, methotrexate, leflunomide, and cyclophosphamide.

Traditional Chinese Medicine (TCM) Perspective:

In TCM, Sjögren's syndrome falls under the category of “dryness impediment”. Most modern TCM practitioners locate the disease in the lungs, spleen and stomach, and liver and kidneys, with yin deficiency and fluid depletion considered the core pathogenesis. Diagnosis and treatment draw on the Inner Canon and the Treatise on Febrile Diseases, incorporating differentiation of organ syndromes, qi, blood and body fluids, and the three jiao.

TCM classifies SS into the following syndrome types:

Lung dryness syndrome

Yin deficiency with internal dryness syndrome

Qi and yin deficiency syndrome

Yang deficiency with fluid stagnation syndrome

Accumulation of dryness-toxin syndrome

Qi and blood stasis syndrome

TCM Treatment:

The strengths of TCM in treating Sjögren's syndrome lie in the diversity of its methods. By combining syndrome differentiation with disease differentiation, TCM can improve both local and systemic symptoms — particularly in relieving dry mouth and eyes, reducing fatigue, alleviating joint and muscle pain, managing anxiety and depression, and enhancing overall quality of life.

Care and Nursing:

• Patients with SS are advised to maintain a positive outlook, avoid overexertion, and get adequate sleep.
• Indoors, a comfortable temperature and humidity level should be maintained, with care taken to avoid exposure to wind, cold, dampness, and excessive heat.
• Diet should consist of soft, easily digestible foods while still ensuring adequate nutrition. Smoking, alcohol, and spicy or irritating foods should be strictly avoided.
• Good oral hygiene and regular dental checkups are important.
• The skin should be kept clean, and scratching dry or itchy areas should be avoided to prevent infection.
• For more severe cases, blood pressure, heart rate, and respiration should be monitored regularly, and adequate rest is essential.