Dry syndrome is a chronic inflammatory autoimmune disease mainly involving exocrine glands, also known as autoimmune exocrine gland epithelial cellulitis or autoimmune exocrinopathy. In addition to dry mouth and eyes due to decreased function of salivary glands and lacrimal glands, other exocrine glands and other organs outside the glands are also involved and symptoms of multisystemic damage occur.
The disease is insidious in its onset and has various clinical manifestations.
1.Local manifestations
(1) Dry mouth disease is caused by salivary gland lesions, resulting in a lack of salivary mucin and causing the following common symptoms.
(1) Most of the patients complain of dry mouth, and in serious cases, the oral mucosa, teeth and tongue become sticky, so that they need to drink water frequently when they talk, and when they eat solid food, they need to send it down with water or liquid food.
②Rampant dental caries is one of the characteristics of this disease. About 50 patients have multiple carious teeth with uncontrollable development, manifested as gradual blackening of teeth, followed by small pieces falling off, and finally only the residual roots remain.
(iii) In adult mumps, 50 patients present with intermittent alternating parotid swelling and pain, involving unilateral or bilateral. Most of them subside on their own in about 10 days, but sometimes the swelling persists. A few have submandibular gland enlargement, and less frequently sublingual gland enlargement.
④The tongue shows painful tongue, dry and cracked tongue, and atrophied and smooth tongue papillae.
⑤ The oral mucosa appears to be ulcerated or secondary to infection.
(2) Dry keratoconjunctivitis This is due to the decrease of mucin secreted by the lacrimal glands and presents with symptoms such as dry eyes, foreign body sensation, few tears, and in severe cases, painful crying without tears. Some patients have recurrent purulent infection of the eyelid margin, conjunctivitis, keratitis, etc.
(3) Other superficial parts such as nose, hard palate, trachea and its branches, digestive tract mucosa, and exocrine glands of vaginal mucosa can be involved, causing less secretion and corresponding symptoms.
2.Systemic manifestations
In addition to dry mouth and eyes, patients may also have systemic symptoms, such as weakness and low fever. About 2/3 of patients have systemic damage.
(1) Allergic purpura-like rash may appear on the skin, mostly on the lower limbs, as red papules with clear borders of the size of rice grains, which do not fade when pressed and appear in batches. Each batch lasts for about 10 days and may fade on its own with brown pigmentation.
(2) Joint arthralgia is more common, mostly without destruction of joint structures.
(3) Kidney About half of the patients have renal damage, mainly involving the distal renal tubules, and may develop renal tubular acidosis. A small proportion of patients show more obvious glomerular damage, with clinical manifestations of massive proteinuria, hypoalbuminemia, and even renal insufficiency.
(4) Lung Most patients have no respiratory symptoms. Those with mild involvement present with a dry cough and those with severe involvement present with shortness of breath. The main pathology of the lungs is interstitial lesions, and another small percentage of patients develop pulmonary hypertension. Those with pulmonary fibrosis and severe pulmonary hypertension have a poor prognosis.
(5) The digestive system may present with nonspecific symptoms such as atrophic gastritis, decreased gastric acid, and dyspepsia, and patients may have liver damage.
(6) Nervous few involve the nervous system. Peripheral nerve damage is the most common.
(7) Hematologic system The disease may present with reduced white blood cell count or (and) thrombocytopenia, and bleeding may occur in severe cases of low platelets. The incidence of lymphoma in this disease is much higher than in the normal population.
Diagnosis requires complex examinations and laboratory tests, which are not repeated here.
Nowadays, the treatment of western medicine is mainly symptomatic, using lubricants, artificial tears, etc. to relieve the symptoms. In addition, Chinese medicine orthopedic technique combined with meridian dredging is used to treat patients with menopausal dryness syndrome, and good results have been achieved.
This disease is mostly caused by liver depression and qi stagnation, the three jiao and bile meridians are not smooth, qi and blood stagnation, coupled with inordinate diet, life pressure and irregular living, finally causing endocrine disorders. Spinal deformity, etc. After the manipulation correction, open up the meridians, so that the immunity to return to normal.