There is a disease in which the patient suffers from dry mouth, reduced sleeping fluid, and dry eyes without tears. Even though they are grief-stricken, they cannot squeeze half a tear out of their eyes. The disease is common in menopausal women around the age of 50, and the prevalence of menopausal women around the age of 50 is about 3-5%. This is the “dry syndrome”. Dry syndrome was first discovered by Swedish ophthalmologist Shoglin in 1933, so people also called it “Shoglin’s disease”. With the development of medical science, people have gradually understood the pathogenesis of this disease. Studies have confirmed that salivary glands and lacrimal glands are damaged by infiltration of lymphocytes and plasma cells, resulting in reduced secretion of sleep and tears, and the main symptoms are dry mouth, dry eyes and dry nose.
At present, it is considered as a kind of systemic chronic inflammatory autoimmune disease mainly based on exocrine gland lesions. Because the onset of dry syndrome is insidious and the early symptoms are light, it is easy to be ignored by patients. In addition, because this disease belongs to the category of autoimmune disease, it was only gradually recognized with the development of immunology, and the general non-specialist doctors know less about it, so that many patients have been missed and misdiagnosed for a long time, and even when the kidney function is damaged, they still have not been correctly diagnosed and treated, which brings great pain to the patients. If patients with dry syndrome can be correctly diagnosed and treated at an early stage, the progress of the disease can be controlled or delayed. If not treated early, the symptoms will gradually worsen and may even lead to irreversible damage to lungs, kidneys and other organs. Therefore, if you find symptoms such as dry mouth and dry eyes, you should go to the rheumatology department promptly. Rheumatologists are familiar with the diagnosis and treatment of this disease. The main clinical manifestations of dry syndrome are
Dry mouth: it is the first symptom of this disease. The patient’s saliva secretion is significantly reduced and very viscous, which can be in the form of strains, so that he must also drink water frequently during speech, mouth chewing and swallowing. Patients have a foreign body sensation in the throat, dry lips, cracked corners of the mouth, strawberry-colored tongue, difficulty in pronunciation, and ulcers on the oral mucosa. Because of the loss of flushing effect due to the decrease of sleeping fluid, the insect-eating damage often occurs, which is called “rampant dental caries”.
Dry eyes: Tears are reduced due to the decrease of lacrimal gland secretion function, and no tears can be shed even if there is abnormal grief. There are often persistent foreign body and burning sensation in the eyes, itchy eyes, blurred vision, eye opening fatigue, photophobia, and symptoms of sticky discharge from the corner of the eyes.
Dry nose: dry, crusty nasal cavity, epistaxis and even septal perforation, eustachian tube obstruction, chronic otitis media and loss of vision.
Dry skin or vagina: dry skin due to decreased sweat secretion, prone to purple spots, decreased vaginal vestibule fluid secretion, resulting in vaginal dryness, and in severe cases, inability to have intercourse.
Joint pain: 70% to 80% have joint pain.
Renal damage: Nearly half of the complications of renal damage commonly involved in the distal tubule, clinical manifestations are symptomatic or subclinical renal tubular acidosis. The former manifestations are.
(i) periodic hypokalemic paralysis;
(ii) renal chondrodysplasia;
(iii) nephrogenic uremia with proximal tubular involvement manifested by amino aciduria, phosphaturia, glycosuria, and β2-microglobulinuria. Glomerular involvement is rare, but the prognosis is poor.
Lung damage: 17% of patients have a dry cough. Diffuse interstitial pulmonary fibrosis with decreased lung function occurs in a small number of patients, but most have no clinical symptoms.
Digestive system damage.
(i) atrophic gastritis, low gastric acid secretion, lack of gastric acid;
②Small intestine malabsorption;
③Exocrine pancreatic hypersecretion;
(4) Hepatomegaly, elevated serum transaminases, jaundice, liver pathology biopsy often shows changes of chronic active hepatitis, etc.
Neurological damage: The symptoms include epilepsy, hemiplegia, hemianopia, myelitis, cerebral neuritis, and peripheral neuritis, due to vasculitis at different sites and constituting different levels of damage to the central nervous system.
Hematological system damage: 1/4 to 1/5 have leukocytopenia and thrombocytopenia, only a few have bleeding phenomenon; 5% to 10% of patients have lymph node enlargement; 50% of patients have a large number of lymphocyte infiltration in internal organs during the course of the disease; the incidence of lymphoma is 44 times higher than normal population.
Because of the insidious onset of dry syndrome and light symptoms in early stage, it is easy to be neglected by patients or not found suitable doctors for consultation and treatment, so that many patients have been missed and misdiagnosed for a long time, and even when the kidney function is damaged, they are still not correctly diagnosed and treated, which brings great pain to patients. If patients with dry syndrome can be treated correctly at an early stage, the progress of the disease can be controlled or delayed. If not treated early, the symptoms will gradually worsen and even lead to irreversible damage to lungs, kidneys and other organs.
Treatment of dry syndrome Western medicine at home and abroad mostly adopts symptomatic treatment methods. For example, if the eyes are dry, use I% methylcellulose or bovine parotid gland extract as artificial tears treatment, and use chloramphenicol eye drops to prevent infection. If the immunoglobulin in the body is high and the anti-nuclear antibody is positive, the use of hormone and immunosuppressant should be considered for treatment.
According to traditional Chinese medicine, dry syndrome is caused by internal attack of dryness, deficiency of Qi and blood, resulting in deficiency of fluids. Therefore, the treatment should be to add fluid, nourish Yin and moisten dryness. The prescription can be taken by decocting 12 grams of Xuan Shen, 12 grams of Mai Dong, 12 grams of Sheng Di, 15 grams of Xu Hua, 12 grams of Yu Zhu, 10 grams of Angelica Sinensis, 12 grams of Bei Sha Shen, 10 grams of Dan Pi, 12 grams of Red Peony, 10 grams of Mimong Hua, 6 grams of Licorice, one dose of water daily, divided into two doses.
For the treatment of dry syndrome, the combination of Chinese and Western medicine is still the best treatment. Combined treatment of Chinese and Western medicine can reduce the side effects of hormones and immunosuppressants, improve the symptoms, and reduce the blood sedimentation, immunoglobulin, anti-nuclear antibody and other experimental indexes.
Since the course of dry syndrome is slow, the treatment course is long and the effect is slow, so the patient should establish firm confidence, pay attention to regular life, pay attention to eating more fresh vegetables and fruits containing more water, and take part in physical exercise appropriately.