Investigation on the Correlation Between Salivary Gland Ultrasound,T Cell Subsets,and Traditional Chinese Medicine Tongue Signs and Syndrome Types in Patients with Primary Sjögren's Syndrome

GUO Zilin; ZHOU Xinyao; LIU Ruihua; LIU Wenjing; HE Jiale; SHAN Xueyan; JIANG Quan; TANG Xiaopo

Abstract：Objective To explore the correlation between salivary gland ultrasound(SGU)and peripheral blood T cell subsets,as well as traditional Chinese medicine(TCM)tongue images and syndrome types in patients with primary Sjögren's syndrome(PSS),to provide a basis for clinical diagnosis and basic research.Methods PSS patients who visited the Rheumatology Department of Guang'anmen Hospital from June to December,2022 were selected.Their SGU report,peripheral blood T lymphocyte levels,and TCM tongue images were collected.Statistical methods were used to explore the correlation between SGU scores of PSS patients and the above indicators.TCM syndrome types were summarized based on the characteristics of tongue images,and the differences among patients with different syndrome types were analyzed.Results A total of 205 patients with PSS were screened,and 48 cases were ultimately included,including 6 cases in the mild salivary gland injury group,38 cases in the moderate injury group,and 4 cases in the severe injury group.As the degree of salivary gland injury increased,the proportions of Tfh,Th1,Th2,Th17,and Tfh17 in the three groups of patients gradually increased,while the proportions of Treg,Tfh1,and Tfh2 gradually decreased.The levels of Tfh,Th1,Th2,Th17,and Tfh17 were positively correlated with SGU scores,while the levels of Treg,Tfh1,and Tfh2 cells were negatively correlated with SGU scores.Mild injury group patients were mainly characterized by a pale tongue,less body fluid or tooth marks,and a thin coating.Moderate injury group patients were mainly characterized by a red tongue,less body fluid,and no or little coating.Severe injury patients were mainly characterized by a dark tongue,cracks,and a thick or greasy coating.The patients in the mild injury group were mainly characterized by Yin deficiency and body fluid deficiency syndrome.The moderate injury group was mainly characterized by Yin deficiency and internal heat syndrome.And the severe injury group was mainly characterized by the combination of dryness and blood stasis syndrome.The above differences were not statistically significant(P>0.05).Conclusion The degree of salivary gland damage,T cell subsets,TCM tongue images,and syndrome types are all diagnostic and therapeutic factors for PSS.There is a positive correlation between the degree of salivary gland injury in patients and the imbalance of T cell subsets.When salivary gland damage worsens,TCM tongue images and syndrome types evolve towards heat,stasis,and deficiency.