Treating Sjogren syndrome based on tongue-guided syndrome differentiation

Sjogren syndrome is a chronic inflammatory autoimmune disorder primarily characterized by lymphocytic infiltration of the exocrine glands. It has a low early diagnosis rate and lacks targeted therapeutic drugs. Tongue manifestations in Sjogren syndrome exhibit distinct features and patterns, which change dynamically with disease progression. These manifestations can reflect the underlying pathogenesis, clinical features, and evolutionary patterns of the disease. Therefore, we proposed a tongue-guided approach to syndrome differentiation and treatment for Sjogren syndrome. By using tongue manifestations as the core basis for managing Sjogren syndrome, including early screening and diagnosis, syndrome differentiation, disease assessment, treatment, and prognosis evaluation, a "tongue manifestation-syndrome-treatment" diagnostic and therapeutic system can be established. Tongue manifestations of patients with Sjogren syndrome can be primarily classified into two major categories: yin deficiency and phlegm-damp tongue manifestations, which may also be accompanied by qi deficiency, dryness-heat, and blood stasis. Integrating these with other information from the four diagnostic methods helps identify the two core pathological mechanisms of this disease-qi and yin deficiency, as well as intermingled dryness and dampness. For patients with both qi and yin deficiency, the primary treatment method is to benefit qi, nourish yin, and moisturize dryness; for patients with intermingled dryness and dampness, the primary treatment approach is to invigorate the spleen to eliminate dampness and moisturize dryness. Furthermore, the characteristic manifestations and dynamic changes of the patient′s tongue can be used to evaluate therapeutic efficacy and adjust medications accordingly. Adopting a tongue-guided syndrome differentiation approach for treating Sjogren syndrome enhances objectivity of syndrome differentiation and treatment, thereby promoting the precise diagnosis and treatment for this condition.