活血解毒养阴生津方干预干燥综合征的临床与实验研究
|
摘要
干燥综合征(Sjogren's Syndrome)是一种主要累及唾液腺和泪腺等外分泌腺的慢性炎症性自身免疫病。临床表现主要为口干、眼干,此外还可累其他部位外分泌腺及腺体外器官,出现呼吸系统、消化系统、神经系统、泌尿系统、血液系统、心血管系统等损害。干燥综合征目前尚无根治方法,主要是改善症状,控制继发感染,延缓因免疫反应引起的系统性病变的进展。
第一部分为文献综述
从中医和西医两个方面,对干燥综合征的病因、发病机制、诊疗现状进行了综述。
第二部分为临床研究
目的：观察活血解毒养阴生津方干预干燥综合征的临床疗效。
方法：采用随机对照的方法,将40例干燥综合征患者按随机区组设计(每组4人),随机分成2组,中药组20例、雷公藤多甙组20例。用中医症状积分干燥综合征疾病活动度指数(ESSDAI)及实验室指标作为评价指标。
结果：中药组脱落病例3例,雷公藤组脱落2例。①中医证候学疗效评价：中药组(治疗组)17例中有效15例,无效2例,总有效率88.2%,雷公藤多甙组(对照组)18例中有效15例,无效3例,总有效率83.3%,经Ridit分析,治疗组R1=0.49,对照组R2=0.51,u=0.68,P>0.05,两组有效率比较无显著差异,P>0.05,进一步分析发现,两组症症状积分改善主要与口、眼、皮肤干燥、肌肉关节疼痛、便秘症状的改善相关,两组相比较基本一致,而治疗组的脉象比对照组改善明显。②ESSDAI积分改善情况：经治疗,两组患者的ESSDAI积分均得到改善,两组患者治疗前后自身比较,ESSDAI积分有显著差异,P<0.01,组间比较无显著差异。③治疗后两组血清学指标的比较：Anti-SSA(Ro)、Anti-SSB(La)、RF指标阳性率比较,未见显著性差异(P>0.05)；两组治疗前后ESR、CRP、免疫球蛋白(IgA、IgG、IgM)有显著差异(P<0.05)；两组组间比较无显著差异(P>0.05)。
结论：活血解毒养阴生津方治疗干燥综合征,可有效改善患者症状及部分实验室指标,使干燥综合征疾病活动度得到改善。第三部分为实验研究
目的：探讨活血解毒养阴生津方干预干燥综合征的作用机制。
方法：以BABL/C小鼠作为正常对照组,以NOD小鼠作为SS模型,随机分入模型组、帕夫林治疗组、中药治疗组,分别给药后观察药物小鼠颌下腺功能、形态学改变,并采用ELISA法及RealTime RT-PCR法检测外周血IL-2、IFN-γ含量及颌下腺IL-2mRNA和IFN-γmRNA表达水平。
结果：①经治疗8周后,活血解毒养阴生津方能改善SS模型的颌下腺功能,减轻颌下腺淋巴细胞浸润。②与正常组相比,模型组血清IL-2含量显著降低(P<0.05),TGPC组、HXJD组血清IL-2含量无明显差异(P>0.05)；模型组、TGPC组、HXJD三组组间比较,血清IL-2含量均无明显差异(P>0.05)。与正常组相比较,模型组血清IFN-γ含量显著高于正常组,P<0.05；与模型组相比较,HXJD组血清IFN-γ含量较模型组有显著降低(P<0.05)。③与模型组比较,TGPC组、HXJD组IFN-γmRNA表达水平较模型组明显下降,具有统计学差异(P<0.05)；与正常组及模型组相比,HXJD组IFN-γmRNA表达水平明显下降,具有统计学差异(P<0.05)。各组颌下腺组织中IL-2 mRNA的表达量未发现统计学差异。
结论：①活血解毒养阴生津方能改善患者的临床症状,并能够使ESSDAI积分得到改善。②活血解毒养阴生津方可以下调IFN-γmRNA表达,并能降低外周IFN-γ含量。③其作用机理与下调IFN-γ基因表达水平,进而减轻Thl反应有天。
Sjogren's Syndrome is considered a chronic autoimmune disease characterized by the inflammation involving the exocrine glands. The most common clinical manifestations include Xerostomia, xerophthalmia. And respiratory system, digestive system, nervous system, urinary system, hematologic system, cardiovascular system also involved. SS can't be cured till today but there is way to Improve Symptoms, control secondary infections, slow the progress of the autoimmune destruction of multi-systems.
The fist part of the paper is literature review on the pathogenesis, pathology, clinical manifestations, management of SS from traditional chinese medicine and modern medicine.
The second part of the paper is clinical study
Purpose:to observe the effect of HuoXueJieDuYangYinShengJin Compound on SS patients.
Method:in the randomized controlled trial,40 SS patients were divided into HXJD group (treatment), Tripterygium Wilfordii group (control), by randomized block design,20 patients each group. We use symptom integral, ESSDAI and laboratory indexes as evaluation indexes. Result:17/20 were involved in the analysis of results and 3 fell off in HXJD group; 18/20 were involved in the analysis of results and 2 fell off in Tripterygium Wilfordii group.
①Efficacy on symptom integral index:15/17 (88.2%) were effective in HXJD group; 15/18 (83.3%) were effective in Tripterygium Wilfordii group. The ranked data had been tested by Ridit analysis, showedthat:R1=0.49 (HXJD group), R2=0.51 (Tripterygium Wilfordii group), u=0.68, P> 0.05. That means the efficacy was no difference between two groups. Further analysis discovered the association between the efficacy and the improvement of Xerostomia, xerophthalmia, dryness of skin, arthralgia, constipation of both groups. There was a greater improvement of HXJD group than that of Tripterygium Wilfordii group.②ESSDAI index improvement: both scores of two groups were improved by self-comparison before and after treatment and significant differences were observed (P<0.01). But there was no significant differences between two groups.③Compare of serology indexes after treatment:positive ratio of Anti-SSA(Ro)、Anti-SSB (La) and RF in two groups were not significantly improved by self-comparison before and after treatment (P>0.05). The scores of ESR, CRP and Igs (IgA、IgG、IgM) in two groups were improved by self-comparison before and after treatment and significant differences were observed (P<0.01)
Conclusion:HuoXueJieDuYangYinShengJin Compound can improve symptoms and serology indexes of SS patients effectively and improve ESSDAI also.
The third part ofthe paper is experimental studies.
Purpose:to explor the theraprutic mechanism of HuoXueJieDuYangYinShengJin Compound on SS.
Method:NOD mice were randomly divided into three groups for the experiments:model group, TGPC group and HXJD group, we took BABL/C mice as normal control group. After treatment, we examined the function and morphology of salivary glands. We also determined IL-2, IFN-γlevels in serum by ELISA and IL-2mRNA, IFN-γmRNA levels in salivary glands by RealTime RT-PCR.
Result:①8 weeks after treatment, improvements of salivary glands funct ion and decreased lymphocy tic infiltration into salivary glands were observed.②Compare with normal group, IL-2 level in serum of model group decreased markedly (P< 0.05) but not of TGPC group nor that of HXJD group. There was no marked difference of serum IL-2 between normal group and the rests. Compare with normal group, IFN-y level in serum of model group increased markedly(P<0.05). Compare with model group, IFN-γlevel in serum of HXJD group decreased markedly (P<0.05).③Compare with model group, IFN-γmRNA level in salivary glands of HXJD group and TGPC group decreased markedly (P< 0.05). Compare with normal group, IFN-γmRNA level in salivary glands of HXJD group decreased markedly (P<0.05). There was no marked difference of IL-2mRNA level in salivary glands of all groups.
Conclusion:①HuoXueJieDuYangYinShengJin Compound can improve symptoms as well as the ESSDAI of SS patients.②HuoXueJieDuYangYinShengJin Compound can down-regulate IFN y mRNA expression in salivary glands as well as IFN-γin serum.③The posable theraprutic mechanism of HuoXueJieDuYangYinShengJin Compound on SS might be connected with regulation of IFN-γwhich decreasing Thl effect.
第一部分为文献综述
从中医和西医两个方面,对干燥综合征的病因、发病机制、诊疗现状进行了综述。
第二部分为临床研究
目的：观察活血解毒养阴生津方干预干燥综合征的临床疗效。
方法：采用随机对照的方法,将40例干燥综合征患者按随机区组设计(每组4人),随机分成2组,中药组20例、雷公藤多甙组20例。用中医症状积分干燥综合征疾病活动度指数(ESSDAI)及实验室指标作为评价指标。
结果：中药组脱落病例3例,雷公藤组脱落2例。①中医证候学疗效评价：中药组(治疗组)17例中有效15例,无效2例,总有效率88.2%,雷公藤多甙组(对照组)18例中有效15例,无效3例,总有效率83.3%,经Ridit分析,治疗组R1=0.49,对照组R2=0.51,u=0.68,P>0.05,两组有效率比较无显著差异,P>0.05,进一步分析发现,两组症症状积分改善主要与口、眼、皮肤干燥、肌肉关节疼痛、便秘症状的改善相关,两组相比较基本一致,而治疗组的脉象比对照组改善明显。②ESSDAI积分改善情况：经治疗,两组患者的ESSDAI积分均得到改善,两组患者治疗前后自身比较,ESSDAI积分有显著差异,P<0.01,组间比较无显著差异。③治疗后两组血清学指标的比较：Anti-SSA(Ro)、Anti-SSB(La)、RF指标阳性率比较,未见显著性差异(P>0.05)；两组治疗前后ESR、CRP、免疫球蛋白(IgA、IgG、IgM)有显著差异(P<0.05)；两组组间比较无显著差异(P>0.05)。
结论：活血解毒养阴生津方治疗干燥综合征,可有效改善患者症状及部分实验室指标,使干燥综合征疾病活动度得到改善。第三部分为实验研究
目的：探讨活血解毒养阴生津方干预干燥综合征的作用机制。
方法：以BABL/C小鼠作为正常对照组,以NOD小鼠作为SS模型,随机分入模型组、帕夫林治疗组、中药治疗组,分别给药后观察药物小鼠颌下腺功能、形态学改变,并采用ELISA法及RealTime RT-PCR法检测外周血IL-2、IFN-γ含量及颌下腺IL-2mRNA和IFN-γmRNA表达水平。
结果：①经治疗8周后,活血解毒养阴生津方能改善SS模型的颌下腺功能,减轻颌下腺淋巴细胞浸润。②与正常组相比,模型组血清IL-2含量显著降低(P<0.05),TGPC组、HXJD组血清IL-2含量无明显差异(P>0.05)；模型组、TGPC组、HXJD三组组间比较,血清IL-2含量均无明显差异(P>0.05)。与正常组相比较,模型组血清IFN-γ含量显著高于正常组,P<0.05；与模型组相比较,HXJD组血清IFN-γ含量较模型组有显著降低(P<0.05)。③与模型组比较,TGPC组、HXJD组IFN-γmRNA表达水平较模型组明显下降,具有统计学差异(P<0.05)；与正常组及模型组相比,HXJD组IFN-γmRNA表达水平明显下降,具有统计学差异(P<0.05)。各组颌下腺组织中IL-2 mRNA的表达量未发现统计学差异。
结论：①活血解毒养阴生津方能改善患者的临床症状,并能够使ESSDAI积分得到改善。②活血解毒养阴生津方可以下调IFN-γmRNA表达,并能降低外周IFN-γ含量。③其作用机理与下调IFN-γ基因表达水平,进而减轻Thl反应有天。
Sjogren's Syndrome is considered a chronic autoimmune disease characterized by the inflammation involving the exocrine glands. The most common clinical manifestations include Xerostomia, xerophthalmia. And respiratory system, digestive system, nervous system, urinary system, hematologic system, cardiovascular system also involved. SS can't be cured till today but there is way to Improve Symptoms, control secondary infections, slow the progress of the autoimmune destruction of multi-systems.
The fist part of the paper is literature review on the pathogenesis, pathology, clinical manifestations, management of SS from traditional chinese medicine and modern medicine.
The second part of the paper is clinical study
Purpose:to observe the effect of HuoXueJieDuYangYinShengJin Compound on SS patients.
Method:in the randomized controlled trial,40 SS patients were divided into HXJD group (treatment), Tripterygium Wilfordii group (control), by randomized block design,20 patients each group. We use symptom integral, ESSDAI and laboratory indexes as evaluation indexes. Result:17/20 were involved in the analysis of results and 3 fell off in HXJD group; 18/20 were involved in the analysis of results and 2 fell off in Tripterygium Wilfordii group.
①Efficacy on symptom integral index:15/17 (88.2%) were effective in HXJD group; 15/18 (83.3%) were effective in Tripterygium Wilfordii group. The ranked data had been tested by Ridit analysis, showedthat:R1=0.49 (HXJD group), R2=0.51 (Tripterygium Wilfordii group), u=0.68, P> 0.05. That means the efficacy was no difference between two groups. Further analysis discovered the association between the efficacy and the improvement of Xerostomia, xerophthalmia, dryness of skin, arthralgia, constipation of both groups. There was a greater improvement of HXJD group than that of Tripterygium Wilfordii group.②ESSDAI index improvement: both scores of two groups were improved by self-comparison before and after treatment and significant differences were observed (P<0.01). But there was no significant differences between two groups.③Compare of serology indexes after treatment:positive ratio of Anti-SSA(Ro)、Anti-SSB (La) and RF in two groups were not significantly improved by self-comparison before and after treatment (P>0.05). The scores of ESR, CRP and Igs (IgA、IgG、IgM) in two groups were improved by self-comparison before and after treatment and significant differences were observed (P<0.01)
Conclusion:HuoXueJieDuYangYinShengJin Compound can improve symptoms and serology indexes of SS patients effectively and improve ESSDAI also.
The third part ofthe paper is experimental studies.
Purpose:to explor the theraprutic mechanism of HuoXueJieDuYangYinShengJin Compound on SS.
Method:NOD mice were randomly divided into three groups for the experiments:model group, TGPC group and HXJD group, we took BABL/C mice as normal control group. After treatment, we examined the function and morphology of salivary glands. We also determined IL-2, IFN-γlevels in serum by ELISA and IL-2mRNA, IFN-γmRNA levels in salivary glands by RealTime RT-PCR.
Result:①8 weeks after treatment, improvements of salivary glands funct ion and decreased lymphocy tic infiltration into salivary glands were observed.②Compare with normal group, IL-2 level in serum of model group decreased markedly (P< 0.05) but not of TGPC group nor that of HXJD group. There was no marked difference of serum IL-2 between normal group and the rests. Compare with normal group, IFN-y level in serum of model group increased markedly(P<0.05). Compare with model group, IFN-γlevel in serum of HXJD group decreased markedly (P<0.05).③Compare with model group, IFN-γmRNA level in salivary glands of HXJD group and TGPC group decreased markedly (P< 0.05). Compare with normal group, IFN-γmRNA level in salivary glands of HXJD group decreased markedly (P<0.05). There was no marked difference of IL-2mRNA level in salivary glands of all groups.
Conclusion:①HuoXueJieDuYangYinShengJin Compound can improve symptoms as well as the ESSDAI of SS patients.②HuoXueJieDuYangYinShengJin Compound can down-regulate IFN y mRNA expression in salivary glands as well as IFN-γin serum.③The posable theraprutic mechanism of HuoXueJieDuYangYinShengJin Compound on SS might be connected with regulation of IFN-γwhich decreasing Thl effect.
引文
[1]傅宗翰.干燥综合征初探[J]中医杂志.1983,(08)：4-8.
[2]赵丽娟,李振吉,王殉.补脾益气及阴阳双补法治疗干燥综合征[J].中医杂志,1985,(06)：41-42.
[3]秦长林.“顽燥”辨治[J].安徽中医临床杂志,2000,12(05)：351-353.
[4]马武开.干燥综合征的中医病因病机探讨[J].中医药研究,2000,(04)：2-3.
[5]路志正.治痹心得[C].2004,首届国际中西医结合风湿病学术会议：30-33.
[6]Reveille JD, MacleodMJ, Whittington K, et al. Specif ic amino acid residues in the second hypervariable region of HLA～DQA1 and DQB1 chain genes promote the Ro (SS-A)/La (SS-B) autoantibody responses. [J]J Immunol 1991; 146:3871～6.
[7]Priori R, Medda E, Conti F,et al. Risk factors for Sjogren's syndrome: a case-control study. Clin Exp Rheumatol.2007,25 (03):378～84.
[8]张雄鹰,宋秀珍,秦雄伟,等.山西汉族原发性干燥综合征与HLA-DQ基因多态性相关性的研究[J].细胞与分子免疫学杂志,2011,(02)：182-185.
[9]姜良铎,张文生.从毒论治初探[J].北京中医药大学学报,1998,21(05)：2-3.
[10]王永炎.关于提高脑血管疾病疗效难点的思考[J].中国中西医结合杂志,1997,17(04)：195-196.
[10]常富业,张允岭,王永炎,等.毒的概念诠释[J].中华中医药学刊,2008,26(09)：1897-1899.
[11]张允岭,郭蓉娟,王嘉麟,等.基于专家问卷的中医“毒”的特性分析.[J].中医杂志,2010,51(01)：27-29.
[12]路志正,焦树德.实用中医风湿病学[M].北京：人民卫生出版社.2001：269-285.
[13]郝炜欣,董振华.干燥综合征106例中医证候分类的研究.中国中医风湿病学杂志[M],2004,3(04)：61.
[14]秦长林.从干燥综合征看“燥必入血”的病变特点.山东中医杂志[M],2000,19(12)：710-712.
[15]骆天炯.刘永年教授治疗干燥综合征的经验[J].江苏中医药,2005,26(11)：7.
[16]王海隆,张显彬.冯兴华治疗干燥综合征经验[J].中国中医药信息杂志,2007,(05)：85
[17]潘文萍,周翠英.干燥综合征从燥毒论治理论探析[J].新中医,2010,42(04)：5-6.
[18]周唯.阴虚血瘀证探析[J].山东中医药大学学报,2007,31(3)： 2.中医杂志,1981,22(8)：31.
[19]刘健,孙桐.试论阴虚血瘀及滋阴活血法[J].南京中医药大学学报,1999,15(6)：331-332.
[20]谭达人.冠心病“阳虚”“阴虚”病人血液流变性的初步观察[J].中医杂志,1981,(08)：31-33.
[21]董振华.活血化瘀法在干燥综合征中的应用[J].北京中医,2001(03)：9-11.
[22]潘文奎.口眼干燥综合征的辨证论治[J].辽宁中医杂志,1998,5：21-23.
[23]钟起诚.干燥综合征之中医病因病机探讨[J].中国中医药信息杂志,2003,(02)： 73.
[24]赵美娥.调理阴阳法治疗干燥综合征.光明中医[J],2006,21(12)：88-89.
[25]何迅,陶巧林.干燥综合征的中医诊治近况[J].四川中医,2001,19(07)：14-16.
[26]许宁,周翠英.三焦辨证分治原发性干燥综合征[A].王承德.第十二届全国中医风湿病学术研讨会专辑[C].中国云南昆明：中国中医风湿病学杂志社,2008：163-164.
[27]路志正,焦树德,阎孝诚.痹病论治学[M].北京：人民卫生出版社.1989：281283.
[28]路志正,焦树德.实用中医风湿病学[M].北京：人民卫生出版社.2001：269-285.
[29]吴坚,朱良春.朱良春治疗干燥综合征经验[J].实用中医药杂志,2006,(08)：501.
[30]娄玉铃.中国风湿病学.北京：人民卫生出版社.2001：2209-2216.
[31]姜迎萍,李靖.干燥综合征的中医证治规律探讨[J].四川中医,2003,21(03)：14-15.
[32]郝伟欣,董振华.干燥综合征106例中医证候分类回顾性研究[J].中医杂志,2006,47(07)：528-530.
[33]杨香生,陈高材.干燥综合征的中医分型论治探讨[J].江西中医药,1989,(05)：26-28.
[34]傅宗翰,刘永年.干燥综合征的辨证施治规律[J].南京中医学院学报,1987,(3)：11-14.
[35]刘永年.干燥综合征的中医诊治与研究[M].北京：人民卫生出版社,2006：92-95.
[36]王承德,沈丕安,胡荫奇.实用中医风湿病学[M].北京：人民卫生出版社,2009：334-336.
[37]钱垠,金实.从肺论治干燥综合征.[J]南京中医药大学学报(自然科学版)2002,18(05)：268-269.
[38]丁德经；周学平；开泄法在干燥综合征中的运用[J].新中医,2010,(03)：10-11.
[39]吕慧为.健脾益气生津治疗原发性干燥综合征27例[J].山东中医药大学学报,2001,25(04)：288.
[40]茅建春,陈湘君,苏励,等.益气健脾法治疗原发性干燥综合征的临床观察[J].中国临床药学杂志,2007,(04)：231-233.
[41]徐愿,阎小萍.阎小萍治疗干燥综合征经验撷菁[J].中国中医药信息杂志,2010,(04)：88-89.
[42]母小真.陈湘君治疗干燥综合征的经验[J].辽宁中医杂志,2002,29(01)：11.
[43]刘国英.疏肝法治疗干燥综合征体会[J].中医杂志,1997,(03)：147.
[44]钟琴,马武开,刘正奇,等.从肺脾肝肾四脏调治干燥综合征.[J]贵阳中医学院学报,2008,30(04)：60-61.
[45]傅培红,章怡祎,张文群.顾仁樾教授治疗干燥综合征经验[J].河北中医,2007,(09)：776-777.
[46]李洁,杨兴智,亓鲁光.亓鲁光治疗干燥综合征经验[J].中医杂志,2010,(11)：978-979.
[47]潘新.干燥综合征的中医诊治体会[J].湖北中医学院学报,2007,9(01)：61.
[48]刘志勤.中医三步治疗干燥综合征述要[J].中医药学刊,2005,23(03)：545.
[49]张晓强,任文栋,李孟芳.化气布津法在治疗干燥综合征中的应用[J].新中医,2011,(10)：137-138.
[50]叶海军.从三焦论治干燥综合征[J].辽宁中医杂志,2004,31(06)：477.
[511陆瑾.陆安康教授治疗干燥综合征经验精粹[J].中医药学刊,2003,21(12)：1991-1992.
[52]马武开,蔺想成,王建华.马永祯治疗干燥综合征的经验.[J]安徽中医临床杂志,1998,10(06)：390.
[53]朱跃兰,韦尼,侯秀娟.活血解毒方治疗干燥综合征63例临床观察[J].北京中医药大学学报(中医临床版),2010,(05)：1-3.
[54]韩善夯,苏建玲.金实教授干燥综合征诊治经验[J].四川中医,2010,28(10)：1-2.
[55]陈爱萍.益气生津散治疗干燥综合征疗效观察[J].山西中医,2008,(05)：13-14.
[56]杜秀兰,宋绍亮.益气养阴润燥糖治疗干燥综合征10例[J].山东中医杂志,1994,13(12)：535.
[57]张水艳,李瑞,朱秀惠,等.金菊清润胶囊治疗原发性干燥综合征50例临床观察[J].中医杂志,2009,(08)：708-711.
[58]覃海；益胃汤合玉女煎加减治疗脾胃阴虚型原发性干燥综合征25例[J].广西中医学院学报,2010,(02)：13-15.
[59]廖承建.门冬清肺饮加减治疗干燥综合征[J].新中医,1999,31(04)：44.
[60]赵振兴,侯绍敏.加味引火汤治疗干燥综合征15例临床观察[J].河北中医,1998,20(01)：226-227.
[61]段波.益气养阴通络法治疗干燥综合征临床观察.湖北中医杂志,2011,33(06)：44-46.
[62]周强,栗占国.白芍总苷的药理作用及其在自身免疫性疾病中的应用[J].中国新药与临床杂志,2003,22(11)：96.
[63]厉小梅,李向培,汪国生,等.白芍总苷治疗干燥综合征的有效性和安全性评价[J].安徽医学,2006,(05)：370-371.
[64]李春蕾,何菁,华红.中药白芍总苷预防非肥胖型糖尿病小鼠自发性涎腺炎的研究[J].华西口腔医学杂志,2011,(02)：187-190.
[65]朱士龙,陈迪钊,李勇,等.青藤碱最新研究进展[J].吉首大学学报(自然科学版),2011,(05)：95-100.
[66]姚骥如,孙莹,罗顺葵,等.雷公藤多苷的临床应用进展[J].中国新药与临床杂志,2010,(03)：179-182.
[67]柯晓云,张汗承.口服雷公藤多甙治疗Sjogren综合征的疗效观察[J].中国实用眼科杂志,2007,25(03)：315-316.
[68]于璐,张燕,陈程,等.针灸防治哮喘的免疫调节机制研究进展[J].长春中医药大学学报,2010,(04)：615-617.
[69]白桦,唐强.针灸治疗干燥综合征20例[J].针灸临床杂志,2006,(02)：18.
[70]唐有为.主诉干燥症状的干燥综合征患者的针刺治疗效果[J].国外医学·中医中药分册,2000,22,01)：59.
[71]刘维,刘滨,郑红霞.针灸治疗干燥综合征60例疗效观察[J].中国针灸,2005,(02)：33-34.
[72]杜革术.针刺治疗干燥综合征40例临床观察[J].中医药导报,2010,16(10)：61-62.
[73]王颖.针灸治疗干燥综合征15例[J].吉林中医药,2007,27(5)：37.
[74]黄建成,任新华.胸腺肽穴位注射治疗舍格林氏综合征24例[J].中医外治杂志,2000,9(02)：19.
[75]郭凤芹,华红.干燥综合征的中医治疗进展[J].现代口腔医学杂志,2003,17(04)：359.
[76]徐宜厚.针药并治SS11例[J].中医杂志,1990,31(08)：42-43.
[77]许杨,赵英凯,程建斌.从三焦辨证治疗干燥综合征的思路与方法[J].中国针灸,2006,26(1)：57-60.
[78]赵学萍；中医内调外治治疗干燥综合征体会[J].中华中医药杂志,2011,(08)：886-888.
[79]何庆勇.针药并用治疗干燥综合征23例[J].中国针灸,2007,27(01)：38-38.
[80]王玲.中药配合针灸辨证治疗干燥综合征[J].中国中医药信息杂志,2007,(12)：86-87.
[81]边晓东,王寿椿,罗开涛.针药结合治疗干燥综合征60例[J].山东中医杂志,2011,(03)：178-179.
[1]张乃峥,曾庆馀,张凤山,等.中国风湿性疾病流行情况的调查研究[J].中华风湿病学杂志,1997,1(01)：34-38.
[2]Bowman SJ, Ibrahim GH, Holmes G, et al. Estimating the prevalence among Caucasian women of primary Sjogren's syndrome in two general practices in Birmingham, UK[J]. Scand J Rheumatol,2004,33:39～ 43.
[3]Alamanos Y, TsifetakiN, Voulgari PV, et al. Epidemiology of primary Sjogren's syndrome in north-west Greece,1982～2003 [J]. Rheumatology (Oxford),2006,45:187～91.
[4]Westhoff G, Zink A. Epidemiology of pr imary Sjbrgren's syndrome [J].Z Rheumatol,2010,69 (01):41～9.
[5]Goransson L, Haldorsen K, Brun J, et al. The point prevalence of clinically relevant primary Sjogren's syndrome in two Norwegian counties[J]. Scand J Rheumatol,2011,40:221-4.
[6]胡银秀,陆亚华,郑善翠.120例原发性干燥综合征临床特点分析[J].临床荟萃,2011,(08)：704-706.
[7]Fox P C, Bowman S J, Segal B, et al. Oral involvement in primary Sjogren syndrome [J]. J Am Dent Assoc,2008,139(12):1592～1601.
[8]竺红,赵岩,董怡,等.原发性干燥综合征的心脏病变[J].中国误诊学杂志,2002,2(12)：1820-1821.
[9]赵岩,董怡,郭晓萍,等.原发性干燥综合征的临床分析[J].北京医学,1997,19(02)：100-104.
[10]Sung MJ, Park SH, Kim SK, et al. Complete atrioventricular block in adult Sjogren's syndrome with anti-Ro autoantibody[J]. Korean J Intern Med,2011,26 (02):213～5.
[11]王志敏.以心包积液为首发表现的干燥综合征误诊为结核性心包炎[J].临床误诊误治,2011,(06)：49-50.
[12]Friedman JA, Miller EB, Green L, et al. A community based cohort of 201 consecutive patients with primary Sjogren's syndrome in Israel:Ashkenazi patients compared with those of Sephardic descent [J].Clin Exp Rheumatol,2006,24:274～80.
[10]Ramos M, Cervera R, Garcia-Carraso M, et al. Primary Sjogren's syndrome:clinical and immunologic study of 80 patients[J]. Med Clin (Bare),1997,108:652～7.
[11]杨瑞红,何权瀛,高占成.原发性干燥综合征合并间质性肺病38例临床分析[J].江西医药,2011,(09)：786-788.
[12]Sarkar PK, Patel N, Furie RA, et al. Pulmonary manifestations of primary Sjogren's syndrome[J]. Indian J Chest Dis Allied Sci 2009,51 (02):93～101.
[13]白久武,李惠萍,徐金富.继发于干燥综合征的间质性肺病21例临床分析[J].临床肺科杂志,2010,(03)：320-322.
[14]Segal B, Carpenter A, Walk D. Involvement of nervous system pathways in primary Sjogren's syndrome [J]. Rheum Dis Clin North Am,2008,34 (04):885-906, viii.
[15]Lafitte C, Amoura Z, Cacoub P, et al. Neurological complications of primary Sjogren's syndrome [J]. Neurol,2001,248:577～584.
[16]徐欣萍,董怡,陈元方.干燥综合征消化系临床表现80例分析[J].中华消化杂志,1996,16(01)：29-31.
[17]郑明英,陈武,董晓枫,等.原发性干燥综合征的消化系统表现[J].中国现代医学杂志,2006,(23)：3665.
[18]朱春兰,赵阴环,田素礼,等.原发性干燥综合征胃黏膜病理特点分析[J].中华风湿病学杂志,2004,(02)：88-91.
[19]Fox RI. Sjogren's syndrome [J]. Lancet,2005,366:321～31.
[20]Teramoto N, Katayama I, Arai H, et al. Annular erythema:possible association with primarySjogren's syndrome[J]. J Am Acad Dermatol, 1989,20:596～601.
[21]Katayama I, Teramoto N, Arai H, et al.Annular erythema:a comparative study of Sjogren's syndrome wi th subacute cutaneous lupus erythematosus[J]. Int J Dermatol,1991,30:635～9.
[22]Katayama I, Yamamoto T, Otoyama K, et al.Clinical and immunological analysis of annular erythema associated with Sjogren's syndrome [J]. Dermatology,1994,189:147.
[23]Ost lere LS, Harris D, Rustin MH. Urt icated annular erythema:a new manifestation of Sjogren's syndrome [J]. Clin Exp Dermatol,1993, 18:50～1.
[24]. Haimowitz JE, McCauliffe DP, Seykora J, et al. Annular erythema of Sjogren's syndrome in a white woman [J]. J Am Acad Dermatol,2000, 42:1069～73.
[25]De Winter S, van Buchem M, Vermer MH. Annular erythema of Sjogren' s syndrome [J]. Lancet,2006,367:1604.
[26]Ruzicka T, Faes J, Bergner T, et al.Annular erythema associated with Sjogren's syndrome:a variant of systemic lupus erythematosus [J]. J Am Acad Dermatol,1991,25:557～60.
[27]Lazarus MN, Robinson D, Mak V, et al. Incidence of cancer in a cohort of patients with primary Sjogren's syndrome [J]. Rheumatology 2006; 45:1012～5.
[28]Kassan SS, Thomas TL, Moutsopoulos HM, et al. Increased risk of lymphoma in sicca syndrome [J]. Ann Intern Med,1978,89:888～92.
[29]Kauppi M, Pukkala E, Isomaki H. Elevated incidence of hematologic malignancies in patients with Sjogren's syndrome compared with patients with rheumatoid arthritis (Finland) [J]. Cancer Causes Control,1997,8:201～4.
[30]Vinagre F, Santos MJ, Prata A, et al. Assessment of salivary gland function in Sjogren's syndrome:the role of salivary gland scintigraphy [J]. Autoimm Rev,2009,8:672～6.
[31]Voulgarelis M, Dafni UG, Isenberg DA, et al. Ma li gnant lymphoma in primary Sjogren's syndrome. Amulticenter, retrospective, clinical study by the European Concerted Action of Sjogren's syndrome[J]. Arthritis Rheum,1999,42:1765～72
[32]Sutcliffe N, Inane M, Speight P, et al. Predictors of lymphoma development in primary Sjogren's syndrome[J]. Semin Arthritis Rheum,1998,28:80～7.
[33]Royer B D, Cazals-Hatem J, Sibilila F, et al. Lymphomas in patients with Sjogren's syndrome are marginalzone B cell neoplasms, arise in diverse extranodal and nodal sites, and are not associated with viruses [J]. Blood,1997,90:766～75.
[34]Skopouli FN, Dafni U, Ioannidis JPA, et al. Clinical evolution, and morbidity and mortality of primary Sjogren's syndrome[J]. Semin Arthritis Rheum,2000,29:296～304.
[35]董怡,张乃峥.干燥综合征的肾脏损害[J].中华内科杂志,1988,27(03)：162-164.
[36]刘正钊；胡伟新；章海涛；鲍浩；刘志红；原发性干燥综合征肾损害的临床病理特征及预后[J].肾脏病与透析肾移植杂志,2010,(03)：225-229+251.
[37]Saugar Maripuri, Joseph P. Grande, Thomas G. Osborn, et al. Renal Involvement in Primary Sjogren's Syndrome:A Clinicopathologic Study [J]. Clin J Am Soc Nephrol,2009,4 (09):1423～1431.
[38]Jara LJ, Navarro C, Brito-Zeron Mdel P, et al. Thyroid disease in Sjogren's syndrome [J]. Clin Exp Rheumatol,2007,25(03):378～ 84.
[39]Morrow J, Nelson L, Watts R, et al. (1999) Sjogren's syndrome. In:Morrow J, Nelson L, Watts R, et al. (eds) Autoimmune rheumatic diseases,2nd edn. Oxford University Press, Oxford, pp 147～169.
[40]张嵩,刘桂玲,黄杰,等.以血小板减少首诊的干燥综合征7例临床分析[J].淮海医药,2011,(01)：27-28.
[41]程韬；陈志伟；原发性干燥综合征合并血小板减少85例分析[J].江苏医药,2011,(03)：345-347.
[42]任敏,武加标,肖菁.原发性干燥综合征并粒细胞缺乏一例报告[J].临床误诊误治,2011,(01)：42-43.
[43]谢雯.原发性干燥综合征血液系统损害临床特点[J].现代实用医学,2002,(08)：409-410.
[44]王亮；王迁；秦岭；冷晓梅；蒋颖；庄俊玲；原发性干燥综合征合并骨髓异常增生综合征1例[J].中华临床免疫和变态反应杂志,2011,(02)：151-153.
[45]Priori R, Medda E, Conti F, et al. Risk factors for Sjogren's syndrome:a case-control study[J]. Clin Exp Rheumatol,2007,25 (03):378～84.
[46]Bolstad AI, Wassmuth R, Haga HJ, et al. HLA markers and clinical characteristics in Caucasians with primary Sjogren's syndrome [J]. J Rheumatol,2001,28:1554～62.
[47]Fye KH, Terasaki PI, MichalskiJP, et al. Relationshipp of HLA-Dw3 and HLA-B8 to Sjogren's syndrome[J]. Arthritis Rheum,1978,21: 337～42.
[48]Mann DL, Moutsopoulos HM. HLA DR alloantigens in different subsets of patients with Sjogren's syndrome and in family members [J]. Ann Rheum Dis,1983,42:533～6.
[49]张雄鹰,宋秀珍,秦雄伟,等.山西汉族原发性干燥综合征与HLA-DQ基因多态性相关性的研究[J].细胞与分子免疫学杂志,2011,(02)：182-185.
[49]Reveille JD, Macleod MJ, W hittington K, et al. Specific amino acid residues in the second hypervariable region of HLA-DQA1 and DQB1 chain genes promote the Ro (SS-A)/La (SS-B) autoantibody responses [J]. J Immunol,1991,146:3871～6.
[50]Miceli-Richard C, Comets E, Loiseau P, et al. Association of an IRF5 gene functional polymorphism with Sjogren's syndrome [J]. Arthritis Rheum,2007,56:3989～94.
[51]Nordmark G, Kristjansdottir G, Theander E, et al.Additive effects of the major risk alleles of IRF5 and STAT4 in primary Sjogren's syndrome [J]. Genes Immun,2009,10:68～76.
[52]Korman BD, Alba MI, Le JM, et al. Variant form of STAT4 is associated with primary Sjogren's syndrome [J]. Genes Immun,2008, 9:267～70.
[53]Nordmark G, Kristjansdottir G, Theander E, et al. Association of EBF1, FAM167A (C8orf 13)-BLK and TNFSF4 gene variants with primary Sjogren's syndrome [J]. Genes Immun,2011,12:100～9.
[54]Maiti AK, Kim-Howard X, Viswanathan P, et al. Confirmation of an association between rs6822844 at the 112-1121 region and multiple autoimmune diseases:evidence of a general susceptibi lity locus[J]. Arthritis Rheum,2010,62(02):323～9.
[55]李恩泽,辛苗苗,胡彬,等.IL-18基因多态性与原发性干燥综合征的相关性[J].青岛大学医学院学报,2010,(04)：333-335+338.
[56]Toussirot E, Roudier J. Epstein-Barr virus in autoimmune diseases [J]. Best Pract Res Clin Rheumatol,2008,22 (05):883～ 96.
[57]Talal N, DauphineeMJ, Dang H, et al. Detect ion of serum antibodies to retroviral proteins in patients with primary Sjogren's syndrome (autoimmune exocrinopathy) [J]. Arthritis Rheum,1990,33:774～ 81.
[58]Saito I, Nishimura S, Kudo I, et al. Detection of Epstein-Barr virus and human herpes virus type 6 in saliva from patients with lymphoproliferative diseases by the polymerase chain reaction[J]. Arch Oral Biol,1991,36:779～84.
[59]Couty JP, Ranger-Rogez S, Vidal E, et al. Study of HHV-8 in primary Sjogren's syndrome[J]. Clin Exp Rheumatol,1997,15:333～4.
[60]Shillitoe EJ, Daniels TE, Whitcher JP, et al. Antibody to cytomegalovirus in patients with Sjogren's syndrome [J]. As determined by an enzyme-linked immunosorbent assay, Arthritis Rheum,1982,25:260～5.
[61]Shattles WG, Brookes SM, Venables PJ, et al. Expression of ant igen reactive with a monoclonal antibody to HTLV-1 P19 in salivary glands in Sjogren's syndrome [J]. Clin Exp Immunol,1992,89:46～51.
[62]Triantafyllopoulou A, Tapinos N, Moutsopoulos HM. Evidence for coxsackievirus infection in primary Sjogren's syndrome [J]. Arthritis Rheum,2004,50:2897～902.
[63]Wen S, Shimizu N, Yoshiyama H et al. Association of Epstein-Barr virus (EBV) with Sjogren's syndrome:different ial EBV expression between epithelial cells and lymphocytes in salivary glands [J]. (1996) Am J Pathol,149:1511～1517.
[64]Maitland N, Flint S, Scully C, et al. Detection of cytomegalovirus and Epstein-Barr virus in labial salivary glands in Sjogren's syndrome and non-specific sialadenitis [J].1995, J Oral Pathol Med 24:293～298.
[65]Venables P J, Teo C G, Baboonian C, et al. Persistence of Epstein-Barr virus in salivary gland biopsies from healthy individuals and patients with Sjogren's syndrome [J]. Cl in Exp Immunol,1989,75(03): 359～364.
[66]Crane IJ, Forrester JV. Thl and Th2 lymphocytes in autoimmune disease[J]. Crit Rev Immunol,2005,25:75～102.
[67]Brookes SM, Cohen SB, Price EJ, Webb LM, Feldmann M, Maini RN, Venables PJ. T cell clones from a Sjogren's syndrome salivary gland biopsy produce high levels of IL-10 [J]. Clin Exp Immunol,1996,103: 268～72.
[68]Bave U, Nordmark G, Lovgren T, et al.Activation of the type I interferon system in primary Sjogren's syndrome:a possible etiopathogenic mechanism[J]. Arthritis Rheum,2005,52:1185～95.
[69]Gottenberg JE, Cagnard N, Lucchesi C, et al. Activation of IFN pathways and plasmacytoid dendritic cell recrui tment in target organs of primary Sjogren's syndrome[J]. Proc Natl Acad Sci U S A,2006, 103:2770～5.
[70]Wildenberg ME, van Helden-Meeuwsen CG, van de Merwe JP, et al. Systemic increase in type I interferon activity in Sjogren's syndrome:a putative role for plasmacytoid dendritic cells [J]. Eur J Immunol,2008,38:2024～33.
[71]Oxholm P, Daniels TE, Bendtzen K. Cytokine expression in labial salivary glands from patients with primary Sjogren's syndrome[J]. Autoimmunity,1992,12:185～91.
[72]Emamian ES, Leon JM, Lessard CJ,et al. Peripheral blood gene expression profiling in Sjogren's syndrome[J]. Genes Immun,2009 10 (04):285～96.
[73]Anaya JM, Mantilla RD, Correa PA. Immunogenetics of primary Sjogren' s syndrome in Colombians[J]. Semin Arthritis Rheum,2005,34:735～ 43.
[74]Szodoray P, Alex P, Jonsson MV, et al. Distinct profiles of Sjogren' s syndrome patients with ectopic salivary gland germinal centers revealed by serum cytokines and BAFF[J]. Clin Immunol,2005,117: 168～76.
[75]Shiozawa S, Shiozawa K, Shimizu S, et al. Immunoreactive circulating alpha-interferon is low in Sjogren's syndrome[J]. Br J Rheumatol, 1990,29:50～2.
[76]Hemmer B, Nessler S, Zhou D, et al. Immunopathogenesis and immunotherapy of multiple sclerosis [J]. Nat Clin Pract Neurol,2006,2:201～11.
[77]Schulze-Koops H, Kalden JR. The balance of Th1/Th2 cytokines in rheumatoid arthritis[J]. Best Pract Res Clin Rheumatol,2001,15: 677～91.
[78]Baccala R, Kono DH, Theofilopoulos AN. Interferons as pathogenic effectors in autoimmunity[J]. Immunol Rev,2005,204:9～26.
[79]Wu AJ, Kurrasch RH,Katz J,et al. Effect of tumor necrosis factor-alpha and interferon-gamma on the growth of a human salivary gland cell line[J]. J Cell Physiol,1994,161:217～26.
[80]van Woerkom JM, Kruize AA, Wenting-van Wijk MJ, et al. Salivary gland and peripheral blood T helper 1 and 2 cell activity in Sjogren' s syndrome compared with non-Sjogren's sicca syndrome [J]. Ann Rheum Dis,2005,64:1474～9.
[81]Wakamatsu E, Nakamura Y, Matsumoto I, et al. DNA microarray analysis of labial salivary glands of patients with Sjogren's syndrome [J]. Ann Rheum Dis,2007,66:844～5.
[82]Dinarello CA. Interleukin-18 and the pathogenesis of inflammatory diseases [J]. Semin Nephrol,2007,27:98～114.
[83]Bombardieri M, Barone F, Pittoni V, et al. Increased circulating levels and salivary gland expression of interleukin-18 in patients with Sjogren's syndrome:relationship with autoantibody production and lymphoid organization of the periductal inflammatory infiltrate[J]. Arthritis Res Ther,2004,6:R447～56.
[84]Eriksson P, Andersson C, Ekerfelt C, et al. Sjogren's syndrome with myalgia is associated with subnormal secretion of cytokines by peripheral blood mononuclear cells [J]. J Rheumatol,2004,31:729～ 35.
[85]Sakai A, Sugawara Y, Kuroishi T, et al. Identification of IL-18 and Th17 cells in salivary glands of patients with Sjogren's syndrome, and amplification of IL-17-mediated secretion of inflammatory cytokines from salivary gland cells by IL-18 [J]. J Immunol,2008, 181:2898～906.
[86]Kolkowski EC, Reth P, Pelusa F, et al. Thl predominance and perforin expression in minor salivary glands from patients with primary Sjogren's syndrome [J]. J Autoimmun,1999,13:155～62.
[87]Manoussakis MN, Boiu S, Korkolopoulou P, et al. Rates of infiltration by macrophages and dendritic cells and expression of interleukin-18 and interleukin-12 in the chronic inflammatory lesions of Sjogren' s syndrome:correlation with certain features of immune hyper activity and factors associated with high risk of lymphoma development[J]. Arthritis Rheum,2007,56:3977～88.
[88]Kamachi M, Kawakami A, Yamasaki S, et al. Regulation of apoptotic cell death by cytokines in a human salivary gland cell line:distinct and synergistic mechanisms in apoptosis induced by tumor necrosis factor alpha and interferon gamma[J]. J Lab Clin Med,2002,139: 13～9.
[89]Kulkarni K, Selesniemi K, Brown TL. Interferon-gamma sensitizes the human salivary gland cell line, HSG, to tumor necrosis factor-alpha induced activation of dual apoptotic pathways [J]. Apoptosis,2006, 11:2205～15.
[90]McArthur C, Wang Y, Veno P, et al. Intracellular trafficking and surface expression of SS-A (Ro), SS-B (La), poly (ADP-ribose) polymerase and alpha-fodrin autoantigens during apoptosis in human salivary gland cells induced by tumour necros is factor-alpha [J]. Arch Oral Biol,2002,47:443～8.
[91]Moutsopoulos NM, Katsifis GE, Angelov N, et al. Lack of efficacy of etanercept in Sjogren's syndrome correlates with failed suppression of tumour necrosis factor alpha and systemic immune activation[J]. Ann Rheum Dis,2008,67(10):1437～1443.
[92]Garcic-Carrasco M, Font J, Filella X, et al. Circulating levels of Thl/Th2 cytokines in patients with primary Sjogren's syndrome: correlation with clinical and immunological features[J]. Clin Exp Rheumatol,2001,19:411～5.
[93]Ek M, Popovic K, Harris HE, et al. Increased extracellular levels of the novel proinflammatory cytokine high mobility group box chromosomal protein 1 in minor salivary glands of patients with Sjogren's syndrome [J]. Arthritis Rheum,2006,54:2289～94.
[94]Ishihara K, Hirano T.IL-6 in autoimmune disease and chronic inflammatory proliferative disease [J].Cytokine Growth Factor Rev, 2002,13:357～68.
[95]Chen Q, Fisher DT, Clancy KA, et al. Fever-range thermal stress promotes lymphocyte trafficking across high endothelial venules via an interleukin 6 trans-signaling mechanism[J]. Nat Immunol,2006,7: 1299～308.
[96]Boras VV, Cikes N, Lukac J, et al. The significance of salivary and serum interleukin 6 and basic fibroblast growth factor levels in patients with Sjogren's syndrome [J]. CollAntropol,2004,28 (Suppl 2):305～9.
[97]Vucicevic Boras V, Brailo V, Lukac J, et al. Sal ivary inter leukin-6 and tumor necrosis factor alpha in patients with drug-induced xerostomia [J]. Oral Dis,2006; 12:509～11.
[98]Boras VV, Brailo V, Lukac J, et al. Salivary interleukin-6 and tumor necrosis factor-alpha in patients with burning mouth syndrome [J]. Oral Dis,2006,12(03):353～5.
[99]Gross JA, Johnston J, Mudri S, et al. TACI and BCMA are receptors for a TNF homologue implicated in B-cell autoimmune disease[J]. Nature, 2000,404:995～9.
[100]Daridon C, Devauchelle V, Hutin P, et al. Aberrant expression of BAFF by B lymphocytes infiltrating the salivary glands of patients with primary Sjogren's syndrome [J]. Arthritis Rheum,2007,56:1134～ 44.
[101]Pers JO, Devauchelle V, Daridon C, et al. BAFF-modulated repopulation of B lymphocytes in the blood and salivary glands of rituximab-treated patients with Sjogren's syndrome [J]. Arthritis Rheum,2007,56:1464～77.
[102]Szodoray P, Alex P, Brun JG, et al. Circulat ing cytokines in primary Sjogren's syndrome determined by a multiplex cytokine array system[J]. Scand J Immunol,2004,59 (06):592～9.
[103]Annunziato F, Cosmi L, Santarlasci V, et al. Phenotypic and functional features of human Th17 cells [J]. J Exp Med,2007,204: 1849～61.
[104]Wilson NJ, Boniface K, Chan JR, et al. Development, cytokine prof ile and function of human inter leuk in 17-producing helper T cells [J]. Nat Immunol,2007,8:950～7.
[105]Steinman L. A brief history of T (H) 17, the first major revision in the T(H) 1/T (H) 2 hypothesis of T cell-mediated tissue damage [J]. Nat Med,2007,13:139～45.
[106]Wahl SM. Transforming growth factor-beta:innately bipolar [J]. Curr Opin Immunol,2007,19:55～62.
[107]Ogawa N, Dang H, Lazaridis K, et al. Analysis of transforming growth factor beta and other cytokines in autoimmune exocrinopathy (Sjogren's syndrome) [J]. J Interferon Cytokine Res,1995,15:759～ 67.
[108]Kolkowski EC, Reth P, Pelusa F, et al. Thl predominance and perforin expression in minor salivary glands from patients with primary Sjogren's syndrome [J]. J Autoimmun,1999,13:155～62.
[109]van Woerkom JM, Kruize AA, Wenting-van Wijk MJ, et al. Salivary gland and peripheral blood T helper 1 and 2 cell activity in Sjogren' s syndrome compared with non-Sjogren's sicca syndrome [J]. Ann Rheum Dis,2005,64:1474～9.
[110]Sharif MN, Tassiulas I, Hu Y, et al. IFN-alpha priming results in a gain of proinflammatory function by IL-10:implications for systemic lupus erythematosus pathogenesis [J]. J Immunol,2004,172:6476～ 81.
[111]Rousset F, Peyrol S, Garcia E, et al. Long-term cultured CD40-activated B lymphocytes differentiate into plasma cells in response to IL-10 but not IL-4 [J]. Int Immunol,1995,7:1243～53.
[112]Anaya JM, Mantilla RD, Correa PA. Immunogenetics of primary Sjogren's syndrome in Colombians[J]. Semin Arthritis Rheum,2005, 34:735～43.
[113]Bertorello R, Cordone MP, Contini P, et al. Increased levels of interleukin-10 in sal iva of Sjogren's syndrome patients. Correlation with disease activity [J]. Clin Exp Med,2004,4:148～51.
[114]Rachel. L Redfern, Alison M. McDermott. Toll-Like Receptors in Ocular Surface Disease [J]. Exp Eye Res,2010 June; 90 (6):679～ 687.
[115]郑凌艳,张志愿,俞创奇,等.Toll样受体7、8、9在原发性舍格伦综合征中的表达[J].中国口腔颌面外科杂志,2011,(02)：101-107.
[116]Spachidou M P, Bourazopoulou E, Maratheftis CI, et al. Expression of functional Toll-like receptors by salivary gland epithelial cells: increased mRNA expression in cells derived from patients with primary Sjogren's syndrome [J]. Cl in Exp Immunol,2007,147(03):497～503.
[117]Hasegawa M, Inoue A, Kohno M, et al. Antagonist of interferon-inducible protein 10/CXCL10 amelio rates the progression of autoimmune sialadenitis in MRL/lpr mice [J]. Arthritis Rheum,2006,54:1174～ 83.
[118]Dawson L, Tobin A, Smith P, et al. Antimuscarinic antibodies in Sjogren's syndrome:where are we, and where are we going? [J]. Arthritis Rheum,2005,52:2984～2995.
[119]WalchL, Brink C, Norel X. Themuscarinicreceptor subtypes in human bloodvessels [J]. Therapie,2001,56(03):223～226.
[120]Beroukas D, GoodfellowR, Hiscock J, et al.UP-regulation of M3-muscarinicreceptorsin labial salivary gland acini in primary Sjogren's syn-drome [J]. Lab Invest,2002; 82(02):203～210.
[121]Ubels JL, Hoffman HM, Srikanth S et al. Geneexpress ion in rat lacrimal glandduct cells collectedusinglaser capturemicrodissection evidencefor K+secretion by duct cells [J]. Invest Ophthalmol VisSci, 2006,47 (05):1876～1885.
[122]Berggreen E, Nylokken K, Delaleu N et al. Impairedvascular responses to parasympathetic nerve stimulation and muscarinic receptor activationin the submandibular gland in nonobese diabeticmice [J]. Arthritis Res Ther,2009,11 (01):1～12.
[123]罗慧臣,李萍,肖卫国.M3R与AQP5在干燥综合征患者唇腺中的表达与意 义[J].中国免疫学杂志,2011,(01)：79-81+87.
[124]MaT, SongY, GillespieAet al.Defective secretion of salivaintransgenic mice lacking aquaporin-5 water channels [J]. J Biol Chem,1999,274 (29):20071～20074.
[125]Konttinen YT, Tensing EK, Laine Met al. Abnormal distribution of aquaporin-5 in salivaryglands in the NOD mouse model for Sjogren' s syndrome [J]. J Rheumatol,2005,32(06):1071～1075.
[126]Cai FZ, Lester S, Lu T, et al. Mild autonomic dysfunction in primary Sjogren's syndrome:a controlled study [J]. Arthritis Res Ther,2008, 10:R31.
[127]Mandl T, Granberg V, Apelqvist J, et al. Autonomic nervous symptoms in primary Sjogren's syndrome [J]. Rheumatology (Oxford),2008,47: 914～919.
[128]Barendregt PJ, Visser MR, Smets EM, et al. Fatigue in primary Sjogren's syndrome[J]. Ann Rheum Dis,1998,57:291～295.
[129]Andonopoulos AP, Christodoulou J, Ballas C, et al. Autonomic cardiovascular neuropathy in Sjogren's syndrome:a controlled study [J].J Rheumatol,1998,25:2385～2388.
[130]Kovacs L, Papos M, Takacs R, et al. Autonomic nervous system dysfunction involving the gastrointestinal and the urinary tracts in primary Sjogren's syndrome [J]. Clin Exp Rheumatol,2003,21:697～ 703.
[131]赵岩,贾宁,魏丽,等.原发性干燥综合征2002年国际分类(诊断)标准的临床验证[J].中华风湿病学杂志,2003,(09)：537-540.
[132]Ramos-Casals M, Tzioufas AG, Font J. Primary Sjogren's syndrome: new clinical and therapeutic concepts[J]. Ann Rheum Dis,2005,64 (03):347～354.
[133]翦新春.口干综合征(Sjogren's Syndrome)口干的治疗[J].临床口腔医学杂志.2003(06)：377-379.
[134]Leung KC, McMillan AS, Wong MC, et al. The efficacy of cevimeline hydrochloride in the treatment of xerostomia in Sjogren's syndrome in southern Chinese patients:a randomised double-blind placebo-controlled crossover study[J]. Clin Rheumatol,2008,27 (04):429～36.
[135]Fife RS, Chase W F, Dore R K et al. Cevimeline for the Treatment of Xerostomia in Patients With Sjogren Syndrome. a randmized trial [J]. Arch Intern Med,2002,162:1293～1300.
[136]Cankaya H, Alpoz E, Karabulut G, et al. Effects of hydroxychloroquine on salivary flow rates and oral complaints of Sjogren patients:a prospective sample study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod[J].2010,110 (01):62～7.
[137]马艳,厉小梅,王玮,等.M3受体激动剂治疗干燥综合征的临床观察[J].安徽医药,2010,(10)：1212-1213.
[138]孙京华,刘常明,王慧,等.环孢素A滴眼液治疗结膜干燥综合征小鼠的机制[J].医药导报,2006,(07)：626-628.
[139]Moutsopoulos NM, Katsifis GE, Angelov N, et al. Lack of efficacy of etanercept in Sjogren syndrome correlates with failed suppression of tumour necrosis factor alpha and systemic immune activation [J]. Ann Rheum Dis,2008,67(10):1437～43.
[140]Mavragani CP, Niewold TB, Moutsopoulos NM, et al. Augmented interferon-alpha pathway activation in patients with Sjogren's syndrome treated with etanercept [J]. Arthri tis Rheum,2007,56(12): 3995～4004.
[141]Meijer JM, Meiners PM, Vissink A, et al. Effectiveness of ri tuximab treatment in primary Sjogren's syndrome:a randomized, double-blind, placebo-controlled trial [J]. Arthri t is Rheum,2010,62(04):960-8.
[142]Devauchelle-Pensec V, Morvan J, Rat AC, et al. Effects of rituximab therapy on quality of life in patients with primary Sjogren's syndrome [J]. Cl in Exp Rheumatol,2011,29(01):6～12.
[143]Sugai S, Takahashi H, Ohta S, et al. Efficacy and safety of rebamipide for the treatment of dry mouth symptoms in patients with Sjogren's syndrome:a double-blind placebo-controlled multicenter trial[J]. Mod Rheumatol,2009,19(02):114～24.
[144]Nakayamada S, Fujimoto T, Nonomura A, et al. Usefulness of initial histological features for stratifying Sjogren's syndrome responders to mizoribine therapy [J]. Rheumatology (Oxford),2009,48 (10): 1279～82.
[145]Nakayamada S, Saito K, Umehara H, et al. Efficacy and safety of mizoribine for the treatment of Sjogren's syndrome:a multicenter open-label clinical trial [J].Mod Rheumatol,2007,17(06):464～9.
[1]母小真.陈湘君治疗干燥综合征的经验[J].辽宁中医杂志,2002,29(01)：11.
[2]张绪磊.40例干燥综合征的阴虚舌象分析[J].江苏中医杂志,2005,3(01)：28.
[3]孙素平,潘文萍,周翠英.试论干燥综合征以燥毒为本[J].山东中医杂志2001,20(10)：581.
[4]赵丽娟,李振吉,王洵.补脾益气及阴阳双补法治疗干燥综合征[J].中医杂志,2005,26(06)：41.
[5]马武开.干燥综合征辨证分型探讨[J].光明中医,2001,16(01)：30.
[6]顾勤,刘菊妍.张仲瑛教授治疗干燥综合征经验介绍.新中医[J],2002,34(09)：7.
[7]朱跃兰.干燥综合征从瘀毒论治机理初探[J].中华中西医结合杂志,2006,12(07)：1120.
[8]朱跃兰,韦尼,侯秀娟.活血解毒方治疗干燥综合征63例临床观察.北京中医药大学学报(中医临床版),2010,17(05)：1.
[9]Seror R, Ravaud P, Bowman SJ, et al.EULAR Sjogren's syndrome disease activity index:development of a consensus systemic disease activity index for primary Sjogren's syndrome [J]. Ann Rheum Dis,2010 June, 69 (06):1103～1109.
[10]Campar A, Isenberg D A. Primary S jogren's syndrome activity and damage indices comparison [J]. Eur J Clin Invest,2010,40 (07):636～ 644.
[1]Makino S, Kunimoto K, Muraoka Y, et al.Breeding of a non-obese, diabetic strain of mice[J]. Jikken Dobutsu,1980,29(01):1～13.
[1]Anaya JM, Mantilla RD, Correa PA. Immunogenetics of primary Sjogren' s syndrome in Colombians[J]. Semin Arthritis Rheum,2005,34:735～ 43.
[2]Miyasaka N, Murota N, Yamaoka K, et al.Interleukin 2 defect in the peripheral blood and the lung in patients with Sjogren's syndrome [J].Clin Exp Immunol.1986, September,65 (03):497～505.
[3]Schloot NC, Hanifi-Moghaddam P, Goebel C, et al. Serum IFN-gamma and IL-10 levels are associated with disease progression in non-obese diabetic mice [J].Diabetes Metab Res Rev,2002,18(01):64～70.
[4]Yamanouchi J, Rainbow D, Serr P a,et al. Interleukin-2 gene variation impairs regulatory T cell function and causes autoimmunity[J]. Nat. Genet,2007,39:329～337.
[1]Schmittgen T D. Real-time quantitative PCR [J]. Methods,2001,25 (04):383～385.
[2]Humphreys-Beher MG, Hu Y, Nakagawa Y, et al. Utilization of the non-obese diabetic (NOD) mouse as an animal model for the study of secondary Sjogren's syndrome [J]. Adv Exp Med Biol 1994,350:631～636.
[3]Robinson CP, Yamachika S, Bounous DI, et al. A novel NOD-derived murine model of primary Sjogren's syndrome. Arthri t is Rheum 1998; 41:150～156.
[4]Hemmer B, Nessler S, Zhou D, et al.Immunopathogenesis and immunotherapy of multiple sclerosis [J]. Nat Cl in Pract Neurol,2006,2:201～11.
[5]Schulze-Koops H, Kalden JR. The balance of Thl/Th2 cytokines in rheumatoid arthritis[J]. Best Pract Res Clin Rheumatol,2001,15: 677～91.
[6]van Woerkom JM, Kruize AA, Went ing-van Wijk MJ, et al. Salivary gland and peripheral blood T helper 1 and 2 cell activity in Sjogren's syndrome compared with non-Sjogren's sicca syndrome [J]. Ann Rheum Dis,2005,64:1474～9.
[7]Wu AJ, Kurrasch RH, Katz J, et al. Effect of tumor necrosis factor-alpha and interferon-gamma on the growth of a human salivary gland cell line[J]. J Cell Physiol,1994,161:217～26.
[8]Schloot NC, Hanifi-Moghaddam P, Goebel C, et al. Serum IFN-gamma and IL-10 levels are associated with disease progression in non-obese diabetic mice[J]. Diabetes Metab Res Rev,2002,18 (01):64～70.
[9]Anaya JM, Mantilla RD, Correa PA. Immunogenetics of primary Sjogren' s syndrome in Colombians [J]. Semin Arthr it is Rheum,2005,34:735～ 43.
[10]Yamanouchi J, Rainbow D, Serr P a, et al. Inter leukin-2 gene variation impairs regulatory T cell function and causes autoimmunity [J].Nat. Genet,2007,39:329～337.
[11]张志利.IL-2对NOD鼠糖尿病的影响[J].中华微生物学和免疫学杂志,1994,14(03)：168-172.
[12]Killedar SJ, Eckenrode SE, Mclndoe RA,et al. Early pathogenic events associated with Sjogren's syndrome (SjS)-like disease of the nod mouse using microarray analysis [J]. Lab Invest,2006,86,1243～1260.
[2]赵丽娟,李振吉,王殉.补脾益气及阴阳双补法治疗干燥综合征[J].中医杂志,1985,(06)：41-42.
[3]秦长林.“顽燥”辨治[J].安徽中医临床杂志,2000,12(05)：351-353.
[4]马武开.干燥综合征的中医病因病机探讨[J].中医药研究,2000,(04)：2-3.
[5]路志正.治痹心得[C].2004,首届国际中西医结合风湿病学术会议：30-33.
[6]Reveille JD, MacleodMJ, Whittington K, et al. Specif ic amino acid residues in the second hypervariable region of HLA～DQA1 and DQB1 chain genes promote the Ro (SS-A)/La (SS-B) autoantibody responses. [J]J Immunol 1991; 146:3871～6.
[7]Priori R, Medda E, Conti F,et al. Risk factors for Sjogren's syndrome: a case-control study. Clin Exp Rheumatol.2007,25 (03):378～84.
[8]张雄鹰,宋秀珍,秦雄伟,等.山西汉族原发性干燥综合征与HLA-DQ基因多态性相关性的研究[J].细胞与分子免疫学杂志,2011,(02)：182-185.
[9]姜良铎,张文生.从毒论治初探[J].北京中医药大学学报,1998,21(05)：2-3.
[10]王永炎.关于提高脑血管疾病疗效难点的思考[J].中国中西医结合杂志,1997,17(04)：195-196.
[10]常富业,张允岭,王永炎,等.毒的概念诠释[J].中华中医药学刊,2008,26(09)：1897-1899.
[11]张允岭,郭蓉娟,王嘉麟,等.基于专家问卷的中医“毒”的特性分析.[J].中医杂志,2010,51(01)：27-29.
[12]路志正,焦树德.实用中医风湿病学[M].北京：人民卫生出版社.2001：269-285.
[13]郝炜欣,董振华.干燥综合征106例中医证候分类的研究.中国中医风湿病学杂志[M],2004,3(04)：61.
[14]秦长林.从干燥综合征看“燥必入血”的病变特点.山东中医杂志[M],2000,19(12)：710-712.
[15]骆天炯.刘永年教授治疗干燥综合征的经验[J].江苏中医药,2005,26(11)：7.
[16]王海隆,张显彬.冯兴华治疗干燥综合征经验[J].中国中医药信息杂志,2007,(05)：85
[17]潘文萍,周翠英.干燥综合征从燥毒论治理论探析[J].新中医,2010,42(04)：5-6.
[18]周唯.阴虚血瘀证探析[J].山东中医药大学学报,2007,31(3)： 2.中医杂志,1981,22(8)：31.
[19]刘健,孙桐.试论阴虚血瘀及滋阴活血法[J].南京中医药大学学报,1999,15(6)：331-332.
[20]谭达人.冠心病“阳虚”“阴虚”病人血液流变性的初步观察[J].中医杂志,1981,(08)：31-33.
[21]董振华.活血化瘀法在干燥综合征中的应用[J].北京中医,2001(03)：9-11.
[22]潘文奎.口眼干燥综合征的辨证论治[J].辽宁中医杂志,1998,5：21-23.
[23]钟起诚.干燥综合征之中医病因病机探讨[J].中国中医药信息杂志,2003,(02)： 73.
[24]赵美娥.调理阴阳法治疗干燥综合征.光明中医[J],2006,21(12)：88-89.
[25]何迅,陶巧林.干燥综合征的中医诊治近况[J].四川中医,2001,19(07)：14-16.
[26]许宁,周翠英.三焦辨证分治原发性干燥综合征[A].王承德.第十二届全国中医风湿病学术研讨会专辑[C].中国云南昆明：中国中医风湿病学杂志社,2008：163-164.
[27]路志正,焦树德,阎孝诚.痹病论治学[M].北京：人民卫生出版社.1989：281283.
[28]路志正,焦树德.实用中医风湿病学[M].北京：人民卫生出版社.2001：269-285.
[29]吴坚,朱良春.朱良春治疗干燥综合征经验[J].实用中医药杂志,2006,(08)：501.
[30]娄玉铃.中国风湿病学.北京：人民卫生出版社.2001：2209-2216.
[31]姜迎萍,李靖.干燥综合征的中医证治规律探讨[J].四川中医,2003,21(03)：14-15.
[32]郝伟欣,董振华.干燥综合征106例中医证候分类回顾性研究[J].中医杂志,2006,47(07)：528-530.
[33]杨香生,陈高材.干燥综合征的中医分型论治探讨[J].江西中医药,1989,(05)：26-28.
[34]傅宗翰,刘永年.干燥综合征的辨证施治规律[J].南京中医学院学报,1987,(3)：11-14.
[35]刘永年.干燥综合征的中医诊治与研究[M].北京：人民卫生出版社,2006：92-95.
[36]王承德,沈丕安,胡荫奇.实用中医风湿病学[M].北京：人民卫生出版社,2009：334-336.
[37]钱垠,金实.从肺论治干燥综合征.[J]南京中医药大学学报(自然科学版)2002,18(05)：268-269.
[38]丁德经；周学平；开泄法在干燥综合征中的运用[J].新中医,2010,(03)：10-11.
[39]吕慧为.健脾益气生津治疗原发性干燥综合征27例[J].山东中医药大学学报,2001,25(04)：288.
[40]茅建春,陈湘君,苏励,等.益气健脾法治疗原发性干燥综合征的临床观察[J].中国临床药学杂志,2007,(04)：231-233.
[41]徐愿,阎小萍.阎小萍治疗干燥综合征经验撷菁[J].中国中医药信息杂志,2010,(04)：88-89.
[42]母小真.陈湘君治疗干燥综合征的经验[J].辽宁中医杂志,2002,29(01)：11.
[43]刘国英.疏肝法治疗干燥综合征体会[J].中医杂志,1997,(03)：147.
[44]钟琴,马武开,刘正奇,等.从肺脾肝肾四脏调治干燥综合征.[J]贵阳中医学院学报,2008,30(04)：60-61.
[45]傅培红,章怡祎,张文群.顾仁樾教授治疗干燥综合征经验[J].河北中医,2007,(09)：776-777.
[46]李洁,杨兴智,亓鲁光.亓鲁光治疗干燥综合征经验[J].中医杂志,2010,(11)：978-979.
[47]潘新.干燥综合征的中医诊治体会[J].湖北中医学院学报,2007,9(01)：61.
[48]刘志勤.中医三步治疗干燥综合征述要[J].中医药学刊,2005,23(03)：545.
[49]张晓强,任文栋,李孟芳.化气布津法在治疗干燥综合征中的应用[J].新中医,2011,(10)：137-138.
[50]叶海军.从三焦论治干燥综合征[J].辽宁中医杂志,2004,31(06)：477.
[511陆瑾.陆安康教授治疗干燥综合征经验精粹[J].中医药学刊,2003,21(12)：1991-1992.
[52]马武开,蔺想成,王建华.马永祯治疗干燥综合征的经验.[J]安徽中医临床杂志,1998,10(06)：390.
[53]朱跃兰,韦尼,侯秀娟.活血解毒方治疗干燥综合征63例临床观察[J].北京中医药大学学报(中医临床版),2010,(05)：1-3.
[54]韩善夯,苏建玲.金实教授干燥综合征诊治经验[J].四川中医,2010,28(10)：1-2.
[55]陈爱萍.益气生津散治疗干燥综合征疗效观察[J].山西中医,2008,(05)：13-14.
[56]杜秀兰,宋绍亮.益气养阴润燥糖治疗干燥综合征10例[J].山东中医杂志,1994,13(12)：535.
[57]张水艳,李瑞,朱秀惠,等.金菊清润胶囊治疗原发性干燥综合征50例临床观察[J].中医杂志,2009,(08)：708-711.
[58]覃海；益胃汤合玉女煎加减治疗脾胃阴虚型原发性干燥综合征25例[J].广西中医学院学报,2010,(02)：13-15.
[59]廖承建.门冬清肺饮加减治疗干燥综合征[J].新中医,1999,31(04)：44.
[60]赵振兴,侯绍敏.加味引火汤治疗干燥综合征15例临床观察[J].河北中医,1998,20(01)：226-227.
[61]段波.益气养阴通络法治疗干燥综合征临床观察.湖北中医杂志,2011,33(06)：44-46.
[62]周强,栗占国.白芍总苷的药理作用及其在自身免疫性疾病中的应用[J].中国新药与临床杂志,2003,22(11)：96.
[63]厉小梅,李向培,汪国生,等.白芍总苷治疗干燥综合征的有效性和安全性评价[J].安徽医学,2006,(05)：370-371.
[64]李春蕾,何菁,华红.中药白芍总苷预防非肥胖型糖尿病小鼠自发性涎腺炎的研究[J].华西口腔医学杂志,2011,(02)：187-190.
[65]朱士龙,陈迪钊,李勇,等.青藤碱最新研究进展[J].吉首大学学报(自然科学版),2011,(05)：95-100.
[66]姚骥如,孙莹,罗顺葵,等.雷公藤多苷的临床应用进展[J].中国新药与临床杂志,2010,(03)：179-182.
[67]柯晓云,张汗承.口服雷公藤多甙治疗Sjogren综合征的疗效观察[J].中国实用眼科杂志,2007,25(03)：315-316.
[68]于璐,张燕,陈程,等.针灸防治哮喘的免疫调节机制研究进展[J].长春中医药大学学报,2010,(04)：615-617.
[69]白桦,唐强.针灸治疗干燥综合征20例[J].针灸临床杂志,2006,(02)：18.
[70]唐有为.主诉干燥症状的干燥综合征患者的针刺治疗效果[J].国外医学·中医中药分册,2000,22,01)：59.
[71]刘维,刘滨,郑红霞.针灸治疗干燥综合征60例疗效观察[J].中国针灸,2005,(02)：33-34.
[72]杜革术.针刺治疗干燥综合征40例临床观察[J].中医药导报,2010,16(10)：61-62.
[73]王颖.针灸治疗干燥综合征15例[J].吉林中医药,2007,27(5)：37.
[74]黄建成,任新华.胸腺肽穴位注射治疗舍格林氏综合征24例[J].中医外治杂志,2000,9(02)：19.
[75]郭凤芹,华红.干燥综合征的中医治疗进展[J].现代口腔医学杂志,2003,17(04)：359.
[76]徐宜厚.针药并治SS11例[J].中医杂志,1990,31(08)：42-43.
[77]许杨,赵英凯,程建斌.从三焦辨证治疗干燥综合征的思路与方法[J].中国针灸,2006,26(1)：57-60.
[78]赵学萍；中医内调外治治疗干燥综合征体会[J].中华中医药杂志,2011,(08)：886-888.
[79]何庆勇.针药并用治疗干燥综合征23例[J].中国针灸,2007,27(01)：38-38.
[80]王玲.中药配合针灸辨证治疗干燥综合征[J].中国中医药信息杂志,2007,(12)：86-87.
[81]边晓东,王寿椿,罗开涛.针药结合治疗干燥综合征60例[J].山东中医杂志,2011,(03)：178-179.
[1]张乃峥,曾庆馀,张凤山,等.中国风湿性疾病流行情况的调查研究[J].中华风湿病学杂志,1997,1(01)：34-38.
[2]Bowman SJ, Ibrahim GH, Holmes G, et al. Estimating the prevalence among Caucasian women of primary Sjogren's syndrome in two general practices in Birmingham, UK[J]. Scand J Rheumatol,2004,33:39～ 43.
[3]Alamanos Y, TsifetakiN, Voulgari PV, et al. Epidemiology of primary Sjogren's syndrome in north-west Greece,1982～2003 [J]. Rheumatology (Oxford),2006,45:187～91.
[4]Westhoff G, Zink A. Epidemiology of pr imary Sjbrgren's syndrome [J].Z Rheumatol,2010,69 (01):41～9.
[5]Goransson L, Haldorsen K, Brun J, et al. The point prevalence of clinically relevant primary Sjogren's syndrome in two Norwegian counties[J]. Scand J Rheumatol,2011,40:221-4.
[6]胡银秀,陆亚华,郑善翠.120例原发性干燥综合征临床特点分析[J].临床荟萃,2011,(08)：704-706.
[7]Fox P C, Bowman S J, Segal B, et al. Oral involvement in primary Sjogren syndrome [J]. J Am Dent Assoc,2008,139(12):1592～1601.
[8]竺红,赵岩,董怡,等.原发性干燥综合征的心脏病变[J].中国误诊学杂志,2002,2(12)：1820-1821.
[9]赵岩,董怡,郭晓萍,等.原发性干燥综合征的临床分析[J].北京医学,1997,19(02)：100-104.
[10]Sung MJ, Park SH, Kim SK, et al. Complete atrioventricular block in adult Sjogren's syndrome with anti-Ro autoantibody[J]. Korean J Intern Med,2011,26 (02):213～5.
[11]王志敏.以心包积液为首发表现的干燥综合征误诊为结核性心包炎[J].临床误诊误治,2011,(06)：49-50.
[12]Friedman JA, Miller EB, Green L, et al. A community based cohort of 201 consecutive patients with primary Sjogren's syndrome in Israel:Ashkenazi patients compared with those of Sephardic descent [J].Clin Exp Rheumatol,2006,24:274～80.
[10]Ramos M, Cervera R, Garcia-Carraso M, et al. Primary Sjogren's syndrome:clinical and immunologic study of 80 patients[J]. Med Clin (Bare),1997,108:652～7.
[11]杨瑞红,何权瀛,高占成.原发性干燥综合征合并间质性肺病38例临床分析[J].江西医药,2011,(09)：786-788.
[12]Sarkar PK, Patel N, Furie RA, et al. Pulmonary manifestations of primary Sjogren's syndrome[J]. Indian J Chest Dis Allied Sci 2009,51 (02):93～101.
[13]白久武,李惠萍,徐金富.继发于干燥综合征的间质性肺病21例临床分析[J].临床肺科杂志,2010,(03)：320-322.
[14]Segal B, Carpenter A, Walk D. Involvement of nervous system pathways in primary Sjogren's syndrome [J]. Rheum Dis Clin North Am,2008,34 (04):885-906, viii.
[15]Lafitte C, Amoura Z, Cacoub P, et al. Neurological complications of primary Sjogren's syndrome [J]. Neurol,2001,248:577～584.
[16]徐欣萍,董怡,陈元方.干燥综合征消化系临床表现80例分析[J].中华消化杂志,1996,16(01)：29-31.
[17]郑明英,陈武,董晓枫,等.原发性干燥综合征的消化系统表现[J].中国现代医学杂志,2006,(23)：3665.
[18]朱春兰,赵阴环,田素礼,等.原发性干燥综合征胃黏膜病理特点分析[J].中华风湿病学杂志,2004,(02)：88-91.
[19]Fox RI. Sjogren's syndrome [J]. Lancet,2005,366:321～31.
[20]Teramoto N, Katayama I, Arai H, et al. Annular erythema:possible association with primarySjogren's syndrome[J]. J Am Acad Dermatol, 1989,20:596～601.
[21]Katayama I, Teramoto N, Arai H, et al.Annular erythema:a comparative study of Sjogren's syndrome wi th subacute cutaneous lupus erythematosus[J]. Int J Dermatol,1991,30:635～9.
[22]Katayama I, Yamamoto T, Otoyama K, et al.Clinical and immunological analysis of annular erythema associated with Sjogren's syndrome [J]. Dermatology,1994,189:147.
[23]Ost lere LS, Harris D, Rustin MH. Urt icated annular erythema:a new manifestation of Sjogren's syndrome [J]. Clin Exp Dermatol,1993, 18:50～1.
[24]. Haimowitz JE, McCauliffe DP, Seykora J, et al. Annular erythema of Sjogren's syndrome in a white woman [J]. J Am Acad Dermatol,2000, 42:1069～73.
[25]De Winter S, van Buchem M, Vermer MH. Annular erythema of Sjogren' s syndrome [J]. Lancet,2006,367:1604.
[26]Ruzicka T, Faes J, Bergner T, et al.Annular erythema associated with Sjogren's syndrome:a variant of systemic lupus erythematosus [J]. J Am Acad Dermatol,1991,25:557～60.
[27]Lazarus MN, Robinson D, Mak V, et al. Incidence of cancer in a cohort of patients with primary Sjogren's syndrome [J]. Rheumatology 2006; 45:1012～5.
[28]Kassan SS, Thomas TL, Moutsopoulos HM, et al. Increased risk of lymphoma in sicca syndrome [J]. Ann Intern Med,1978,89:888～92.
[29]Kauppi M, Pukkala E, Isomaki H. Elevated incidence of hematologic malignancies in patients with Sjogren's syndrome compared with patients with rheumatoid arthritis (Finland) [J]. Cancer Causes Control,1997,8:201～4.
[30]Vinagre F, Santos MJ, Prata A, et al. Assessment of salivary gland function in Sjogren's syndrome:the role of salivary gland scintigraphy [J]. Autoimm Rev,2009,8:672～6.
[31]Voulgarelis M, Dafni UG, Isenberg DA, et al. Ma li gnant lymphoma in primary Sjogren's syndrome. Amulticenter, retrospective, clinical study by the European Concerted Action of Sjogren's syndrome[J]. Arthritis Rheum,1999,42:1765～72
[32]Sutcliffe N, Inane M, Speight P, et al. Predictors of lymphoma development in primary Sjogren's syndrome[J]. Semin Arthritis Rheum,1998,28:80～7.
[33]Royer B D, Cazals-Hatem J, Sibilila F, et al. Lymphomas in patients with Sjogren's syndrome are marginalzone B cell neoplasms, arise in diverse extranodal and nodal sites, and are not associated with viruses [J]. Blood,1997,90:766～75.
[34]Skopouli FN, Dafni U, Ioannidis JPA, et al. Clinical evolution, and morbidity and mortality of primary Sjogren's syndrome[J]. Semin Arthritis Rheum,2000,29:296～304.
[35]董怡,张乃峥.干燥综合征的肾脏损害[J].中华内科杂志,1988,27(03)：162-164.
[36]刘正钊；胡伟新；章海涛；鲍浩；刘志红；原发性干燥综合征肾损害的临床病理特征及预后[J].肾脏病与透析肾移植杂志,2010,(03)：225-229+251.
[37]Saugar Maripuri, Joseph P. Grande, Thomas G. Osborn, et al. Renal Involvement in Primary Sjogren's Syndrome:A Clinicopathologic Study [J]. Clin J Am Soc Nephrol,2009,4 (09):1423～1431.
[38]Jara LJ, Navarro C, Brito-Zeron Mdel P, et al. Thyroid disease in Sjogren's syndrome [J]. Clin Exp Rheumatol,2007,25(03):378～ 84.
[39]Morrow J, Nelson L, Watts R, et al. (1999) Sjogren's syndrome. In:Morrow J, Nelson L, Watts R, et al. (eds) Autoimmune rheumatic diseases,2nd edn. Oxford University Press, Oxford, pp 147～169.
[40]张嵩,刘桂玲,黄杰,等.以血小板减少首诊的干燥综合征7例临床分析[J].淮海医药,2011,(01)：27-28.
[41]程韬；陈志伟；原发性干燥综合征合并血小板减少85例分析[J].江苏医药,2011,(03)：345-347.
[42]任敏,武加标,肖菁.原发性干燥综合征并粒细胞缺乏一例报告[J].临床误诊误治,2011,(01)：42-43.
[43]谢雯.原发性干燥综合征血液系统损害临床特点[J].现代实用医学,2002,(08)：409-410.
[44]王亮；王迁；秦岭；冷晓梅；蒋颖；庄俊玲；原发性干燥综合征合并骨髓异常增生综合征1例[J].中华临床免疫和变态反应杂志,2011,(02)：151-153.
[45]Priori R, Medda E, Conti F, et al. Risk factors for Sjogren's syndrome:a case-control study[J]. Clin Exp Rheumatol,2007,25 (03):378～84.
[46]Bolstad AI, Wassmuth R, Haga HJ, et al. HLA markers and clinical characteristics in Caucasians with primary Sjogren's syndrome [J]. J Rheumatol,2001,28:1554～62.
[47]Fye KH, Terasaki PI, MichalskiJP, et al. Relationshipp of HLA-Dw3 and HLA-B8 to Sjogren's syndrome[J]. Arthritis Rheum,1978,21: 337～42.
[48]Mann DL, Moutsopoulos HM. HLA DR alloantigens in different subsets of patients with Sjogren's syndrome and in family members [J]. Ann Rheum Dis,1983,42:533～6.
[49]张雄鹰,宋秀珍,秦雄伟,等.山西汉族原发性干燥综合征与HLA-DQ基因多态性相关性的研究[J].细胞与分子免疫学杂志,2011,(02)：182-185.
[49]Reveille JD, Macleod MJ, W hittington K, et al. Specific amino acid residues in the second hypervariable region of HLA-DQA1 and DQB1 chain genes promote the Ro (SS-A)/La (SS-B) autoantibody responses [J]. J Immunol,1991,146:3871～6.
[50]Miceli-Richard C, Comets E, Loiseau P, et al. Association of an IRF5 gene functional polymorphism with Sjogren's syndrome [J]. Arthritis Rheum,2007,56:3989～94.
[51]Nordmark G, Kristjansdottir G, Theander E, et al.Additive effects of the major risk alleles of IRF5 and STAT4 in primary Sjogren's syndrome [J]. Genes Immun,2009,10:68～76.
[52]Korman BD, Alba MI, Le JM, et al. Variant form of STAT4 is associated with primary Sjogren's syndrome [J]. Genes Immun,2008, 9:267～70.
[53]Nordmark G, Kristjansdottir G, Theander E, et al. Association of EBF1, FAM167A (C8orf 13)-BLK and TNFSF4 gene variants with primary Sjogren's syndrome [J]. Genes Immun,2011,12:100～9.
[54]Maiti AK, Kim-Howard X, Viswanathan P, et al. Confirmation of an association between rs6822844 at the 112-1121 region and multiple autoimmune diseases:evidence of a general susceptibi lity locus[J]. Arthritis Rheum,2010,62(02):323～9.
[55]李恩泽,辛苗苗,胡彬,等.IL-18基因多态性与原发性干燥综合征的相关性[J].青岛大学医学院学报,2010,(04)：333-335+338.
[56]Toussirot E, Roudier J. Epstein-Barr virus in autoimmune diseases [J]. Best Pract Res Clin Rheumatol,2008,22 (05):883～ 96.
[57]Talal N, DauphineeMJ, Dang H, et al. Detect ion of serum antibodies to retroviral proteins in patients with primary Sjogren's syndrome (autoimmune exocrinopathy) [J]. Arthritis Rheum,1990,33:774～ 81.
[58]Saito I, Nishimura S, Kudo I, et al. Detection of Epstein-Barr virus and human herpes virus type 6 in saliva from patients with lymphoproliferative diseases by the polymerase chain reaction[J]. Arch Oral Biol,1991,36:779～84.
[59]Couty JP, Ranger-Rogez S, Vidal E, et al. Study of HHV-8 in primary Sjogren's syndrome[J]. Clin Exp Rheumatol,1997,15:333～4.
[60]Shillitoe EJ, Daniels TE, Whitcher JP, et al. Antibody to cytomegalovirus in patients with Sjogren's syndrome [J]. As determined by an enzyme-linked immunosorbent assay, Arthritis Rheum,1982,25:260～5.
[61]Shattles WG, Brookes SM, Venables PJ, et al. Expression of ant igen reactive with a monoclonal antibody to HTLV-1 P19 in salivary glands in Sjogren's syndrome [J]. Clin Exp Immunol,1992,89:46～51.
[62]Triantafyllopoulou A, Tapinos N, Moutsopoulos HM. Evidence for coxsackievirus infection in primary Sjogren's syndrome [J]. Arthritis Rheum,2004,50:2897～902.
[63]Wen S, Shimizu N, Yoshiyama H et al. Association of Epstein-Barr virus (EBV) with Sjogren's syndrome:different ial EBV expression between epithelial cells and lymphocytes in salivary glands [J]. (1996) Am J Pathol,149:1511～1517.
[64]Maitland N, Flint S, Scully C, et al. Detection of cytomegalovirus and Epstein-Barr virus in labial salivary glands in Sjogren's syndrome and non-specific sialadenitis [J].1995, J Oral Pathol Med 24:293～298.
[65]Venables P J, Teo C G, Baboonian C, et al. Persistence of Epstein-Barr virus in salivary gland biopsies from healthy individuals and patients with Sjogren's syndrome [J]. Cl in Exp Immunol,1989,75(03): 359～364.
[66]Crane IJ, Forrester JV. Thl and Th2 lymphocytes in autoimmune disease[J]. Crit Rev Immunol,2005,25:75～102.
[67]Brookes SM, Cohen SB, Price EJ, Webb LM, Feldmann M, Maini RN, Venables PJ. T cell clones from a Sjogren's syndrome salivary gland biopsy produce high levels of IL-10 [J]. Clin Exp Immunol,1996,103: 268～72.
[68]Bave U, Nordmark G, Lovgren T, et al.Activation of the type I interferon system in primary Sjogren's syndrome:a possible etiopathogenic mechanism[J]. Arthritis Rheum,2005,52:1185～95.
[69]Gottenberg JE, Cagnard N, Lucchesi C, et al. Activation of IFN pathways and plasmacytoid dendritic cell recrui tment in target organs of primary Sjogren's syndrome[J]. Proc Natl Acad Sci U S A,2006, 103:2770～5.
[70]Wildenberg ME, van Helden-Meeuwsen CG, van de Merwe JP, et al. Systemic increase in type I interferon activity in Sjogren's syndrome:a putative role for plasmacytoid dendritic cells [J]. Eur J Immunol,2008,38:2024～33.
[71]Oxholm P, Daniels TE, Bendtzen K. Cytokine expression in labial salivary glands from patients with primary Sjogren's syndrome[J]. Autoimmunity,1992,12:185～91.
[72]Emamian ES, Leon JM, Lessard CJ,et al. Peripheral blood gene expression profiling in Sjogren's syndrome[J]. Genes Immun,2009 10 (04):285～96.
[73]Anaya JM, Mantilla RD, Correa PA. Immunogenetics of primary Sjogren' s syndrome in Colombians[J]. Semin Arthritis Rheum,2005,34:735～ 43.
[74]Szodoray P, Alex P, Jonsson MV, et al. Distinct profiles of Sjogren' s syndrome patients with ectopic salivary gland germinal centers revealed by serum cytokines and BAFF[J]. Clin Immunol,2005,117: 168～76.
[75]Shiozawa S, Shiozawa K, Shimizu S, et al. Immunoreactive circulating alpha-interferon is low in Sjogren's syndrome[J]. Br J Rheumatol, 1990,29:50～2.
[76]Hemmer B, Nessler S, Zhou D, et al. Immunopathogenesis and immunotherapy of multiple sclerosis [J]. Nat Clin Pract Neurol,2006,2:201～11.
[77]Schulze-Koops H, Kalden JR. The balance of Th1/Th2 cytokines in rheumatoid arthritis[J]. Best Pract Res Clin Rheumatol,2001,15: 677～91.
[78]Baccala R, Kono DH, Theofilopoulos AN. Interferons as pathogenic effectors in autoimmunity[J]. Immunol Rev,2005,204:9～26.
[79]Wu AJ, Kurrasch RH,Katz J,et al. Effect of tumor necrosis factor-alpha and interferon-gamma on the growth of a human salivary gland cell line[J]. J Cell Physiol,1994,161:217～26.
[80]van Woerkom JM, Kruize AA, Wenting-van Wijk MJ, et al. Salivary gland and peripheral blood T helper 1 and 2 cell activity in Sjogren' s syndrome compared with non-Sjogren's sicca syndrome [J]. Ann Rheum Dis,2005,64:1474～9.
[81]Wakamatsu E, Nakamura Y, Matsumoto I, et al. DNA microarray analysis of labial salivary glands of patients with Sjogren's syndrome [J]. Ann Rheum Dis,2007,66:844～5.
[82]Dinarello CA. Interleukin-18 and the pathogenesis of inflammatory diseases [J]. Semin Nephrol,2007,27:98～114.
[83]Bombardieri M, Barone F, Pittoni V, et al. Increased circulating levels and salivary gland expression of interleukin-18 in patients with Sjogren's syndrome:relationship with autoantibody production and lymphoid organization of the periductal inflammatory infiltrate[J]. Arthritis Res Ther,2004,6:R447～56.
[84]Eriksson P, Andersson C, Ekerfelt C, et al. Sjogren's syndrome with myalgia is associated with subnormal secretion of cytokines by peripheral blood mononuclear cells [J]. J Rheumatol,2004,31:729～ 35.
[85]Sakai A, Sugawara Y, Kuroishi T, et al. Identification of IL-18 and Th17 cells in salivary glands of patients with Sjogren's syndrome, and amplification of IL-17-mediated secretion of inflammatory cytokines from salivary gland cells by IL-18 [J]. J Immunol,2008, 181:2898～906.
[86]Kolkowski EC, Reth P, Pelusa F, et al. Thl predominance and perforin expression in minor salivary glands from patients with primary Sjogren's syndrome [J]. J Autoimmun,1999,13:155～62.
[87]Manoussakis MN, Boiu S, Korkolopoulou P, et al. Rates of infiltration by macrophages and dendritic cells and expression of interleukin-18 and interleukin-12 in the chronic inflammatory lesions of Sjogren' s syndrome:correlation with certain features of immune hyper activity and factors associated with high risk of lymphoma development[J]. Arthritis Rheum,2007,56:3977～88.
[88]Kamachi M, Kawakami A, Yamasaki S, et al. Regulation of apoptotic cell death by cytokines in a human salivary gland cell line:distinct and synergistic mechanisms in apoptosis induced by tumor necrosis factor alpha and interferon gamma[J]. J Lab Clin Med,2002,139: 13～9.
[89]Kulkarni K, Selesniemi K, Brown TL. Interferon-gamma sensitizes the human salivary gland cell line, HSG, to tumor necrosis factor-alpha induced activation of dual apoptotic pathways [J]. Apoptosis,2006, 11:2205～15.
[90]McArthur C, Wang Y, Veno P, et al. Intracellular trafficking and surface expression of SS-A (Ro), SS-B (La), poly (ADP-ribose) polymerase and alpha-fodrin autoantigens during apoptosis in human salivary gland cells induced by tumour necros is factor-alpha [J]. Arch Oral Biol,2002,47:443～8.
[91]Moutsopoulos NM, Katsifis GE, Angelov N, et al. Lack of efficacy of etanercept in Sjogren's syndrome correlates with failed suppression of tumour necrosis factor alpha and systemic immune activation[J]. Ann Rheum Dis,2008,67(10):1437～1443.
[92]Garcic-Carrasco M, Font J, Filella X, et al. Circulating levels of Thl/Th2 cytokines in patients with primary Sjogren's syndrome: correlation with clinical and immunological features[J]. Clin Exp Rheumatol,2001,19:411～5.
[93]Ek M, Popovic K, Harris HE, et al. Increased extracellular levels of the novel proinflammatory cytokine high mobility group box chromosomal protein 1 in minor salivary glands of patients with Sjogren's syndrome [J]. Arthritis Rheum,2006,54:2289～94.
[94]Ishihara K, Hirano T.IL-6 in autoimmune disease and chronic inflammatory proliferative disease [J].Cytokine Growth Factor Rev, 2002,13:357～68.
[95]Chen Q, Fisher DT, Clancy KA, et al. Fever-range thermal stress promotes lymphocyte trafficking across high endothelial venules via an interleukin 6 trans-signaling mechanism[J]. Nat Immunol,2006,7: 1299～308.
[96]Boras VV, Cikes N, Lukac J, et al. The significance of salivary and serum interleukin 6 and basic fibroblast growth factor levels in patients with Sjogren's syndrome [J]. CollAntropol,2004,28 (Suppl 2):305～9.
[97]Vucicevic Boras V, Brailo V, Lukac J, et al. Sal ivary inter leukin-6 and tumor necrosis factor alpha in patients with drug-induced xerostomia [J]. Oral Dis,2006; 12:509～11.
[98]Boras VV, Brailo V, Lukac J, et al. Salivary interleukin-6 and tumor necrosis factor-alpha in patients with burning mouth syndrome [J]. Oral Dis,2006,12(03):353～5.
[99]Gross JA, Johnston J, Mudri S, et al. TACI and BCMA are receptors for a TNF homologue implicated in B-cell autoimmune disease[J]. Nature, 2000,404:995～9.
[100]Daridon C, Devauchelle V, Hutin P, et al. Aberrant expression of BAFF by B lymphocytes infiltrating the salivary glands of patients with primary Sjogren's syndrome [J]. Arthritis Rheum,2007,56:1134～ 44.
[101]Pers JO, Devauchelle V, Daridon C, et al. BAFF-modulated repopulation of B lymphocytes in the blood and salivary glands of rituximab-treated patients with Sjogren's syndrome [J]. Arthritis Rheum,2007,56:1464～77.
[102]Szodoray P, Alex P, Brun JG, et al. Circulat ing cytokines in primary Sjogren's syndrome determined by a multiplex cytokine array system[J]. Scand J Immunol,2004,59 (06):592～9.
[103]Annunziato F, Cosmi L, Santarlasci V, et al. Phenotypic and functional features of human Th17 cells [J]. J Exp Med,2007,204: 1849～61.
[104]Wilson NJ, Boniface K, Chan JR, et al. Development, cytokine prof ile and function of human inter leuk in 17-producing helper T cells [J]. Nat Immunol,2007,8:950～7.
[105]Steinman L. A brief history of T (H) 17, the first major revision in the T(H) 1/T (H) 2 hypothesis of T cell-mediated tissue damage [J]. Nat Med,2007,13:139～45.
[106]Wahl SM. Transforming growth factor-beta:innately bipolar [J]. Curr Opin Immunol,2007,19:55～62.
[107]Ogawa N, Dang H, Lazaridis K, et al. Analysis of transforming growth factor beta and other cytokines in autoimmune exocrinopathy (Sjogren's syndrome) [J]. J Interferon Cytokine Res,1995,15:759～ 67.
[108]Kolkowski EC, Reth P, Pelusa F, et al. Thl predominance and perforin expression in minor salivary glands from patients with primary Sjogren's syndrome [J]. J Autoimmun,1999,13:155～62.
[109]van Woerkom JM, Kruize AA, Wenting-van Wijk MJ, et al. Salivary gland and peripheral blood T helper 1 and 2 cell activity in Sjogren' s syndrome compared with non-Sjogren's sicca syndrome [J]. Ann Rheum Dis,2005,64:1474～9.
[110]Sharif MN, Tassiulas I, Hu Y, et al. IFN-alpha priming results in a gain of proinflammatory function by IL-10:implications for systemic lupus erythematosus pathogenesis [J]. J Immunol,2004,172:6476～ 81.
[111]Rousset F, Peyrol S, Garcia E, et al. Long-term cultured CD40-activated B lymphocytes differentiate into plasma cells in response to IL-10 but not IL-4 [J]. Int Immunol,1995,7:1243～53.
[112]Anaya JM, Mantilla RD, Correa PA. Immunogenetics of primary Sjogren's syndrome in Colombians[J]. Semin Arthritis Rheum,2005, 34:735～43.
[113]Bertorello R, Cordone MP, Contini P, et al. Increased levels of interleukin-10 in sal iva of Sjogren's syndrome patients. Correlation with disease activity [J]. Clin Exp Med,2004,4:148～51.
[114]Rachel. L Redfern, Alison M. McDermott. Toll-Like Receptors in Ocular Surface Disease [J]. Exp Eye Res,2010 June; 90 (6):679～ 687.
[115]郑凌艳,张志愿,俞创奇,等.Toll样受体7、8、9在原发性舍格伦综合征中的表达[J].中国口腔颌面外科杂志,2011,(02)：101-107.
[116]Spachidou M P, Bourazopoulou E, Maratheftis CI, et al. Expression of functional Toll-like receptors by salivary gland epithelial cells: increased mRNA expression in cells derived from patients with primary Sjogren's syndrome [J]. Cl in Exp Immunol,2007,147(03):497～503.
[117]Hasegawa M, Inoue A, Kohno M, et al. Antagonist of interferon-inducible protein 10/CXCL10 amelio rates the progression of autoimmune sialadenitis in MRL/lpr mice [J]. Arthritis Rheum,2006,54:1174～ 83.
[118]Dawson L, Tobin A, Smith P, et al. Antimuscarinic antibodies in Sjogren's syndrome:where are we, and where are we going? [J]. Arthritis Rheum,2005,52:2984～2995.
[119]WalchL, Brink C, Norel X. Themuscarinicreceptor subtypes in human bloodvessels [J]. Therapie,2001,56(03):223～226.
[120]Beroukas D, GoodfellowR, Hiscock J, et al.UP-regulation of M3-muscarinicreceptorsin labial salivary gland acini in primary Sjogren's syn-drome [J]. Lab Invest,2002; 82(02):203～210.
[121]Ubels JL, Hoffman HM, Srikanth S et al. Geneexpress ion in rat lacrimal glandduct cells collectedusinglaser capturemicrodissection evidencefor K+secretion by duct cells [J]. Invest Ophthalmol VisSci, 2006,47 (05):1876～1885.
[122]Berggreen E, Nylokken K, Delaleu N et al. Impairedvascular responses to parasympathetic nerve stimulation and muscarinic receptor activationin the submandibular gland in nonobese diabeticmice [J]. Arthritis Res Ther,2009,11 (01):1～12.
[123]罗慧臣,李萍,肖卫国.M3R与AQP5在干燥综合征患者唇腺中的表达与意 义[J].中国免疫学杂志,2011,(01)：79-81+87.
[124]MaT, SongY, GillespieAet al.Defective secretion of salivaintransgenic mice lacking aquaporin-5 water channels [J]. J Biol Chem,1999,274 (29):20071～20074.
[125]Konttinen YT, Tensing EK, Laine Met al. Abnormal distribution of aquaporin-5 in salivaryglands in the NOD mouse model for Sjogren' s syndrome [J]. J Rheumatol,2005,32(06):1071～1075.
[126]Cai FZ, Lester S, Lu T, et al. Mild autonomic dysfunction in primary Sjogren's syndrome:a controlled study [J]. Arthritis Res Ther,2008, 10:R31.
[127]Mandl T, Granberg V, Apelqvist J, et al. Autonomic nervous symptoms in primary Sjogren's syndrome [J]. Rheumatology (Oxford),2008,47: 914～919.
[128]Barendregt PJ, Visser MR, Smets EM, et al. Fatigue in primary Sjogren's syndrome[J]. Ann Rheum Dis,1998,57:291～295.
[129]Andonopoulos AP, Christodoulou J, Ballas C, et al. Autonomic cardiovascular neuropathy in Sjogren's syndrome:a controlled study [J].J Rheumatol,1998,25:2385～2388.
[130]Kovacs L, Papos M, Takacs R, et al. Autonomic nervous system dysfunction involving the gastrointestinal and the urinary tracts in primary Sjogren's syndrome [J]. Clin Exp Rheumatol,2003,21:697～ 703.
[131]赵岩,贾宁,魏丽,等.原发性干燥综合征2002年国际分类(诊断)标准的临床验证[J].中华风湿病学杂志,2003,(09)：537-540.
[132]Ramos-Casals M, Tzioufas AG, Font J. Primary Sjogren's syndrome: new clinical and therapeutic concepts[J]. Ann Rheum Dis,2005,64 (03):347～354.
[133]翦新春.口干综合征(Sjogren's Syndrome)口干的治疗[J].临床口腔医学杂志.2003(06)：377-379.
[134]Leung KC, McMillan AS, Wong MC, et al. The efficacy of cevimeline hydrochloride in the treatment of xerostomia in Sjogren's syndrome in southern Chinese patients:a randomised double-blind placebo-controlled crossover study[J]. Clin Rheumatol,2008,27 (04):429～36.
[135]Fife RS, Chase W F, Dore R K et al. Cevimeline for the Treatment of Xerostomia in Patients With Sjogren Syndrome. a randmized trial [J]. Arch Intern Med,2002,162:1293～1300.
[136]Cankaya H, Alpoz E, Karabulut G, et al. Effects of hydroxychloroquine on salivary flow rates and oral complaints of Sjogren patients:a prospective sample study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod[J].2010,110 (01):62～7.
[137]马艳,厉小梅,王玮,等.M3受体激动剂治疗干燥综合征的临床观察[J].安徽医药,2010,(10)：1212-1213.
[138]孙京华,刘常明,王慧,等.环孢素A滴眼液治疗结膜干燥综合征小鼠的机制[J].医药导报,2006,(07)：626-628.
[139]Moutsopoulos NM, Katsifis GE, Angelov N, et al. Lack of efficacy of etanercept in Sjogren syndrome correlates with failed suppression of tumour necrosis factor alpha and systemic immune activation [J]. Ann Rheum Dis,2008,67(10):1437～43.
[140]Mavragani CP, Niewold TB, Moutsopoulos NM, et al. Augmented interferon-alpha pathway activation in patients with Sjogren's syndrome treated with etanercept [J]. Arthri tis Rheum,2007,56(12): 3995～4004.
[141]Meijer JM, Meiners PM, Vissink A, et al. Effectiveness of ri tuximab treatment in primary Sjogren's syndrome:a randomized, double-blind, placebo-controlled trial [J]. Arthri t is Rheum,2010,62(04):960-8.
[142]Devauchelle-Pensec V, Morvan J, Rat AC, et al. Effects of rituximab therapy on quality of life in patients with primary Sjogren's syndrome [J]. Cl in Exp Rheumatol,2011,29(01):6～12.
[143]Sugai S, Takahashi H, Ohta S, et al. Efficacy and safety of rebamipide for the treatment of dry mouth symptoms in patients with Sjogren's syndrome:a double-blind placebo-controlled multicenter trial[J]. Mod Rheumatol,2009,19(02):114～24.
[144]Nakayamada S, Fujimoto T, Nonomura A, et al. Usefulness of initial histological features for stratifying Sjogren's syndrome responders to mizoribine therapy [J]. Rheumatology (Oxford),2009,48 (10): 1279～82.
[145]Nakayamada S, Saito K, Umehara H, et al. Efficacy and safety of mizoribine for the treatment of Sjogren's syndrome:a multicenter open-label clinical trial [J].Mod Rheumatol,2007,17(06):464～9.
[1]母小真.陈湘君治疗干燥综合征的经验[J].辽宁中医杂志,2002,29(01)：11.
[2]张绪磊.40例干燥综合征的阴虚舌象分析[J].江苏中医杂志,2005,3(01)：28.
[3]孙素平,潘文萍,周翠英.试论干燥综合征以燥毒为本[J].山东中医杂志2001,20(10)：581.
[4]赵丽娟,李振吉,王洵.补脾益气及阴阳双补法治疗干燥综合征[J].中医杂志,2005,26(06)：41.
[5]马武开.干燥综合征辨证分型探讨[J].光明中医,2001,16(01)：30.
[6]顾勤,刘菊妍.张仲瑛教授治疗干燥综合征经验介绍.新中医[J],2002,34(09)：7.
[7]朱跃兰.干燥综合征从瘀毒论治机理初探[J].中华中西医结合杂志,2006,12(07)：1120.
[8]朱跃兰,韦尼,侯秀娟.活血解毒方治疗干燥综合征63例临床观察.北京中医药大学学报(中医临床版),2010,17(05)：1.
[9]Seror R, Ravaud P, Bowman SJ, et al.EULAR Sjogren's syndrome disease activity index:development of a consensus systemic disease activity index for primary Sjogren's syndrome [J]. Ann Rheum Dis,2010 June, 69 (06):1103～1109.
[10]Campar A, Isenberg D A. Primary S jogren's syndrome activity and damage indices comparison [J]. Eur J Clin Invest,2010,40 (07):636～ 644.
[1]Makino S, Kunimoto K, Muraoka Y, et al.Breeding of a non-obese, diabetic strain of mice[J]. Jikken Dobutsu,1980,29(01):1～13.
[1]Anaya JM, Mantilla RD, Correa PA. Immunogenetics of primary Sjogren' s syndrome in Colombians[J]. Semin Arthritis Rheum,2005,34:735～ 43.
[2]Miyasaka N, Murota N, Yamaoka K, et al.Interleukin 2 defect in the peripheral blood and the lung in patients with Sjogren's syndrome [J].Clin Exp Immunol.1986, September,65 (03):497～505.
[3]Schloot NC, Hanifi-Moghaddam P, Goebel C, et al. Serum IFN-gamma and IL-10 levels are associated with disease progression in non-obese diabetic mice [J].Diabetes Metab Res Rev,2002,18(01):64～70.
[4]Yamanouchi J, Rainbow D, Serr P a,et al. Interleukin-2 gene variation impairs regulatory T cell function and causes autoimmunity[J]. Nat. Genet,2007,39:329～337.
[1]Schmittgen T D. Real-time quantitative PCR [J]. Methods,2001,25 (04):383～385.
[2]Humphreys-Beher MG, Hu Y, Nakagawa Y, et al. Utilization of the non-obese diabetic (NOD) mouse as an animal model for the study of secondary Sjogren's syndrome [J]. Adv Exp Med Biol 1994,350:631～636.
[3]Robinson CP, Yamachika S, Bounous DI, et al. A novel NOD-derived murine model of primary Sjogren's syndrome. Arthri t is Rheum 1998; 41:150～156.
[4]Hemmer B, Nessler S, Zhou D, et al.Immunopathogenesis and immunotherapy of multiple sclerosis [J]. Nat Cl in Pract Neurol,2006,2:201～11.
[5]Schulze-Koops H, Kalden JR. The balance of Thl/Th2 cytokines in rheumatoid arthritis[J]. Best Pract Res Clin Rheumatol,2001,15: 677～91.
[6]van Woerkom JM, Kruize AA, Went ing-van Wijk MJ, et al. Salivary gland and peripheral blood T helper 1 and 2 cell activity in Sjogren's syndrome compared with non-Sjogren's sicca syndrome [J]. Ann Rheum Dis,2005,64:1474～9.
[7]Wu AJ, Kurrasch RH, Katz J, et al. Effect of tumor necrosis factor-alpha and interferon-gamma on the growth of a human salivary gland cell line[J]. J Cell Physiol,1994,161:217～26.
[8]Schloot NC, Hanifi-Moghaddam P, Goebel C, et al. Serum IFN-gamma and IL-10 levels are associated with disease progression in non-obese diabetic mice[J]. Diabetes Metab Res Rev,2002,18 (01):64～70.
[9]Anaya JM, Mantilla RD, Correa PA. Immunogenetics of primary Sjogren' s syndrome in Colombians [J]. Semin Arthr it is Rheum,2005,34:735～ 43.
[10]Yamanouchi J, Rainbow D, Serr P a, et al. Inter leukin-2 gene variation impairs regulatory T cell function and causes autoimmunity [J].Nat. Genet,2007,39:329～337.
[11]张志利.IL-2对NOD鼠糖尿病的影响[J].中华微生物学和免疫学杂志,1994,14(03)：168-172.
[12]Killedar SJ, Eckenrode SE, Mclndoe RA,et al. Early pathogenic events associated with Sjogren's syndrome (SjS)-like disease of the nod mouse using microarray analysis [J]. Lab Invest,2006,86,1243～1260.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |