This paper summarizes clinical insights on treating the syndrome of coexisting dryness and dampness in Sjögren's syndrome （SS） based on the "three methods for liver diseases". It is proposed that the core pathogenesis of this subtype lies in the liver's failure to regulate and disperse， leading to fluid retention and transformation into dryness； disharmony between wood （liver） and earth （spleen）， resulting in internal generation of dryness and dampness； and liver impairment affecting the kidney， eventually causing extreme dryness to transform into dampness. This syndrome is thus characterized by disharmony between the liver and spleen， as well as dysfunction between ti （character， 体） and yong （function， 用）. Drawing from the Guide to Clinical Case （《临证指南医案》）， the "three methods for liver diseases" are applied as follows，i.e. using pungent and dispersing herbs to regulate the liver and resolve qi stagnation； using sweet and gentle herbs to soothe the liver and address the root of concurrent dryness and dampness； and using sour and purgative herbs to soften the liver and restore fluid balance. The coordinated use of these three methods， treating both ti and yong， facilitates the separation of dryness and dampness， providing a novel approach to syndrome differentiation and treatment for this subtype of SS.

Objective:To screen the active components, target genes and signaling pathways of Shaoteng Decoction in the treatment of Sjogren's syndrome by network pharmacology; To conduct relevant experimental verification to explore the mechanism of action of Shaoteng Decoction in the treatment of Sjogren's syndrome.Methods:The active components and targets of Shaoteng Decoction were collected by retrieving TCMSP. The target genes of Sjogren's syndrome were collected through the GeneCards database. The intersection targets of drugs and diseases were obtained by using Venn. The intersection targets were imported into the STRING database to obtain PPI networks, and the "drug-active component -therapeutic target-disease" network was constructed by Cytospace 3.7.2 software. The DAVID database was used for GO function enrichment analysis and KEGG pathway analysis. The 18 NOD mice were divided into model group, TCM group, hydroxychloroquine group, with 6 mice in each group, and 6 Balb/C mice were set as normal control group. TCM group was gavaged with 2.3 g/kg of Shaoteng Decoction, hydroxychloroquine group was gavaged with 60 mg/kg of hydroxychloroquine, and model group and normal control group were gavaged with equal volume of deionized water once a day for 4 consecutive weeks. The daily water intake of mice during the administration period was recorded, the pathological changes of submandibular gland tissue were observed by HE staining, and the levels of serum inflammatory factors IL-17 and TNF-α were determined by ELISA method.Results:39 main active components of Shaoteng Decoction, 1 062 targets of Sjogren's syndrome, and 64 targets of drug and disease intersection were obtained, including TNF, IL6, NCOA1, AKT1, TP53, etc. The treatment targets of Sjogren's syndrome mainly affected biological processes such as response to bacterium and cellular response to lipid, and regulated TNF-α pathway and IL-17 signaling pathway. The experimental results showed that the levels of TNF-α and IL-17 in the TCM group were lower than those in the model group ( P<0.05). Conclusion:Shaoteng Decoction can regulate IL-17 and TNF-α signaling pathways, inhibit inflammation, delay submandibular gland disruption, and alleviate the symptoms of Sjogren's syndrome.

Screening and evaluating the diseases responding specifically to traditional Chinese medicine （TCM） will help to highlight the advantages of TCM treatment， and the evaluation method should be standardized with consideration to the unique characteristics of the diseases. The incidence of Sjögren's Syndrome （SS） is increasing year by year， while the pathogenesis of this disease remains unclear. Modern therapies for this disease include biological agents and immunosuppressants， which generally have unsatisfactory efficacy. The TCM treatment of SS focuses on the harmony of the physical and mental health. The Rheumatology Branch of the China Association of Chinese Medicine organizes experts in TCM， Western medicine， and evidence-based medicine to form working groups. Delphi method and bibliometric method were used for analysis， and SS was selected as a disease responding specifically to TCM. Furthermore， the evaluation system was established for this disease， and the consensus regarding this disease was reached after seminar discussion. This paper summarized the whole process of the evaluation of the advantages of TCM treatment of SS. First， because TCM atomization is widely used in clinical practice and enriches TCM administration methods， this therapy is included after other non-drug therapies were taken as characteristic therapies. Second， the evaluation indicators of therapeutic effect should be determined with consideration to international acceptance and the current research status. Third， the expression method should be accurate， standardized， and objective， highlight the natural advantages of TCM， and avoid arbitrary extension. This paper provides a reference for clinicians to explore other diseases responding specifically to TCM.

Objective To compare the differences in the composition and diversity of intestinal flora between knee osteoarthritis(KOA)patients with dampness-heat obstruction syndrome,cold-dampness blockage syndrome and healthy people;To explore the characteristics of intestinal flora of KOA patients with the above two TCM syndrome types.Methods According to the inclusion and exclusion criteria,dampness-heat obstruction syndrome group,cold-dampness blockage syndrome group,and healthy control group were screened,with 10 cases for each group,and then their fecal samples were collected.16S rDNA sequencing technology was used to compare the differences of intestinal flora among groups by Alpha and Beta diversity analysis.Results There was no significant difference in species richness of intestinal flora among the three groups,but there was statistical significance in species diversity between cold-dampness blockage syndrome group and dampness-heat obstruction syndrome group,and healthy control group(P<0.05).There were statistical significance among the three groups in intestinal flora composition(P= 0.001).At the phylum level,Bacteroidota and Firmicutes were significantly dominant,and at genus level,the abundance of Prevotella in dampness-heat obstruction syndrome group and cold-dampness blockage syndrome group increased.The abundance of Enterobacteriaceae,Lachnospira and Klebsiella was relatively large in dampness-heat obstruction syndrome group.The abundance of Prevotella and Pseudomonas in cold-dampness blockage syndrome group was large.Conclusion There are differences in the intestinal flora structure between KOA patients with dampness-heat obstruction syndrome and cold-dampness blockage syndrome.

Objective To analyze the TCM syndrome distribution and prescription law of inpatients with Sj?gren syndrome(SS)complicated by lung interstitial disease(ILD)using data mining methods.Methods The clinical data of SS-ILD inpatients who met the screening criteria from January 2010 to December 2021 at Guang'anmen Hospital,China Academy of Chinese Medical Sciences were collected.A statistical analysis of TCM syndrome type and basic information,clinical manifestation,tongue and pulse,laboratory examination,TCM prescription and so on was conducted.Results Totally 87 patients were included.There was no significant difference in gender,age,age of onset,disease course or smoking history across patients with distinct syndrome types.Patients with syndrome of combination of dryness and dampness had the highest probability of drinking history(P<0.05).There were substantial differences between syndrome types in the major complaints of xerostomia,joint swelling and pain,chest tightness,cough and joint swelling(P<0.05),but no significant differences in ILD special symptoms,tongue or pulse.The level of urea nitrogen was highest in patients with yin deficiency internal heat syndrome(P<0.05),with no significant difference in other laboratory data.There were 79 prescriptions and 217 kinds of Chinese materia medica in total.High-frequency medications were primarily used to strengthen the spleen and replenish qi,nourish yin and clear heat,nourish blood and promote blood circulation,mainly with neutral property,sweet taste,the main meridians were lung meridians,liver meridians and spleen meridians.The commonly used medicine matched the pathogenesis of deficiency and excess,and the core prescription was a modified combination of Bazhen Decoction and Yangyin Qingfei Decoction.Conclusion The TCM syndrome of SS-ILD is a mixture of deficiency and excess,with qi and yin deficiency as the foundation,turbid phlegm and blood stasis as the superficiality,lung,liver and spleen as the disease's locations.Clinical treatment of replenishing qi and nourishing yin,resolving phlegm,removing blood stasis,and dredging collaterals should be the general guidance.

Objective:To study the pharmacodynamics of Shaoteng Decoction obtained by three different extraction methods; To explore the immunosuppressive effect of Shaoteng Decoction; To optimize the extraction process.Methods:The extract of Shaoteng Decoction was prepared by water extraction, 70% ethanol extraction and water extraction and alcohol precipitation respectively. Totally 30 NOD mice were randomly divided into Shaoteng Decoction water extraction group (processⅠ), Shaoteng Decoction 70% ethanol extraction group (processⅡ), Shaoteng Decoction water extraction and alcohol precipitation group (processⅢ), model group and hydroxychloroquine group according to their body weight, with 6 mice in each group. Another 6 Balb/C mice were set as normal control group. In the processⅠ, process Ⅱ, and process Ⅲ groups, 16 g/kg of Shaoteng Decoction extract was given by gavage, while in the hydroxychloroquine group, 60 mg/kg of hydroxychloroquine sulfate was given by gavage. The normal control group and the model group were given the same volume of deionized water once a day for 4 weeks. After the last administration, the spleen index and submandibular gland index were calculated, the pathological morphology of submandibular gland was observed by HE staining, and the serum levels of IL-1β, IL-6, TNF-α, dehydroepiandrosterone (DHEA), estradiol (E 2) and immunoglobulin G (IgG) were determined by ELISA. Results:Compared with the model group, the spleen index of each drug group decreased ( P<0.01 or P<0.05), and the submandibular gland index of the process Ⅲ group and hydroxychloroquine group increased ( P < 0.01). The pathological score of submandibular gland in each administration group decreased ( P<0.01 or P<0.05), the serum levels of IL-1β, IL-6, TNF-α and IgG decreased ( P<0.01 or P<0.05), and the DHEA level increased ( P<0.01 or P < 0.05). The level of serum E 2 in process group Ⅰ, process group Ⅲ and hydroxychloroquine group increased ( P<0.01 or P<0.05). Conclusion:Shaoteng Decoction can effectively reduce inflammation and inhibit immunity of NOD mice. In addition, the extract under the process of water extraction and alcohol precipitation has better efficacy, which is the optimal technology.

This paper explored the relationship between systemic lupus erythematosus （SLE） and yin-yang toxins based on the discussion of yin-yang toxin in Synopsis of the Golden Chamber （《金匮要略》）， and found that the two are similar in symptoms， and there is a potential relationship between adverse prognosis factors； and the idea that early treatment of SLE can improve prognosis is in accordance with the opinion in traditional Chinese medicine claiming that yin-yang toxin should be diagnosed and treated as soon as possible. Therefore， it is proposed to take yin-yang as general and toxin pathogen as key to explain the pathogenesis， use yin-yang toxin theory for guidance， discuss on the treatment of SLE around the pathological elements including “toxin， heat， stasis”， and take into account of the kidney essence. Accordingly， Shengma Biejia Decoction （升麻鳖甲汤） is recommended as the basic formula with modifications in accordance with different syndromes in staged treatment， providing reference for the clinical diagnosis and treatment of SLE.

The pathogenesis of Sjögren's syndrome （SS） was considered to involve external dryness， internal injured essence and blood， yin-deficiency endowment， and abnormal emotion and spirit， and it was believed that SS has the characteristics of dryness and impassability， and the pathogenesis of deficiency-excess in complexity. According to the theory “upper dryness treats qi， and lower dryness treats blood” in YE Gui's monograph “Medical Records for Clinical Guidance”， the dryness was divided into upper dryness and lower dryness syndromes to be differentiated and treated. When treating dryness syndrome， the patient should follow the characteristics of the five zang organs， using soft and cool medicines， avoiding warm and dry medicines， and valuing the animal products. The upper dryness could be treated with Sangxiang Decoction （桑杏汤） to clear the qi and moisten the dryness， Qiaohe Decoction （翘荷汤） to clear the upper with pungent-cool， and Shashen Maidong Decoction （沙参麦冬汤） to nourish yin and promote the production of body fluid. The lower dryness could be treated with Fumai Decoction （复脉汤） to enrich and nourish the five kinds of fluid. Liuwei Dihuang Pill （六味地黄丸） to nourish the kidneys and supplement essence， and Wuren Pill （五仁丸） to moisten the dryness and nourish the blood， which provided a new way of thinking for differentiation of the dryness syndrome.

Objective To summarize professor Lu Zhizheng's clinical experience in the treatment of rheumatoid arthritis,in order to better guide clinic. [Method]By analyzing professor Lu Zhizheng's treatment of two patients with rheumatoid arthritis of the medical record data, it summarized from the aspects of etiology and pathogenesis,syndrome differentiation and treatment.[Result]Professor Lu argued that invigorating spleen to remove dampness should be throughout the course of the treatment of rheumatoid arthritis.Two patients can reduce joint swel ing and pain,improve the appetite gradual y,and the symptoms were relieved obviously by replenishing qi and reconciling ying,adjusting ying and wei.[Conclusion]Professor Lu Zhizheng's Chinese medicine treatment of rheumatoid arthritis has significant curative effect,it is worthy of reference study.

Objective To Evaluate the efficacy and safety of Qingre-Huoxue Recipe ( QHR ),Qingre -Huoxue Recipe and Methotrexate(QHR+MTX) in improving clinical symptoms of dampness-heat and blood-stasis syndrome of rheumatoid arthritis.Methods According to multi-center,randomized,and control intervention design,142 RA patients were randomly divided into QHR group (71 cases) and QHR+MTX group (71 cases).With clinical symptoms as evaluation indexes,FAS set and PP set were adapted for analysis.Results FAS set analysis:Both groups can significantly reduce pain VAS score [ (4.82 ± 1.98) vs (4.31 ± 1.85) ],reduce tenderness and swollen joint number[(4.87±4.05)vs(4.20±3.36)、(8.72±6.24)vs(7.14±5.03)respectively],shorten morning stiffness [ (39.56 ± 46.68) min vs (36.65 + 42.58) min] and significantly reduce the symptoms of fatigue[ (4.13 ±2.34) vs (3.74 ±2.20) ],also with good security.But there was no statistically significant difference between the two groups.Conclusion Qingre-Huoxue Recipe with MTX had no significant advantage in improving clinical symptoms in patients with the dampness-heat and blood-stasis syndrom of RA than without MTX.