Résumé
ObjectiveTo analyze the clinical characteristics of geographic tongue in patients with primary Sjögren's syndrome （pSS）. MethodPatients with pSS treated in the China-Japan Friendship Hospital from December 2018 to October 2021 were enrolled and divided into different groups according to the presence of geographic tongue or the severity. Phi correlation analysis，Chi-square test， and Mann-Whitney test were used to analyze the clinical characteristics of patients with geographic tongue. ResultA total of 182 pSS patients were included in this study，including 75 （41.2%） patients with geographic tongue and 107 （58.8%） without geographic tongue. Partial exfoliation was more common than total exfoliation， and the anterior part of the tongue was the most common exfoliation site. The number of patients with severe geographic tongue was more than those with mild-to-moderate geographic tongue. Compared with pSS patients without geographic tongue，those with geographic tongue were more common in fissured tongue （92.0%/41.1%，χ2=48.491，P<0.05），red or crimson tongue （48.0%/23.3%，χ2=12.009，P<0.05），Yin deficiency syndrome （100.0%/43.9%，χ2=62.739，P<0.05），and Qi deficiency syndrome （94.7%∶50.5%，χ2=40.046，P<0.05），less common in phlegm-dampness syndrome （33.3%/72.0%，χ2=26.709，P<0.05），and showed higher proportions in hyperglobulinemia （89.3%/65.4%，χ2=13.547，P<0.01），ANA ≥1∶160 （78.1%/57.3%，χ2=8.227，P<0.01），and positive RF （51.4%/36.5%，χ2=3.877，P<0.05）. Compared with pSS patients with mild geographic tongue，pSS patients with moderate-to-severe geographic tongue had higher proportions in hyperglobulinemia （98.1%/68.2%，χ2=14.617，P<0.01），positive anti-CENP-B （26.0%/4.8%，χ2=4.214，P<0.05），and reduced complement 3 （26.4%/4.5%，χ2=4.647，P<0.05）. The geographic tongue was positively associated with fissured tongue （φ=0.531），Yin deficiency syndrome （φ=0.587），and Qi deficiency syndrome （φ=0.469），negatively associated with phlegm-dampness syndrome （φ=-0.447），and weakly associated with tongue color （φ<0.4）. There was no statistical difference in the disease activity index between patients with or without geographic tongue and severity. ConclusionMore than 40% of pSS patients had geographic tongue accompanied by fissured tongue. Geographic tongue is positively associated with Yin deficiency syndrome and Qi deficiency syndrome，and negatively associated with phlegm-dampness syndrome， indicating that treatment should be based on tonifying Qi and nourishing Yin. Compared with pSS patients without geographic tongue， those with geographic tongue may have higher positive rate of some immune indicators，which deserves further exploration.
Résumé
ObjectiveTo explore the characteristics of tongue manifestations and traditional Chinese medicine （TCM） syndromes in patients with primary Sjogren's syndrome （pSS） of different time. MethodpSS patients who visited TCM Department of Rheumatism in China-Japan Friendship Hospital from December 2018 to October 2021 were included and grouped according to the disease courses （short<5 years， medium 5-10 years， long > 10 years）. Chi-square test was used for comparison between three groups and Bonferroni method for multiple comparisons. In the pairwise comparison， P<0.017 indicated significant difference. Chi-square test was performed on the syndrome and specific tongue manifestations with inter-group differences to analyze the trend of tongue manifestations and TCM syndromes over time （interval： two years）. ResultA total of 193 pSS patients were enrolled， with 85 （44.0%） of short disease course， 69 （35.8%） of medium disease course， and 39 （20.2%） of long disease course. The common tongue manifestations were crimson tongue， fissured tongue， thin tongue， lack of fluid， and dry coating， which showed no significant difference among the three groups. Higher proportion of patients with light red tongue was observed in the group with short disease course than in group with medium disease course （χ2=6.407， P<0.017）. Higher proportions of patients with thick coating （χ2=6.784， P<0.017） and phlegm-dampness syndrome （χ2=11.545， P<0.017） and lower proportion of patients with Qi deficiency syndrome （χ2=12.706， P<0.017） were found in the group with short disease course than in the group with long disease course. Patients with medium （χ2=6.358， P<0.017） and long （χ2=8.279， P<0.017） disease course tended to have exfoliated coating compared with those with short disease course， and the proportion of patients with exfoliated coating rose and the proportion of patients with thick greasy coating decreased over time （Ptrend<0.05）. In addition， the proportion of patients with phlegm-dampness syndrome decreased and that with Qi deficiency syndrome increased over time （Ptrend<0.05）. ConclusionIn the early stage， patients with pSS often show both dryness and dampness， as manifested by the thick greasy coating and phlegm-dampness syndrome. In the medium and late stage， patients often have Qi-Yin deficiency， as evidenced by exfoliated coating and Qi deficiency. In the clinical practice， medicines should be prescribed based on tongue manifestations and TCM syndrome of patients.
Résumé
The paper takes the shared terms of tongue manifestations in the book World Health Organization International Standard Terminologies on Traditional Medicine in the Western Pacific Region.2007 and ISO 23961-1:2021 Traditional Chinese medicine-Vocabulary for diagnostics-Part 1:Tongue,as the basic contrastive analysis corpus, and. makes Diagnostics of Traditional Chinese Medicine edited by Zhu Wenfeng and the eighth edition of Oxford Advanced English-Chinese Dictionary as reference books . Based on the translation theory of "Adaptation" and "Selection", the main characteristics of the terminology standards of tongue manifestation in the two versions are analyzed and summarized from the dimension of language, culture and communication. And then, problems such as selection of terms, difference of term property and structure, single choices of term-selection standard for compound tongue manifestations, different contexts for the same term and a lack of certain terminologies are found. Thus, this paper finds that to achieve different communicative effects in the context, the differences of the applicable objects of terms should be considered. These findings suggest that terms of WHO serve as the tool of education and training, targeting practitioner as main user, while terms of ISO serve as information objectivization, aiming to specify data exchange for diagnostic instrument.