Sjögren's syndrome is an autoimmune disease characterized by primary symptoms including dry mouth, dry eyes, and systemic discomfort. The treatment goal is to alleviate symptoms, prevent complications, and improve quality of life. Currently, there is no cure, but through a multifaceted treatment strategy, patients can effectively manage their condition.
Treatment plans need to be personalized based on the severity of the disease and the affected organ systems. Physicians typically combine medication with non-pharmacological therapies and encourage patients to actively participate in their daily care. Regular follow-ups and assessments of treatment responses are crucial for adjusting treatment directions.
Current treatments are divided into four main directions: symptom relief, immunomodulation, complication management, and supportive therapy. Symptom relief focuses on significant discomforts such as dry mouth and dry eyes, immunomodulation is used to control autoimmune responses, while complication management targets affected organs such as the lungs or kidneys.
Treatment principles include:
Moderate to severe patients may use corticosteroids or immunosuppressants, such as mycophenolate mofetil and azathioprine. These medications can suppress immune system activation but require monitoring for blood and liver side effects.
Biologics such as rituximab have shown efficacy in clinical trials for specific patients but have not yet become first-line treatments. Physicians will select medication combinations based on the types of autoantibodies and the degree of organ damage.
Antimalarial drugs such as hydroxychloroquine can alleviate joint pain and fatigue and are often used in combination with other medications. Their mechanism is related to modulating T cell function, and regular checks of retinal health are necessary.
Sjögren's syndrome-specific treatment drugs such as lifitegrast eye drops can modulate inflammation in the lacrimal glands and improve tear secretion function.
Local symptom management is foundational therapy. Artificial tears and preservative-free eye drops can provide immediate relief for dry eye discomfort, and daily use is recommended to maintain ocular surface moisture.
For patients with joint involvement, physical therapists will design joint range of motion training and muscle strengthening exercises. Alternating hot and cold compresses can reduce inflammation-related pain.
Respiratory therapy is particularly important for patients with lung involvement, as deep breathing exercises and coughing technique training can improve lung function.
Adjusting daily habits can significantly improve symptoms. Maintaining adequate fluid intake (2-3 liters per day) and avoiding diuretic beverages such as caffeine and alcohol are recommended. Using a humidifier to maintain environmental humidity at 40-60% is ideal.
Oral care should be enhanced: using fluoride mouthwash to prevent cavities and having dental check-ups every six months. Skin moisturizers should be fragrance-free lotions applied immediately after bathing to lock in moisture.
A high-fiber diet can prevent digestive issues caused by insufficient saliva, with a preference for easily chewable soft foods. Vitamin B12 and iron supplementation should be done under medical supervision to avoid overdose.
Regular exercise can improve overall blood circulation, but high-intensity workouts that lead to dehydration should be avoided. Water aerobics and yoga are suitable options, and electrolytes should be replenished immediately after exercise.
Research is focused on developing new drugs that modulate specific immune pathways. Monoclonal antibody drugs targeting anti-SSA/SSB antibodies are currently in clinical trials and may reduce abnormal immune system activation.
The field of regenerative medicine is exploring mesenchymal stem cell transplantation in an attempt to repair damaged exocrine glands. Gene therapy is aimed at silencing specific inflammatory factors, and these innovative therapies are still in experimental stages.
Biomarker-based treatment strategies are being developed, tailoring treatment plans according to the patient's autoantibody types and the extent of organ damage. Blood biomarkers can assist physicians in assessing treatment responses.
Seek medical attention immediately if the following conditions occur: persistent worsening of blurred vision, difficulty swallowing affecting eating, unexplained weight loss, or the appearance of purpura on the skin. These may be warning signs of disease progression or complications.
When adjusting treatment plans, if symptoms do not improve within 3-6 months or if severe side effects occur (such as frequent infections or abnormal blood indices), a reassessment of the treatment strategy with an immunologist or rheumatologist is necessary.
When dry mouth or dry eyes cause severe discomfort, such as inability to chew normally, persistent blurred vision, or the perception that current medications are becoming less effective, it is advisable to proactively discuss treatment adjustments with your physician. The physician may assess whether to adjust immunosuppressants or increase symptom relief medications using objective indicators (such as saliva secretion measurements) or symptom severity scoring.
What non-pharmacological methods can relieve dry mouth and dry eyes in daily life?Using preservative-free artificial tears several times a day can improve dry eye symptoms; low-sugar, sugar-free gum can stimulate saliva secretion to relieve dry mouth. Additionally, maintaining indoor humidity at 40%-60% and avoiding prolonged exposure to fans or air conditioning can help reduce symptom exacerbation.
What dietary precautions should be taken during immunosuppressant treatment?During immunosuppressant use, it is important to avoid raw foods (such as sashimi, unwashed fresh fruits, and vegetables) to reduce infection risk, and to regularly monitor blood cell counts. If taking antimalarial medications (such as plaquenil), high mineral intake (such as iron supplements) should be limited, and retinal examinations should be conducted as directed by a physician.
How can Sjögren's syndrome patients prevent oral and gum infections?It is recommended to have dental check-ups every 3-6 months, use fluoride mouthwash to clean the gums, and choose alcohol-free mouthwash to avoid irritating mucous membranes. If saliva secretion is severely insufficient, saliva substitute sprays may be used under physician guidance to reduce the risk of cavities and periodontal disease.
Can traditional Chinese medicine be used alongside Western medical treatments? What risks should be noted?Some patients may use traditional Chinese acupuncture or herbal remedies to alleviate symptoms, but it is important to choose qualified practitioners and avoid herbs that may affect the immune system (such as angelica or ginseng). When combining Eastern and Western medicine, all medications must be disclosed to the primary physician to avoid drug interactions.
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