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Journal of Traditional Chinese Medicine >

2026 , Vol. 46 >Issue 4: 972 - 981

DOI: https://doi.org/10.19852/j.cnki.jtcm.2026.04.017

Original Articles

Construction of a nomogram for anxiety and depression in patients with Sjögren’s syndrome by combining tongue and pulse characteristics: a cross-sectional study based on a prospective cohort

  • SHAN Xueyan ,
  • HE Jiale ,
  • GUO Zilin ,
  • PANG Fengtao ,
  • LIU Ruihua ,
  • LIU Ying ,
  • JIANG Ping ,
  • JI Wei ,
  • YU Jing ,
  • ZHOU Xinyao ,
  • TANG Xiaopo
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  • 1 Department of Rheumatology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
    2 Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China
    3 Department of Rheumatology, Shaanxi Provincial People's Hospital, Xi’an 710068, China
    4 Department of Rheumatology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, China
    5 Department of Rheumatology, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing 210029, China
    6 Department of Rheumatology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110031, China

Received date: 2025-07-27

  Accepted date: 2025-11-18

  Online published: 2026-08-08

Supported by

Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences: Development of a Stratified Prevention and Treatment Strategy and Chronic Disease Management Model Based on Traditional Chinese Medicine for Multisystem Comorbidities in Sjögren’s Syndrome(CI2026A01503)

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Abstract

OBJECTIVE: To develop and validate a predictive model for predicting psychological complications of Sjögren’s syndrome (SS) in combination with tongue and pulse characteristics.

METHODS: This cross-sectional study was based on a prospective cohort study including SS patients recruited from 30 major tertiary hospitals in China. Nomograms were developed based on the clinical characteristics, tongue and pulse manifestations, and laboratory tests of these patients, and univariate and multivariate logistic regression analyses were used to screen for various correlates of anxiety and depression, and the column charts were evaluated using the area under the curve (AUC), calibration curves, and decision curve analysis.

RESULTS: A total of 444 patients were included, comprising 424 females (95.5%) and 20 males (4.5%), with a mean age of (46 ± 13) years. The prevalence of anxiety and depression was 45.5% (n = 202) and 42.1% (n = 187), respectively. Peeled tongue was associated with higher rates of both anxiety and depression among SS patients [odds ratio (OR) for anxiety = 0.44, 95% CI (0.26, 0.74), P = 0.002; OR for depression = 0.44, 95% CI (0.27, 0.73), P = 0.002]. Regarding pulse diagnostics, a thready pulse was linked to increased anxiety [OR= 1.99, 95% CI(1.11, 3.60), P = 0.022], while a slippery pulse correlated with depression [OR = 0.32, 95% CI(0.14, 0.74), P = 0.007]. Nomograms developed from these findings demonstrated good predictive performance, with AUC values of 0.767 for anxiety and 0.741 for depression in both training and validation cohorts.

CONCLUSIONS: Integrating Traditional Chinese Medicine diagnostics with conventional clinical assessments provides a robust predictive model for psychological comorbidities in SS. The innovative approach enhances personalized management, offering a pathway for targeted interventions to treat anxiety and depression effectively in affected patients.

Key words： Sjögren's syndrome; nomograms; tongue diagnosis; pulse diagnosis; anxiety; depression

Cite this article

SHAN Xueyan , HE Jiale , GUO Zilin , PANG Fengtao , LIU Ruihua , LIU Ying , JIANG Ping , JI Wei , YU Jing , ZHOU Xinyao , TANG Xiaopo . Construction of a nomogram for anxiety and depression in patients with Sjögren’s syndrome by combining tongue and pulse characteristics: a cross-sectional study based on a prospective cohort[J]. Journal of Traditional Chinese Medicine, 2026 , 46(4) : 972 -981 . DOI: 10.19852/j.cnki.jtcm.2026.04.017

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