Abstract
Objective: This meta-analysis aimed to systematically assess the therapeutic efficacy and safety of Qinghao Biejia decoction combined with conventional chemical medicine in patients with systemic lupus erythematosus (SLE), and to provide reference for clinical medication.Methods: Multiple databases were retrieved by computer for randomized controlled trials (RCTs) of treating SLE with Qinghao Biejia decoction combining chemical medicine, from the establishment of the database to January 2021. Study screening, data collection, and quality assessment were performed independently by two reviewers. RevMan 5.4 and Stata 15.1 software were used for Meta-analysis.Results: Nine eligible studies, involving 655 SLE participants, were included. Meta-analysis showed that the additional use of Qinghao Biejia decoction superior to chemical medicine alone in people with SLE in improving the overall response rate (RR = 1.30, 95% CI [1.19, 1.41], p < 0.00001, heterogeneity p = 0.61, I 2 = 0%), and can decrease SLE Disease Activity Index (SLEDAI) and TCM symptom scores, improve immunological indexes (C3, C4, IgG, IgA, IFN-γ, IL-4, Th1/Th2), reduce the occurrence of adverse events in treatment (P ≤ 0.05).Conclusion: Based on this meta-analysis, the additional use of Qinghao Biejia decoction has more advantages in the treatment of SLE than conventional chemical medication alone, which could enhance the efficacy and reduce adverse reactions, and is worthy of clinical promotion. However, more and higher quality RCTs are still need to confirm our findings.
Highlights
Systemic lupus erythematosus (SLE) is an autoimmune disease with a complex pathogenesis, which can be involved in all systems of the human body, and can damage multiple target organs
Embase, Google Scholar, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), Chinese Scientific Journals Database (VIP), Wanfang Database, etc. were retrieved with the retrieval words “Systemic lupus erythematosus”, “lupus erythematosus”, “SLE”, “Randomized controlled trials”, “RCT”, “Qinghao Biejia decoction”, “Qinghao”, “Biejia”, etc., in Chinese or English, and both use a combination of subject words and free words
Yin deficiency and endogenous heat is the core pathogenesis of SLE, blood stasis block throughout the disease, so the treatment principle is nourishing yin and clearing heat, detoxification and removing blood stasis (Han and Jiang, 2017)
Summary
Systemic lupus erythematosus (SLE) is an autoimmune disease with a complex pathogenesis, which can be involved in all systems of the human body, and can damage multiple target organs. Abrupt onset with target-organ involvement is common, such as hematologic findings (thrombocytopenia, leukopenia, lymphopenia, or anemia), renal findings (hematuria, proteinuria, cellular casts, or elevated serum creatinine level), respiratory symptoms (cough, dyspnea, hemoptysis, or pleuritic pain), central nervous system signs (headache, photophobia, or focal neurologic deficits) (Kiriakidou and Ching, 2020). Estimates of SLE prevalence in adults range from 30 to 150 per 100,000, and incidence ranges from 2.2 to 23.1 per 100,000 per year (Durcan et al, 2019). 1.3 million people in China suffer from SLE, with an average prevalence of 0.0975–0.376% (Carter et al, 2016)
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