Chinese Herbal Medicine in Treating Primary Sjögren's Syndrome: A Systematic Review of Randomized Trials

Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Chaoyang District, Beijing 100029, China.
Evidence-based Complementary and Alternative Medicine (Impact Factor: 2.18). 08/2012; 2012:640658. DOI: 10.1155/2012/640658
Source: PubMed

ABSTRACT Background. There is no curative treatment for primary Sjögren's syndrome (PSS). Chinese herbal medicine (CHM) is widely used in the treatment of PSS in China. Objective. To evaluate the effectiveness and safety of CHM for PSS. Methods. PubMed, Cochrane Library, China Knowledge Resource Integrated Database, Chinese Biomedical Database, Wanfang Data, and the Database for Chinese Technical Periodicals were searched for randomized controlled trials (RCTs) of CHM or CHM plus conventional medicine for PSS compared with placebo or conventional medicine. RevMan 5.0.17 was employed to conduct data analyses and assess homogeneity. Statistical models were chosen according to heterogeneity. Results. A total of 52 RCTs were included. The overall methodological quality of included trials was low. 49 trials reported response rates, of which 32 found significant improvements favoring CHM treatment against controls; 20 trials reported lacrimal function by Schirmer test scores, of which 16 trials reported a significant difference favoring CHM treatment. 21 trials reported salivary function by salivary flow rate, of which 10 reported significant favorable effects of CHM treatment. Other trials found no difference. The reported adverse effects of CHM included nausea, diarrhea, and other minor digestive symptoms, but more frequent adverse effects occurred in conventional medicine groups. Conclusions. Preliminary evidence from RCTs suggests the effect of CHM is promising for relieving symptoms, improving lacrimal and salivary function in PSS. However, the poor methodological quality of the included trials means that further well-designed, multicentered, larger trials are needed.

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    ABSTRACT: Ethnopharmacological relevance: Traditional Chinese medicines (TCM), when given for symptom relief, have gained widespread popularity among Sjogren's patients. The aim of this study was to analyze the utilization of TCM among Sjogren's patients in Taiwan. Materials and methods: The usage, frequency of service, and the Chinese herbal products prescribed among Sjogren's patients were evaluated in a cohort of 1,000,000 beneficiaries recruited from the National Health Insurance Research Database. The logistic regression method was employed to estimate the odds ratios (ORs) for utilization of a TCM. Results: More than 90% of Sjogren's patients received TCM out-patient services at least once during the study period. Patients with secondary Sjogren's syndrome were more likely to seek TCM treatment than those with primary Sjogren's syndrome. The aOR for those suffering from at least one rheumatologic disease was 1.56(95% CI: 1.26-1.93), those with two rheumatologic diseases was 1.98 (95% CI: 1.29-3.04), while those with three or more rheumatologic diseases was 7.86 (95% CI: 1.09-56.58). Compared to Sjogren's patients who used no medical treatment, the aOR for those who took one type of conventional medication was 1.55 (95% CI: 1.25-1.92), those who took two types was 1.98 (95% CI: 1.60-2.47) while those who took three or more types was 2.91 (95% CI: 2.20-3.84). Qi-Ju-Di-Huang-Wan (Lycium Berry, Chrysanthemum, and Rehmannia Pill) was the most frequently prescribed formula among Sjogren's patients. Conclusion: Qi-Ju-Di-Huang-Wan is the most commonly prescribed Chinese herbal formula for Sjogren's syndrome and its effects should be taken into account by healthcare providers.
    Journal of Ethnopharmacology 06/2014; 155(1). DOI:10.1016/j.jep.2014.05.049 · 2.94 Impact Factor

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