Systematic Review Of Effect Of Combination Of Traditional Chinese Medicine And Western Medicine And Of Sole Western Medicine In The Treatment Of Primary Sjogren’s Syndrome

Purpose:To evaluate the effectiveness and safety of combination of traditional Chinese medicine and western medicine and of sole Western medicine in the treatment of Primary Sjogren’s syndrome, and figure out an effective feasible treatment plan.Method:1.Search strategy: According to Cochrane’s method of literature search, computer searching is mainly relied on, supplemented with manual searching. The time interval is set to range from the moment of database foundation to November 18, 2015. The databases for computer researching include: Chinese Science and Technology Periodical Database(VIP),China National Knowledge Infrastructure Database(CNKI), Chinese Biomedical Literature Database(CBM), Pub Med, and Embase.2.Inclusion criteria: The inclusion criteria are set according to the PICOS principle.Research object: Patients with primary Sjogren’s syndrome. Intervention and comparison measures: Use combination of traditional Chinese medicine and western medicine and solely use western medicine. Results: Effectiveness and safety. Research type: Randomized Controlled Trails(RCTs).3.Data extraction and analysis: Two trained personnel independently extract data according to the preset inclusion criteria. Quality evaluation of literature is carried out in accordance with the quality evaluation standard manual from Cochrane collaboration network. Rev Man5.3 was selected with the meta analysis software to extract data and thenV detect the heterogeneity, and an appropriate effect model was selected based on the results thereof. The effect indicator qualitative data of the outcome is expressed with relative risk(RR), together with a confidential interval(CI) of 95%, while the quantitative data and measurement data are expressed with difference in means(MD) or standardized mean differences(SMD), together with a confidential interval(CI) of 95%.Results:1.Results of literature search: A total of 13 randomized controlled trials were included, and 994 cases of primary Sjogren’s syndrome patients were involved. Among the cases, 549 cases were treated with the combination of traditional Chinese medicine and western medicine, and 445 cases were treated solely with western medicine.2.Results of literature quality evaluation: Through test, the included literatures are found to be of low quality as a whole, including only 1 high-quality literature, 4medium-quality literatures, and 9 low-quality literatures. According to the primary outcome indicator, 10 research reports show improvement of symptoms, and 6 show adverse reactions; according to the secondary outcome indicator, 3 researches are about dynamic flow ratio f saliva, 6 about Schirmer I Test(SIT), and 8 about Ig G.3.Analysis of statistical results:Primary outcome indicator: 10 researches on the effectiveness are of homogeneity(heterogeneity test: p=0.07, I2=43%), a fixed effect model(RR=1.34, 95%CI: 1.24~1.46)was adopted for evaluating the effect size, and it is considered that the combination of traditional Chinese medicine and western medicine is superior to sole western medicine;regarding safety, the adverse reactions as reported include gastrointestinal reaction, skin reaction, eye reaction, concurrent pulmonary infection, hematological abnormality and dysfunction of liver. The gastrointestinal symptoms include abdominal discomfort and diarrhea. 3 cases taking the combination of traditional Chinese medicine and western medicine and 4 cases taking sole western medicine suffered gastrointestinal reaction,respectively. The symptoms of skin reaction include rash and pruritus. 1 case taking the combination of traditional Chinese medicine and western medicine and 9 cases taking solewestern medicine suffered skin reaction, respectively. Regarding eye reaction, 0 case taking the combination of traditional Chinese medicine and western medicine and 5 cases taking sole western medicine reported blurring of vision, respectively. 5 cases taking the combination of traditional Chinese medicine and western medicine and 6 cases taking sole western medicine suffered concurrent pulmonary infection, respectively. 0 case taking the combination of traditional Chinese medicine and western medicine and 3 cases taking sole western medicine reported dysfunction of liver, respectively. Comparison between the group taking the combination of traditional Chinese medicine and western medicine and that taking sole western medicine(RR=0.41, 95%CI: 0.22~0.76) shows that the incidence of adverse reaction of the latter is higher than that of the former.Secondary outcome indicator: Based on the combined three researches on dynamic flow rate(p=0.78, I 2 =0%), testing results show that the combination of Chinese and western medicine is better than sole western medicine(MD=-7.01, 95%CI:-8.74~-5.28);for the 6 researches on SIT, a fixed effect model(p=0.37; I2=6%) was selected, and results of combined testing show that the former is better than the latter(SMD=0.29, 95%CI:0.11~0.47); based on the combination of effect size of the 8 researches on Ig G(p=0.27; I2=20%), results show that the former is better than the latter(MD=-2.53, 95%CI:-3.49~-1.57).Conclusion:The combination of Chinese and western medicine is superior to sole western medicine in respect of effectiveness, safety, and detection of dynamic flow rate of salivary,SIT and Ig G. To sum up, the combination of traditional Chinese medicine and western medicine is clinically preferable in the treatment of primary Sjogren’s syndrome. In this way, the characteristic of getting effect instantly of western medicine is put into play, and it is possible to reduce side effect and immune impairment via individualized prescription of traditional Chinese medicine.