Meta-analysis Of The Clinical Efficacy Of Replenishing Qi And Nourishing Yin In The Treatment Of Sjogren’s Syndrome

Purpose:Meta-analysis of multiple independent studies on the treatment of Sjogren,s syndrome with Qi-tonifying and Yin-nourishing prescriptions,by discussing its clinical efficacy,adverse reactions and effects on salivary flow rate,CRP,ESR,IgA,IgM,IgG,RF,to provide evidence-based evidence for clinical treatment and research of Sjogren,s syndrome.Data and method:To Formulate a search strategy,and to search comprehensively the RCT literature of Qi-tonifying and Yin-nourishing prescriptions in the treatment of Sjogren,s syndrome in the databases of CNKI,Wanfang,Weipu and Chinese biomedical literature.the search period is from database establishment to December 2018.To determine the inclusion and exclusion criteria for the literature,two researchers independently screened,qualitied,and extracted the literature.Results:1.A total of 19 RCT literatures including 1274 patients were included in this study.In terms of total efficiency,the heterogeneity test results were[Chi~2=8.74,df=18(P=0.97);I~2=0%],and the analysis results showed OR=3.19,95%CI=(2.37,4.30),Z=7.63,P<0.00001,suggesting that Qi-tonifying and Yin-nourishing prescriptions are better than Western medicine alone in treating Sjogren,s syndrome.2.Salivary flow rate was mentioned as an observational index in 4 literatures.Meta-analysis showed that SMD=1.84,95%CI=(-0.00,3.69),Z=1.96,P=0.05,suggesting that the experimental group could effectively improve the salivary flow rate of Sjogren’s syndrome patients,which was better than the control group.3.Only two articles mentioned RF as an observation index.The results of meta-analysis showed that SMD=-1.07,95%CI=(-2.92,0.78),Z=1.14,P=0.26,which could not explain that the experimental group had better effect on reducing RF in Sjogren’s syndrome patients than the control group.4.A total of 6 literatures mentioned IgA as an observation index.The results of meta-analysis showed that MD=-0.21,95%CI=(-0.47,0.05),Z=1.56,P=0.12,which could not explain that the experimental group had better effect on reducing IgA in Sjogren’s syndrome patients than the control group.5.A total of 10 articles mentioned IgG as an observation index.Meta-analysis showed that SMD=-0.46,95%CI=(-0.86,-0.07),Z=2.29,P=0.02,suggesting that the experimental group had a better effect on the reduction of IgG in patients with Sjogren’s syndrome than the control group.6.A total of 5 literatures mentioned IgM as an observation index.The results of meta-analysis showed that MD=-0.12,95%CI=(-0.29,0.04),Z=1.45,P=0.15,which could not explain that the experimental group had better effect on reducing IgM in patients with Sjogren’s syndrome than the control group.7.A total of 10 articles mentioned ESR as an observation index.The results of meta-analysis showed that SMD=-0.42,95%CI=(-0.75,-0.08),Z=2.43,P=0.01,suggesting that the experimental group had a better effect on ESR reduction in Sjogren’s syndrome patients than the control group.8.A total of 6 articles mentioned CRP as an observation index.The results of meta-analysis showed that MD=-1.17,95%CI=(-1.87,-0.46),Z=3.25,P=0.001,suggesting that the experimental group had a better effect on reducing CRP in patients with Sjogren’s syndrome than the control group.9.A total of 9 literatures reported adverse reactions.The results of meta-analysis showed that RR=0.31,95%CI=0.16,0.59,Z=3.55,P=0.0004,suggesting that the incidence of adverse reactions of Qi-tonifying and Yin-nourishing prescriptions in the treatment of Sjogren’s syndrome was lower than that of the control group.Conclusion:1.The prescriptions of Tonifying Qi and Nourishing Yin have definite clinical effect in the treatment of Sjogren,s syndrome of deficiency of both qi and yin.2.The prescriptions of Tonifying Qi and Nourishing Yin can effectively improve salivary flow rate in patients with Sjogren,s syndrome of deficiency of both qi and yin.3.The prescriptions of Tonifying Qi and Nourishing Yin can effectively reduce IgG,ESR and CRP in patients with Sjogren,s syndrome of deficiency of both qi and yin.4.The adverse reactions of prescriptions of Tonifying Qi and Nourishing Yin in treating Sjogren,s syndrome of deficiency of both qi and yin are significantly less than those of Western medicine alone.The prescriptions of Tonifying Qi and Nourishing Yin have better safety and are worthy of promotion in clinical practice.