Wang Weijie, Wang Yu-Hsun, Yang Kepeng, Ye Xiangsheng, Wang Xinchang, Wei James Cheng-Chung
Department of Rheumatology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Science, Beijing, China.
Front Pharmacol. 2023 Jun 1;14:1185809. doi: 10.3389/fphar.2023.1185809. eCollection 2023.
To investigate the association between traditional Chinese medicine (TCM) therapy and the risk of pneumonia in patients with systemic lupus erythematosus (SLE). This population-based control study analyzed the data retrieved from the National Health Insurance Research database in Taiwan. From a cohort of 2 million records of the 2000-2018 period, 9,714 newly diagnosed patients with SLE were initially included. 532 patients with pneumonia and 532 patients without pneumonia were matched 1:1 based on age, sex, and year of SLE diagnosis using propensity score matching. The use of TCM therapy was considered from the SLE diagnosis date to the index date and the cumulative days of TCM therapy were used to calculate the dose effect. Conditional logistic regression was used to investigate the risk of pneumonia infection. Furthermore, to explore the severity of pneumonia in SLE, sensitivity analyses were performed after stratification using the parameters of emergency room visit, admission time, and antibiotic use. TCM therapy for >60 days could significantly reduce the risk of pneumonia in patients with SLE (95% CI = 0.46-0.91; = 0.012). Stratified analysis showed that TCM use also reduced the risk of pneumonia in younger and female patients with SLE by 34% and 35%, respectively. TCM for >60 days significantly reduced the risk of pneumonia in the follow-up periods of >2, >3, >7, and >8 years. In addition, the exposure of TCM for >60 days reduced the risk of pneumonia in patients with SLE who were treated with antibiotics for moderate or severe pneumonia. Finally, the study found that using formulae to tonify the kidney for more than 90 days and formulae to activate blood circulation for less than 30 days could significantly reduce the risk of pneumonia infection in patients with SLE. TCM use is associated with a lower risk of pneumonia among patients with SLE.
探讨中医治疗与系统性红斑狼疮（SLE）患者肺炎风险之间的关联。这项基于人群的对照研究分析了从台湾国民健康保险研究数据库中检索到的数据。在2000 - 2018年期间的200万条记录队列中，最初纳入了9714例新诊断的SLE患者。采用倾向得分匹配法，根据年龄、性别和SLE诊断年份，将532例肺炎患者和532例无肺炎患者进行1:1匹配。从SLE诊断日期到索引日期考虑中医治疗的使用情况，并使用中医治疗的累积天数来计算剂量效应。采用条件逻辑回归分析肺炎感染风险。此外，为了探讨SLE患者肺炎的严重程度，使用急诊就诊、住院时间和抗生素使用等参数进行分层后进行敏感性分析。中医治疗超过60天可显著降低SLE患者肺炎风险（95%CI = 0.46 - 0.91；P = 0.012）。分层分析显示，使用中医治疗还分别使年轻和女性SLE患者的肺炎风险降低了34%和35%。中医治疗超过60天在随访2年、3年、7年和8年以上时均显著降低了肺炎风险。此外，中医治疗超过60天降低了中度或重度肺炎患者使用抗生素治疗的SLE患者的肺炎风险。最后，研究发现使用补肾方剂超过90天和活血化瘀方剂少于30天可显著降低SLE患者的肺炎感染风险。SLE患者使用中医治疗与较低的肺炎风险相关。
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