Chen Yong, He Mang, Zhao Si-Jin, Chen Yan-Juan, Zhang Yong-Qiao, Chen Xiao-Long, Yang Chuan-Jie, Luo Yu-Zhuo, Nandakumar Kutty Selva, Xing Zhou-Xiong, Tian Mei
Department of Rheumatology and Immunology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.
Undergraduate Students of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.
J Inflamm Res. 2024 Aug 17;17:5509-5519. doi: 10.2147/JIR.S468880. eCollection 2024.
To investigate the clinical value of adding Jin-gu-lian (JGL) capsules into rheumatoid arthritis (RA) treatment by examining its impact on disease activity and quality of life (QoL) through a real-world study (RWS).
RWS was conducted to compare the inflammatory markers, including IgM-RF, ESR, and CRP, between RA patients treated with only Western medicine (reference group) and Western medicine plus JGL (study group) during one-year follow-up. The clinical data was acquired from the hospital information system (HIS). Telephone call-based follow-up on QoL (SF-36) and accompanying symptoms, including gastrointestinal complaints, attacks of pneumonia, herpes zoster, URTIs, UTIs, and LTBIs. Finally, the anti-rheumatic drugs given to both groups were also compared. RWS was further validated for its feasibility by performing studies with hydroxychloroquine (HCQ) treatment, which is a commonly used anti-rheumatic drug for RA with mild effect.
The study group failed to show a significant effect on inflammatory markers, especially on the CRP levels, indicating no additional clinical value of supplementing with JGL. Similarly, at the endpoint, no significant differences between the two groups on QoL and related symptoms were observed. Our study suggests that the patients in the study group might need more anti-rheumatic drugs to fill the treatment insufficiency, and the application ratio of NSAIDs would be significantly higher than the reference group. By conducting this study on HCQ treatment, the positive aspects of controlling disease activity and reducing NSAIDs application were found, which demonstrates the utility of performing the RWS to evaluate the effect of JGL.
Adding JGL did not significantly improve the clinical efficacy of RA treatment by this RWS. Folk herbal prescriptions such as JGL are suggested to underwent strict clinical trials before application.
通过一项真实世界研究(RWS),研究在类风湿关节炎(RA)治疗中加用金骨莲(JGL)胶囊对疾病活动度和生活质量(QoL)的影响,以探讨其临床价值。
进行RWS,比较仅接受西药治疗的RA患者(参照组)和接受西药加JGL治疗的患者(研究组)在一年随访期间的炎症标志物,包括IgM-RF、ESR和CRP。临床数据从医院信息系统(HIS)获取。通过电话随访QoL(SF-36)及伴随症状,包括胃肠道不适、肺炎发作、带状疱疹、上呼吸道感染(URTIs)、泌尿系统感染(UTIs)和潜伏性结核感染(LTBIs)。最后,还比较了两组给予的抗风湿药物。通过对羟氯喹(HCQ)治疗进行研究,进一步验证了RWS的可行性,HCQ是一种常用于RA且疗效温和的抗风湿药物。
研究组对炎症标志物未显示出显著效果,尤其是对CRP水平,表明加用JGL无额外临床价值。同样,在终点时,两组在QoL和相关症状方面未观察到显著差异。我们的研究表明,研究组患者可能需要更多抗风湿药物来弥补治疗不足,且非甾体抗炎药(NSAIDs)的应用比例显著高于参照组。通过对HCQ治疗进行这项研究,发现了控制疾病活动度和减少NSAIDs应用的积极方面,这证明了进行RWS以评估JGL效果的实用性。
通过这项RWS,加用JGL并未显著提高RA治疗的临床疗效。建议像JGL这样的民间草药处方在应用前进行严格的临床试验。