Wei Chen-Ying, Chu Chiao-Hsuan, Shen Hsuan-Shu, Ko Po-Chuan, Chen Jiun-Liang, Yu Han-Hua
Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Curr Med Res Opin. 2025 Mar;41(3):559-567. doi: 10.1080/03007995.2025.2478160. Epub 2025 Mar 19.
Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disorder that significantly impacts renal function. Despite conventional treatments, morbidity and mortality remain high, necessitating the exploration of safer and more effective therapies, including the potential benefits of Traditional Chinese Medicine (TCM) for improving kidney health and survival rates.
Patients with newly diagnosed SLE with catastrophic illness certificate were retrospectively enrolled from the Chang Gung Research Database (CGRD) between 2005 and 2020. Patients were stratified into groups based on TCM treatment post-diagnosis. Outcomes measured included end-stage renal disease (ESRD) incidence and all-cause mortality, using Cox proportional hazard models and Kaplan-Meier analysis for statistical evaluation.
Among 10,462 newly diagnosed SLE patients, 1,831 had received at least 28 days of TCM treatment, while 7,966 had not received TCM treatment. After propensity score matching, there were equally 1,831 individuals in each group, with no significant baseline differences in age, sex, biochemical profiles, or comorbidities. TCM usage was associated with a significantly reduced rate of ESRD over a 0.5-year follow-up (adjusted hazard ratio (aHR) = 0.24; 95% confidence interval (CI) = 0.07-0.80, = .02), with a trend that persisted over 5 years. The TCM group's proteinuria was significantly lower than that of the non-TCM group at various time points post-index date, including 6 months (174.98 mg vs. 248.09 mg, <.001), 1 year (161.05 mg vs. 303.03 mg, <.001), 3 years (150.26 mg vs. 250 mg, = .03), and 10 years (147.06 mg vs. 190.75 mg, = .03). After adjusting for confounding covariates, TCM users had a significantly decreased risk of mortality (aHR = 0.70, 95% CI = 0.58-0.83).
Integrating TCM with conventional treatment could lower risk of ESRD and mortality, highlighting the potential for a more holistic approach to patient care for SLE.
系统性红斑狼疮（SLE）是一种多方面的自身免疫性疾病，对肾功能有重大影响。尽管有传统治疗方法，但发病率和死亡率仍然很高，因此需要探索更安全、更有效的治疗方法，包括中医药（TCM）对改善肾脏健康和提高生存率的潜在益处。
2005年至2020年期间，从长庚研究数据库（CGRD）中回顾性纳入了新诊断为SLE且有灾难性疾病证明的患者。根据诊断后是否接受中医药治疗将患者分层。测量的结局包括终末期肾病（ESRD）发病率和全因死亡率，使用Cox比例风险模型和Kaplan-Meier分析进行统计评估。
在10462例新诊断的SLE患者中，1831例接受了至少28天的中医药治疗，而7966例未接受中医药治疗。经过倾向得分匹配后，每组各有1831人，年龄、性别、生化指标或合并症方面无显著基线差异。在0.5年的随访中，使用中医药与ESRD发生率显著降低相关（调整后风险比（aHR）=0.24；95%置信区间（CI）=0.07-0.80，P=0.02），这种趋势在5年中持续存在。在索引日期后的各个时间点，中医药组的蛋白尿均显著低于非中医药组，包括6个月（174.98mg对248.09mg，P<0.001）、1年（161.05mg对303.03mg，P<0.001）、3年（150.26mg对250mg，P=0.03）和10年（147.06mg对190.75mg，P=0.03）。在调整混杂协变量后，使用中医药的患者死亡风险显著降低（aHR=0.70，95%CI=0.58-0.83）。
将中医药与传统治疗相结合可降低ESRD风险和死亡率，突出了采用更全面的方法治疗SLE患者的潜力。
