Meta-analysis of efficacy and safety of primary Sj?gren's syndrome treated by total glucosides of paeony
[Objective]To systematically evaluate the efficacy and safety of primary Sjögren's syndrome(pSS)treated by total glucosides of paeony(TGP).[Methods]Databases of CNKI,VIP,CBM,Wanfang,PubMed,EMBASE,and Cochrane were searched(from inception to October 29,2022)to screen the randomized controlled trials(RCTs)of TGP for pSS.Two authors independently screened the literature,extracted data,and performed literature quality evaluation,and Meta-analysis was performed using RevMan 5.4 software.[Results]A total of 368 literatures were retrieved,and 10 RCTs were included after the screening,including 874 subjects.The Meta-analysis showed that the treatment of pSS with TGP alone was more effective in the Schirmer's test[MD=1.31,95%CI(0.74,1.88),P＜0.00001],salivary flow rate[MD=0.12,95%CI(0.02,0.21),P=0.02],and erythrocyte sedimentation rate(ESR)[MD=-7.30,95%CI(-16.64,1.24),P=0.000 4].When TGP in combination with Western medicine,and efficacy in the Schirmer's test[MD=1.10,95%CI(0.36,3.17),P=0.01],salivary flow rate[MD=-6.96,95%CI(-8.34,-5.57),P＜0.000 01],ESR[MD=-9.87,95%CI(-12.64,-7.10),P＜0.000 01],rheumatoid factor(RF)[MD=-9.95,95%CI(-13.45,-6.45),P＜0.000 01],C-reactive protein(CRP)[MD=-1.76,95%CI(-2.92,-0.60),P=0.003],immunoglobulin G(IgG)[MD=-3.19,95%CI(-4.22,-2.17),P＜0.000 01],IgA[MD=-0.97,95%CI(-1.36,-0.58),P＜0.000 01]and IgM[MD=-0.44,95%CI(-0.72,-0.16),P=0.002]were significantly more efficacious,with significantly higher efficiency and fewer adverse effects,all with statistically significant differences(P＜0.05).[Conclusion]The current research evidence suggests that TGP is effective in improving exocrine function(Schirmer's test and salivary flow rate),reducing inflammatory indices(ESR,RF and CRP)and immunoglobulins(IgG,IgA and IgM)in pSS patients,improving serum gamma globulin,ESSPRI and other indices,while having fewer and less symptomatic adverse effects and the safety is better.However,due to the limitations of the sample size,methodological quality,and outcome indicators of the included studies,this conclusion needs to be validated by more high-quality studies.
systematic reviewtotal glucosides of paeonyprimary Sjögren's syndromerandomized controlled trial
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