Clinical Efficacy of Modified Shenling Baizhu Powder(参苓白术散加减)in Treatment of Sj?gren Syndrome of Lung and Spleen Qi Deficiency Type and Its Effect on TLR4/NF-κB Levels
Objective To explore the clinical efficacy of Modified Shenling Baizhu Powder(参苓白术散加减)in the treatment of Sjögren syndrome of lung and spleen Qi deficiency type and its effect on toll-like receptor 4/nuclear factor kappa B(TLR4/NF-κB)levels.Methods One hundred and seven patients with Sjögren syndrome in the hospital from March 2019 to March 2022 were enrolled,and classified into two groups by using sealed opaque envelopes.The patients with the numbers greater than or equal to 54 were included in the observation group(54 cases)and those with the numbers less than 54 were included in the control group(53 cases).The control group was given hydroxychloroquine sulphate tablets and methylprednisolone tablets for treatment.Based on this,the observation group was treated with Modified Shenling Baizhu Powder.Then the TCM syndrome scores,EULAR Sjögren's Syndrome Disease Activity Index(ESSDAI),EULAR Sjögren's Syndrome Patient Reported Index(ES-SPRI),inflammatory factors,immune function and serum TLR4/NF-κB levels were observed before and after treatment in both groups.Then the clinical efficacy was compared between two groups.Results The scores of TCM syndromes including ocular dry-ness,joint pain,dry mouth and throat,dry skin,fatigue and salivary gland swelling yielded no statistical difference between two groups before treatment(P＞0.05),while the above TCM syndrome scores of the observation group were lower than those of the control group(P＜0.05).ESSDAI and ESSPRI scores showed no statistical difference between two groups before treatment(P＞0.05),while the observation group scored lower on ESSDAI and ESSPRI than those of the control group after treatment(P＜0.05).The serum levels of interferon-y(IFN-γ)and interleukin-17(IL-17)denoted no statistical difference between two groups(P＞0.05),while the two inflammation factors were lower in the observation group than those in the control group after treatment(P＜0.05).The values of CD4+,CD8+and CD4+/CD8+demonstrated no statistical difference between two groups before treatment(P＞0.05).After treatment,an increase in CD4+and CD4+/CD8+along with a decrease in CD8+were observed in both groups.Furthermore,the two changes were both more remarkable in the observation group than those in the control group(P＜0.05).TLR4/NF-κB levels demonstrated no statistical difference between two groups before treatment,while the TLR4/NF-κB level of the observation group was lower than that of the control group(P＜0.05).The clinical efficacy rate was 96.30％in the observation group,which was higher than 84.91％in the control group,with statistical difference(x2=4.096,P=0.043).Conclusion Application of Modified Shenling Baizhu Powder in the treatment of Sjögren syndrome can effectively reduce ESSDAI and ESSPRI scores,improve TLR4/NF-κB and immune function in patients.
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