Integrative therapy decreases the risk of lupus nephritis in patients with systemic lupus erythematosus: A population-based retrospective cohort study

Ching Mao Chang, Po Chang Wu, Jen Huai Chiang, Yau Huei Wei, Fang Pey Chen, Tzeng Ji Chen, Tai Long Pan, Hung Rong Yen*, Hen Hong Chang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Ethnopharmacological relevance Evidence on alleviating the risk of lupus nephritis by integrative therapy with conventional medicine (CM) and herbal medicine (HM) had not been addressed. Aim of the study We investigated the integrative effect associated the risk by a retrospective Systemic Lupus Erythematosus (SLE) cohort from Taiwan National Health Insurance Research Database (NHIRD). Materials and methods SLE patients with a catastrophic illness certificate (CIC) were retrospectively enrolled from the SLE cohort of the Taiwan NHIRD between 1997 and 2011. The patients were divided into an integrative medicine (IM: integrated CM plus HM) and a non-IM (CM only) group with 1:1 propensity score matching. Cox proportional regression model and the Kaplan-Meier method were conducted to estimate the hazard ratio (HR) for lupus nephritis in the cohort. Results Among 16,645 newly diagnosed SLE patients holding a CIC (SLE/CIC), 1933 had received HM and 1571 had received no HM treatment. After propensity score matching, there were 273 patients with lupus nephritis-120 in the IM group and 153 in the non-IM group. The adjusted HR (0.68, 95% confidence interval [CI]: 0.54–0.87, p<0.01) for lupus nephritis was lower in the IM group than in the non-IM group. The adjusted HR (0.69, 95% CI: 0.54–0.88, p<0.001) for lupus nephritis was also lower in the group of patients who had received CM plus HM than in the group that received CM only. The core pattern of HM prescriptions, which were integrated with CM for preventing lupus nephritis, was “Sheng-Di-Huang” (raw Rehmannia glutinosa Libosch.), “Mu-Dan-Pi” (Paeonia suffruticosa Andr.), “Dan-Shan” (Salvia miltiorrhiza Bge.), “Zhi-Bo-Di-Huang-Wan.”, and “Chi-Shao” (Paeoniae lactiflorae Rubra). Conclusion Integrative therapy decreased the risk of lupus nephritis among SLE patients in Taiwan. Further investigation of the pharmacological mechanism and clinical efficacy are warranted.

Original languageEnglish
Pages (from-to)201-212
Number of pages12
JournalJournal of Ethnopharmacology
Volume196
DOIs
StatePublished - 20 Jan 2017

Keywords

  • Complementary and alternative medicine
  • Herbal medicine
  • Integrative therapy
  • Lupus nephritis
  • Systemic lupus erythematosus

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