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Data Mining Study on Prescription Patterns of Different Dosage Forms of Chinese Herbal Medicines for Treating and Improving Immune-Inflammatory Indices in Patients with Rheumatoid Arthritis

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Abstract

Objective

To explore the prescription patterns of different dosage forms of Chinese herbal medicines (CHMs) for the treatment of rheumatoid arthritis (RA) and their effects on immune-inflammatory indices.

Methods

Clinical data were collected from patients with RA in 4 hospitals (3 Class A comprehensive hospitals and 1 Class B comprehensive hospital) in Anhui Province, China, from August 2012 to June 2018 via the electronic medical record gathering system. Following extraction of prescription information, each prescribed herb was quantified and standardized according to the knowledge base to establish a database of RA treatment formulae. The medical records were divided into the granules group and decoction pieces group. Core herbs and their combination patterns were obtained from the two groups of cases using Liquorice software. Changes in immune-inflammatory and hepatic and renal function indices were compared between the two groups using SPSS 23.0 software. The Aprior module of SPSS Clementine 11.1 software was applied to analyse the correlation between CHMs and improvement in indices. Finally, the ORACLE 10 g tool was used to evaluate the random walk model of the immune-inflammatory indices between the two groups.

Results

(1) We retrospectively analysed 35,898 prescriptions for 6,829 patients with RA who received CHM treatment. There were 3,816 patients in the granules group and 3,013 in the decoction pieces group. (2) The core herbs were Pi (Spleen)-strengthening and dampness-resolving drugs, blood-activating and stasis-resolving drugs, wind/dampness-dispelling drugs and heat-clearing and detoxifying drugs. (3) Both dosage forms could improve immune-inflammatory indices in RA patients, with similar efficacy and no influence on hepatic or renal function. (4) Herba Siegesbeckiae and Oldenlandia had a stronger association with immune-inflammatory indices in the two groups. (5) The immune-inflammatory indices showed obvious improvement after treatment with granules and decoction pieces of CHMs, and there were long range correlations between the comprehensive evaluation indices and interventions.

Conclusions

The principal CHM treatment methods for RA in four hospitals in Anhui Province are strengthening Pi and resolving dampness, activating blood and resolving stasis, dispelling wind/dampness and clearing heat. Granules and decoction pieces of CHMs have similar efficacy in improving immune-inflammatory indices in RA patients and could be used as treatment options for RA.

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References

  1. Firestein GS. Evolving concepts of rheumatoid arthritis. Nature 2003;423:356–361.

    Article  CAS  Google Scholar 

  2. Davis JM. Rheumatoid arthritis: a severe disease that preventive approaches would greatly benefit. Clin Ther 2019;41:1240–1245.

    Article  Google Scholar 

  3. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010;69:1580–1588.

    Article  Google Scholar 

  4. Gulati M, Farah Z, Mouyis M. Clinical features of rheumatoid arthritis. Medicine 2018;46:211–215.

    Article  Google Scholar 

  5. Richman NC, Yazdany J, Graf J, Chernitskiy V, Imboden JB. Extraarticular manifestations of rheumatoid arthritis in a multiethnic cohort of predominantly hispanic and Asian patients. Medicine 2013;92:92–97.

    Article  CAS  Google Scholar 

  6. Naz SM, Symmons DP. Mortality in established rheumatoid arthritis. Best Pract Res Clin Rheumatol 2007;21:871–883.

    Article  Google Scholar 

  7. Dos Santos JBR, Guerra Junior AA, Da Silva MRR, Almeida AM, Acurcio FA, Alvares-Teodoro J. First line of biological drugs in rheumatoid arthritis: a medication persistence analysis. Expert Rev Clin Pharmacol 2019;12:363–370.

    Article  CAS  Google Scholar 

  8. McLaughlin M, Östör A. Safety of subcutaneous versus intravenous tocilizumab in combination with traditional disease-modifying antirheumatic drugs in patients with rheumatoid arthritis. Expert Opin Drug Saf 2015;14:429–437.

    Article  CAS  Google Scholar 

  9. Ruderman EM. Overview of safety of non-biologic and biologic DMARDs. Rheumatology 2012;51:vi37–vi43.

    Article  Google Scholar 

  10. Sepriano A, Kerschbaumer A, Smolen JS, van der Heijde D, Dougados M, van Vollenhoven R, et al. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2019 update of the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis 2020;79:760–770.

    Article  CAS  Google Scholar 

  11. Zhang C, Jiang M, Lu AP. Evidence-based Chinese medicine for rheumatoid arthritis. J Tradit Chin Med 2011;31:152–157.

    Article  Google Scholar 

  12. Lee WY, Chen HY, Chen KC, Chen CY. Treatment of rheumatoid arthritis with traditional Chinese medicine. Biomed Res Int 2014;2014:528018.

    PubMed  PubMed Central  Google Scholar 

  13. Liu J, Liu RL. The potential role of Chinese medicine in ameliorating extra-articular manifestations of rheumatoid arthritis. Chin J Integr Med 2011;17:735–737.

    Article  Google Scholar 

  14. Wang Y, Liu Y, Xi Z, Yu Y, Liu L, Mao J, et al. A multicenter, randomized, double-blind, placebo-controlled trial evaluating the efficacy and safety of Huangqi Guizhi Wuwutang Granule in patients with rheumatoid arthritis. Medicine (Baltimore) 2019;98:e14888.

    Article  Google Scholar 

  15. Guo Q, Mao X, Zhang Y, Meng S, Xi Y, Ding Y, et al. Guizhi-Shaoyao-Zhimu Decoction attenuates rheumatoid arthritis partially by reversing inflammation-immune system imbalance. J Transl Med 2016;14:165.

    Article  Google Scholar 

  16. Peng M. Research on the effect of formula granule of Duhuo Jisheng Decoction and traditional prepared drug in pieces on the biochemical index and clinical symptoms of patients with rheumatoid arthritis. Guangming J Chin Med (Chin) 2015;30:2106–2109.

    Google Scholar 

  17. Villeneuve E, Nam J, Emery P. 2010 ACR-EULAR classification criteria for rheumatoid arthritis. Rev Bras Reumatol 2010;50:481–483.

    Article  Google Scholar 

  18. Rheumatology Branch, Chinese Society of Traditional Chinese Medicine. Rheumatoid arthritis combined diagnosis and treatment guidelines. J Tradit Chin Med (Chin) 2018;59:1794–1800.

    Google Scholar 

  19. National Pharmacopoeia Committee. Pharmacopoeia of the People’s Republic of China. Beijing: China Medical Science Press;2015.

    Google Scholar 

  20. Gao XM, ed. Traditional Chinese medicine, 2nd. Beijing: China Traditional Chinese Medicine Publishing House;2011.

    Google Scholar 

  21. Xia P, Gao K, Xie J, Sun W, Shi M, Li W, et al. Data mining-based analysis of Chinese medicinal herb formulae in chronic kidney disease treatment. Evid Based Complement Alternat Med 2020;2020:9719872.

    PubMed  PubMed Central  Google Scholar 

  22. Xie JG, Wang N, Ding RK, Guo JC, Xin L, Liu J. Association learning of Chinese herbal medicines and disease treatment efficacy. Int J Prod Res 2019;57:683–702.

    Article  Google Scholar 

  23. Peng CK, Buldyrev SV, Goldberger AL, Havlin S, Sciortino F, Simons M, et al. Long range correlations in nucleotide sequence. Nature 1992;6365:168–170.

    Article  Google Scholar 

  24. Moudgil KD, Berman BM. Traditional Chinese medicine: potential for clinical treatment of rheumatoid arthritis. Expert Rev Clin Immun 2014;10:819–822.

    Article  CAS  Google Scholar 

  25. Zhang C, Jiang M, Lu AP. A traditional Chinese medicine versus Western combination therapy in the treatment of rheumatoid arthritis: two-stage study protocol for a randomized controlled trial. Trials 2011;12:137–137.

    Article  CAS  Google Scholar 

  26. Liu J, Wan L, Huang HB. Discussion on Bi disease caused by Spleen deficiency. China J Tradit Chin Med Pharm (Chin) 2017;32:2440–2444.

    Google Scholar 

  27. Humphreys JH, Van Nies JA, Chipping J, Marshall T, van der Helm-van Mil AH, Symmons DP, et al. Rheumatoid factor and anti-citrullinated protein antibody positivity, but not level, are associated with increased mortality in patients with rheumatoid arthritis: results from two large independent cohorts. Arthritis Res Ther 2014;16:483.

    Article  Google Scholar 

  28. Trouw LA, Haisma EM, Levarht EW, van der Woude D, Ioan-Facsinay A, Daha MR, et al. Anti-cyclic citrullinated peptide antibodies from rheumatoid arthritis patients activate complement via both the classical and alternative pathways. Arthritis Rheum 2009;60:1923–1931.

    Article  CAS  Google Scholar 

  29. Alemao E, Bao Y, Weinblatt ME, Shadick N. Association of seropositivity and mortality in rheumatoid arthritis and the impact of treatment with disease-modifying antirheumatic drugs: results from a real-world study. Arthritis Care Res (Hoboken) 2020;72:176–183.

    Article  CAS  Google Scholar 

  30. Wang X, Cheng W, Yao X, Guo X. Qualitative analysis of the chemical constituents in Hedyotis diffusa by HPLC-TOF-MS. Nat Prod Res 2012;26:167–172.

    Article  CAS  Google Scholar 

  31. Jia P, Liu W, Liu S, Gao W. Therapeutic effects of Hedyotis diffusa Willd on type II collagen-induced rheumatoid arthritis in rats. Chin J Appl Physiol 2018;34:558–561.

    Google Scholar 

  32. Yang X, Li Y, Lv R, Qian H, Chen X, Yang CF. Study on the multitarget mechanism and key active ingredients of Herba siegesbeckiae and volatile oil against rheumatoid arthritis based on network pharmacology. Evid Based Complement Alternat Med 2019;2019:8957245.

    PubMed  PubMed Central  Google Scholar 

  33. Zhang QR, Zhong ZF, Sang W, Xiong W, Tao HX, Zhao GD, et al. Comparative comprehension on the anti-rheumatic Chinese herbal medicine Siegesbeckiae Herba: combined computational predictions and experimental investigations. J Ethnopharmacol 2019;228:200–209.

    Article  Google Scholar 

  34. Xiong X, Tan M, Boyett J. A sequential procedure for monitoring clinical trials against historical controls. Stat Med 2007;26:1497–1511.

    Article  Google Scholar 

Download references

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Authors and Affiliations

Authors

Contributions

Liu J conceived of and designed the study; Huang D wrote the manuscript; Xin L provided technical support for the data mining; Huang D and Xin L extracted and analysed the data; Xie JG provided guidance on the analysis and writing; and Zhu Q, Chen PS, Shen ZB, Meng QH, and Wang HY identified subjects and the collected clinical data.

Corresponding author

Correspondence to Jian Liu.

Ethics declarations

The authors declare that there are no conflicts of interest associated with this work.

Additional information

Supported by the National Key Research and Development Program of the Ministry of Science and Technology (No. 2018YFC1705204), the Major Science and Technology Project of Anhui Province (No. 17030801009), the Key Research and Development Projects of Foreign Scientific and Technological Cooperation planned in Anhui Province (No. 201904b11020011), the Anhui Provincial Laboratory of Internal Medicine Application and Development of Modern Chinese Medicine (No. 2016080503B041), the Construction Project of LIU Jian Studio of Traditional Chinese Medicine in Anhui Province (Secretary of Development of Traditional Chinese Medicine [2018] No. 11), and the 12th Batch of the “115” Innovation Team in Anhui Province (No. 1 [2019] of the Anhui Talent Office)

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Data Mining Study on Prescription Patterns of Different Dosage Forms of Chinese Herbal Medicines for Treating and Improving Immune-Inflammatory Indices in Patients with Rheumatoid Arthritis

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Huang, D., Liu, J., Xin, L. et al. Data Mining Study on Prescription Patterns of Different Dosage Forms of Chinese Herbal Medicines for Treating and Improving Immune-Inflammatory Indices in Patients with Rheumatoid Arthritis. Chin. J. Integr. Med. 28, 215–222 (2022). https://doi.org/10.1007/s11655-020-3480-1

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