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Evidence-Based Complementary and Alternative Medicine
Volume 2013, Article ID 327245, 10 pages
http://dx.doi.org/10.1155/2013/327245
Research Article

Chinese Herbal Medicine (Zi Shen Qing) for Mild-to-Moderate Systematic Lupus Erythematosus: A Pilot Prospective, Single-Blinded, Randomized Controlled Study

1Clinical Division, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong
2Department of Rheumatology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 725 Wan Ping South Road, Shanghai, China
3Department of Pharmacy, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 725 Wan Ping South Road, Shanghai, China

Received 9 February 2013; Revised 8 April 2013; Accepted 10 April 2013

Academic Editor: Aiping Lu

Copyright © 2013 Linda L. D. Zhong et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. T. Stoll, N. Sutcliffe, J. Mach, R. Klaghofer, and D. A. Isenberg, “Analysis of the relationship between disease activity and damage in patients with systemic lupus erythematosus: a 5-year prospective study,” Rheumatology, vol. 43, no. 8, pp. 1039–1044, 2004. View at Publisher · View at Google Scholar · View at Scopus
  2. American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Guidelines, “Guidelines for referral and management of systemiclupus erythematosus in adults,” Arthritis & Rheumatism, vol. 42, no. 9, pp. 1785–1796, 1999. View at Google Scholar
  3. J. Nossent, E. Kiss, B. Rozman et al., “Disease activity and damage accrual during the early disease course in a multinational inception cohort of patients with systemic lupus erythematosus,” Lupus, vol. 19, no. 8, pp. 949–956, 2010. View at Publisher · View at Google Scholar · View at Scopus
  4. J. Klippel, Primer on the Rheumatic Diseases, Arthritis Foundation, Atlanta, Ga, USA, 11th edition, 1997.
  5. J. Font, R. Cervera, M. Ramos-Casals et al., “Clusters of clinical and immunologic features in systemic lupus erythematosus: analysis of 600 patients from a single center,” Seminars in Arthritis and Rheumatism, vol. 33, no. 4, pp. 217–230, 2004. View at Publisher · View at Google Scholar · View at Scopus
  6. G. S. Firestein, Kelley's Textbook of Rheumatologyed, Saunders, Philadelphia, Pa, USA, 8th edition, 2008.
  7. A. Mak, D. A. Isenberg, and C. S. Lau, “Global trends, potential mechanisms and early detection of organ damage in SLE,” Nature Reviews. Rheumatology, 2012. View at Publisher · View at Google Scholar
  8. A. Doria, L. Iaccarino, A. Ghirardello et al., “Long-term prognosis and causes of death in systemic lupus erythematosus,” The American Journal of Medicine, vol. 119, no. 8, pp. 700–706, 2006. View at Publisher · View at Google Scholar · View at Scopus
  9. A. Ippolito and M. Petri, “An update on mortality in systemic lupus erythematosus,” Clinical and Experimental Rheumatology, vol. 26, pp. S72–S79, 2008. View at Google Scholar
  10. G. Bertsias and D. T. Boumpas, “Update on the management of lupus nephritis: let the treatment fit the patient,” Nature Clinical Practice Rheumatology, vol. 4, no. 9, pp. 464–472, 2008. View at Publisher · View at Google Scholar · View at Scopus
  11. A. N. Kiani and M. Petri, “Quality-of-life measurements versus disease activity in systemic lupus erythematosus,” Current Rheumatology Reports, vol. 12, no. 4, pp. 250–258, 2010. View at Publisher · View at Google Scholar · View at Scopus
  12. Y. N. Liao, C. S. Liu, T. R. Tsai et al., “Preliminary study of a traditional Chinese medicine formula in systemic lupus erythematosus patients to taper steroid dose and prevent disease flare-up,” The Kaohsiung Journal of Medical Sciences, vol. 27, no. 7, pp. 251–257, 2011. View at Publisher · View at Google Scholar · View at Scopus
  13. B. Y. Zhang, J. H. Dong, and Z. Y. Zhou, Traditional Chinese Internal Medicine, Shang Hai Science and Technology Press, Shanghai, China, 1985.
  14. D. P. Chen, C. K. Wong, P. C. Leung et al., “Anti-inflammatory activities of Chinese herbal medicine sinomenine and Liang Miao San on tumor necrosis factor-α-activated human fibroblast-like synoviocytes in rheumatoid arthritis,” Journal of Ethnopharmacologyvol, vol. 137, no. 1, pp. 457–468, 2011. View at Google Scholar
  15. Chinese Pharmacopoeia Commission, Pharmacopoeia of the People's Republic of China, People's Medical Publishing House, Beijing, China, 2005.
  16. X. F. Xu, H. R. Qu, Z. Y. Xiang et al., “Effects of Ziyin Jiedu Quyu Decoction on glucocorticoid dosage in systemic lupus erythematosus: a double-blind randomized controlled trial,” Shang Hai Journal of Traditional Chinese Medicine, vol. 46, no. 1, pp. 33–36, 2012. View at Google Scholar
  17. H. H. Li and X. L. Lu, “An overview of Chinese Medicine in the treatment of systemic lupus erythematosus,” Modern Journal of Integrated Traditional Chinese and Western Medicineno, vol. 21, no. 36, pp. 4100–4102, 2012. View at Google Scholar
  18. P. J. Zhao, J. C. Mao, X. J. Chen et al., “Efficacy observation on mild to moderate active systemic lupus erythematosus treated with compound Zishenqing formula,” World Journal of Integrated Traditional and Western Medicine, vol. 7, no. 1, pp. 37–39, 2012. View at Google Scholar
  19. X. J. Chen and J. H. Gu, “Observational study of Zi Shen Qing in the treatment of active systemic lupus erythematosus,” Shang Hai Journal of Traditional Chinese Medicine, no. 10, pp. 16–18, 1999. View at Google Scholar
  20. X. J. Chen, J. H. Gu, J. C. Mao et al., “Clinical study of Zi Shen Qing combination with Western medicine in the treatment of systemic lupus erythematosus,” Jiang Su Journal of Traditional Chinese Medicine, vol. 41, no. 8, pp. 26–28, 2009. View at Google Scholar
  21. S. Q. Liu and X. J. Chen, “Treatment of 62 mild to moderate active systemic lupus erythematosus with Zi Shen Qing formula,” Hei Long Jiang Medicine Journal, vol. 123, no. 12, pp. 224–226, 2010. View at Google Scholar
  22. W. J. Koopman, Arthritis and Allied Conditionsed, Williams & Wilkins, Baltimore, Md, USA, 13th edition, 1997.
  23. The State Administration of traditional Chinese Medicine of the People's Republic of China, Guidance For Clinical Research of Chinese Herbal Medicine 2002, China Press of Traditional Chinese Medicine, Beijing, China, 2002.
  24. The State Administration of traditional Chinese Medicine of the People's Republic of China, Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine, Nanjing University Press, Beijing, China, 1994.
  25. X. Zhou, R. F. Xie, J. H. Gu et al., “Use HPLC-MS-MS to determine the astragaloside content of ZSQ granules,” Shan Xi Journal of Traditional Chinese Medicine, vol. 29, no. 4, pp. 490–492, 2008. View at Google Scholar
  26. X. Zhou, J. H. Gu, R. F. Xie et al., “The qualitative identification and quantitative detection for total paeoniflorin in ZSQ granules,” Journal of Hangzhou Teachers College, vol. 28, no. 4, pp. 265–269.
  27. Z. Touma, M. B. Urowitz, S. Taghavi-Zadeh, D. Ibañez, and D. D. Gladman, “Systemic lupus erythematosus disease activity Index 2000 responder index 50: sensitivity to response at 6 and 12 months,” Rheumatology, vol. 51, no. 10, pp. 1814–1819, 2012. View at Google Scholar
  28. C. S. Yee, V. T. Farewell, D. A. Isenberg et al., “The use of systemic lupus erythematosus disease activity index-2000 to define active disease and minimal clinically meaningful change based on data from a large cohort of systemic lupus erythematosus patients,” Rheumatology, vol. 50, no. 5, Article ID keq376, pp. 982–988, 2011. View at Publisher · View at Google Scholar · View at Scopus
  29. D. Ibañez, D. D. Gladman, Z. Touma, M. Nikpour, and M. B. Urowitz, “Optimal frequency of visits for patients with systemic lupus erythematosus to measure disease activity over time,” The Journal of Rheumatology, vol. 38, no. 1, pp. 60–63, 2011. View at Publisher · View at Google Scholar · View at Scopus
  30. P. P. Smith and C. Gordon, “Systemic lupus erythematosus: clinical presentations,” Autoimmunity Review, vol. 10, no. 1, pp. 43–45, 2010. View at Google Scholar
  31. C. E. Tseng, J. P. Buyon, M. Kim et al., “The effect of moderate-dose corticosteroids in preventing severe flares in patients with serologically active, but clinically stable, systemic lupus erythematosus: findings of a prospective, randomized, double-blind, placebo-controlled trial,” Arthritis & Rheumatism, vol. 54, no. 11, pp. 3623–3632, 2006. View at Publisher · View at Google Scholar · View at Scopus
  32. J. M. Esdaile, “The efficacy of antimalarials in systemic lupus erythromatosus,” Lupus, vol. 2, no. 1, pp. S3–S8, 1993. View at Google Scholar · View at Scopus
  33. S. Q. Liu and X. J. Chen, “The effectiveness of Zi Shen Qing formula on regulation of CD4, CD25 with the mild to moderate active systemic lupus erythematosus patients,” Liao Ning Journal of Traditional Chinese Medicine, vol. 34, no. 12, pp. 1669–1770.
  34. E. Whitley and J. Ball, “Statistics review 2: samples and populations,” Critical Care, vol. 6, no. 2, pp. 143–148, 2002. View at Google Scholar · View at Scopus
  35. H. Bootsma, P. Spronk, R. Derksen et al., “Prevention of relapses in systemic lupus erythematosus,” The Lancet, vol. 345, no. 8965, pp. 1595–1599, 1995. View at Google Scholar
  36. M. F. Marmor, R. E. Carr, M. Easterbrook, A. A. Farjo, and W. F. Mieler, “Recommendations on screening for chloroquine and hydroxychloroquine retinopathy: a report by the american academy of ophthalmology,” Ophthalmology, vol. 109, no. 7, pp. 1377–1382, 2002. View at Publisher · View at Google Scholar · View at Scopus
  37. T. Dörner, “Therapy: hydroxychloroquine in SLE: old drug, new perspectives,” Nature Reviews Rheumatology, vol. 6, pp. 10–11, 2010. View at Publisher · View at Google Scholar
  38. G. Ruiz-Irastorza, M. Ramos-Casals, P. Brito-Zeron, and M. A. Khamashta, “Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: a systematic review,” Annals of the Rheumatic Diseases, vol. 69, no. 1, pp. 20–28, 2010. View at Publisher · View at Google Scholar · View at Scopus
  39. S. C. Chiu, Y. L. Lai, H. H. Chang et al., “The therapeutic effect of modified Yu Ping Feng San on idiopathic sweating in end-stage cancer patients during hospice care,” Phytotherapy Research, vol. 23, no. 3, pp. 363–366, 2009. View at Publisher · View at Google Scholar · View at Scopus
  40. P. M. K. Poon, C. K. Wong, K. P. Fung et al., “Immunomodulatory effects of a traditional Chinese medicine with potential antiviral activity: a self-control study,” The American Journal of Chinese Medicine, vol. 34, no. 1, pp. 13–21, 2006. View at Publisher · View at Google Scholar · View at Scopus
  41. J. H. Gu and X. J. Chen, “Animal experimental study on immune regulating function of ZSQ formula,” Acta Universitatis Traditionis Medicalis Sinensis Pharmacologiaeque Shanghaino, vol. 15, no. 2, pp. 44–45, 2001. View at Google Scholar
  42. I. K. Zarkadis, D. Mastellos, and J. D. Lambris, “Phylogenetic aspects of the complement system,” Developmental and Comparative Immunology, vol. 25, no. 8-9, pp. 745–762, 2001. View at Publisher · View at Google Scholar · View at Scopus
  43. M. M. Frank, J. P. Atkinson et al., Samter's Immunologic Diseases, Lippincott Williams & Wilkins, Philadelphia, Pa, USA, 6 edition, 2001.
  44. Y. P. Chuang, C. H. Wang, N. C. Wang, D. M. Chang, and H. K. Sytwu, “Modulatory function of invariant natural killer T cells in systemic lupus erythematosus,” Clinical and Developmental Immunology, vol. 2012, Article ID 478429, 8 pages, 2012. View at Publisher · View at Google Scholar
  45. J. H. Gu and X. J. Chen, “Observation on compound Zishenqing on peripheral blood mononuclear Cell (PBMC) of active SLE by serum pharmacology,” Shan Dong Journal of Traditional Chinese Medicine, vol. 25, no. 1, pp. 47–51, 2007. View at Google Scholar
  46. Z. Z. Yang, D. M. Grote, S. C. Ziesmer et al., “Soluble IL-2Rα facilitates IL-2-mediated immune responses and predicts reduced survival in follicular B-cell non-Hodgkin lymphoma,” Blood, vol. 118, no. 10, pp. 2809–2820, 2011. View at Google Scholar
  47. E. M. El-Shafey, G. F. El-Nagar, A. S. El-Bendary, A. A. Sabry, and A. G. Selim, “Serum soluble interleukin-2 receptor alpha in systemic lupus erythematosus,” Iranian Journal of Kidney Diseases, vol. 2, no. 2, pp. 80–85, 2008. View at Google Scholar · View at Scopus
  48. R. K. Luijten, R. D. Fritsch-Stork, J. W. Bijlsma, and R. H. Derksen, “The use of glucocorticoids in Systemic Lupus Erythematosus. After 60 years still more an art than science,” Autoimmunity Review, vol. 12, no. 5, pp. 617–628, 2012. View at Publisher · View at Google Scholar
  49. G. Franchin and B. Diamond, “Pulse steroids: how much is enough?” Autoimmunity Reviews, vol. 5, no. 2, pp. 111–113, 2006. View at Publisher · View at Google Scholar · View at Scopus
  50. G. G. Illei, H. A. Austin, M. Crane et al., “Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis,” Annals of Internal Medicine, vol. 135, no. 4, pp. 248–257, 2001. View at Google Scholar · View at Scopus
  51. M. Petri, “Monitoring systemic lupus erythematosus in standard clinical care,” Best Practice and Research, vol. 21, no. 4, pp. 687–697, 2007. View at Publisher · View at Google Scholar · View at Scopus
  52. M. Thamer, M. A. Hernán, Y. Zhang, D. Cotter, and M. Petri, “Prednisone, lupus activity, and permanent organ damage,” The Journal of Rheumatology, vol. 36, no. 3, pp. 560–564, 2009. View at Publisher · View at Google Scholar · View at Scopus