A Retrospective Cohort Study of Chinese Herbal Medicine Reducing the Risk of Readmission of Rheumatoid Arthritis Complicated with Sjogren's Syndrome

Background Many patients with rheumatism seek Chinese herbal medicine (CHM). Currently, CHM is effective in treating rheumatoid arthritis (RA) and Sjogren's syndrome (SS), but there are few studies on whether CHM reduces the risk of readmission for rheumatoid arthritis with Sjogren's syndrome (RA+SS) . Objective To determine whether CHM can reduce the readmission risk ratio of rheumatoid arthritis with Sjogren's syndrome (RA+SS) . Methods a retrospective cohort design was used in this study, and the data were collected from the First Affiliated Hospital of Anhui University of Chinese Medicine hospital information system (HIS) from 2012 to 2021. All subjects were followed up until January 2022. They were divided into RA+SS patients and RA patients according to their disease conditions. RA+SS patients were divided into CHM users and non-CHM users according to drug use. Cox regression model was used to investigate the factors affecting the readmission of patients with RA+SS. Kaplan-Meier (KM) curve was used to compare the readmission ratio between the CHM group and the non-CHM group. Results The incidence of liver dysfunction, chronic renal dysfunction, autoimmune hepatitis, the levelof rheumatoid factor (RF), and positive rates of anti-SS-A antibody (SSA) and anti-SS-B antibody (SSB) were higher in the RA+SS group than in the RA group, and the number of recurrent hospitalizations was higher in the RA group (P<0.05). Cox proportional risk model analysis showed that the adjusted HR for readmission risk of RA+SS in CHM patients was lower (0.45) (95%CI=0.28-0.71). Kaplan-Meier survival analysis showed that the readmission rate of RA + SS was higher than that of RA group (χ2=56.254, P<0.01). The readmission rate of CHM group was lower than that of non-CHM group (χ2=24.020, P=0.019), and the readmission rate of female patients in CHM group was reduced more significantly (χ2=20.577, P=0.002). The readmission rate of patients over 60 years of age in CHM group was reduced more significantly (χ2=6.583, P=0.006) . Conclusion The addition of CHM treatment to RA+SS patients on the basis of conventional treatment can reduce the need for readmission, especially for female patients or patients over 60 years old, and provide theoretical basis for clinical treatment of RA+SS patients.