Treatment of juvenile idiopathic arthritis combined with atopy by using Chinese traditional and Western medicine

Objective To confirm the therapeutic effect of traditional Chinese medicine (TCM) on juvenile idiopathic arthritis (JIA). Methods Patients who were newly diagnosed as JIA between December 2012 and December 2013 in Renji Hospital, School of Medicine, Shanghai Jiaotong University were enrolled in this study.All patients were divided into 3 groups. Group one was briefed as atopy-TCM group, which had 14 patients with both JIA and atopy, and was treated with TCM integrated medicine; group two was briefed as atopy-Western medicine group, which had 15 patients with both JIA and atopy, and was treated with Western medicine alone; and group three was briefed as non-atopy-Western medicine group, which had 36 patients with JIA, and was treated by Western medicine alone. And 25 healthy children were enrolled as healthy control group. First the effect of atopy on JIA patients who received Western medicine were compared, and then the effects of TCM on patients with JIA and atopy. The clinical effect was evaluated by using ACR 30 method which was made by American College of Rheumatology and the serum level of interleukin(IL)-1β, IL-6, IL-17 were studied by way of enzyme-linked immunosorbent assay. Results All the patients were followed up for at least 6 months among whom 55 completed the follow-up, and 10 withdrew. (1)When enrolled, atopy-TCM group and atopy-Western medicine group had higher levels of erythrocyte sediment rates (ESR) than non-atopy-Western medicine group respectively [(33.89±20.11) mm/1 h vs (17.35±10.71) mm/1 h, t=2.13, P 0.05). Atopy-TCM group had 4 patients (33.3%) achieving ACR30, 7 patients (58.3%) achieving ACR50 with an obvious difference from atopy-Western medicine group(u=40.5, P<0.05). (4) After 6 months′ follow-up, atopy-Western group had obviously higher level of IL-17 than that of atopy-TCM group [(0.75±0.33)ng/L vs (0.37±0.44) ng/L, t=2.43, P<0.05]. Conclusions Atopy will obviously improve inflammation cytokines level of patients with JIA.And TCM-integrated therapy can get better effects through suppression of cytokine level, especially IL-17. Key words: Juvenile idiopathic arthritis; Atopy; Synergistic therapy of Chinese traditional medicine and Western medicine; Cytokine