Expert Consultation Study On Treatment Of Lupus Erythematosus Skin And Mucosa Damage With Integrated Traditional Chinese And Western Medicine

ObjectiveThis study used the Delphi method to explore the preliminary clinical consensus of integrated traditional Chinese and western medicine for the treatment of skin and mucosal lesions of lupus erythematosus(LE),and provided the basis for the development of clinical treatment plans,clinical pathways and related guidelines for LE skin and mucosal lesions.MethodsIn this study,the Delphi method was mainly used to consult experts in the LE research field on the treatment plan of integrated Chinese and Western medicine for skin and mucosal lesions of the disease through a questionnaire,and the results of expert assessment were statistically analyzed.1.Literature Research(1)According to the principles of evidence-based medicine,manual search and computer search are adopted to search the domestic and foreign literature databases to comprehensively collect the literature related to the treatment of LE skin and mucosa in traditional Chinese and Western medicine,and to the initial literature according to the inclusion and exclusion criteria Screening;(2)Classify and summarize the TCM syndrome types,prescriptions,Western medicines and other indicators included in the literature;(3)Classify the included documents according to the type of study and use literature quality evaluation tools such as the improved Jadad scale and the MINORS scale to evaluate the quality.2.Expert survey(1)An expert questionnaire was formed based on the literature research results,which was distributed in the form of paper and electronic questionnaires.This study conducted a total of two rounds of consultation;(2)According to the Delphi statistical method,statistical analysis was carried out on each round of questionnaires to explore the clinical consensus of integrated traditional Chinese and western medicine treatment for LE skin and mucosal damage,and to find the optimal integrated traditional Chinese and western medicine treatment plan.Results1.Literature research resultsThis study finally included 84 related literatures after screening.The included literatures are all domestic reports.The literature types are mainly expert experience and case reports,and there are few high-quality randomized controlled trials.There are also 3 related books and 4 clinical guidelines,mainly related to the treatment of LE.2.Questionnaire results(1)Expert Positive Coefficient Results:This study conducted two rounds of questionnaire consultation with 31 clinical experts in the field of LE across the country,and the questionnaire recovery rate was 100%,indicating that this subject was highly concerned by the experts participating in the questionnaire survey,ensuring the credibility of the results.(2)Questionnaire reliability results:In the two rounds of expert questionnaires,the average degree of expert familiarity,judgment basis,and authority are all greater than 0.90.The questionnaire has good credibility,and the content of expert consensus has important practical significance.3.Expert consensus:Summarizing the results of the two rounds of questionnaires,the consensus is as follows:①Most of the affected population are:young women;②The main factors leading to treatment difficulties:complex clinical manifestations and repeated attacks;③Common clinical manifestations:butterfly erythema,light sensitivity,mucosal ulcer,discoid erythema,Raynaud sign,hair loss;④Common clinical syndromes:severe heat toxin syndrome,yin deficiency with internal heat;⑤Common clinical treatment methods:Cooling blood and detoxifying,nourishing yin and clearing heat,nourishing liver and kidney;⑥Commonly used single drug:artemisia annua,radix astringenti,radix salviae miltiorrhiza;⑦Common prescriptions:zhibai dihuang soup,rhinoceros horn dihuang soup;⑧Commonly used plant extracts and proprietary Chinese medicines:tripterygium wilfordii polyglycoside tablets,total paeony glycoside capsules,compound glycyrrhizin tablets,Liuweidihuang pills;⑨External use:Glucocorticoids,calcineurin inhibitors;⑩Systematic use:antimalarial drugs,glucocorticoids,thalidomide;(11)Basic treatment:sun protection,cold prevention,standard control of lupus,strengthening skin and mucous membrane care,and avoiding drugs that can induce lupus.ConclusionIn this study,the Delphi method was used to preliminarily summarize the expert consensus on the treatment of LE skin and mucosal damage with integrated traditional Chinese and western medicine.The expert evaluation results are credible and the conclusions are reliable,which is conducive to standardizing the treatment of LE skin and mucosal damage.Especially in the absence of evidence-based medical evidence support for some of the current treatment programs,this study can provide a certain reference for the treatment of skin and mucosal lesions of lupus erythematosus with integrated Chinese and Western medicine.