This study performed to observe the effect of Yiqi Jianpi Shengjin recipe on Tfr/Tfh cell balance and autophagy expression in primary Sj?gren's syndrome(pSS)patients,and to explore the intervention mechanism of Yiqi Jianpi Shengjin recipe in treating pSS.We collected 60 cases of pSS with deficiency of both qi and yin from the Department of Rheumatology and Immunology of Anhui Provincial Hospital of TCM and randomly grouped them into experimental group and control group,with each group consisting of 30 cases.The control group was given a dose of hydroxychloroquine sulphate 0.2 g bid,the experimental group received an additional oral dose of Yiqi Jianpi Shengjin formula on top of the control group's treatment,and both continued to take it for 12 weeks.IL-10,IL-21 and IL-6 levels were measured by enzyme-linked immunosorbent assay,Tfh and Tfr cells ratios were measured by Flow cytometry,Western blot was used to detect the protein expression of Atg5,Beclin1 and LC3-Ⅱ/Ⅰ,and qPCR was used to detect the RNA expression of Atg5,Beclin1 and LC3.The indexes of inflammation,dryness,ESSPRI,ESSDAI and TCM syndrome integral before and after treatment were statistically analyzed.Data showed that the scores of corneal fluorescence stainin g in the experimental group were significantly lower and the static saliva flow rate was significantly higher compared with the control group.The experimental group showed a marked reduction in TCM,ESSPRI and ESSDAI score after treatment compared to control group.The expression of IL-21,IL-10 and IgG in the experimental group was markedly lower compa red with the control group.Tfr cells were significantly lower in the experimental group as compared to the control group.T he expression and ratio of autophagy protein and mRNA in the experimental group were significantly lower compared with t he control group.In conclusion,Yiqi Jianpi Shengjin recipe can effectively reestablish the balance of Tfr/Tfh cells,regulate cytokines,inhibit autophagy and activity,relieve clinical symptoms,delay disease activity,and improve the secretion of lacrimal gland and salivary gland.

ObjectiveTo investigate the clinical efficacy and safety of Qihuang Jianpi Zishen granules in the treatment of cardiac involvement in systemic lupus erythematosus （SLE）. MethodA total of 62 SLE patients with cardiac involvement treated in the Department of Rheumatology and Immunology， the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2021 to December 2022 were randomized into control and observation groups （n=31）. The control group was treated with methylprednisolone tablets and hydroxychloroquine sulfate tablets， and the observation group with Qihuang Jianpi Zishen granules on the basis of the therapy in the control group. After 12 weeks of treatment， the two groups were compared in terms of the therapeutic effect， cardiac function indicators ［left atrial end-diastolic diameter （LADd）， left ventricular end-diastolic diameter （LVDd）， left ventricular posterior wall thickness （LVPWTd）， peak blood flow velocity in early diastolic period （peak E）， peak blood flow velocity in late diastolic period （peak A）， E/A ratio， stroke volume （SV）， left ventricular ejection fraction （LVEF）， left ventricular short axis shortening rate （LVFS）， and B-type natriuretic peptide （BNP）］， vascular damage indicators ［nitric oxide （NO）， endothelin-1 （ET-1）， vascular endothelial growth factor （VEGF）， and homocysteine （Hcy）］， inflammation indicators ［erythrocyte sedimentation rate （ESR） and hypersensitive C-reactive protein （Hs-CRP）］， anti-double-stranded DNA （dsDNA） antibodies， disease activity index （SLEDAI） score， mitigation of symptoms and signs， and occurrence of adverse reactions. ResultThe total response rate in the observation group was 87.09%， which was higher than that （67.74%） in the control group （P<0.01）， and the incidence of adverse reactions had no significant difference between the two groups. After treatment， the control group showed lowered LVDd， LVPWTd， BNP， ET-1， VEGF， and Hcy （P<0.05） and increased E peak， E/A ratio， SV， LVEF， and LVFS （P<0.05）. In the observation group， LADd， LVDd， LVPWTd， peak A， BNP， NO， ET-1， VEGF， and Hcy decreased （P<0.05）， while peak E， E/A ratio， SV， LVEF and LVFS increased （P<0.05） after treatment. The treatment in both groups decreased the scores of palpitation， chest tightness， dyspnea， and edema （P<0.05）， reduced ESR， Hs-CRP， ds-DNA， and SLEDAI （P<0.05）. After treatment， the observation group had lower LADd， LVDd， LVPWTd， peak A， BNP， and scores of palpation， chest tightness， dyspnea， and edema （P<0.05） and higher peak E， E/A ratio， SV， LVEF， and LVFS （P<0.05） than the control group. In addition， the observation group had lower NO， ET-1， VEGF， Hcy， ESR， Hs-CRP， ds-DNA， and SLEDAI than the control group （P<0.05）. ConclusionQihuang Jianpi Zishen granules combined with hydroxychloroquine sulfate and methylprednisolone can improve multiple indicators and mitigate the symptoms and signs of SLE patients with cardiac involvement， demonstrating a clinical application value.