{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T18:55:21Z","timestamp":1769799321358,"version":"3.49.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the effects of the Xin\u2019an Jianpi Tongbi Formula (XAJPF), composed mainly of Huangqin Qingre Chubi Capsule (HQC) and Xinfeng Capsule (XFC), on the systemic inflammation and self-perception of patients (SPP) composite outcomes in rheumatoid arthritis (RA), and innovatively analyze the mediating effect of systemic inflammation index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study was conducted in the Department of Rheumatology of the First Affiliated Hospital of Anhui University of Chinese Medicine from August 2023 to February 2025. The study used admission and discharge as primary time points, grouping 935 RA patients based on their baseline median neutrophil-to-lymphocyte ratio (NLR) levels and employing propensity score matching to control for intergroup confounders. Exposure was defined as receiving XAJPF treatment (divided into high\/low exposure groups based on the type). Multimodal analyses, including logistic regression, association rules, mediation analysis, and sensitivity analysis, were used to comprehensively evaluate the effects of XAJPF on the primary outcomes (SPP scores) and secondary outcomes [NLR and systemic inflammation response index (SIRI)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, baseline characteristics were balanced between groups. Higher inflammatory status was associated with worse SPP scores. Compared with the non-exposure group, XAJPF exposure demonstrated superior efficacy in improving SPP outcomes and systemic inflammation levels, without causing hepatic or renal injury. Multivariable-adjusted logistic regression identified XAJPF as an independent protective factor against worsening PF, GH, VT, MH, VAS, PGA, PhGA, CPRI-RA, SDS, SDH, and SDSSD, with odds ratios of 0.24, 0.60, 0.54, 0.50, 0.44, 0.46, 0.54, 0.56, 0.43, 0.29, and 0.49 (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt;0.05), with exposure-response relationships observed. Mediation analysis indicated that NLR and SIRI mediated 5.1\u201314.4% of XAJPF\u2019s improvement effects on VAS, PhGA, and SDSSD scores. Subgroup and sensitivity analyses underscored the robustness of these effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study establishes the pivotal role of NLR and SIRI in the inflammation-perception axis of RA and confirms them as partial mediators of the multidimensional therapeutic effects of XAJPF. This provides a novel perspective for understanding the clinical application of the Chinese compound.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1756862","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T06:43:29Z","timestamp":1769755409000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidimensional effects of the Xin\u2019an Jianpi Tongbi Formula on self-perception of patients with rheumatoid arthritis: focusing on the mediating role of systemic inflammation index"],"prefix":"10.3389","volume":"13","author":[{"given":"Yang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Rheumatology, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei","place":["Anhui, China"]},{"name":"Anhui Provincial Key Laboratory of Applied Basic and Clinical Translational Research in Traditional Chinese Medicine Rheumatology, 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