Psoriasis is a common and recurring chronic inflammatory skin disease, commonly known as “psoriasis” and “Bai H” in Chinese medicine, which is a chronic erythematous, scaly skin disease of unknown origin and belongs to the category of “dermatophytosis It is a chronic, erythematous, scaly skin disease of unknown origin, and belongs to the category of “dyschromia. It is a chronic erythematous, scaly skin disease of unknown origin, and belongs to the category of “dry ringworm”, “dermatophytosis”, “pineal ringworm”, “white H”, “white H wind”, and “white H”. The diseases “white H wind”, “snake wind” and “white shell sore” are all related to this disease.
Western medicine believes that its onset is related to various factors such as genetics, infection, metabolic disorders, endocrine disorders, neuropsychiatric factors and immune disorders. The disease is recurrent, stubborn and difficult to cure, and has a high recurrence rate, causing great pain to patients, and is one of the key skin diseases in the field of dermatology at home and abroad. Chinese medicine has accumulated rich experience in the treatment of psoriasis, and its efficacy is certain and its side effects are small, which can best reflect the characteristics and advantages of Chinese medicine.
1.Fuyang therapy
1.1 Clinical treatment method of psoriasis clinically, the prescriptions and experience of each Chinese medicine school in treating psoriasis are different, but the treatment method is basically the same. For the evidence types of psoriasis such as blood heat, blood stasis, blood dryness and blood deficiency, treatment rules are given to clear heat and cool blood, invigorate blood stasis, nourish blood and moisten dryness, nourish yin and nourish blood respectively.
Representative treatment methods include.
①Zhao Bingnan divided psoriasis into blood-heat type (progressive stage) and blood-dry type (resting stage), and gave Bai H1 formula (30 g of raw acacia flower, 15 g of Zi Cao root, 15 g of red peony, 30 g of white foxglove root, 30 g of raw earth, 15 g of Dan Shen, 30 g of chicken blood vine) to clear heat and cool the blood and invigorate the blood, and Bai H2 formula (30 g of chicken blood vine, 30 g of Tu Fu Ling, 15 g of Angelica sinensis Shengdi 15g, Wei Lingxian 15g, Shan Yao 15g, Lu Hifang 15g) plus and minus treatment.
Zhang Zhili has basically classified common psoriasis into five types: Blood-heat type, with the formula of Cool Blood, Invigorate Blood, plus and minus; Blood-dry type, with the formula of Nourish Blood, Detoxify Tang, plus and minus; Blood-stasis type, with the formula of Invigorate Blood, Disperse Blood Stasis, plus and minus; Damp-heat type, with the formula of Raw Atractylodes, Raw Citrus Aurantium, Raw Coix Seed, Raw Gorgonian, Chuan Dioscorea, Red Stone Resin, Che Qian Zi, Che Qian Cao, Ze Xie Di, Raw Huang Bai, Bai Xian Pi, Bitter Ginseng, Tu Fu Ling, Raw Di Huang, Mudan Pi, Liu Yi San etc;
For the heat toxicity type, we can use honeysuckle, forsythia, dandelion, sophora, jin lantern, shanduan root, panacea root, big blue leaf, white foxglove root, comfrey root, cyperus root, xuan ginseng, shonglou, white flowered snake tongue grass, etc. In the clinical evidence, Zhu Renkang, according to the characteristics of the lesions and their tongue and pulse, divided the disease into blood-heat and wind-dry and blood-deficiency and wind-dry;
The treatment of blood-heat and wind-dryness is to clear heat and detoxify the toxin; choose “Ke-Yin Fang”, prescription: Tu Fu Ling, Lonicerae, Cao He Che, Bai Xian Pi, Bei Dou Gen, Pan Lan Gen, Wei Ling Xian, Sheng Gan Cao; the treatment of blood-deficiency and wind-dryness is to nourish Yin, nourish blood and moisten dryness, clear heat and detoxify the toxin, choose “Ke-Yin Fang”, prescription: Sheng Di, Dan Shen, Xuan Shen The prescription: Sheng Di, Dan Shen, Xuan Shen, Hemp Seed, Da Qing Ye, Bai Xian Pi, Cao He Che 15g each, Bei Dou Gen, Hemp Ren, Lian Lian 10g each, 1 dose daily, water decoction morning and evening each time. Throughout the many medical practitioners, there are very few who treat psoriasis with Fu Yang therapy.
1.2 What is Fu Yang therapy?
Yang Qi plays an important role in the human body in warming, promoting and consolidating. Therefore, in the chapter of Su Wen – Anger Tong Tian Lun, it is said that “Yang Qi is like the sky and the sun. The eight methods of sweating, vomiting, downing, harmonizing, warming, clearing, eliminating and tonifying, among which the method of warming is the method of warming and supporting Yang Qi, are the basic methods throughout the treatment rules of the Treatise on Typhoid Fever by Zhang Zhongjing in the Han Dynasty.
In this regard, the method of Fu Yang was produced in clinical practice. However, many doctors understand the support of Yang as a one-sided way to warm Yang, or only pay attention to warm Yang to support Yang. Unbeknownst to them, the promotion of yang is also an equally important part of the support of yang. The Yang Qi in the human body is popularized through the normal lifting and lowering of the cloth to perform its various functions such as warming and consolidating. The purpose of Tong Yang is to unblock the “depressed” Yang Qi by various means and restore its normal movement.
Therefore, both warming and toning treatments are important parts of Yang support. In clinical practice, Yang Qi deficiencies and blockages often occur together, therefore, the combination of the two methods of warming and clearing Yang should be paid attention to in order to jointly achieve the purpose of supporting Yang and curing diseases. “The onset of psoriasis has a great relationship with the deficiency of positive qi, and the positive qi mentioned here mainly refers to yang qi. Therefore, the treatment of psoriasis by using Fu Yang therapy is also well documented and clinically proven, and has achieved better curative effects.
2. Typical case
Wang, a male, aged 37, was first diagnosed on February 25, 2007. Eight years ago, the patient developed scaly erythematous plaques without any causative factors, with intense itching, and was diagnosed as “psoriasis” at the local county hospital, and was given traditional Chinese medicine and western medicine treatment, which was ineffective. The skin lesions are sometimes light and sometimes heavy, heavy in winter and light in summer. The present symptoms are: scattered erythema all over the body, dark red, the size of a bean, covered with white scales, itching is not very. He is thin, white in complexion, can eat and drink, has a light tongue with white coating, weak pulse on the right and sunken on the left.
She was diagnosed as “common psoriasis”, and the diagnosis was kidney yang deficiency and qi deficiency with blood stasis. Initial prescription: Radix Aconiti 6g, Gui Zhi 9g, Radix Astragali 18g, Radix Aconiti 30g, Radix Rehmanniae 20g, Radix Paeoniae 15g, Radix Ziziphi 20g, Rhizoma Bifidum 30g, Centipede 2, Pan Lan Gen 20g.
Seven doses, one dose per day with water decoction. In the second consultation, the skin lesion was reduced, the tongue was light, the fur was white and slightly greasy, the pulse was weak on the right and sunken on the left, the initial prescription was to remove prunus ginseng and add 15g of Xu Changqing, seven doses, one dose per day with water.
At the third examination, the skin lesions are nearly fading, only a few bean-sized flat red papules remain, no scales, dark red tongue, thin white moss, slightly sunken pulse. In the first consultation, the formula of Gui Zhi and Prince’s Ginseng was removed, and 20g of Salvia miltiorrhiza was added. 18g of Salvia miltiorrhiza was added for seven doses, one dose per day with water decoction. At the fourth examination, the skin lesions subsided and only pigmentation remained, with a light tongue, white fur and a slightly sunken pulse. Keeping to the initial prescription, seven doses, one dose per day with water decoction. After that, he took pills for one month to consolidate the efficacy, and no recurrence has been observed since the follow-up.
Summary.
The etiology of psoriasis is complex, the course of the disease is long, and the evidence patterns are varied. In clinical practice, we should insist on the combination of local identification and overall identification, and according to the patient’s pulse and symptoms, detailed examination, we should not stick to fixed types of evidence and prescriptions, but should use them flexibly and add and subtract according to the evidence;
Only under the premise of correct identification, the corresponding treatment rules should be established in order to achieve satisfactory results.
In short, for the treatment of Yang support, according to the clinical symptoms of the patient, it is appropriate to have Yang deficiency and cold stagnation, stagnation and obstruction. The specific symptoms can be mild or heavy, and can be more or less, including both fatigue, lazy speech, spontaneous sweating, curled up drowsiness, weak and feeble pulse and other qi deficiency symptoms, but also the fear of cold extremities, cold extremities, waist and back, light mouth, loose urine and stool, white face and light tongue and other symptoms of Yang does not control Yin, cold Qi, at this time can be added to the soup appropriate warming Yang, Tong Yang products, in order to enhance the therapeutic effect.