Identify]
(A) Blood heat
This type corresponds to the progressive stage, with rapid development of the rash, new lesions appearing continuously, more scales, and pronounced itching, often accompanied by heart trouble, mouth f, dry stools, and yellow urine. The tongue is red, the coating is yellow, and the pulse is stringent or slippery.
(B) Blood dryness
This type corresponds to the stable stage, with hypertrophic lesions, dark red color, long lasting, dry and itchy skin, less new rashes, and partial remission of the original lesions. The tongue is dark red, the coating is thin and white, and the pulse is knotted or sunken.
(C) Blood stasis
This type corresponds to the degenerative stage, with thickened lesions, dark red, tightly adherent scales, itching, and often accompanied by facial brown spots. The tongue is dark red, with petechiae or petechiae, and the pulse is thin and slow and astringent.
(D) Pustulosis
This type is equivalent to pustular psoriasis, in which most dense shallow small pustules appear on the psoriasis lesions, some of which fuse into patches with burning sensation, accompanied by fever, mouth f, joint pain, yellow urine and stool. The coating is yellow, and the pulse is smooth and slippery.
(E) Wind-dampness blocking the ligament
This type is equivalent to arthritic psoriasis, with psoriatic skin lesions combined with arthropathy, mainly damaged small joints of hands and feet, with swollen and painful joints, restricted movement, or even stiff and deformed, unable to straighten. The tongue is light with thin white greasy coating, and the pulse is smooth or moist.
(F) Heat toxin injury to yin
It is equivalent to erythrodermic psoriasis, with diffuse flushing all over the body, massive flaky flaking, accompanied by fever of different severity, chilliness, heart trouble, mouth f and other symptoms, yellow and red urine and dry stools. The tongue is red and vivid, without moss or with crackles, and the pulse is slippery.
【Treatment
(A) Chinese medicine treatment
1, blood heat evidence type treatment is appropriate to cool the blood and detoxify. Prescription: 20g each of raw Sophora japonica, Radix Bupleurum, Radix et Rhizoma, Radix Paeoniae Alba, Comfrey, 30g each of Fu Ling, Salviae Miltiorrhizae, Phellodendron, 10g each of Salviae Miltiorrhizae, Radix et Rhizoma Ginseng, Silver Flower, Panax notoginseng, 1 dose daily with water.
2. The treatment of blood dryness should be to nourish blood and moisten dryness. Herbs: Radix Angelicae Sinensis, Radix et Rhizoma Zizanoides, Radix et Rhizoma Ginseng, Radix et Rhizoma Polygonatum, Radix et Rhizoma Macrocephalae, Radix Asparagus, 6g each, Poria Cocos, Bryophyllum Album, Radix et Rhizoma Virens, Radix et Rhizoma Seven-leaved Flower, Radix et Rhizoma Bupleurum, Radix et Rhizoma Comfrey, 15g each.
3.Blood stasis is recommended to activate blood circulation, remove blood stasis and move Qi. Recipe: Radix Angelicae Sinensis 30g, Rhizoma Ligustici Chuanxiong 20g, Salviae Miltiorrhizae 20g, Radix Rehmanniae 20g, Radix Achyranthes Bidentatae 12g, Radix Scorpion 10g, Centipede 2, Rhizoma Polygonatum 40g, Poria Cocos 30g, Rhizoma Trigonellae 10g, Rhizoma Curcumae 10g, Radix Glycyrrhiza Uralensis 10g.
4. The treatment is to clear heat and cool the blood, detoxify and remove dampness. The formula: Detoxification and Blood Cooling Soup with Addition: 6g of water hyacinth, 15g of raw earth, 10g of dandruff, 30g of white foxglove, 30g of silver flower, 15g of forsythia, 15g of big green leaf, 15g of raw barley, 10g of bitter ginseng, 15g of talcum powder, 30g of white moss bark. 1 dose of water decoction daily, divided into 2 doses.
5, wind and dampness blocking the ligament type treatment is appropriate to activate blood circulation, dispel wind and remove dampness. Radix et Rhizoma Dulcis: Gentiana Macrophylla 10g, Fructus Bupleurum 10g, Radix et Rhizoma Dulcis 10g, Radix et Rhizoma Mulberry 30g, Radix et Rhizoma Vulgaris 10g, Radix et Rhizoma Bupleurum 15g, Radix et Rhizoma Angelicae Sinensis 10g, Radix et Rhizoma Paeoniae 10g, Radix et Rhizoma Rooster 15g, Radix et Rhizoma Oxalis 10g. 1 dose in water, divided into 2 doses.
6, heat poisoning yin evidence type treatment is appropriate to clear the camp and detoxify, cool the blood and nourish yin. Radix Rehmanniae et Rhizoma: 6g of raw tortoiseshell, 6g of raw gardenia, 3g of Chuan Huanglian, 30g of silver flower, 15g of forsythia, 15g of dandelion, 30g of raw earth, 30g of white foxglove, 15g of dandanbark, dendrobium, yucca, 10g of maitake. 1 dose in water, divided into 2 doses daily.
(II) Western medical treatment.
1.Systemic treatment
①Vitamins: vitamin A 300,000u, im, Bid, vitamin B12 500μg, im, qd, vitamin B6, C, can regulate nerve function and maintain normal development of epithelial cells.
② sedative and anti-itch drugs: paracetamol, reserpine, cyproheptadine, etc.
③Intravenous closed therapy: procaine 300mg~450mg plus 5% glucose solution 500ml, vitamin C2g, intravenous drip, once a day, 10 times for a course.
④Antibacterial agent: treat with penicillin and erythromycin for those with upper respiratory tract infection, pharyngitis and tonsillitis.
⑤ Immunosuppressants: used when general drugs are ineffective and the rash is severe and widespread. Available ethyleneimine 0,1g, tid, or ethylene double morpholine 0,2g, tid, but toxic reactions, before and after treatment should check liver and kidney function and blood routine. Methotrexate is suitable for erythrodermic, arthropathic, pustular and generalized psoriasis vulgaris.
(6) Retinoic acid and corticosteroids are only suitable for special types of psoriasis.
2. Local treatment is based on reducing agents, keratin exfoliators and cytostatic agents. Drugs with strong irritation should not be used in the progressive stage.
①Tar preparations: 2% to 5% coal tar and black bean distillate are commonly used, 1 to 3 times a day.
②Anthralin preparations: 0, 1% to 1% anthralin ointment is applied externally, which can be combined with ultraviolet radiation for 5 to 20 minutes.
③Corticosteroid preparations: de-inflammatory pine urea cream, clofloxacin ointment, etc. applied externally or sealed, 2 to 3 times a day.
④Other: 0,025%～0,3% retinoic acid cream, 5% weakly benzoic acid mercury ointment, 5-10% sulfur ointment, etc.
3.Physical therapy
①Ultraviolet light: used for resting or winter type cases.
②Photochemotherapy: oral administration of 8-methoxypsoralen (8-MOP), and then irradiation of ultraviolet light.
③Bath therapy: It can remove scales, clean the skin, improve blood circulation and metabolism.
Prevention and regimen
1.Do not drink alcohol and consume beef and mutton, etc.
2.Avoid upper respiratory tract infection and eliminate infectious lesions.
3.Keep enough sleep, eliminate mental trauma, and relieve mental worries.
4.Avoid physical, chemical substances and drug stimulation, prevent trauma and drug abuse.