Chinese medicine has been widely used in the treatment of psoriasis, but there are also some problems. Chinese medicine has been widely used in the treatment of common psoriasis, forming a large amount of clinical research literature, which has led to different treatment methods and prescriptions due to various treatment modalities, inconsistent identification and typing and efficacy judgment standards, etc. Although it has certain efficacy, it makes it difficult to grasp when it is clinically applied.
I. Diagnostic criteria
(1) Blood heat evidence: This evidence is mainly seen in the progressive stage of common psoriasis. Main symptoms.
(1) Bright red skin lesions.
②New rash increasing or rapidly expanding.
(3) Hypertrophic infiltration or maceration of the original skin lesions.
Secondary symptoms.
① irritability.
② yellow urine.
③ congestion of the pharynx and enlarged tonsils.
④Red or reddish tongue.
⑤ pulse is slippery or counted. The symptoms are determined: with all the main symptoms can be diagnosed, visible secondary evidence.
(2) Blood dryness evidence: this evidence is mainly seen in the receding and quiescent stages of common psoriasis. Main symptoms.
(1) light red skin lesions.
②Dry scales.
Secondary symptoms.
① dryness of the mouth and throat.
②Pale tongue with little coating or red and little fluid.
③ pulse is thin or fine. The symptoms are determined: with all the main symptoms can be diagnosed, visible secondary evidence.
(3) Blood stasis evidence: this evidence is mainly seen in the stationary phase of common psoriasis.
The main symptoms are
(1) dark red skin lesions.
(2) The lesions are hypertrophic and dry, and do not subside after a long time.
Secondary symptoms.
① dark menstruation or stasis.
②Purple tongue or petechiae, petechiae.
③Pulse is astringent or slow. The symptoms can be diagnosed by having all the main symptoms, and the secondary symptoms can be seen.
II. Treatment of proprietary Chinese medicine
1. Oral proprietary Chinese medicine treatment is recommended: if the diagnosis is in line with common psoriasis (white H), the principle of identification and treatment in Chinese medicine should be followed, and proprietary Chinese medicine treatment can be used. Most of the pCms have more flavors and take into account several types of evidence and concurrent evidence, so the principle of diagnosis and treatment can also be adopted.
2.Recommended drugs: the main Chinese patent medicines are: silver dandruff capsule, the main ingredients of which are Tu Fu Ling and Sarsaparilla, with the effect of dispelling wind and detoxification. Yuzhen Yinduan tablets, the main ingredients are gentiana, angelica, calamus, cypress, aromatic herb (made in wine), tulip (made in vinegar), stellaria, curcuma (made in vinegar), frankincense (made in vinegar), xuanming powder, strychnine powder, saponaria, wood turtle seed (shelled and smashed), peach kernel, safflower, salammoniac (white), rhubarb, turtle worms, Qing Dai, with the effect of unblocking qi and blood, softening hardness and eliminating accumulation, clearing heat and detoxifying, drying dampness and killing worms. Yin Qi Ling Granules, the main ingredients of which include Bitter Ginseng, Licorice, Bai Xian Pi, Fang Feng, Tu Fu Ling, Cicada Sox, Huang Bai, Sheng Di Huang, Jin Yin Hua, Red Peony, Lian Qiao and Angelicae, have the effects of dispelling wind and drying dampness, clearing heat and detoxifying toxins, activating blood circulation and resolving blood stasis. Ke-Yin Pill, the main ingredients of which include Fu Ling, Bai Xian Pi, Bei Dou Root and Quan Ginseng, has the effect of clearing heat and removing toxins, dispelling wind and relieving itching. Yin Dissipation Granules (Yin Dissipation Capsule), the main ingredients are Dihuang, Peony Skin, Red Peony, Radix Angelicae Sinensis, Bitter Ginseng, Goldenseal, Xuan Shen, Burdock, Cicada, Bai Xian Pi, Fang Feng, Da Qing Ye, Red Flower, with the effect of nourishing blood and activating blood circulation, dispelling wind and relieving itch. Zidan Yin Qi Capsules, the main ingredients are Scammoniac, Semen Cassia, Radix et Rhizoma (made), Radix Ginger, Cinnamomum Cassia, Rhizoma Atractylodis Macrocephalae, Radix Paeoniae Alba, Radix Astragali, Salviae Miltiorrhizae, Radix et Rhizoma Ginseng, Starch, which can nourish blood and dispel wind, moisten dryness and relieve itching. In addition, Danshen injection, Qingkailing injection and Leigongteng preparation can also be considered. Suggestions: psoriasis capsule is suitable for various types of psoriasis, psoriasis capsule has less medicinal taste and needs to be combined with other treatments; yujin psoriasis tablet has yujin as its core ingredient, which can unblock qi and blood, soften hardness and eliminate stagnation, clear heat and detoxify, dry dampness and kill insects, and it favors softening and eliminating stagnation, yujin psoriasis tablet contains toxic Chinese medicine strychnine and heavy metal salammoniac, which should be used with clinical caution and prohibited for children and pregnant women; danshen injection favors activating blood circulation and removing blood stasis. Yinchuling has more medicinal flavors, and its function is to clear heat, remove wind and detoxify toxins, and it is more suitable for blood-heat psoriasis. Qingkailing injection and Leigongteng preparation focus on clearing heat and detoxifying toxins. They are commonly used in clinical evidence-based treatment of psoriasis, and their reasonable use alone or in combination has certain curative effects.
(1) Blood-heat evidence: the basic treatment principle is to cool the blood and detoxify the toxin. It can also be used to clear heat, remove dampness, dispel wind and invigorate blood. Recommended drugs: compound Qing Dai capsule, compound Qing Dai pill, compound Qing Dai tablet, anti-silver granule, anti-silver capsule, anti-silver tablet, Ke-silver pill, Zidan psoriasis capsule. Suggestion: compound Qing Dai preparation has the efficacy of clearing heat and detoxifying, eliminating spots and stasis, dispelling wind and relieving itching, and is clinically used for progressive psoriasis with good efficacy. The adverse reactions of compound Qing Dai are mainly concentrated in compound Qing Dai pill, and there are reports of drug rash, colitis, stomach bleeding, blood in stool, menopause, nail darkening, vitamin A acid syndrome-like reaction and liver damage. There are reports that Keyin Pill can cause acute liver injury, clinical use of Keyin Pill requires close monitoring of liver function.
(2) Blood dryness evidence: the basic treatment principle is to nourish blood and moisten dryness, dispel wind and relieve itching. It can also be used to clear heat, cool the blood and invigorate the blood and other treatment methods. Recommended drugs: anti-silver granules, anti-silver capsules, anti-silver tablets, Zidan silver dandruff capsules, bitter dan pills. Suggestions: Anti-silver granules (anti-silver capsule) can nourish Blood and invigorate Blood, dredge wind and relieve itching, and is clinically used for blood-heat and wind-dry type psoriasis. Bitter Dan Wan has the efficacy of nourishing blood and moistening dryness, cooling blood and resolving blood stasis, dispelling wind and relieving itch, and is suitable for common psoriasis with blood deficiency and wind dryness. However, it has been reported that Bitter Dan Pill caused liver damage after treating arthritic psoriasis, so it should be used with caution.
(3) Blood stasis evidence: The basic treatment principle is to activate blood circulation and remove blood stasis, and to promote the flow of qi and open the channels. Recommended drug: Salvia injection. Recommendation: Salvia injection has the effect of activating blood circulation and removing blood stasis, which is suitable for blood stasis type psoriasis.
3. Topical Chinese medicine: Suitable drugs should be selected according to the characteristics of the lesions, the location and the age of other. And should pay attention to the contraindications of the selected drugs. In clinical practice, it is commonly used to increase the penetration of topical drugs and improve the therapeutic effect. Recommended medications: Bing Huang Skin Lotion Ointment, Zhen Yin Ointment, and Xi Shu Lin Ointment. Recommendation: Ice yellow skin lotion and silver cream are generally used for the treatment of mild psoriasis vulgaris. 0.03% cetrimide ointment is suitable for chronic plaque psoriasis, once a day, the dosage should not exceed 10 g/d, the course of treatment should not exceed 6 weeks, its efficacy is similar to that of 0.02% clobetasol propionate cream, the main adverse effects are irritation and pigmentation, and it should be used on the face with caution.