I. Preface
In ancient Greek mythology, Asclepius, the son of the sun god, Arabesque, and the goddess of the forest, was the god of medicine. He was friendly and wise, just and helpful, and carried a multi-sectioned cane entwined with a divine serpent. Today, the World Health Organization (WHO) and many national medical institutions, ministries of health, and hospitals use the “serpent and scepter” as a symbol of medicine.
The only way to become a good doctor is to arm yourself with the full and extensive knowledge of human beings. “The only way to be a good doctor is to be armed with all human knowledge. When diagnosing and treating diseases, we need to observe carefully with our eyes, listen carefully with our ears, smell with our nose, probe with our tongue, and experience with our body, in addition to mobilizing the sixth sense of “enlightenment, enlightenment, and enlightenment”, and to understand with “intention” in order to better diagnose and treat diseases.
Each patient is an individual, and most of the methods introduced in the book are group programs. “Believing in a book is better than not having a book”, and what is described in the book is mainly common, and the main rules of diagnosis and treatment can only be continuously enriched in practice, guided by practice and theory, and individualized according to different individuals in order to continuously improve the efficacy.
Prescription is just like cooking, although the rice, oil and salt seasonings are the same, the taste of different chefs is very different. While paying attention to the general treatment direction of the disease, it is also necessary to pay attention to the small differences in the branches and seek changes in the same. Selecting the most suitable drug for the patient is like a key to open a lock, as the saying goes, “cast the spring”.
II. Basic principles of psoriasis treatment
The treatment of psoriasis should follow the following five points: one principle, two treatments, three good and three bad, four difficult and four not difficult, and five to five not to.
(A) a principle
Psoriasis is a harmless disease and should never be treated with harmful methods.
Psoriasis itself is not life-threatening, but because its rash is widely distributed and its condition is recurrent, it brings enormous pressure on the minds and bodies of patients. Many patients seek “quick fix” treatments, but fail to notice that many drugs applied without the guidance of a regular doctor can cause serious adverse effects on the body. The temporary “quick effect” in exchange for permanent damage, the loss is not worth the gain, only the efficacy and safety of “green therapy” is the gospel of patients.
(B) two treatment
To treat psoriasis like an allergy, to treat psoriasis like a drug allergy.
The triggering and aggravation of psoriasis are related to allergy, and psoriasis can be regarded as a metamorphic reaction of the organism to a certain allergenic factor. The onset of psoriasis seen clinically is partly related to dietary allergies, inhalant allergies and too frequent contact with daily chemicals, such as the aggravation of skin lesions in some patients after hair dyeing. There are also patients with psoriasis who experience aggravation or recurrence of skin lesions after using certain drugs, which should be considered to be related to drug allergies, including, of course, traditional Chinese medicine.
Patients with psoriasis, when allergies occur, often do not show a specific rash type of drug rash, such as exfoliative dermatitis, eczema-like, acne-like, urticaria-like, erythema multiforme-like, scarlet fever-like erythema, measles-like erythema, photosensitivity, fixed erythema and other rash types, but only show an increase in the original skin lesions, aggravation and generalization. In severe cases, it may develop into erythrodermic psoriasis, pustular psoriasis, etc.
Psoriasis is a disease that can be easily triggered, and many treatment methods can trigger the “trigger” if you are not careful, making psoriasis erupt like a volcano.
During the progressive stage of the disease, special attention should be paid to the safety and reliability of medication. In the route of medication again, those that can be taken orally will not be injected, those that can be injected intravenously will not be injected, to prevent possible multiple allergies and cross-allergies; in the type of drugs selected, Chinese medicine should be used, not Western medicine; in the selection of Chinese medicine varieties, protein-containing, animal-based Chinese medicine, such as antelope horn powder, whole scorpion, leeches, etc. should be used with caution. Because these heterogeneous proteins have the possibility of inducing autoimmune disorders in the body and causing hypersensitivity reactions. The treatment of psoriasis should be simple and mobilize its own repair mechanism, so that the rash gradually tends to moderate and achieve the purpose of curing the disease.
(C) three good and three bad
It is better not to treat than to treat indiscriminately, better to treat slowly than to treat quickly, and better to treat with Chinese medicine than with Western medicine.
Psoriasis is a lifelong disease, the pathogenesis of which is unclear, and a complete cure has not been found yet. This is just like a cold, which is prone to recurrence. A cold can cause headaches, muscle aches, weakness, nasal congestion, runny nose, coughing and other symptoms that make patients feel uncomfortable, and in serious cases can even induce serious illnesses such as pneumonia, encephalitis and meningitis, and is often prone to relapse when resistance decreases. Why does the very common cold not cause excessive anxiety? Why don’t people bombard the common cold with heavy medication? The comparison is self-explanatory. Although psoriasis is self-limiting, the lesions are mainly located on the skin and are directly exposed to the outside world, which is the most direct and intuitive first “landscape” for people to interact with society, affecting interpersonal relationships and the quality of daily work and life. When choosing treatment, patients often listen to the lies of some “cure”, the rash will be temporarily cured, but will soon come back. If some drugs and methods are used indiscriminately, they will bring about unnoticeable adverse reactions and even serious consequences while treating psoriasis, which is called “treating a meridian, damaging a meridian”. For example, the application of glucocorticoids can induce erythrodermic or pustular psoriasis; the application of methotrexate, cyclosporine, retinoic acid and immunosuppressive drugs can cause headache, muscle and joint pain, nausea, hair loss, fatigue, leukocyte and platelet reduction, hypertension, hyperlipidemia, hyperglycemia, impaired liver and kidney function and other adverse reactions; inappropriate phototherapy may even induce malignant tumors. We often advise those patients who have the mentality of “cure”, can they be cured of cold? Can a cold never come back? The answer is obvious. We might as well consider psoriasis as a heavy cold, only with a slightly longer course of treatment.
Slow treatment of psoriasis is better than fast treatment. Psoriasis is a chronic and recurring disease with its own cellular dynamics that require enough time to overcome it, otherwise “speed is not enough”. In our experience, a course of two months is appropriate for psoriasis of the common type, and two to three consecutive courses of treatment are needed.
Psoriasis is a stubborn disease with unknown causes, and although there are many therapies, they cannot cut off recurrence in the end. Before the mechanism has been elucidated, reports on the efficacy of treatment should be taken with caution. Prof. Chen Kai believes that for patients with psoriasis, especially the refractory type, it is advisable to start with transforming the vegetative constitution (such as blood heat, blood dryness, blood stasis, toxic heat, damp heat, dampness, cold dampness, dysregulation of the flushing, liver and kidney, etc.), combining the ideas of Chinese medicine to regulate immunity, regulate cell regulating death, activate blood circulation and remove blood stasis, and supplement trace elements, etc. to differentiate and individualize treatment.
Traditional Chinese medicine has a long history and thousands of years of clinical practice have confirmed that Chinese medicine is effective in treating psoriasis with few adverse reactions. Chinese medicine is taken from natural plants and animals and applied to human body after scientific and reasonable preparation, which is in line with the theory of the unity of heaven and man and the general trend of modern society emphasizing “green therapy”. The treatment of psoriasis with TCM has various methods, including internal use of TCM water, external use of TCM ointment and TCM whole-body bathing therapy, etc. It has distinctive national characteristics and has been applied to clinical practice in large quantities. With the treatment of Chinese herbal medicine, the erythema can be eliminated, the scaling can be reduced, the infiltration of the rash can be thinned, the area can be reduced, and the rash can gradually fade away. In clinical practice, the overall state of the patient is regulated according to individualized principles, such as calming the patient’s mind, regulating emotions, soothing the patient’s irritability, relieving thirst and dry throat, dry stools, short and red urine and other uncomfortable symptoms. These advantages are not available in Western medicine.
(D) four difficult four not difficult
1, male patients are difficult to treat, female patients are relatively not difficult to treat;
2, long duration of the disease and no seasonal pattern is difficult to treat, and the short duration of the disease and the winter seasonal pattern is relatively not difficult to treat;
3, the previous treatment method is complex difficult to treat, the treatment method is simple is relatively not difficult to treat;
4, hair in more skin, more tendons, more bone, less gas, less blood parts, such as the scalp, calf shin, sacral tail, chest and ribs, back of the hand, etc. difficult to treat, in more gas, more meat, more blood parts of the muscle is more plump, sufficient gas and blood parts are relatively not difficult to treat.
Immune presence memory. Psoriasis attacked with heavy weapons such as glucocorticoids,, immunosuppressive drugs, etc., relapses again and treatment has to be upgraded. Such repeated strengthening not only changes the inherent pattern of psoriasis that is heavy in winter and light in summer, but also increases the difficulty of future treatment. Clinical data show that the use of immunosuppressive drugs not only endangers health, but also leads to changes in the immune homeostasis of the body, making future treatment more difficult. Simple, safe and effective treatment of psoriasis vulgaris is desirable. Both the recent efficacy and the long-term effect should be considered. From the long-term viewpoint that psoriasis is a lifelong disease with recurrent attacks, such drugs should be used with caution or not. It is better not to treat psoriasis than to treat it indiscriminately, and it is better to treat it steadily than to treat it quickly. Psoriasis is like a silent volcano, if improper treatment triggers the trigger of homomorphic counter, the volcano will gush out. Chinese herbal medicine has a long history of treating psoriasis with remarkable effects, prolonging relapse time and no adverse reactions, making it a green treatment method worth promoting.
It has also been shown that men are more resistant to TCM treatment than women, independent of previous use of immunosuppressive drugs. The remission of lesions during pregnancy and relapse after delivery and the dynamic changes of lesions during menstruation in female patients suggest the need to further explore the influence of hormone levels in the pathogenesis and treatment of psoriasis.
(V) Five wants and five don’ts
1.Be simple not complicated;
2.Be safe not risky;
3, to moderate not confrontation;
4, to leave room for error, do not kill all;
5.To treat people not diseases.
Treatment of psoriasis should first focus on the whole picture. To adjust the organism that has temporarily deviated from the normal state, you can’t just focus on the rash. Treating the rash down for a short period of time is not the goal, but truly restoring the body’s health and achieving yin and yang secrecy is the doctor’s way of treating the root cause.
Do not treat psoriasis indiscriminately. It has been repeatedly reported that long-term use of “secret formula” (containing mercury and arsenic preparations) has led to heavy metal poisoning, causing serious illnesses such as arsenic keratosis or leukemia. To treat people do not cure the disease, the disease is the death of people, is sad. Treatment should be simple, safe and effective, do not sacrifice the health of the body organs in exchange for the surface of the skin lesions recede.
Treatment cannot be confrontational. Just like a volcanic eruption or a flooded dike, when the disease comes, one must be good at channeling the evil out and try to avoid harming oneself.
At a certain level of treatment, a small amount of skin lesions often remain, clinically known as “duty rash”. Professor Chen Kai believes that any rash that remains must be a stubborn, vigorous rash. Sometimes the majority of the body rash can be cured in just a few months, while it takes years to treat the residual rash. Moreover, it is very easy to trigger the “trigger” during the treatment process and cause a recurrence. Don’t kill it all for the sake of perfection, but give the toxic heat a way out. For psoriasis in general, prevention should be the main focus, supplemented by treatment; internal medicine should be the main focus, supplemented by external use; attention should be paid to soothing and avoiding provocation; and the hidden isomorphic reaction phenomenon inherent in psoriasis should be prevented from being triggered by many forms of adverse stimulation and trauma. Psoriasis is like the ebb and flow of the sea, with relapses alternating with healing. The most realistic medication for patients is safe, effective and long-term symptom control; give up the dream of eradication, get rid of helplessness and despair, and arrange their life and treatment scientifically.