Psoriasis is a clinically common chronic skin disease and has become one of the key diseases in dermatology around the world because of the lack of effective treatment drugs. On the basis of summarizing the clinical experience of Zhu Renkang, a famous Chinese medicine dermatologist and surgeon, Professor Zhuang Guokang proposed the treatment methods of “cooling the blood, detoxifying the toxin, invigorating the blood and nourishing the yin” for different stages of common psoriasis with reference to Chinese and Western medicine. His academic thoughts are summarized as follows: Kang Wendi, Department of Dermatology, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine 1. Blood heat is the fundamental pathogenic mechanism of psoriasis Professor Zhuang Guokang inherited the views of researcher Zhu Renkang and believed that blood heat is the fundamental pathogenic mechanism of psoriasis. Most of the psoriasis patients are young and strong who have heat in their bodies, and because of the external sensation of six kinds of lust, or the consumption of spicy wine and mash, or the disturbance of the mind, the seven emotions, etc., all make the blood heat contained within, so that the blood heat and poisonous evil outside the congestion of the skin and the onset of the disease, the heat evil burnt blood, filling the veins, so see the red spots, papules; heat generates wind, the skin loses nourishment, so the scales stacked up; heat is burning Jin, so the scales dry and easy to take off. Therefore, Professor Zhuang Guokang emphasizes that regardless of whether the rash is in the progressive, quiescent or receding stage, and regardless of the state of the lesions, the blood cooling method should be used throughout all stages of psoriasis treatment. The commonly used drugs are raw earth, dandan bark, panax notoginseng, dacryophyllum, caohe che, northern bean root, yuan shen, etc. 2. It is advisable to cool the blood and detoxify the toxin during the progressive stage of psoriasis. The progressive psoriasis rash is dominated by papules and maculopapular rash, with new rashes constantly appearing, the basal skin is bright red, scraping away the scales to see punctate bleeding, with isomorphic reaction, itching of different degrees, accompanied by sore throat, thirst, dry stool, yellow urination, red tongue, yellow coating, and number of veins. Professor Zhuang Guokang believes that this evidence is the initial stage of the disease, the poisonous evil is prevalent, filling the qi camp and affecting the blood, so the treatment should be based on clearing the heat of the qi branch of Yangming, and also clearing the camp and cooling the blood, so a large dose of heat-clearing and detoxifying products and cooling the blood are used, the commonly used formula is Ke-Yin party, commonly used drugs are Tu Fu Ling, Cao He Che, Pan Lan Gen, Da Qing Ye, Fish Fishy Herb, Sheng Di, Dan Pi, Bei Dou Gen, White Flower and Snake Tongue Herb, Raw Sophora, and Comfrey, etc. Case 1: Lu, female, 29 years old, first diagnosed on March 12, 2000. Complaint: generalized erythematous rash with desquamation for 20 days. History: Red papules of green bean size appeared on the trunk and extremities after an external sensation 20 days ago, with obvious itching. After scratching himself, white scales were shed and the same rash appeared at the scratching site. The papules were bright red in color, gradually increased and enlarged, and partly fused into patches with layers of scales on the surface. It is accompanied by sore throat, dry mouth, red stool, red tongue with yellow coating and string pulse. Diagnosis: psoriasis, identified by Chinese medicine as internalized toxin-heat, filling the body and skin, and blood-heat generating wind. Treatment is to clear heat and detoxify the toxin, cool the blood and dispel wind. The formula is selected from the side of gram silver. Prescription: Fu Ling 30g, Da Qing Ye 15g, Bei Dou Gen 6g, Zi Zi 10g, Burdock 12g, Fishy Herb 30g, Sheng Di 30g, Dan Pi 10g, Red Peony 12g, Sheng Sophora 15g, Wei Ling Xian 10g, Sheng Gan Cao 10g, 7 doses with water decoction. The new rash no longer appeared, the color of the original rash became lighter, and the itching was reduced. Then the original formula was added to cool the Blood and nourish the Yin, and the lesions all disappeared after a month of continuous use. The rash in the quiescent phase is suitable for activating the Blood and cooling it. The rash in the quiescent phase has a long duration, the lesions are limited, fused into patches, thick and infiltrated, leathery or moss-like, covered with thick layers of tight scales, which do not subside over time. Modern research suggests that this type of patients are mostly accompanied by increased blood viscosity, decreased deformability of red blood cells, distorted dermal capillaries, and increased vascular permeability. On the basis of the above clinical and experimental studies, Prof. Zhuang Guokang put forward the argument that “hypertrophy is stasis, red color is heat” and further pointed out that hypertrophy of the skin lesions, dark red color and purple tongue are the main points of its dialectic. The treatment is to cool the blood, invigorate the blood, detoxify the blood and open the ligaments. The commonly used formula is Tao Hong Si Wu Tang, commonly used drugs are Sheng Di, Dan Pi, Red Peony, Tao Ren, Safflower, Dan Shen, San Ling, Curcuma, Ze Lan, etc. 4. In the receding period, it is advisable to cool the blood and nourish Yin. In the receding period, the psoriasis rash becomes thinner, the color turns lighter, the scales dry, accompanied by night itching of the rash, the five hearts are hot and bothered, the tongue is thin red or light red, less moss, and the pulse is fine. Professor Zhuang Guokang believes that the course of psoriasis is prolonged, often lasting for decades without healing, and repeated attacks consume qi and hurt yin, with yin and blood deficiency being the most important. When researcher Zhu Renkang was working on the evidence, he emphasized that blood deficiency generates wind and the skin loses nourishment; Professor Zhuang Guokang, on the basis of inheriting Zhu’s scholarship, even put forward the view that fluid and blood have the same origin, and that if both yin and blood are deficient, the skin will not be honored. As Wu Jutong said, “When heat passes through, its yin will be injured”. Therefore, the treatment emphasizes nourishing Yin and nourishing Blood, cooling Blood and clearing heat. The formula is based on the triad of Ke-Yin, and the commonly used drugs are: Sheng Di, Dendrobium, Mai Dong, Xuan Shen, Bei Nan Sha Shen, Huang Jing, Bai Mao Gen, Dan Shen, etc. 5. Salvia miltiorrhiza is bitter in taste and slightly cold in nature, which has the function of activating blood circulation and removing blood stasis, clearing the heart and removing irritation. In modern research, it can improve peripheral microcirculation, reduce blood viscosity, inhibit DNA synthesis of tumor cells, have anti-inflammatory effects and regulate the immune system, which is consistent with the pathological manifestations of excessive proliferation of keratinocytes, inflammatory cell aggregation and capillary tortuous expansion in psoriasis, and is a common drug used by Prof. Zhuang Guokang in the treatment of psoriasis. Fishy grass is slightly cold and pungent in taste, with the function of clearing heat and detoxifying, eliminating carbuncles and pus, diuretic and laxative. Modern pharmacological research has concluded that it has strong antibacterial, antifungal and antiviral effects, and can reduce the number of cancer cells and cancer cell division index. Other drugs such as curcuma longa, tiger stick, white flower snake tongue, grass river car, etc., all have anti-tumor and immune regulating effects and have been used to treat psoriasis with better efficacy.