Blood heat is an intrinsic factor of the body and constitution-it is the main basis of pathogenesis, and blood heat can develop due to the seven emotions, diet, wind evil or wind evil intermingled with dry heat evil visiting the skin, and the combination of internal and external evil. In clinical practice, Zhao Bingnan classifies common psoriasis into two main types: blood-heat and blood-dry. The blood-heat type is caused by heat congestion in the blood channels, wind-heat and dryness, and the rash is constantly flushed; the blood is dried up and difficult to be honored outside because of internal depletion of yin and blood over a long period of time, and the rash is in the form of coins or large pieces. The clinical treatment can be divided into four types.
(I) Internal treatment.
1. The blood-heat type is mostly seen in progressive psoriasis. The skin lesions are flushed, the rash keeps appearing, and the tongue is red with stringiness or number of veins. The evidence belongs to the internal accumulation of heat and accumulation in the blood. Treatment is to clear heat and detoxify the blood, cool the blood and invigorate the blood. Add and reduce with Bai Xuan No.1.
Radix Acanthopanax 30g, Radix Rehmanniae 30g, Radix Zingiber officinale 15g, Radix Paeoniae 30g, Radix Chrysanthemum 30g, Radix Salviae Miltiorrhizae 15g, Radix Bupleurum 30g.
Addition and subtraction: for those with strong wind and itching, add Bai Xian Pi, Tribulus terrestris and Fang Feng; for those with dampness, add Coix Seed, Yin Chen, Fang Ji and Ze Xie; for those with dry stools, add Da Huang and Gardenia; for those induced by pharyngitis and tonsillitis, add Da Qing Ye, Ban Lan Gen, Lian Lian and Yuan Shen.
2. The blood-dry type is mostly seen in the quiescent stage of psoriasis. The duration of the disease is long, the lesions are mostly patchy, and the flakes are dry. The evidence belongs to yin and blood deficiency. The skin is not nourished. Treatment is to nourish blood, nourish yin and moisten skin. Use Bai Xuan No.2 plus and minus.
Fu Ling 30g, Radix Angelicae Sinensis 30g, Rhizoma Polygonati 30g, Rhizoma Polygonati 30g, Rhizoma Polygonati 30g, Rhizoma Polygonati 30g, Rhizoma Polygonati 15g.
Addition and subtraction: wind is very itchy, add white fresh skin, Tribulus terrestris, bitter ginseng; blood deficiency pulse thin, add Shu Di Huang, white peony; Yin deficiency blood heat, red tongue with less coating, add Zhi Mu, ground bark, Sophora; spleen deficiency wet, light tongue with teeth marks, add Poria, Poria, lentils.
3, blood stasis type is mostly seen in long-standing and stubborn psoriasis. The skin lesions are thick and infiltrated, the scales are thick and heavy, the tongue is dull or there are petechiae, the evidence belongs to the blockage of meridians and blood clotting. The treatment is to activate blood circulation, remove blood stasis and move qi. Use Bai Xuan No.3 plus and minus.
Tu Fu Ling 30g, Gui Fang Yu 30g, Coix Seed 30g, Tao Ren 15g, Safflower 15g, Bai Hua Shi Tong Cao 30g, San Ling 15g, Curcuma longa 15g, Chicken Blood Vine 30g, Danshen 15g, Chonglou 15g, Chen Pi 10g.
Addition and subtraction: For patients with liver depression and qi stagnation and emotional disorders, add Chai Hu and Citrus aurantium; for female patients with low menstrual flow or blood clots, add Yi Mu Cao and Dan Shen.
4.Toxic-heat type is mostly seen in erythrodermic psoriasis. The evidence belongs to the heart fire and poisonous evil, the fire flows, enters in the blood, steams and burns the skin. The treatment is to clear the camp and detoxify the toxin, cool the blood and protect yin. Add and subtract with detoxification and Qing Ying Tang.
10g of raw tortoiseshell or 0.6g of antelope horn powder (for punching), 10g of raw gardenia, 6g of Chuan Lian Mian (for punching), 30g of honeysuckle, 30g of dandelion, 30g of septoria, 30g of panacea, 30g of white foxglove, 30g of raw groundnut, 30g of plantain, 30g of gypsum, 15g of forsythia, 15g of comfrey root, 15g of dandan bark, 15g of dendrobium, 15g of maitong.
The following herbs can be used for long-standing disease.
In the acute stage, Gentian Diarrhea Liver Pill and Feng Feng Tong Sheng Pill can be used; in the chronic stage, Gentiana Pill and Rundown Pill can be used; in the blood stasis type, Yin Le Pill can be used.
(II) External treatment.
For blood-heat type, treatment with Qingliang Ointment, Aromatic Wax Ointment, Pulian Ointment, etc.
Blood dry type, treatment with Jing Hong powder ointment, 10% to 20% black bean distillation oil ointment, black red ointment.
Chronic hypertrophy type, treatment with 30% black bean distillation oil ointment, bean green ointment.
Drug composition.
Qingliang ointment: 30g of angelica, 6g of comfrey, 5g of rhubarb noodles, 300g of sesame oil, 120g of yellow wax.
Jing Hong powder ointment: Jing Hong powder 35g, lima cone (the powder left in the bottom of the pot after alchemy) 4g, white wax 4g, Vaseline plus to black red ointment: for black red ointment mixed with black bean distillation oil ointment.