| Psoriasis vulgaris is one of the normal diseases and has high incidence rate in dermatology which effects people's life quality and health badly. Contrasting to western medicine, syndrome differentiation of TCM has superiorities in enhancing life quality and mending symptoms. At present, the most researches of psoriasis vulgaris are about summary of experiences and observation of curative effects. The researches of standard syndrome are less which brings inconvenience to clinical and scientific research work.ObjectiveThis research will discuss the normal syndromes, syndrome elements and symptoms by modern literature review research.Methods1 Search the related literatures of psoriasis vulgaris's syndrome sixty years recently.2 Pick up the syndromes and symptoms from the literatures and save them on the word document. Meanwhile the article title, magazine name, magazine number, page and author are added.3 Set up data base of psoriasis vulgaris's syndromes and symptoms by Epidata3.0 software.4 Standardize the name of syndromes of psoriasis vulgaris and uniform the different name of the same syndrome.5 Classify the standardized syndrome into syndrome elements in literatures according to the definition of syndrome elements and the principle of classifying.6 Analyze the count and frequency of syndromes, syndrome elements and symptoms by SPSS 17.0 statistical software.ResultsThere are 3572 modern articles about syndrome of psoriasis vulgaris collected through the literature searching, and 540 articles selected according to the criterion. By statistical analysis, we found:1 Normal syndromes of psoriasis vulgaris:(1)In all of the 173 syndromes, the most ten syndromes in frequency are(they are showed from high to low frequency, the same blow):blood-heat syndrome, blood stasis syndrome, blood-dryness syndrome, syndrome of wind and dryness due to blood deficiency, blood deficiency, damp-heat syndrome, blood-heat and wind-dryness syndrome, wind-heat syndrome, heat-toxicity syndrome and wind-heat and blood-dryness syndrome.(2) Psoriasis vulgaris can be divided into active stage, telogen and catagen three stage. Normal syndromes of every stage are showed as followed:①There are 43 syndromes in active stage and the frequency above 10% among them is blood-heat syndrome;②There are 35 syndromes in telogen and the frequency above 10% among them are blood dryness syndrome, blood stasis syndrome, syndrome of wind and dryness due to blood deficiency;③There are 35 syndromes in catagen and the frequency above 10% among them are blood dryness syndrome, syndrome of wind and dryness due to blood deficiency;(3) Take a decade as an age, and normal syndromes of every decade are showed as followed:①Syndromes in 60'are wind-cold syndrome, wind-heat syndrome;②There are 8 syndromes in 70'and the frequency above 10% among them are blood-heat syndrome, blood-dryness syndrome;③There are 29 syndromes in 80'and the frequency above 10% among them are blood-heat syndrome, blood-dryness syndrome, blood stasis syndrome;④There are 75 syndromes in 90'and the frequency above 10% among them are blood-heat syndrome, blood stasis syndrome, blood-dryness syndrome;⑤There are 140 syndromes in 00'and the frequency above 10% among them are blood-heat syndrome, blood stasis syndrome, blood-dryness syndrome;⑥The syndromes appearing in 70',80',90'and 00'four ages are blood-heat syndrome, blood stasis syndrome, blood-dryness syndrome, syndrome of wind and dryness due to blood deficiency;(4) The syndromes in literature can be concluded into several syndrome differentiations according to their classification methods. In all 1704 syndromes, there are 1329 syndromes applying qi, blood and body-fluid syndrome differentiation, and the frequency above 10% among them are blood-heat syndrome, blood stasis syndrome, blood-dryness syndrome; there are 251 syndromes applying etiological syndrome differentiation, and the frequency above 10% among them are damp-heat syndrome, wind-heat syndrome; there are 56 syndromes applying visceral syndrome differentiation, and the frequency above 10% among them are liver and kidney deficiency of yin syndrome; there are 31 syndromes applying meridian syndrome differentiation, and the frequency above 10% among them are disharmony between disharmony of Cong and Ren Meridians syndrome; there are 24 syndromes applying the eight principle syndrome differentiation, and the frequency above 10% among them are yin deficiency syndrome, heat syndrome, yang deficiency syndrome, deficiency of both yin and blood; there are 13 syndromes applying defence-qi-nutrient-blood syndrome differentiation, and the frequency above 10% among them are toxic heat into yingfen syndrome;2 Normal syndrome-elements of psoriasis vulgaris:There are 44 syndrome-elements in psoriasis vulgaris, including 21 syndrome-elements of location of disease and 23 syndrome-elements of nature of disease. The frequency of syndrome-elements of location of disease above 10% are liver, kidney, skin; The frequency of syndrome-elements of nature of disease above 10% are blood-heat, blood stasis, wind, blood-dryness.There are 22 syndrome-elements in active stage. The frequency above 10% among them in syndrome-elements of location of disease are skin, qi phase, heart, ying phase; The frequency above 10% among them in syndrome-elements of nature of disease are blood-heat, wind, heat.There are 23 syndrome-elements in telogen. The frequency above 10% among them in syndrome-elements of location of disease are spleen, liver, kidney, skin; The frequency above 10% among them in syndrome-elements of nature of disease are blood-dryness, blood deficiency, blood stasis, wind, dryness.There are 20 syndrome-elements in catagen. The frequency above 10% among them in syndrome-elements of location of disease are skin, liver, spleen, kidney, stomach, meridian, collateral; The frequency above 10% among them in syndrome-elements of nature of disease are blood-dryness, blood deficiency, wind, dryness.3 Normal symptoms of psoriasis vulgaris:(1)The symptoms of psoriasis vulgaris include lesion, soma, tongue and pulse symptoms 4 aspects and 226 kinds. There are 75 lesion symptoms,104 somatic symptoms,29 tongue symptoms and 18 pulse symptoms. The symptoms which frequency are above 3% are shown as followed:①lesion symptoms(10):guttate shape, bright red, dark red, light red, thick scale, infiltrate plump, itch, severe itch, Auspitz sign, new lesions arising and the old growing;②somatic symptoms(8):vexation, irritability, dry mouth, thirst, dry throat, dry stool, constipation, yellow urine;③tongue symptoms(11):red tongue, dark tongue, pink tongue, purple tongue, pale tongue, purple dots or spots on the tongue, yellow coating, thin coating, white coating, greasy coating, few coating;④pulse symptoms(7):thready pulse, rapid pulse, taut pulse, slippery pulse, deep pulse, moderate pulse, sluggish pulse.(2) Normal symptoms in every stageWe take the top ten lesion and somatic symptoms and the top three tongue and pulse symptoms in frequency as normal symptoms. Normal symptoms of psoriasis vulgaris in every stage are shown as followed:①In active stage:new lesions arising and the old growing, bright red lesion, itch, Auspitz sign, lesion developing fast, severe itch, guttate shape, more scale, isomorphism, silvery white scale; yellow urine, vexation, dry stool, dry mouth, thirst, irritability, constipation, dry throat, pharyngalgia, fever, yellow coating, red tongue, thin coating, rapid pulse, taut pulse, slippery pulse;②In telogen stage:bright red lesion, infiltrate plump, dark red lesion, itch, old lesion fading, adherent tight scale, thick scale, less scale, prolonged lesion; dry mouth, dry skin, dry throat, dizziness, tiredness, insomnia, lusterless complexion, pale complexion with puffiness, poor appetite; thin coating, pink tongue, white coating; thready pulse, deep pulse, moderate pulse.③In catagen stage:old lesion fading, bright red lesion, itch, no new lesion, dark red lesion, more scale, less scale, infiltrate plump, dry scale, shedding scale; dry mouth, dry throat, dry stool, dry skin, dizziness, tiredness, hot sensation in five centers with vexation, constipation, tiredness, pink tongue, few coating, thin coating, thready pulse, deep pulse, moderate pulse4 Symptoms in normal syndromeWe take the top ten lesion and somatic symptoms and the top three tongue and pulse symptoms in frequency as normal symptoms. Symptoms in normal syndromes of psoriasis vulgaris are shown as followed:Blood-heat syndrome:bright red lesion, new lesions arising and the old growing, lesion developing fast, guttate shape, more scale, thick scale, expanded integration of the whole body, silvery white scale, shedding scale, patch shape, yellow urine, vexation, dry mouth, irritability, thirst, constipation, dry throat, throat pain, aversion to hot, red tongue, yellow coating, thin coating, rapid pulse, taut pulse, slippery pulse. Blood stasis syndrome:dark red lesion, infiltrate plump, prolonged lesion, thick scale, plaque shape, adherent tight scale, itch, purple dark lesion, carapace shape, severe itch, dry mouth, bend to stretch disadvantage knuckle, dim complexion, green purple lip, swollen and painful joint, rough skin, dysmenorrhea, yellow urine, dark tongue, purple dots or spots on the tongue, purple tongue, sluggish pulse, thready pulse, moderate pulse.Blood-dryness syndrome:light red lesion, old lesion fading, less scale, adherent tight scale, infiltrate plump, itch, few new lesion arising, coin shape, fusing lesion, no new lesion arising, dry mouth, dry throat, dry skin, hot sensation in five centers with vexation, constipation, dry stool, dry lip, dizziness, insomnia, pink tongue, few coating, thin coating, thready pulse, deep pulse, moderate pulse.Blood deficiency and wind-dryness syndrome:lesion light red, itch, more scale, shedding scale, fissure, severe itch, old lesion fading, dry scale, thick scale, dark red lesion, dry mouth, dry skin, dry stool, dizziness, dry throat, constipation, tiredness, sallow face, poor appetite, spirit exhausted, thin coating, pink tongue, white coating, thready pulse, taut pulse, moderate pulse.Blood deficiency syndrome:lesion light red, few new lesion arising, itch, dry scale, lesion thin, expanded integration of the whole body, plaque shape, dark red lesion, silvery white scale, more scale, tastelessness, dizziness, lusterless complexion, dry skin, tiredness, insomnia, dry mouth, poor appetite, pale face, pink tongue, few coating, thin coating, thready pulse, deep pulse, taut pulse.Damp-heat syndrome:itch, seepage, lesion in skin drape, exudation, flushing and tumefaction basement, pustule, severe itch, lesion in lower limbs, patch shape, oil scale, stomach block-up, poor appetite, yellow urine, tiredness, dry mouth, chest distress, bitter taste, much leukorrhea, heavy lower limbs, greasy coating, yellow coating, red tongue, rapid pulse, slippery pulse, taut pulse.Blood-heat and wind-dryness syndrome:bright red lesion, Auspitz sign, itch, new lesions arising and the old growing, lesion developing fast, severe itch, guttate shape, shedding scale, severe itch, yellow urine, thirst, dry stool, vexation, dry mouth, constipation, dry throat, pharyngalgia, irritability, bitter taste, red tongue, yellow coating, thin coating, taut pulse, rapid pulse, slippery pulse.Wind-heat syndrome:bright red lesion, itch, new lesions arising and the old growing, guttate shape, lesion developing fast, shedding scale, severe itch, Auspitz sign, expanded integration of the whole body, severe itch, yellow urine, dry mouth, thirst, pharyngalgia, fever, constipation, vexation, bitter taste, dry throat, dry stool, red tongue, yellow coating, thin coating, rapid pulse, floating pulse, taut pulse.Heat-toxicity syndrome:bright red lesion, itch, new lesions arising and the old growing, dark red lesion, shedding scale, expanded integration of the whole bodyion, severe itch, lesion developing fast, guttate shape, bright red lesion, fever, vexation, thirst, dry mouth, constipation, yellow urine, irritability, fidget, coma, bitter taste, red tongue, yellow coating, crimson tongue, rapid pulse, taut pulse, surge pulse.Wind-heat and blood-dryness syndrome:Auspitz sign, new lesions arising and the old growing, bright red lesion, film phenomenon, isomorphism, itch, guttate shape, lesion light red, silvery white scale, thick scale, yellow urine, vexation, thirst, dry stool, dry throat, constipation, dry mouth, dry lip, dry skin, red tongue, yellow coating, greasy coating, rapid pulse, taut pulse, slippery pulse. Conclusions1 Normal syndromes of psoriasis vulgaris are blood-heat syndrome, blood stasis syndrome, blood-dryness syndrome, syndrome of wind and dryness due to blood deficiency, blood deficiency, damp-heat syndrome, blood-heat and wind-dryness syndrome, wind-heat syndrome, heat-toxicity syndrome and wind-heat and blood-dryness syndrome.2 Normal syndrome-elements of location of disease are blood, liver, kidney, skin; Normal syndrome-elements of nature of disease are blood-heat, wind, heat, blood deficiency, dry, damp.3 lesion symptoms, tongue symptoms, pulse symptoms are main syndrome differentiation evidences. And somatic symptoms are necessary complement.4 In literature, it is common that the researchers do not use diagnosis standards when they report literatures.5 It is common that the syndromes and symptoms names of psoriasis vulgaris are not standardized.6 The syndromes of psoriasis vulgaris are complex, but it can be easier when researchers study them in syndrome-elements aspects.Meanwhile it provides evidence for syndrome standardization researches. |
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