Data Mining Of Chinese Herbal Compound Treatment Of Psoriasis And Meta-analysis Of Its Treatment Of Blood-heat Type Psoriasis

Backgroud Psoriasis is an immune-mediated chronic,inflammatory skin disease.The incidence of psoriasis worldwide is 2%-3%,and in China is 0.47%.The main clinical manifestations are erythema,scales on the skin,and occurrence of punctate hemorrhage after gentle scaling.It has a great negative impact on the quality of life and psychology of patients.At present,the pathogenesis of psoriasis is not clear.The existing treatment methods can only relieve and control the symptoms,but not fundamentally solve psoriasis and prevent its recurrence.Therefore,psoriasis has always been the focus of dermatological research.Traditional Chinese medicine(TCM)calls psoriasis "white jaundice" and its main pathogenesis is fever in blood.Traditional Chinese medicine treatment of psoriasis emphasizes individual heterogeneity and appropriate treatment according to the clinical symptom.According to the etiology and pathogenesis of psoriasis,TCM divides it into blood-heat type(53.8%),blood-dryness type(27.4%)and blood-stasis type(18.1%)and other types(0.6%).Blood-heat type is the most common type in TCM,which corresponds to the progressive stage of psoriasis.Symptoms of progressive stage psoriasis include rapid development of rashes,flushing,new skin rashes,more scales,punctate haemorrhage,itching,dry mouth and tongue,constipation,irritability,short and red cress,reddish tongue,thin white or yellowish tongue coating,slippery pulse string and several symptoms of TCM blood fever.The blood-heat type psoriasis has the most serious symptoms and highest PASI score.Clearing heat,cooling blood,activating blood circulation and detoxification are the main therapeutic principles,and clinical studies have shown better curative effect.A large number of studies have reported that traditional Chinese medicine has a definite effect on psoriasis.Compared with traditional western medicine,traditional Chinese medicine has insignificant side effects and lower price,which shows huge asvantages and prospects.It is gradually recognized by patients.Traditional Chinese medicine has unique advantages in syndrome differentiation and treatment,and many cases reported that TCM has remarkable curative effect on psoriasis.Because the pathogenesis of psoriasis is relatively complex,doctors have different understanding of psoriasis.Most of the clinical treatment experience reports focus on individual cases,which makes the clinical efficacy of traditional Chinese medicine in the treatment of psoriasis lack of systematic and scientific combing and summary.The lack of large sample clinical observation of the efficacy of drugs and research on the efficacy mechanism of clinical drugs,to a certain extent,limited the clinical application and development of traditional Chinese medicine in the treatment of psoriasis.It is necessary to sort out and excavate the literature resources of these clinical studies and make a systematic evaluation and analysis so as to explore the medication rule of traditional Chinese medicine in the treatment of psoriasis and provide a basis for rational selection of medication in the clinical treatment of psoriasis and benefit patientsObjective 1.To collect and sort out the prescriptions of traditional Chinese medicine for psoriasis,summarize the underlying principles,treatment and medication rules,and provide basis for the clinical treatment of psoriasis and the research and development of traditional Chinese medicine.2.To systematically evaluate the efficacy and safety of traditional Chinese medicine combined with conventional western medicine in the treatment of psoriasis of blood-heat type,and to provide evidence-based medical evidence for the clinical application of integrated traditional Chinese and Western medicine in the treatment of psoriasis of blood-heat type.Methods 1.Based on the clinical research literature of Chinese medicine for psoriasis collected from CNKI,Wanfang Data Knowledge Service Platform,Wip.Net,CBM and PubMed databases,the Chinese medicine compound prescription database for psoriasis treatment was established by collecting the Chinese medicine compound prescription in the literature according to the inclusion and exclusion criteria,and frequency analysis and system were used.Data mining methods,such as cluster analysis and association rule analysis,were used to analyze the medication of the selected compound prescriptions,and to explore the underlying medication rules and treatment methods.2.Computer searches EMBASE,MEDLINE,Cochrane Library,China Biomedical Literature Database(CBM),China Journal Full-Text Database(CNKI),Weipu Chinese Journal Database,Wanfang Digital Journal Full-Text Database and Chinese Science and Technology Journal Database(VIP)databases to collect randomized controlled literature on the clinical efficacy of traditional Chinese medicine combined with conventional western medicine in the treatment of hemothermic psoriasis.Jadad scale was used to evaluate the quality of the study,and the characteristic information was extracted.Revman 5.3 software was used for meta-analysis.The clinical efficacy of traditional Chinese medicine combined with conventional western medicine in the treatment of psoriasis of blood-heat type was evaluated systematically,and the efficiency was compared.Results 1.327 prescriptions for psoriasis were screened in 370 literatures.The most common syndromes were blood-heat type,followed by blood-stasis type and blood-dryness type,involving 240 traditional Chinese medicines,33 high-frequency drugs(more than 30 occurrences),mainly heat-clearing and blood-cooling drugs,and the single-flavor drugs with the highest frequency were Rehmannia glutinosa(204 occurrences),followed by Paeonia Rubra(163 occurrences),and Glycyrrhiza(158 clustering).The results showed that the results were better when the number of clusters was 10.The commonly used drugs were Radix Rehmanniae,Radix Paeoniae Rubra,Licorice,Peony Bark,Angelicae Sinensis,Poria cocos,Salvia Miltiorrhiza,Fresh Bark,Lithospermum,Hedyotis diflora,etc.Prescription,blood stasis syndrome commonly used blood-activating drugs and decomposing blood and eliminating symptoms drug pairs,blood deficiency and wind dryness syndrome commonly used blood-tonifying,heat-cooling and blood-cooling medicine2.According to the inclusion and exclusion criteria,13 high-quality studies were screened out.The effective rate of traditional Chinese medicine combined with routine western medicine in the treatment of psoriasis of blood-heat type(95%CI(1.19-1.33))was better than that of routine western medicine alone,with statistical significance(P<0.05).Conclusions 1.The main prescriptions for psoriasis are clearing away heat,cooling blood,detoxification,nourishing yin,activating blood circulation and removing blood stasis.Liangxue Jiedu Decoction is the most widely used prescription.The most commonly used ingredients were Radix Rehmanniae,Radix Paeoniae Rubra,Licorice and Peony Bark.2.The clinical efficacy of Radix Rehmanniae combined with Radix Isatidis,Radix Rehmanniae combined with Rhizoma Impatiens,rattan and insect drugs in the treatment of psoriasis deserves further study and discussion.3.Meta analysis preliminarily indicated that the effective rate of traditional Chinese medicine combined with conventional western medicine in the treatment of psoriasis of blood-heat type was better than that of simple western medicine.