| Objective:Traditional Chinese medicine has a long history in the treatment of psoriasis,and its clinical effect is remarkable.The most obvious way to determine the efficacy of psoriasis is whether the erythema has subsided or not,which is the most commonly used PASI scoring method.Clinical syndrome differentiation and curative effect evaluation of TCM lack objective quantitative parameters,so the repeatability of clinical research is poor,which is not conducive to academic exchanges and clinical promotion.Modern studies have found that NO and plasma elastase in psoriasis lesions can be used as objective indicators for evaluation of curative effect,but they are invasive examinations,and patients' acceptance is low.However,the commonly used clinical efficacy evaluation indicators such as psoriasis lesion area and severity index(PASI) score and TCM syndrome score have some shortcomings,such as rough measurement,large subjectivity and poor repeatability.Without objective quantitative parameters,it is difficult to generalize the accurate experience of syndrome differentiation and efficacy summary,which makes the clinical characteristics and advantages of TCM unable to reflect.Therefore,if the characteristic treatment methods of TCM are combined with objective quantitative data of modern science and technology,scientific parameters of repeatable analysis and non-invasive advantages,the advantages of TCM in the treatment of psoriasis will be objectively reflected.Methods:A self-controlled clinical trial was conducted in this study,thirty patients with psoriasis vulgaris of blood-heat syndrome were admitted to the Department of Dermatology,Yueyang Integrative Medical Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai.They were treated with Qinzhu Liangxue Mixture(in-hospital preparation)decocted orally,twice a day,30 ml each time.Laser speckle contrast imaging quantitative analysis was performed before,during and after 90 days of treatment.The quantitative parameters of psoriasis "blood-heat syndrome" detected by laser speckle contrast imaging technology were determined by combining the clinical evaluation of validity and inefficiency of conventional PASI score,so as to supplement a new evaluation method for clinical PASI scoreResults:1.In 30 cases of psoriasis with blood-heat syndrome,the parameters of P25 speckle laser were 2.6,P50 speckle laser was 3.33 and P75 speckle laser was 5.79.It can be initially defined as quasi-blood-heat syndrome,standard blood-heat syndrome and classical blood-heat syndrome by speckle laser parameters to guide clinical practice.2.The PASI score of psoriasis patients with blood-heat syndrome decreased from 56.60±9.54 before treatment to 23.40±6.17 after 9 weeks of treatment(P<0.05).The speckle laser parameters decreased from 82.24±52.64 to 14.54±12.83 before and after treatment(P < 0.05).3.By regression analysis,Pearson r = 0.7001(0.5955,0.7813);regression equation Y = 2.126*X-42.46;slope 95% CI = 1.730 to 2.521;R2 = 0.4901;Sy.x = 32.49,tested,P<0.01,so there is a linear relationship between PASI and laser parameters.The correlation between PASI difference and laser parameters in 30 patients was analyzed by regression analysis.Pearson r=0.3687(0.00965,0.6436);regression equation Y=1.466*X+19.03;slope 95%CI=0.03559 to 2.896;R2=0.136;Sy.x=42.62,tested,P<0.05,so there was a linear relationship between PASI difference and laser parameters.Conclusion:1.Speckle laser technique is a reliable and non-invasive method for quantitative analysis of target lesions of psoriasis in patients with blood-heat syndrome.2.The quantitative parameters of speckle laser can be used as an assistant analysis method for the blood-heat syndrome of psoriasis.The change of this parameter can provide a reliable method for clinical treatment of TCM and monitoring the change of curative effect.3.Qinzhu Liangxue Mixture is an effective prescription for the treatment of psoriasis due to blood-heat syndrome. |
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