Study On The Regularity Of Medication For TCM Syndrome Differentiation Of Psoriasis

Purpose:To explore the characteristics of TCM prescriptions based on syndrome differentiation for psoriasis in the recent 21 years.To composite statistical formulas deriving from high frequency Chinese herbal medicines for typical syndromes.To analyze the characteristics of four Qis and five flavors by searching out the high frequency Qis and flavors.To deduce the principal mechanism of disease of psoriasis,and the main pathogenic zang-fu organ by finding out the high frequency meridian distributions.Method:The published psoriasis cases are collected from China Biology Medicine disc,Wanfang Med Online and China National Knowledge Infrastructure ranging from 2000.1.1 to2020.12.31.The data of the Chinese herbal medicines in the formulas are put into tables in WPS Office software,including names of basic syndromes,names of the medicines?the four Qis,five flavors and meridian distributions.The high frequency medicines in the statistics are arranged in descending order according to 6 principal syndrome types and are composed into formulas.Medicines in all of the 6 syndromes as a whole are taken into cluster analysis.Statistical formulas for each syndrome are consisted of high frequency medicines and the relative medicines clustered.The high frequency Qis and flavors are searched out and the characteristics of four Qi and five flavors are analyzed.The high frequency meridian distributions are found out and the main pathogenic zang-fu organ and the principal mechanism of disease of psoriasis are deduced.The frequency of medicines is counted in WPS office.The multiple comparison of sample average(SNK-q)and cluster analysis are carried out in SPSS Statistics 17.0.Results:90 reported cases are taken into statistics,including 144 prescriptions.Results are are represented below.1.The high frequency medicines are listed in the following.Blood heat syndrome: dried rehmannia root,radix paeoniae rubra,moutan bark,lithospermum,liguoric,rhizoma smilacis glabrae,Oldenlandia,buffalo horn,cortex dictamni,honeysuckle,Salvia Miltiorrhiza,lalang grass rhizome.Blood stasis syndrome: Salvia Miltiorrhiza,safflower carthami,Angelica sinensis,peach kernel,liguorice,dried rehmannia root,curcuma zedoary,radix paeoniae rubra,honeysuckle,rhizoma smilacis glabrae,zaocys dhumnade,Oldenlandia,cortex dictamni,,Caulis Spatholobi,Rhizoma Sparganii.Blood dryness syndrome: dried rehmannia root,Angelica sinensis,liguorice,rhizoma smilacis glabrae,Caulis Spatholobi,Salvia Miltiorrhiza,Polygonum multiflorum,cicada slough,radix paeoniae rubra,cortex dictamni,Saposhnicovia divaricata,Radix Ophiopogonis.Excessive toxic heat syndrome: dried rehmannia root,honeysuckle,moutan bark,radix paeoniae rubra,lalang grass rhizome,isatis root,rhizoma smilacis glabrae,fructus forsythiae,Scutellaria baicalensis,semen plantaginis.Damp-heat retention syndrome: dried rehmannia root,semen coicis,radix paeoniae rubra,rhizoma smilacis glabrae,honeysuckle,Scutellaria baicalensis,liguorice,cortex dictamni,Angelica sinensis,felwort.Wind-dampness syndrome: dried rehmannia root,Poria cocos,moutan bark,cassia twig,Fraxinus bungeana,liguorice,Angelica sinensis,Caulis Spatholobi,parasitic loranthu,Cydonia lagenaria Lois.The highest 30 medicines are divided into 15 groups by clustered analysis.6 statistical formula are obtained accordingly by combining the high frequency medicines for each of the 6 basic syndromes and those clustered medicines.2.In blood heat syndrome,blood stasis syndrome,excessive toxic heat syndrome and damp-heat syndrome,bitter is the flavor of highest frequency.In blood dryness syndrome and wind-dampness syndrome sweet is the flavor of highest frequency.Bitter,sweet and pungent are all included in the 3 flavors with the highest frequency in all the 6 typical syndromes.In gross,the highest ratio of Five flavors are bitter(0.37±0.06),sweet(0.33±0.03)and pungent(0.18±0.04),and the multiple comparison among them results in P<0.05.The difference is of statistical significance.Cold is the Qi with the highest frequency in all the 6typical syndromes.In gross,the highest ratio of Four Qis are cold(0.59±0.18),warm(0.22±0.12)and mild(0.18±0.05),and the multiple comparison between cold and the other two results in P<0.05.The difference is of statistical significance.3.The liver meridian is of the highest frequency in all the 6 typical syndromes.The stomach meridian is of the second highest frequency in damp-heat syndrome and the heart meridian is of the second highest frequency in other 5 typical syndromes.In gross,The meridians with highest ratio are liver(0.24±0.03),heart(0.16±0.02),stomach(0.13±0.02)and lungs(0.12±0.01).The multiple comparison between the liver and the other three results in P<0.05.The difference is of statistical significance.Conclusion:In this study:1.In each of all the 6 typical syndromes,heat-clearing and blood-cooling medicines are included,and are core medicines for the curing of psoriasis.2.In each of all the 6 typical syndromes,the characteristics of the four Qis and five flavors of the medicines are bitter integrated with sweet and pungent,and cold is the main property in the treatment of psoriasis.3.In each of all the 6 typical syndromes,the liver meridian is of the highest frequency.According to the theory of “deriving pathogenesis from medicines”,the liver is closely related with the pathogenesis of psoriasis.Analyzed with the clinical features,it can be deduced that the key pathogenesis of psoriasis lies in the liver.