| Objective:To observe the therapeutic effect of ultrasonic atomization of traditional Chinese medicine combined with fire needle on plaque psoriasis(blood stasis syndrome),and to observe the changes of blood vessels in the fixed skin lesion during the treatment with dermatoscope,the correlation between the change of vessel diameter and clinical effect was discussed.Methods:A total of 60 patients were selected from the outpatient or inpatient department of the Dermatology Department of the Jiangxi University of Traditional Chinese Medicine Hospital.All patients met the diagnostic criteria of plaque psoriasis(blood stasis syndrome).All the patients were randomly divided into treatment group(N = 30)and control group(N = 30),and in the limbs or trunk to select a location,size and skin lesions in the two groups were roughly similar to the observation of skin lesions,called target lesions.The treatment group was treated with ultrasonic atomization of traditional Chinese medicine combined with fire needle twice a week for 6 weeks,while the control group was treated with 308 nm ultraviolet light combined with carbamazepine ointment.During the course of treatment(before treatment,after 2 weeks,4 weeks,6 weeks),the skin lesions were assessed with PASI score,pruritus score and TCM syndrome score respectively.At the same time,the severity of the target lesion was evaluated,and the vascular changes of the target lesion during the treatment were observed by dermoscopy.Results:1.Baseline Data: 60 patients were divided into treatment group and control group,there were no significant differences in age,course of disease,sex,PASI score,pruritus score,TCM syndrome score,target lesion severity score and vessel diameter between the two groups(P>0.05).2.Comparison of clinical therapeutic effect: after treatment,the cure and marked rate of the treatment group and the control group were 67.9% and 30.0%respectively,there was a difference between the two groups(P<0.05),and the former was higher than the latter.3.Comparison of PASI scores: comparison between groups: after 2 weeks of treatment,there was no significant difference in PASI scores between the two groups(P>0.05).After 4 weeks of treatment,the difference was significant(P<0.01),there was significant difference(P<0.05).The improvement of PASI score in the treatment group was better than that in the control group.The decrease of PASI score in the two groups was significant at 4 weeks(P<0.05).Within-group comparison: with the prolongation of treatment time,the PASI scores of both groups decreased gradually,and the level was significant(P<0.01).4.There was no significant difference between the two groups after 2 and 4weeks of treatment(P>0.05),but there was significant difference after 6weeks of treatment(P<0.05),the improvement of the score of pruritus in the treatment group was better than that in the control group(P<0.05).There was a significant difference in the reduction of the score of pruritus between the two groups at the 6th week of treatment(P<0.05).In the treatment group,the score of pruritus decreased gradually with the prolongation of treatment time,and the level of pruritus in the treatment group was significantly lower than that in the control group(P<0.01),the scores of pruritus in the control group were significantly different(P<0.05)before and after treatment for 2 weeks,after treatment for 4 weeks and after treatment for 6 weeks,and after treatment for 2 weeks and after treatment for 4 weeks,the difference was significant(P<0.01).5.Comparison of TCM syndrome score: comparison between groups: there was no significant difference in TCM syndrome score between the two groups after 2weeks of treatment(P>0.05),but there was significant difference after 4 weeks of treatment(P<0.05),after 6 weeks of treatment,the difference was significant(P<0.01).The improvement of TCM syndrome score in the treatment group was superior to that in the control group(P<0.05).In-group comparison:with the treatment time prolonged,the TCM syndrome scores of both groups gradually decreased,the level was significant(P<0.01).6.Comparison of target lesion severity score: there was no significant difference between the two groups after 2 weeks of treatment(P>0.05).After4 weeks of treatment,the difference was significant(P>0.01),there was significant difference between the two groups(P<0.05).The improvement of the target lesion severity score in the treatment group was superior to that in the control group(P<0.05),the score of target lesion severity decreased with the treatment time in both groups(P<0.01).7.Comparison of vessel diameter: comparison between groups: after treatment for 2 weeks,the change of vessel diameter between two groups was significant(P<0.01),after treatment for 4 and 6 weeks,there was significant difference(P<0.05),the decrease of vessel diameter in the treatment group was superior to that in the control group(P<0.05),and the decrease of vessel diameter in the two groups was significantly different after 2 weeks of treatment(P<0.01),and the former was greater than the latter,the blood vessel diameter decreased gradually in both groups(P<0.01).8.The recurrence rate was 15.00% in treatment group and 55.56% in control group(P<0.05).9.Correlation comparison: the vessel diameter was positively correlated with PASI score(R = 0.950),pruritus score(R = 0.859)and TCM syndrome score(R = 0.864)in the treatment group(P<0.01),there was a positive correlation between the vessel diameter and the target lesion severity score(R = 0.950,(P<0.01),which was consistent with the PASI score of the whole lesion and changed with the time of treatment,the relative index of vessel diameter and the relative index of target lesion severity score gradually increased,and the former was always smaller than the latter.10.In the treatment group,one patient developed redness and swelling after fire acupuncture treatment for one day,and was treated with Mupirocin ointment in time,and the redness and swelling subsided after external application Two patients in the control group developed scaling and blistering after 308 nm ultraviolet light treatment,which delayed the next treatment and continued the original treatment after the symptoms disappeared.Conclusion:1.Ultrasonic atomization of traditional Chinese medicine combined with fire needle therapy is effective in the treatment of plaque psoriasis,and can significantly improve the severity of the lesions,pruritus symptoms,TCM syndrome,vasodilatation,and reduce the recurrence rate.2.The therapeutic effect,safety and recurrence rate of the therapy of ultrasonic nebulization of traditional Chinese medicine combined with fireneedle therapy on plaque psoriasis were superior to those of the therapy of308 nm excimer light combined with casotriol ointment.3.The vessel diameter under dermoscopy is strongly correlated with PASI score,pruritus score,TCM syndrome score and target lesion severity score,so it is suggested that dermoscopy is of clinical significance in evaluating the severity and efficacy of psoriasis. |
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