Psoriasis

Introduction	Back to Top
Psoriasis is a common chronic inflammatory dermatosis, characterized by red macular eruption spots or plaques with silvery scraps. It may appear anywhere on the surface of the body, though it is more frequently seen on the medial side of the four limbs and the scalp. This disease tends to linger for a period of time, with temporary remissions and recurring symptoms in between. In traditional Chinese medicine, it falls into the category of "Gan Xuan" (chronic eczema) or "Feng Xuan" (tinea corporis).

Etiology/Pathogenisis	Back to Top
Psoriasis is a common chronic inflammatory dermatosis, characterized by red macular eruption spots or plaques with silvery scraps. It may appear anywhere on the surface of the body, though it is more frequently seen on the medial side of the four limbs and the scalp. This disease tends to linger for a period of time, with temporary remissions and recurring symptoms in between. In traditional Chinese medicine, it falls into the category of "Gan Xuan" (chronic eczema) or "Feng Xuan" (tinea corporis).

Primary Treatments with Medicinal Herbs	Back to Top
Xiao Yin Pian Ingredients: Sheng Di Huang (Rehmannia Root), Jin Yin Hua (Lonicera Flower), Ku Shen (Sophora Root), Da Qing Ye (Isatis Leaf), Chi Shao (Peony Red), Fang Feng (Siler) Clinical Application: Li, et al. used Xiao Yin Pian to treat 200 cases of psoriasis. The Xiao Yin Pian study consisted of Sheng Di (Rehmannia Root), Chi Shao (Peony Red), Mu Dan Pi (Moutan), Fang Feng (Siler), Dang Gui (Dang Gui), Jin Yin Hua (Lonicera Flower), Hong Hua (Carthamus), Ku Shen (Sphora Root), Bai Xian Pi (Dittany Bark), Chan Tui (Cicada Slough), Da Qing Ye (Isatis Leaf), and Niu Bang Zi (Arctium). Research has established that Xiao Yin Pian can counteract histamine-induced allergic reactive asthma and bovine serum-induced type-1 allergic reaction in guinea-pigs, and that it not only postpones the appearance of allergic reaction but also reduces the probability of its occurrence. The results: 47.6% of the patients were resolved, 35.7% improved, and the remaining 16.7% did not respond to the treatment, with a total effective rate of 83.3%. On average, the patients recovered in 54.4 days.(1)

Other Treatments with Medicinal Herbs	Back to Top
Yin Xiao San Yu used Yin Xiao San to treat 200 cases of psoriasis. Yin Xiao San consisted of Da Huang (Rhubarb), Bai Xian Pi (Dittany Bark), Tu Fu Ling (Smilax), artificial Niu Huang (Cow Be-zoar), Qing Dai (Natural Indigo), Sheng Di Huang (Rehmannia Root), and Chen Pi (Citrus Peel). The adult oral dosage (for patients between the ages of 16 to 60) is 7.5 grams, three times a day. For children between 8 to 12 years old, the dosage is reduced by half, and for children between 12 to 15 years and for people older than 60 years of age, the dosage is 75% of the adult dosage. One course of treatment lasted 30 days. The results: after 2-3 courses of treatment, 70 cases recovered, 62 significantly improved, 36 improved, 20 responded to the treatment, and the remaining 12 did not respond to the treatment, with a total effective rate of 94%.(2) Tui Yin Tang Xie treated 106 cases of psoriasis (59 active and 47 stationary) with Tui Yin Tang. The basic formula consisted of Sheng Di Huang (Rehmannia Root), Dang Gui (Dang Gui), He Shou Wu (Fleece-flower Root), Nu Zhen Zi (Ligustrum), Huang Jing (Polygonatum Root), Bai Ji Li (Tribulus), Mai Dong (Ophiopogon Root), Wu Shao She (Dried Zaocys), and Wu Gong (Centipede). For patients with active psoriasis, Tu Fu Ling (Smilax), Shi Gao (Gypsum), and Dan Pi (Moutan) were added to the basic formula; and for patients with stationary psoriasis, San Leng (Burreed Tuber), E Zhu (Zedoaria), and Yu Jin (Curcuma Root) were added. One dose of the formula in decoction was administered daily, and 20 days constituted one course of treatment. There was a 5-day interval between courses of treatment. During treatment, patients were asked to not take hormones or ethylimini. For patients with severe itching, histamine was administered. The results: of the active 59 cases, 28 cases recovered, 23 significantly improved, 6 improved, and 2 did nor respond to the treatment; of the 47 stationary cases, 21 cases recovered, 20 significantly improved, 4 improved, and the remaining 2 did not respond to the treatment.(3) Tu Huai Yin Liu, et al. treated 62 cases of psoriasis with Tu Huai Yin. The formula consisted of Tu Fu Ling (Smilax), Huai Hua (Sophora), Fang Feng (Siler), Jin Yin Hua (Lonicera Flower), Chan Tui (Cicada Slough), Niu Bang Zi (Arctium), Dang Gui (Dang Gui), Chi Shao (Red Peony), Ci Ji Li (Fructus Tribuli), Bai Xian Pi (Dittany Bark), and Gan Cao (Licorice). Modifications were made according to the patients' symptoms. One dose of the formula in decoction (600ml) was administered daily, and 15 doses constituted one course of treatment. The dregs were retained and decocted again with She Chuang Zi (Cnidium Fruit), Dan Pi (Moutan), Fang Feng (Siler), Di Fu Zi (Kochia), Liu Huang (Sulphur), Ku Shen (Sophora Root), Xing Ren (Apricot Seed), and Fang Feng (Siler), and the decoction was used to fumigate and wash the affected areas for one hour each evening (the patient was advised to stay unexposed to wind for two hours). The results: after 1- 4 courses of treatment, 46 cases recovered, 12 cases improved, and the remaining 4 cases did not respond to the treatment.(4)

Other Treatments	Back to Top
Zhu treated 24 cases of psoriasis with auricular bloodletting. The procedure is as follows: First, the transverse running venous vessels in area 1 in the back of the ear were located. After local sterilization, the distal end of the vessel was cut, about 0.3cm long longitudinally to let a little blood out. Then a dry cotton-ball with a bit of Kufan (Aumen Exsiccatum) was used to press on the incision and was fixed with a piece of adhesive plaster. The treatment was conducted once every week and the next incision was performed near the first incision. If the vessel at the root of the ear was not easily identifiable, an incision at the distal end was made. The results: 21 cases improved, and the remaining 3 cases did not respond to the treatment, with a total effective rate of 87.5%.(5) Kong, et al. used acupoint catgut embedding therapy to treat psoriasis. The procedure is as follows: Along an imaginary line running from the 7^th cervical vertebra to the second sacral vertebra, and on the bilateral sides about 67mm from the spinal column, 10 points (5 on each side) were selected as the catgut embedding sites. The patient was asked to take a seated position on a chair with his or her back facing the practitioner. After local anesthesia with 1% lidocaine, a segment of surgical catgut was threaded through the puncture needle. The needle was inserted into the local anesthetized site, advanced toward the spinal column about 2.5cm deep, and then slowly withdrawn to leave the catgut in the subcutaneous tissues. This procedure was conducted once every 15 to 20 days, and 3 sessions constituted one course of treatment. Concurrently, the patient took a compound Qing Dai (Natural Indigo) bolus, 6g each time, twice a day. The results: 24 cases recovered, 18 significantly improved, and the remaining 4 did not respond to the treatment, with a total effective rate of 93.3%.(6)

Acupuncture & Acupressure	Back to Top
He treated 115 cases psoriasis with acupuncture. The acupoints selected for treatment were He Gu (LI 4), San Yin Jiao (SP 6), Xue Hai (SP 1), and Qu Chi (LI 11). Depending on the topical focus areas, supplemental treatment was administered as follows: Feng Shi (GB 31) was treated for focus in the four limbs; Feng Chi (GB 20) for the scalp; Feng Men (BL 12) for the torso; Fei Shu (BL 13), Ge Shu (BL 17), and Zu San li (ST 36) for refractory and chronic psoriasis; and Shen Men (HT 7) for insomnia. The following acupoints were treated with the reducing method: He Gu (LI 4), Xue Hai (SP 1) and Qu Chi (LI 11), Feng Shi (GB 31), Feng Chi (GB 20), Feng Men (BL 12) and Shen Men (HT 7), while the reinforcing method was applied to San Yin Jiao (SP 6), Fei Shu (BL 13), Ge Shu (BL 17), and Zu San Li (ST 36), and the needles were retained for 30 minutes. The treatment was conducted daily, and 10 sessions constituted one course of treatment. The results: after 3-5 courses of treatment, 25 cases recovered, 54 significantly improved, 19 improved, and the remaining 17 did not respond to the treatment.(7)

Footnotes	Back to Top
¹ Li Feng Lin, et al. Xiao Yin Pian's mechanism in treating psoriasis. Journal of Chinese Materia Medica. 1988;19(10):462-463. ² Yu Min Biao. Treating 200 cases of psoriasis with Yin Xiao San. Hubei Journal of TCM. 1999;21(11):509. ³ Xie Yong. 106 cases of psoriasis treated with Tui Yin Tang. Journal of Applied TCM. 1999;15(11):13. ⁴ Liu Shi Gang, et al. Treating psoriasis with Tu Huai Yin. Shandong Journal of TCM. 1999;18(12):547-548. ⁵ Zhu Wei Guo. Treating psoriasis with auricular bloodletting. Journal of Folk Chinese Medical Treatment. 1999;7(5):13. ⁶ Kong Qing Rong, et al. 60 cases of psoriasis treated by acupoint catgut embedding therapy. China Journal of Acupuncture. 1999;19(7):397. ⁷ He Xing. 115 cases of psoriasis treated with acupuncture. China Journal of Acupuncture. 1999;19(3):157-158.