| Objective:1.To observe the changes in the skin lesion area and severity index(PASI)scores of patients with different traditional Chinese medicine syndromes of psoriasis before and after the treatment of calcipotriol cream combined with ultraviolet light therapy,and to compare psoriasis Whether there are differences in the PASI scores of patients with different TCM syndromes,and compare the changes in the severity of the skin lesions of the patients before and after treatment;2.Use reflectance confocal microscopy(RCM)to detect the dermal papillary area and dermal papillary circumference values at the skin lesions and normal skin of patients with psoriasis vulgaris,and compare The difference between the two indicators in the skin lesions of patients with psoriasis and the normal skin,and observe the correlation with the PASI score,whether it can be used as the basis for the evaluation of the efficacy before and after treatment;3.Use RCM to measure the dermal papillary area and dermal papillary circumference of the skin lesions and normal skin of patients with psoriasis vulgaris,explore whether the values can be used as an indicator of the TCM classification of psoriasis,and observe the RCM in the disease The monitoring role played during the treatment.Methods:A total of 32 patients with psoriasis vulgaris who met the inclusion criteria and obtained informed consent who were in the Dermatology Clinic of Wuhan First Hospital from November2020 to January 2021 were selected.TCM syndrome differentiation and PASI were conducted through senior physicians.After scoring,select the typical new skin lesions of the patient’s trunk or limbs and the normal skin on the opposite side of the affected limb or normal skin adjacent to the affected site.Use RCM to detect the area of the skin dermal papilla and the circumference of the dermal papilla,and record the obtained data.After calcipotriol cream combined with ultraviolet light therapy,2 patients fell off during the treatment.Four weeks later,the original skin lesions were scanned again according to the same procedure,and the patients were scored by PASI to compare the dermal papilla area and the dermal papillary circumference of the psoriasis lesions Compared with normal skin,compare the changes of PASI score,dermal papilla area,and dermal papilla circumference before and after treatment,and the correlation between PASI score and dermal papilla area and dermal papilla circumference.Results:1.A total of 32 patients with psoriasis were included in this experiment(2 patients fell off during the treatment),including 12 cases of blood-heat syndrome,8 cases of blood stasis syndrome,and 10 cases of blood dryness syndrome.A oneway analysis of variance was performed on the PASI scores of the three types of syndromes before treatment.The differences in the PASI scores of the three types of syndromes were not statistically significant(P>0.05);after 4 weeks of treatment,the PASI scores of the three types of syndromes were again analyzed for the three types of syndromes.One-way analysis of variance was performed on the PASI score,and the difference in PASI score was also statistically significant(P<0.05).Paired T test was performed on the PASI scores of patients with the same syndrome before and after treatment,and the difference was statistically significant(P<0.05).Observe the change rate of the severity of skin lesions before and after treatment. Effective,markedly effective and cured patients account for90% of the total number of patients.The clinical manifestations of most of the patients’ skin lesions have improved.2.One-way analysis of variance was performed on the dermal papilla area of the skin lesions of the three types of psoriasis patients before treatment,and the difference was not statistically significant(P>0.05);after 4 weeks of treatment,the three types of psoriasis were again analyzed The area of the dermal papilla of the patient’s skin lesions was analyzed by one-way analysis of variance,and the difference was not statistically significant(P>0.05).One-way analysis of variance was performed on the dermal papillary circumference of the skin lesions of the three syndromes before treatment,and the difference was not statistically significant(P>0.05); after 4 weeks of treatment,the skin lesions of the three syndromes were again analyzed The perimeter of the dermal papilla was analyzed by one-way analysis of variance,and the difference was not statistically significant(P>0.05).The dermal papillary area,dermal papillary area,dermal papillary area and dermal papillary circumference at the skin lesions of patients with the same syndrome were statistically significant differences by paired T test(P<0.05);patients with the same syndrome The area of dermal papilla and circumference of dermal papilla after treatment were significantly different from those before treatment by paired T test(P<0.05).3.The correlation between the dermal papillary area and dermal papillary circumference before and after treatment and the PASI score has not been found yet,and the dermal papillary area and dermal papillary circumference cannot be used as indicators for judging the severity of psoriasis and TCM scores The basis of the type.Conclusion:The differences in PASI scores,dermal papillary area and dermal papillary circumference before and after treatment of the three TCM syndromes of psoriasis patients are statistically significant,indicating that RCM can reflect the subcutaneous lesions to a certain extent during the treatment of psoriasis.The true condition of the internal microstructure indicates the recovery of the condition.However,there is no significant correlation between the PASI score and the area of the dermal papilla and the circumference of the dermal papilla,suggesting that we cannot use the area of the dermal papilla and the perimeter of the dermal papilla as the index for judging the severity of psoriasis and the TCM classification of psoriasis.Indicators need to be explored in the future. |
PDF Full Text Request