Study On The Mechanism Of Mongolian Mind-body Interactive Psychotherapy In The Treatment Of Psoriasis

Psoriasis is an immune-mediated inflammatory disease.It is a complex disease affected by multiple factors.More and more evidence shows that psychological stress has a great negative impact on patients with psoriasis,and psychological intervention measures are carried out on patients.In Inner Mongolia,Mongolian mind-body interactive psychotherapy(MMIP),mainly a combination of narrative therapy and hypnosis,has been widely used and cured dozens of psoriasis patients previously.In2018,a formal clinical trial(clinical trial registration number: Chi CTR1800015533)with a western medicine standard treatment control group was launched.The main purpose of this project is to study the mechanism of Mongolian mind-body interactive psychotherapy in the treatment of psoriasis.There are currently 153 patients enrolled in the group,106 of whom have relatively complete data.The data collected included Psoriasis Area and Severity Index(PASI),Psoriasis Disability Index(PDI),Dermatology Life Quality Index(DLQI),Psoriasis Life Stress Inventory(PLSI),anxiety value,depression value,and biological samples include the skin,blood,saliva,and feces of the patients.Statistical methods were used to analyze the PASI,PDI,DLQI,PLSI,anxiety value,and depression value of the patient during the three treatment periods,and analysis the correlation between the six clinical indicators and the salivary cortisol concentration.At the same time,the skin of the patients was analyzed for transcriptome sequencing analysis and cortisol mass spectrometry imaging analysis.The main results are as follows:1.MMIP treatment significantly reduces the PASI,PDI,DLQI,PLSI,anxiety value,and depression value of patients.2.The PASI value of patients who are sensitive to MMIP treatment is significantly higher than that of non-sensitive patients,and the PLSI value of patients who are sensitive to MMIP treatment is significantly lower than that of non-sensitive patients.The PASI value and anxiety value of patients insensitive to MMIP treatment showed a high positive correlation in the early stage of treatment,and the HPA axis imbalance of insensitive patients was obvious in the middle and late stages of treatment.3.The results of mass spectrometry imaging analysis showed that the cortisol content in the skin of improved patients in the late treatment stage was more than that in the middle treatment stage.4.Transcriptome sequencing results showed that FOXA1,HSD11B1,PITX1,ADCYAP1 were related to MMIP treatment,FOXA1,HSD11B1 were up-regulated in improved patients,and PITX1 and ADCYAP1 were up-regulated in non-improved patients.After q RT-PCR verification and analysis of PITX1 and ADCYAP1,their expression trends are consistent with the sequencing results.5.GSEA and CIBERSORT analyzed the gene enrichment pathways,differential genes,and immune cell infiltration results of improved patients and unimproved patients,and the results showed that the skin of unimproved patients was in a state of immune activation.