Research On Clinical And Mechanism In Treating Psoriasis Vulgaris With Abdominal Breathing Training

Psoriasis is a kind of common psychosomatic skin diseases. Although it is easy be diagnosed, up to now there are still no ideal therapy. It was worth paying attention by dermatologists because the chronic repeatedly recurrence of psoriasis may bring huge burden on patients both mentally and economically. We having being carry out psychotherapy and biofeedback therapy to treating psoriasis over ten years, and accumulate richer clinical experience. Which has good influence both in domestic and abroad. In order to improve behavior therapies in treating psoriasis, we develop a new therapy—abdominal breathing training.Abdominal breathing is a kind of important manners in Chinese tradition convalesce. This kind of slow and deep breathing may help human quiet and relax not only in body but also in mind. Presently some experts apply breathing training method to train the functions of lungs and respiratory muscle. It was not until resent years its relax effect was gradually being recognized. According this principle, different breathingtraining instruments had been designed successfully to treating hypertension in some countries including American and Japan. It was a daring conceive and attempt to apply abdominal breathing in the field of dermatology especially in psychosomatic skin diseases such as psoriasis.AimsIn order to standardize the abdominal breathing training, we developed a new feedback abdominal breathing training instrument Then we research the influence of abdominal breathing training on heart rate, respiratory sinus arrhythmia and blood pressure both health people and psoriatic patients as well as the expression of pituitary adenylate cyclase activating polypeptid and its receptor in psoriatic and non- psoriatic skin. At the some times watched the change of lesion and discussed the role of abdominal breathing training in treating psoriasis vulgaris.Methods Section One The development of feedback abdominalbreathing training instrumentWe developed a kind of feedback abdominal breathing training instrument on the basis of the principle of biofeedback collaborated with the aviation biological medicine research center of air force. It was consisted of the guiding part of breathing movement, the demonstrate part of breathing movement measuring, the survey part of electrocardiogram, blood pressure and the feedback part of signal manager. All of the information was shown on the screen of 10.4inch TFT colorful liquid crystal. The breathingmovement was guided in two ways, including voice and figures.This instrument has study software. It is to learn the biggest range of respiratory in different trainers. In this way the software will make guiding respiratory mode according to differently person. During training the trainer may breath follow the mode and voice suggestion or watch the error figure, and making the error as minor as possible.Section two Research about physiological parameters ofhealth people during abdominal breathing trainingIn order to explore the influence of abdominal breathing on health people and determine the property and stability of this instrument, we test on health people at first. 45 health volunteer were divided into two groups randomly as abdominal breathing training (25 cases) and convalesce (20 cases).Feedback abdominal breathing training instrument were adopted in training 25cases. The 30 minutes training period were divided into 4 stages: rest stage(5min); training stage I (10min);training stage II (10min),and convalescence stage(5min). While the 20 cases as control group took peace and nature breathing. The results of heart rate, RSA and blood pressure were printed and analyzed by SPSS statistics software.Section three Clinical research on treating psoriasis withabdominal breathing training1 The influence of abdominal breathing training on psoriatic patientsThe 30 psoriatic out-patients, male 16, female 14, age between 15-44 ; the lesion area were 5%-55%. They were asked peacefully site inchairs for 30 minutes, to be test the change of every physiologic parameters. Then do abdominal breathing training for 30 minutes under the guiding of feedback abdominal breathing training instrument.2 The clinical condition of psoriatic patients after treatment withabdominal breathing trainingAfter the standardized training, the patients were asked to doabdominal breathing at home twice every day for 30min every times. They would respiration in the mode of longer expiration and shorter absorbing. Then took strength training under the guiding of feedback abdominal breathing instrument every 2 to 3 weeks. At the some time watch the change of their lesions.3 Research on the expression of PACAP and PACAP-R on the pathogenesis of psoriasis both before and after treatment Immunohistochemical technique was employed to study the expression of PACAP and PACAP-R in 10 normal skin, 25 involved skin and un-involved psoriatic skin both before and after abdominal breathing training.ResultsSection One The development of feedback abdominal breathing training instrumentThe feedback abdominal breathing training instrument had stable property in using. The voice guiding and the respiration histogram may help patients taking standard training. It may feedback well and truly dynamic changes of every physiology parameter. The trainers maystrengthen their confidence and improve training effect follow two feedback ways including voice and physiology parameters. This instrument has been declared patent.Section two The influence of abdominalbreathing training on health peopleThe basic heart rate of the abdominal breathing training group was 73.11min^-1, comparing with the base line, there was no obvious change at the first period. At the second period the heart rate of the abdominal breathing training group declined evidently (71.09min^-1, there was obvious difference (P<0.05). And the basic RSA of the abdominal breathing training group was 35.85ms.At the first period and the second period RSA was respectively 47.31ms and 48.15ms, there was evidently difference (P<0.01). Moreover blood pressure descended especially in systolic pressure (14.49+1.54 KPa vs 14.98+1.32 KPa P<0.05; 14.53 + 1.21 KPa vs 14.98 + 1.32 KPa P<0.05).Section three The clinical research in treating psoriasis withabdominal breathing training1 The influence of abdominal breathing training on psoriatic patientsThe average heart rate of psoriatic patients was 79.40ms^-1 at the first period of peace condition, while it was 77.2 6ms^-1 in abdominal breathing at the first period. The average heart rate was 79.18 ms^-1 in the second period, it decline to 75.02 ms^-1 at the some period in abdominal breathing. There was obvious difference. The average RSAwas 33.39ms at the first period of peace condition, while it was 44.55ms in abdominal breathing at the first period. The average RSA was 33.78ms in the second period, it increased to 44.24ms at the some period in abdominal breathing. There was obvious difference. The average SP was 14.66 kPa at the first period of peace condition, while it was 14.33 kPa in abdominal breathing at the first period. There was obvious difference, but there was no obvious difference in the second period. The average DP was 9.90 kPa at the first period of peace condition, it declined to 9.50 kPa and 9.41 kPa respectively inabdominal breathing first and second period.2 The clinical condition of psoriatic patients after treatment with abdominal breathing training27 out of 30 psoriasis patients carry on abdominal breathing training. There are 13cases had intact dates. The others were contacted with telephone.2.1 The changes of physical parametersAfter 6 months training, there was litter difference in heart rate between before and after training in the condition of natural breathing(78.05±9.91min^-1 vs 79.23±0.47mm^-1. While the RSA had evidently increase which being from 31.36 ±6.86ms to 37.69 ±9.57ms.There was obvious difference (t=2.365, P<0.05). But the blood pressure had little change. 2. 2 The changes of the lesionsAfter treatment for 6 months, there were 5 cases having been cured, about 18.5% of the all case. There were 12 cases having obvious effect(44.4%),while 7cases having some effect(25.9%) andremain 3 cases having little effect(11.1%). It may be found that anyone who insisted doing training and being aided by his family can get good result. 3 Research on the expression of PACAP and PACAP-R on thepathogenesis of psoriasis both before and after treatment There was a significant decrease of PACAP and PACAP-R in the involved skin than those in un-involved skin in psoriasis, The quantitative results showed that the area density and mean optical density of PACAP and PACAP-R in the involved skin were obviously decreased than those in un-involved skin in psoriasis(p<0.01); Comparing with health people group, the area density and mean optical density of PACAP and PACAP-R in the un-involved skin were lower (p<0.05). After treatment the expression of PACAP and PACAP-R in cured-lesions were nearly approach to that in the health people group.Conclusions1 We developed a kind of feedback abdominal breathing training instrument collaborated with the aviation biological medicine research center of air force, realizing the combine of the principle of biofeedback with clinical medicine requirement. This instrument had stable property, and the training can be trained standardized. Its development help to open a new road for carrying out abdominal breathing training in the field of dermatology. This instrument we developed collaborated with the aviation biological medicine research center of air force has been declared patent. The patent number is 200410039589.2.2 Our experiment showed that the abdominal breathing training may improve the activity of parasympathetic nerve, displaying decreasing in heart rate, declining in blood pressure and increasing in RSA, which suggests that the abdominal breathing training has better relax effect. This experiment provide scientific basis for treating psoriasis with abdominal breathing training.3 The lower-expression of PACAP and PACAP-R in psoriatic skin suggests that PACAP might be related to the hyperproliferation of psoriatic keratinocytes. Abdominal breathing training may help recovering of.the expression of PACAP and PACAP-R in psoriatic skin.4 Our test showed out that the expecting result to treat psoriasis by abdominal breathing training therapy, has been realized through improving the patient in whole body and it's self-adapted abilities.5 The major affectivities out of abdominal breathing training therapy to the psoriasis is included in the following:a. The acceptance of the patients to the behavior therapy;b. The communication between the doctors and the patients;c. The persistent self- training of the patients;d. The influence comes from the family and society environmentaround the patients.6 The bring forth new ideas in this paper are the following: Combination of biological medicine engineer with clinical dermatology, to improve patient's self adoptability and adaptability with abdominal breathing training. To recearch on the expreesion of PACAP and PACAP-R in psoriatic skin and explored the material basement of...