The Application Of Evidence-based Medicine In The Diagnosis Of Traditional Chinese Medicine With Psoriasis Vulgaris

Research background:Psoriasis is a common chronic-scaly erythematous skin disease,prolonged healing,easy to relapse,and influencing people’s life greatly.Data displays that spirit,trauma,infection,drugs and many other factors are connected with it,which is the key to overcome difficulty diseases in dermatology.The vulgaris psoriasis,whose western medicine treatment are topical drugs and system treatment is more common in clinical.But the long-term use of the negative side effects and patient’s intolerance led to reduced quality of life.However the traditional Chinese medicine brings great benefit,but due to the lack of uniform rule of syndrome differentiation and treatment methods lead to the syndrome differentiation system complex,clinical efficacy not exactly,not conducive to the correct guidance of the theory of traditional Chinese medicine and the correct use of beginners.Study objective:Under the evidence-based medicine guidelines,This research take into two parts,sorting through the modern literature,exploring the vulgaris psoriasis’s characteristics of TCM syndrome and treatment method,to develop and optimize its TCM treatment options for early literature study preparation, and the next step for the conduct of multicenter, large sample clinical research as a foundation,for the objectivity of traditional Chinese medicine, modernization to provide feasible way.The first partResearch methods:Search strategy:take the electronic retrieval as the principal thing,retrieval of Chinese biomedical literature database, Chinese periodical full-text database, Chinese HowNet database,Wanfang digital periodical full-text database of nearly10years published in the national core medical journals about psoriasis vulgaris’s type of TCM, which meet the requirement of standard literature.Data:the retrievals are recorded one by one according to the syndrome distribution,and ginseng photographic off names of Chinese medicine syndrome code books.The elected retrievals are decomposed into basic elements(syndrome),then statistics its frequency distribution and combination rule.Result:Screening48articles meet the standard,involving50types,12syndrome factors,whose frequency of occurrence is226times,respectively heat(50),blood (42),dry(38),wind (30),blood(16),venom(16),wet(14),(8),Yin Yang (4),and(4),cold(3),fire(1).The highest frequency of sufferred part is blood, respectively blood stasis (42),blood hot (37),blood dry(25),blood deficiency(16),blood poisoning(2),blood cold(1).According to the frequency suffered in viscera,from high to low followed by the liver,heart,lung,spleen and kidney.Conclusion:Psoriasis’s clinical TCM syndrome elements is complex,taking the syndrome factor into serious can make the certain theoretical and practical significance in Traditional Chinese Medicine’s dialectical standardization.This study found that the argument in blood of psoriasisis the most. The second partResearch methods:Search strategy:retrieval of Chinese biomedical literature database, Chinese periodical full-text database, Chinese HowNet database, Wanfang digital periodical full-text database of nearly10years published in the national core medical journals about psoriasis vulgaris treated by traditional Chinese medicine,manual search with standard literature. Data sort and analysis:the screened studies are evaluated by Jadad quality score,whose total scores are from1to5points,more than3points is high quality research,while1-2points is low quality.The research on the efficient,the incidence of adverse reactions,the recurrence rates are compared and combined by Cochrane network,who processing the RevMan4.2software to carry out data.Result:A total of11researches are involved,incorporated in1334patients.According to the Jadad score,most are low quality.The meta of efficiency:In the11RCTs,717cases of treatment group were reported,effective rate is87.9%;the control group contains679cases,effective rate is76.9%.Heterogeneity test:P>0.05.Comprehensive test results was:Z=5.38,P<0.00001,the combined value of OR is2.21,95%CI[1.66,2.95],with statistically significant differences between the two groups,indicating that the efficiency of treatment group is better than that of control group.The incidence of adverse reactions:a total of8articles reporting adverse reactions,mainly for digestive system symptoms,including dry mouth,nausea,vomiting,stomach discomfort, diarrhea,defecate number increase,the remaining visible skin itching and dryness, dizziness,spirit dispiriting,leukopenia,Valley elevation of alanine aminotransferase. the total sample size of incorporated into the analysis of adverse reaction of are1074patients,including555cases in the treatment group,the incidence of adverse reactions was6.3%;the control group are519cases,the incidence of adverse reactions is9.6%. Heterogeneity test results is:P>0.01.Comprehensive test results is:Z=1.94,P=0.05,the combined value of OR is0.64,95%CI[0.41,1].though the treatment group’s adverse rate show slightly lower than that of the control group,but no obvious significant statistically difference.The recurrence rate:2cases report follow-up observation one year after treatment.In the treatment group,54cases were observed,the recurrence rate was24.1%;the control group involved40cases,the recurrence rate was40%. Heterogeneity test shows:P>0.05.Comprehensive test results was:Z=1.63,P=0.1,the combined value of OR is0.48,95%CI[0.2,1.16].The treatment group’s recurrence rate show slightly lower than that of control group,but no obvious significant statistically difference.The inclusion Chinese medicine of the11articles are52kinds,wherein the highest frequency of the top ten in turn are shengdi,danshen,baixianpi,danpi,zicao,baimaogen, qiancaogen,chishao,jixueteng,shenghuaihua.Conclusion: Cooling blood and activating blood circulation method for treatment of psoriasis vulgaris in clinical is more effective than the control group,the difference was statistically significant.However,despite the clinical adverse reaction rate and recurrence rate are lower than the control group, because of the low quality of involved reseach,there are all kinds of bias possibility,so the results showed no statistically significant difference.