Clinical Investigation For The Risk Factors And TCM Syndrome Differentiation On Psoriasis With Depression

OBJECTIVE:To investigate patients with psoriasis vulgaris are associated with depression and degree of depression by using questionnaires.To compare psoriasis and normal physical examination populations in general conditions,observe the syndrome differentiation of psoriasis with depression,and analyze the risk factors.It provides a theoretical basis for the treatment of psoriasis with depression by TCM syndrome differentiation.METHODS:A total of 200 psoriasis vulgaris patients from the Department of Dennatology of Jiangsu Provincial Hospital of Traditional Chinese Medicine met the inclusion criteria from January,2016 to January,2018 were collected through questionnaires.Questionnaires were used to collect general data of patients,and according to the information of four medical consultations,TCM syndrome differentiation was performed.Two trained physicians performed an examination of the included study population and used conversational and observational methods to assess the subject's depression and degree using the Hamilton Depression Scale.In accordance with the principle of 1:1 matching(same gender,and mean age ± 3 years),a control group was selected among healthy people who visited the physical examination center during the same period to collect general infonnation,performing depression and degree scores.The collected data was recorded in an EXCEL table to establish a database.SPSS 18.0 software was used to perform statistical analysis using corresponding statistical methods.Risk factors associated with depression of psoriasis were analyzed using binary logistic regression.Results:?The patients with psoriasis vulgaris had 67 cases of depressive symptoms(33.5%).The degree of depression from light to heavy was 55(27.5%),8(4%)and 4(2%)respectively.The control group had 45 cases of depressive symptoms(22.5%),and the degree of depression from light to heavy was 44(22%),1(0.5%)and 0.The difference was statistically significant(x 2=6.122,P=0.032<0.05).?Psoriasis patients had lower annual income and education than the control group.There were more bad habits of smoking and alcohol than the control group.The number of overweight and obesity was higher than that of the control group.The duration of exercise per week was higher than that of the control group.The difference between groups was statistically significant.? The binary logistic regression analysis showed that the two factors:Female(OR=2.85)and nail involvement(OR=5.44)were the main risk factors for psoriasis with depressive symptoms(P<0.05).?In this study,the patterns of TCM syndromes in patients with psoriasis vulgaris varied from more to less:43(21.5%)cases with blood heat syndrome,35(17.5%)cases with wind-heat syndrome,28(14%)cases with yin deficiency syndrome,26(13%)cases with Spleen wet dampness,and 19(9.5%)cases with damp heat syndrome.The proportions of TCM syndromes with depressive symptoms ranged from more to less:15(22.4%)cases with yin deficiency heat syndrome,13(19.4%)cases with liver qi stagnation,and 11(16.4%)with wind-heat syndrome.Conclusion:?Patients with psoriasis vulgaris have a higher number of depression than normal people.?Females and nail involvement may be risk factors for the depression in patients with psoriasis.?The number of depression in patients with yin deficiency internal heat syndrome and liver qi stagnation syndrome was significantly higher than that without depression psoriasis patients.Based on the theory of threatment for psoriasis by liver,Proposing the theoretical guidance of Shugan Jieyu and Yangxue Rougan in the treatment of psoriasis-specific syndromes(liver qi stagnation syndrome and Yin deficiency syndrome),as a supplement to psoriasis treatment.? On the basis of syndrome differentiation and treatment,attention should be paid to the application of Shugan Jieyu method in the treatment of psoriasis.