The Role Of Laser Speckle Flow Imaging In Differentiation Of TCM Syndrome And Evaluation Of Therapeutic Effect In Psoriasis Vulgaris

Objective:1.Psoriasis area and severity index(PASI)were evaluated in patients with psoriasis vulgaris,and to compare the differences of PASI scores among patients with different syndromes.2.Laser Speckle Perfusion Imaging was used to detect the Speckle Flow Index(SFI)in the skin lesions and normal skin of patients with psoriasis vulgaris to reflect the blood flow level of the local lesions,and to analyze the difference of their expression in the lesions and normal skin of the patients with psoriasis vulgaris and the correlation between them and psoriasis.3.To investigate the relationship between the SFI of psoriasis vulgaris and the TCM syndrome type of psoriasis by detecting the SFI of psoriasis vulgaris patients with different TCM syndrome differentiation types.4.To analyze the correlation between the changes of SFI and PASI score before and after routine treatment in patients with psoriasis vulgaris according to the experimental results,and whether it can be used as the basis for evaluating the efficacy of psoriasis vulgaris.Methods: Selecting the patients with psoriasis vulgaris from July 2018 to December 2018 in Wuhan NO.1 Hospital,perfecting the data information,classifying them by traditional Chinese medicine(TCM)dialectical classification,and carrying on the PASI score.Laser Speckle Perfusion Imaging used to measure the SFI in the typical lesions and normal skin.After 4 weeks of routine treatment(Carpotriol cream?silicone cream for external use,UV phototherapy),the above steps were followed again in the same position.The data were expressed by mean ±standard deviation(x ±s).According to SPSS 22.0 software,test was used for significant comparison between the two groups,and Wilcoxon rank sum test was used for data that did not accord with normal distribution.Analysis of variance was used for comparison of significance between groups,Spearman analysis was used for correlation analysis,and bilateral test was used to test the level a=0.05.The correlation analysis was performed by the analysis of variance and the correlation analysis by means of analysis of variance.Results:1.PASI scores of patients with different syndromes were found by one-way variance test: PASI scores of patients with blood heat syndrome,blood stasis syndrome and blood dryness syndrome before treatment were statistically significant(P<0.05),while PASI scores of patients with blood stasis syndrome and blood dryness syndrome were not statistically significant(P>0.05).There was no significant difference in PASI score between blood heat syndrome and blood stasis syndrome,blood stasis syndrome and blood dryness syndrome after treatment(P>0.05).There was significant difference in PASI score between blood heat syndrome and blood dryness syndrome(P<0.05).The PASI scores of patients before and after treatment were found by paired T-test: the PASI scores of patients with psoriasis vulgaris including different syndromes such as blood heat syndrome,blood stasis syndrome and blood dryness syndrome were significantly decreased after treatment compared with those before treatment.There was significant difference in score before and after treatment(P<0.05).2.The SFI in the skin lesions of patients with psoriasis Vulgaris was significantly higher than that of their own normal skin before and after treatment.There was a significant difference in the SFI in the lesions and normal skin by paired T test(P<0.05).The SFI in the skin lesions of the Patients with psoriasis decreased significantly after treatment.The SFI after treatment was significantly different from that before treatment by paired T test(P<0 05).3.There was a significant difference in SFI among the Patients with different syndrome types before treatment(P< 0.05)through the analysis of one-way ANOVA(P<0.05).The SFI in normal skin of patients with different syndrome types was no significant difference(P > 0.05)by one-way ANOVA.One-way ANOVA analysis showed that there was no significant difference(P> 0.05)in the SFI in the lesions of patients with different syndrome types after treatment(P>0.05).4.There was a moderate positive correlation between the SFI and the PASI score before treatment,but there was no significant positive correlation between the SFI and the PASI score after treatment.Conclusion: The difference of PASI score and SFI among patients with different syndrome types before treatment is statistically significant.PASI score and SFI can be used as reference indexes for typing.Before and after treatment,the SFI and PASI score of the patients decreased obviously,and the treatment improved.There was a positive correlation between the two before treatment.The PASI score and the SFI could also be used as reference indexes for the severity of the disease.The closer to normal patients,the smaller the difference in pathological and clinical manifestations of patients with different syndrome types,the more likely to use the SFI as a reference treatment,its accuracy will be reduced.This also puts forward higher requirements for the accuracy of the LSPI.Although the difference decreases,the change of SFI based on pathological changes is more objective than the PASI score based on clinical manifestations,which can be used as a reference index for determining the duration of continuous treatment in patients with clinical recovery.