Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
Curr Med Res Opin. 2023 Jan;39(1):19-25. doi: 10.1080/03007995.2022.2129803. Epub 2022 Oct 11.
To explore the distribution law of traditional Chinese medicine (TCM) syndrome types in patients with psoriasis vulgaris complicated by metabolic disorders based on the same pathogenic factors as blood-heat and blood-stasis in the pathogenesis of psoriasis and metabolic disorders and to further analyze the correlation between adiponectin and the distribution law.
From 1 January 2018 to 31 December 2019, patients diagnosed with psoriasis in the inpatient or outpatient department of Dermatology Ward of Shanghai Yueyang Hospital and normal participants who underwent physical examination in the physical examination center over the same period were retrospectively reviewed. Demographic data, medical history, metabolic disorder indices, and TCM syndrome indices of psoriasis patients and healthy volunteers were evaluated.
We included 307 patients with psoriasis and 613 healthy controls. On analyzing past medical history, the proportion of overweight and obesity and the comorbidity of diabetes in the psoriasis group (53.42 and 14.66%) were significantly higher than in the control group (43.88 and 7.67%, respectively; < .05). The abnormal rates of triglyceride (34.20%), high-density lipoprotein cholesterol (50.49%), and HbA1c (18.57%) levels in the psoriasis group were higher than those in the normal control group (26.75, 17.13, and 12.56%, respectively). Overall, the incidence of metabolic disorders in psoriasis patients (267/307, 86.97%) was higher than that in the normal controls (484/613, 78.96%). Among the different syndrome types, the blood-stasis group had significantly higher rates of hypertension, diabetes, and abnormal glycosylated hemoglobin (46.07, 19.10, and 24.72%, respectively) than those of the control group (27.57, 7.67, and 12.56%; < .05). Patients with blood stasis syndrome had the highest metabolic disorder comorbidity rate (93.26%) and lowest adiponectin level ( < .05).
TCM syndrome differentiation of psoriasis, especially the diagnosis of blood-stasis syndrome, prompts the early screening of patients with metabolic comorbidities. For patients with psoriasis with metabolic disorder, TCM for promoting blood circulation and removing blood stasis can be compatibly applied without contraindications.
The trial was registered at ClinicalTrials.gov (Trial ID: NCT03942185).
基于血热血瘀在银屑病发病机制和代谢紊乱中的相同致病因素，探讨寻常型银屑病合并代谢紊乱患者的中医证型分布规律，并进一步分析脂联素与分布规律的相关性。
回顾性分析 2018 年 1 月 1 日至 2019 年 12 月 31 日期间在上海岳阳医院皮肤科病房住院或门诊就诊的银屑病患者及同期在体检中心体检的正常志愿者的人口统计学资料、病史、代谢紊乱指标及中医证型指标。
共纳入 307 例银屑病患者和 613 例健康对照者。分析既往病史发现，银屑病组超重和肥胖的比例（53.42%和 14.66%）以及糖尿病合并症的比例（53.42%和 14.66%）明显高于对照组（43.88%和 7.67%，均<0.05）。银屑病组三酰甘油（34.20%）、高密度脂蛋白胆固醇（50.49%）和糖化血红蛋白（HbA1c）（18.57%）异常率高于正常对照组（26.75%、17.13%和 12.56%，均<0.05）。总体而言，银屑病患者（267/307，86.97%）的代谢紊乱发生率高于正常对照组（484/613，78.96%）。在不同的证型中，血瘀组高血压、糖尿病和糖化血红蛋白异常的发生率明显高于对照组（46.07%、19.10%和 24.72%，均<0.05）。血瘀证患者的代谢紊乱合并症发生率最高（93.26%），脂联素水平最低（<0.05）。
银屑病的中医辨证，特别是血瘀证的诊断，提示了对代谢合并症患者的早期筛查。对于合并代谢紊乱的银屑病患者，在无禁忌症的情况下，可合用活血化瘀的中药。
本试验在 ClinicalTrials.gov 注册（注册号：NCT03942185）。
