Min Mildred, Dulai Ajay S, Ahmad Nabeel, Sivamani Raja K
Integrative Skin Science and Research, Sacramento, CA, USA.
College of Medicine, California Northstate University, Elk Grove, CA, USA.
J Psoriasis Psoriatic Arthritis. 2024 Jul;9(3):108-114. doi: 10.1177/24755303241236386. Epub 2024 Feb 20.
Psoriasis is a chronic inflammatory condition with cutaneous and systemic involvement. Although many efficacious treatment options are available, concerns regarding costs and duration of treatment have expanded interest in the role of integrative medical therapies for psoriasis.
In this review, we aim to provide evidence for the use of integrative medical approaches in the management of psoriasis, namely approaches utilizing the microbiome, probiotics, diet, and mindfulness.
PubMed/Medline and Google Scholar databases were searched from inception up to 16 August 2023 to identify clinical studies that evaluated how integrative medical therapies affect psoriasis severity. Search terms combined "psoriasis" or "psoriatic arthritis" with terms related to the microbiome, diet, and lifestyle.
Multiple clinical studies have shown that integrative approaches can reduce psoriasis severity. Probiotic supplementation in psoriatic patients decreased PASI scores, decreased inflammatory markers, increased quality of life, and reduced the risk of disease relapse. Intermittent fasting, in the context of Ramadan, decreased PASI scores and plasma CRP levels. Low-calorie diets and low-calorie ketogenic diets have been shown to reduce psoriasis severity. Notably, combining low-calorie diets with biologics and cyclosporine synergistically improved psoriasis to a greater extent than pharmaceutical therapy alone. A gluten-free diet improved psoriasis and reduced antigliadin antibodies in those with hypersensitivity. Mindfulness therapies also improved psoriasis severity with and without phototherapy.
Several studies show that integrative medicine can be used to manage psoriasis. Specifically, probiotic supplementation, diets that promote weight loss or modulate antigliadin antibodies, and mindfulness therapies may improve disease severity.
银屑病是一种累及皮肤和全身的慢性炎症性疾病。尽管有许多有效的治疗选择，但对治疗成本和疗程的担忧促使人们对综合医学疗法在银屑病治疗中的作用产生了更大的兴趣。
在本综述中，我们旨在为综合医学方法在银屑病管理中的应用提供证据，即利用微生物群、益生菌、饮食和正念的方法。
检索了PubMed/Medline和谷歌学术数据库，从建库至2023年8月16日，以确定评估综合医学疗法如何影响银屑病严重程度的临床研究。检索词将“银屑病”或“银屑病关节炎”与微生物群、饮食和生活方式相关的词汇相结合。
多项临床研究表明，综合方法可降低银屑病严重程度。对银屑病患者补充益生菌可降低银屑病面积和严重程度指数（PASI）评分，降低炎症标志物水平，提高生活质量，并降低疾病复发风险。在斋月期间进行间歇性禁食可降低PASI评分和血浆C反应蛋白（CRP）水平。低热量饮食和低热量生酮饮食已被证明可降低银屑病严重程度。值得注意的是，将低热量饮食与生物制剂和环孢素联合使用比单独使用药物疗法能更有效地协同改善银屑病。无麸质饮食可改善银屑病，并降低过敏者的抗麦醇溶蛋白抗体水平。无论有无光疗，正念疗法也可改善银屑病严重程度。
多项研究表明，综合医学可用于银屑病的管理。具体而言，补充益生菌、促进体重减轻或调节抗麦醇溶蛋白抗体的饮食以及正念疗法可能会改善疾病严重程度。
