UseofcommonChineseherbsinthetreatmentofpsoriasis

T.W.Tse

MedecinsSansFrontieres,Kowloon,HongKong

Summary

Chineseherbalmedicineshavebeenshowntobeeffectiveinthetreatmentofatopiceczema.However,theWesternscienti c medicalliteraturehasnotfullyexaminedthepotentialusefulnessofherbaltreatmentsinthemanagementofpsoriasis.ThisarticleaimstoprovideanEasterninsightintopsoriasis,consideringthediagnosisofpsoriasisusingChinesemedicalterminologyanditstreatmentusingherbalmedicine,aswellashowtheseherbsmightwork.

ConceptsintraditionalChinesemedicine

Inprinciple,traditionalChinesemedicine(TCM)contendsthatgoodhealthismaintainedbythedynamicbalanceoftheYinandYangcycle,andthe veelementsofthebody:Wood,Fire,Earth,MetalandWater.1–4Inaddition,oneneedsanadequateandfree owofQi(themostbasicmaterialfromwhichthehumanbodyisformedandlifeismaintained)andBlood(thebasiccomponentofthehumanbodyessentialinmaintainingnormalfunc-tion)inordertoprotectthebodyfromdisturbancebythesixcommonpathogens,namelyWind,Cold,Dampness,Dryness,HeatandFire.

patterns.Affectedskinsticks rmlytoitsbaseandscalesareeasytopeeloffleavingbleedingareas.Itchingcanbesevere.

BloodDrynesssyndrome

Thisreferstomorechroniccaseswithcircumscribedorcoalescentplaques,withaffectedskinappearingpaleordullredincolour.Skinlesionsarethickerandmoreadherentwithfewerscales.Theyaredif culttopeel,butiftheyarepeeledoffthereisnoobviousbleeding.Newlesionsarerare.Skinisoftendryandcracked.Nailsaredryanddulllooking.

BloodStasissyndrome

Classi cationofpsoriasisInTCM

InTCM,psoriasisiscommonlyclassi edintothreemainsyndromes,namelyBloodHeat,BloodDrynessandBloodStasis.5–7

BloodHeatsyndrome

Thiscomprisesastaticphase,althoughitincludeschronicrelapsingskinlesionswithanasymmetricaldistribution.Plaquesmaybeirregularinsize,hard,thickandscalywithaclearmargin.Individuallesionsaredullredincolourand rmlyattachedtotheskin.Thelargescalesaredif culttopeelandthereisnobleeding.

Patientsarecharacterizedbyanacuteonsetofaneruptionofnumerousactive,brightredlesions,whichspreadquicklyandhaveirregularplaqueorguttate

ClinicalstudiesoftheuseofChineseherbalmedicineinpsoriasis

Forthisreview,controlledclinicaltrialsinpsoriasisusingChineseherbalmedicinewereobtainedfromthebiomedicaldatabases:MedlineÒ(1966–April2001)andEmBaseÒ(1981–April2001).Keywordsforthesearchwere‘psoriasis’,‘herbalmedicine’and‘traditionalChinesemedicine’.Datawerealsoobtainedfromthe

Correspondence:T.W.Tse,MedecinsSansFrontieres,5B,LaichikokBayGarden,272LaiKingHillRoad,Kowloon,HongKong.Tel.:85223794822.Fax:85298741067.E-mail:tsz910@hotmail.com

Acceptedforpublication18March

2003

Ó2003BlackwellPublishingLtd ClinicalandExperimentalDermatology,28,469–475469