A Randomized Controlled Trial for the Optimal Implementation of Psoriasis Treatment by Integrating Chinese and Western Medicine.

IF 5.2 Q1 DERMATOLOGY
Psoriasis (Auckland, N.Z.) Pub Date : 2025-03-21 eCollection Date: 2025-01-01 DOI:10.2147/PTT.S487536
Yuanting Yu, Xiaoying Sun, Rongyi Hu, Ping Xia, Yuegang Wei, Wenxin Yang, Ning Huang, Yangfeng Ding, Shun Guo, Chunyan Yang, Huilan Weng, Ying Zhang, Xiaojie Ding, Qinsi Huang, Xiaoyong Zhou, Xin Li, Bin Li
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Abstract

Background: Psoriasis is a refractory inflammatory disease affecting people worldwide. Currently, the prevalent guideline-recommended regimen is based on psoriasis severity; however, no corresponding studies have been conducted on the hierarchical selection of integrated Chinese and Western medicine treatments.

Objective: To explore the optimal implementation of psoriasis treatment by integrating Chinese and Western medicine.

Methods: We conducted a 16-week multicenter single-blind randomized controlled trial in China between December 2019 and July 2022. Patients with mild-to-moderate psoriasis (n=107) were randomized to receive oral Jueyin granules (JYG) or moving cupping treatment for 4 weeks, and then transferred to combine the internal or external TCM treatment for another 4 weeks base on the Psoriasis Area and Severity Index (PASI) score. Patients with severe psoriasis (n=193) were randomized to receive treatment with JYG and moving cupping (Group C), narrow-band ultraviolet B (Group D), or JYG, moving cupping and narrow-band ultraviolet B (Group E). Corresponding placebo therapies are applied to ensure single blind implementation. The primary outcome was the effective rate at week 8 and the incidence of relapse at week 16.

Results: The mild-to-moderate psoriasis group showed no differences in the efficacy or relapse resulting from the sequence of internal or external TCM treatment. However, both groups showed significant improvements in PASI score at week 8 compared to baseline (P < 0.001). The severe psoriasis group showed no significant difference in effective rates. While, more participants of Group E achieved PASI 75 (26.79%, P=0.02) at week 8, and Group D had a higher relapse rate at week 16 (21.57%, P=0.03).

Conclusion: Patients with mild-to-moderate psoriasis whether start with internal or external TCM treatment would be viable alternative. Integrated Chinese and Western medicine treatment favors patients with severe psoriasis in the improvement of skin lesions and reduction of recurrence.

Clinicaltrialsgov listing: NCT03941431.

中西医结合治疗银屑病最佳实施方案的随机对照试验。
背景:银屑病是一种世界性的难治性炎症性疾病。目前,流行的指南推荐方案是基于牛皮癣的严重程度;然而,关于中西医结合治疗的分级选择,还没有相应的研究。目的:探讨中西医结合治疗银屑病的最佳实施方法。方法:我们于2019年12月至2022年7月在中国开展了一项为期16周的多中心单盲随机对照试验。轻中度银屑病患者(n=107)随机接受口服厥阴颗粒(JYG)或走罐治疗4周,然后根据银屑病面积及严重程度指数(PASI)评分,再转入中药内外联合治疗4周。193例重度银屑病患者随机分为JYG +走罐治疗组(C组)、窄带紫外线B治疗组(D组)、JYG +走罐+窄带紫外线B治疗组(E组),采用相应的安慰剂治疗,确保单盲实施。主要终点是第8周的有效率和第16周的复发率。结果:轻、中度银屑病组在中医内外治顺序的疗效及复发率上均无差异。然而,与基线相比,两组在第8周的PASI评分均有显著改善(P < 0.001)。严重银屑病组有效率无显著性差异。而E组在第8周达到PASI 75的患者较多(26.79%,P=0.02), D组在第16周的复发率较高(21.57%,P=0.03)。结论:轻中度银屑病患者不论开药时采用中药内服还是外服都是可行的选择。中西医结合治疗有利于严重银屑病患者皮损的改善和复发的减少。Clinicaltrialsgov上市:NCT03941431。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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