Abstract

BackgroundTraditional Chinese medicine (TCM) has a long history in the treatment of psoriasis vulgaris. We aimed to evaluate the clinical efficacy and safety of Chinese herbal Pulian ointment in treating psoriasis vulgaris of blood-heat syndrome.MethodsA multicenter, randomized, double-blind, placebo-controlled trial was conducted. Participants with psoriasis vulgaris of blood-heat syndrome were blinded and randomized to receive Pulian ointment or placebo ointment twice daily for 4 weeks, with follow-up 8 weeks after treatment. Psoriasis Area Severity Index (PASI) scores, severity of each symptom and area of skin lesion and quality of life were assessed at baseline, 2 weeks, and 4 weeks. Adverse events were recorded during the study. SAS 9.4 software and SPSS 17.0 software was applied for data analysis.ResultsA total of 300 participants with psoriasis vulgaris of blood-heat syndrome were assessed for eligibility, and 294 were randomly assigned to the Pulian ointment and placebo group from six study centers. Full analysis set (FAS): after 4 weeks of treatment, there were significant differences between groups in PASI score and the separate score of skin lesion area, favoring Pulian ointment group (P < 0.05). However, no significant differences were observed in scores of scaling, erythema and induration/thickness (P > 0.05). Per protocol set (PPS): There was no statistically significant difference in PASI score and separate score of each symptom and area of skin lesion between two groups (P > 0.05). Quality of life measured by Hamilton Anxiety Rating Scale (HAMA) and 36-Item Short Form Health Survey (SF-36) improved after treatment in both groups, but there was no significant difference between the two groups (P > 0.05). After being followed up for 8 weeks, the total relapse rates of the Pulian Ointment group and placebo group were 5.88 and 8.45%, respectively, and the difference was not statistically significant between the two groups (P > 0.05). No adverse event was observed in both groups throughout the study.ConclusionsPulian Ointment seems effective and well tolerated in improving the PASI score and separate score of skin lesion area for patients with psoriasis vulgaris of blood-heat syndrome. Further research could build on the current study to explore whether other preparation forms and greater intervention intensity are necessary for better therapeutic effects.Trial registrationChictr.org.cn Identifier ChiCTR-TRC-12002054.

Highlights

  • Traditional Chinese medicine (TCM) has a long history in the treatment of psoriasis vulgaris

  • The objective of this study is to explore the clinical efficacy and safety of Pulian ointment in the treatment of participants with psoriasis vulgaris of blood-heat syndrome by external application

  • The six centers were as follows: China-Japan Friendship Hospital, Beijing Hospital of Traditional Chinese Medicine (TCM), Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Guang’anmen Hospital and Air Force General Hospital and Chinese People’s Liberation Army (PLA)

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Summary

Introduction

Traditional Chinese medicine (TCM) has a long history in the treatment of psoriasis vulgaris. We aimed to evaluate the clinical efficacy and safety of Chinese herbal Pulian ointment in treating psoriasis vulgaris of blood-heat syndrome. Psoriasis is a common chronic immune-mediated inflammatory disease of skin and joints. Conventional western medications, such as methotrexate (MTX), acitretin A and ciclosporin, are limited for long-term use due to their limited efficacy and/or various potential toxic and side effects. The introduction of new biologic agents has increased the therapeutic options for the treatment of psoriasis, because of their high price, potential side-effects and unclear long-term efficacy and safety new biologic agents have not been widely used

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