Objective To observe the effects of Huoxue Chubi Decoction on contents of PDGF-A and TGF-βin skin lesion of scleroderma mimicking mice models;To discuss its possible mechanism. Methods Thirty mice were randomly assigned into blank group, model group, TCM high-, medium-, low-dose group, with six mice in each group. Other than blank group, the rest of the 4 groups were given bleomycin-hydrocholoride 0.1 mL intradermal injection daily for 3 weeks to establish scleroderma mice models. From week 4 to 7, blank group and model group received gavage with equal amount of distilled water daily;TCM high-, medium-, low dosage group received gavage with Huoxue Chubi Decoction with different concentrations of 44.8, 22.4, 11.2 g/kg daily. The pathological changes in the skin tissue samples taken from each group were observed under microscope;the thickness of skin from each group was measured and the expression of PDGF-A, TGF-β, type-Ⅰ collagen (COL-Ⅰ) and type-Ⅲ collagen (COL-Ⅲ) were tested through immunohistochemical staining. Results Compare with blank group, the dermis tissue of model group was thicker, with the presence of thicker and greater number of collagen fibers, as well as infiltration of inflammatory cells. Compare with model group, thickness of skin and dermis collagen growth of TCM high-, medium-, low-dose group were milder varied by the concentration of the decoction. The result of immunohistochemical staining showed that the expressions of PDGF-A, TGF-β, COL-Ⅰ and COL-Ⅲ of modelgroup significantly increased than blank group (P<0.01); the expression of the mentioned indicators were statistically significant lower in the TCM high-, medium-, low-dose group than model group; The expressions of PDGF-A and TGF-β showed a positive correlation with the amount of COL-Ⅰ and COL-Ⅲpresented in each group. Conclusion Huoxue Chubi Decoction can suppress collagen expression and fibroblast formation in skin lesion of scleroderma mice models by down regulating the expressions of TGF-β and PDGF-A, thus demonstrate its potential in scleroderma treatment.

[Objective]To analyze the prescription medication pattern of internal Chinese drugs for palmoplantar pustulosis(PPP)based on data mining method.[Methods]China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,China Science and Technology Journal Database and China Biology Medicine disc(CBMdisc)were searched for literature on traditional Chinese medicine(TCM)treatment of PPP from self-establishment date to June 2023,and prescriptions that met the inclusion criteria were screened,standardized and analyzed by drug efficacy categorization,frequency analysis,nature and flavor channel tropism analysis,association rule analysis and entropy clustering analysis for the patterns of drug use.[Results]In the internal treatment of PPP,the most frequently used drugs are"clearing heat and detoxifying""clearing heat and cooling blood""clearing heat and drying dampness";the most frequently used drugs are Rhizoma Smilacis Glabrae,Rehmannia glutinosa Libosch and Glycyrrhizae Radix et Rhizoma;in the analysis of the association of drug use patterns,the top three drugs with high frequency are Rehmannia glutinosa Libosch-Moutan Cortex,Rhizoma Smilacis Glabrae-Glycyrrhizae Radix et Rhizoma,Lonicerae Japonicae Flos-Forsythia suspensa(Thunb.)Vahl.In the analysis of combination pattern rule,Moutan Cortex→Rehmannia glutinosa Libosch,Forsythia suspensa(Thunb.)Vahl→Lonicerae Japonicae Flos,Dictamnus dasycarpus Turcz→Rhizoma Smilacis Glabrae with high confidence;28 potential core combinations and 14 new prescriptions were obtained based on entropy clustering formula grouping rule analysis.[Conclusion]The internal treatment of PPP in TCM often focuses on clearing heat and dispelling dampness as the core of treatment,selecting bitter and cold drugs,focusing on the liver and stomach meridians.The use of Rhizoma Smilacis Glabrae and Rehmannia glutinosa Libosch in the prescription,as well as the combination of Rehmannia glutinosa Libosch and Moutan Cortex,Rhizoma Smilacis Glabrae and Dictamnus dasycarpus Turcz,Lonicerae Japonicae Flos and Forsythia suspensa(Thunb.)Vahl,have great clinical and scientific value.By mining potential and implicit drug formulation patterns in the data,a core combination of dispelling dampness and heat as well as cooling blood and detoxifying can be derived,providing reference for clinical research and prescription medication in the internal treatment of PPP in TCM.

Objective:To analyze the medication law of external application of TCM in the treatment of psoriasis vulgaris (PV) by using data mining method.Methods:Clinical controlled trial literature about external application of TCM in the treatment of PV was retrieved from CNKI, VIP, WanFang, SinoMed, PubMed and Cochrane Library from the establishment of the databases to May 23, 2022. Prescriptions were extracted after screening. TCM inheritance computing platform V3.0 was used to analyze the property, taste, meridian, efficacy, use frequency, common medicinal pairs and the core combinations.Results:A total 186 prescriptions were included, involving 190 kinds of Chinese materia medica. The medicines were mostly bitter and cold in property and taste, mainly belonging to the liver and heart meridians. Heat-clearing drugs were mainly used, followed by blood circulation-activating and stasis-eliminating medicines, and tonic medicines. The ten most frequently used medicines were Sophorae Flavescentis Radix, Dictamni Cortex, Phellodendri Chinensis Cortex, Kochiae Fructus, Angelicae Sinensis Radix, Salviea Miltiorrhizae Radix et Rhizoma, Poria, Rehmannine Radix, and Arnebiae Radix; the 3 commonly used medicinal pairs were Sophorae Flavescentis Radix- Dictamni Cortex, Sophorae Flavescentis Radix- Cnidii Fructus, and Sophorae Flavescentis Radix- Kochiae Fructus; 4 combinations were obtained through evolution. Conclusions:External application of TCM for the treatment of PV is around the core pathogenesis of "heat toxin", mainly treating from the blood, including cooling blood and detoxifcation, activating blood circulation and removing stasis, nourishing the blood and moistening dryness. Clearing heat and drying dampness, dispelling wind and relieving itching are also valued. The treating thoughts can provide some references for clinical treatment.

ObjectiveTo explore the effectiveness and potential mechanism of Shugan Jianpi Granules （疏肝健脾颗粒） combined with Chushi Zhiyang Ointment （除湿止痒软膏） in the treatment of atopic dermatitis with sleep disturbance of liver constraint and spleen deficiency syndrome. MethodsSixty-six patients with atopic dermatitis combined with sleep disturbance of liver constraint and spleen deficiency syndrome were randomly divided into 33 cases each in the treatment group and the control group. Both groups were treated with Chushi Zhiyang Ointment for external use. The treatment group additionally received Shugan Jianpi Granules orally， one dose per day； and the control group received cetirizine hydrochloride tablets orally， 10mg per day， taken before bedtime. Both groups were under the treatment for 4 weeks. Clinical effectiveness was evaluated after treatment， and the SCORing Atopic Dermatitis （SCORAD） index， pruritus visual analog scale （VAS） score， Insomnia Severity Index （ISI） score， and Pittsburgh Sleep Quality Index （PSQI） score were recorded before and after treatment， and serum levels of melatonin （MLT）， interleukin-4 （IL-4）， interleukin-6 （IL-6）， interleukin-13 （IL-13）， and tumor necrosis factor-α （TNF-α） were measured. The patients were also tested for blood routine， liver function and kidney function before and after treatment， and the occurrence of adverse events was also observed. ResultsThe total effective rate in the treatment group （90.63%， 29/32） was significantly higher than that in the control group （66.67%， 20/30， P＜0.05）. After the interventions， the scores for SCORAD， VAS， ISI， and PSQI， as well as the levels of IL-4， IL-6， IL-13， and TNF-α， were significantly reduced in both groups. In contrast， the MLT levels in treatment group significantly elevated compared to that before treatment （P＜0.05）. Comparing between the two groups after treatment， the scores of SCORAD， ISI， PSQI， and VAS， as well as the levels of serum IL-4 and IL-13 in the treatment group were significantly lower than those in the control group， while the MLT levels were markedly higher than that in the control group （P＜0.05 or P＜0.01）. There was no obvious abnormality in blood routine， liver function and kidney function in both groups when compared before and after treatment. The incidence rate of adverse reactions was 9.38% （3/32） in the treatment group and 13.33% （4/30） in the control group， and the difference between groups showed no statistical difference （P＞0.05）. ConclusionOn the basis of topical application of Chushi Zhiyang Ointment， the combined application of Shugan Jianpi Granules can significantly alleviate the degree of skin lesions and itching， and improve the quality of sleep in atopic dermatitis patients with sleep disturbance of liver constraint and spleen deficiency syndrome， and its mechanism may be related to regulating the immune balance， reducing the secretion of inflammatory factors， and elevating the level of MLT.

Objective The study aimed to elucidate the evolution of the syndromes in Traditional Chinese Medicine(TCM)and TCM syndrome elements in different chronic stages of psoriasis vulgaris.Methods A database was constructed using electronic medical records collected from July 2019 to March 2024 from 1,049 patients with psoriasis vulgaris.The study used Sankey diagrams and network association graphs to analyze the evolution of TCM syndromes and their elements in patients at the different stages:initial diagnosis,progressive stage(Week 2-3),progressive stage(Week 4-5),skin lesion improvement stage(Week 6-7),and remission stage.The syndrome elements network was constructed using community detection algorithms,and the association rules between local skin lesion syndrome differentiation and overall syndrome differentiation were displayed using heatmaps.Results(ⅰ)Initial diagnosis.In the syndrome differentiation of local skin lesions,blood heat syndrome was the most common(79.79％);among the disease location of TCM syndrome elements(called"disease location"),liver was the most prevalent(35.62％);and among the pathological factors of TCM syndrome elements(called"pathological factors"),fire(heat)was the most common(75.48％).(ⅱ)Active stage(Week 2-3).In the syndrome differentiation of local skin lesions,blood heat syndrome remained the most prevalent(73.13％);among the disease location,liver was still the most prevalent(31.71％);and among the pathological factors,fire(heat)continued to be the most common(82.11％),while dampness(22.26％)and qi stagnation(8.39％)began to increase.(ⅲ)Active stage(Week 4-5).The syndrome differentiation of local skin lesions was dominated by blood heat syndrome(45.91％)and blood dryness syndrome(37.19％);among disease location,the interior was the most prevalent(15.25％);and among the pathological factors,fire(heat)remained the most common(50.66％),with an increase in yin deficiency(34.26％).(ⅳ)Skin lesion improvement stage(Week 6-7).In the syndrome differentiation of local skin lesions,both blood dryness syndrome(49.44％)and blood stasis syndrome(33.33％)increased;among the disease location,meridians increased most significantly and became the most prevalent(13.44％);and among the pathological factors,blood stasis increased most significantly and became the most prevalent(28.20％).(ⅴ)Remission stage.In the syndrome differentiation of local skin lesions,blood stasis syndrome became the primary(55.69％),while the percentage of blood dryness syndrome decreased(21.16％);meridians(25.71％)and blood stasis(62.34％)remained the most predominant syndrome elements related to disease location or pathological factors.Conclusion The overall pattern of TCM syndromes in psoriasis vulgaris evolved from excess to deficiency.From the initial diagnosis to the active phase(Week 2-3),heat syndrome dominated;during the active phase(Week 4-5),heat syndrome coexisted with damp syndrome or yin deficiency syndrome;changes in the syndrome element network were the most significant during the lesion improvement phase,with blood stasis gradually increasing and peaking during the remission phase.Blood stasis,dampness,and qi stagnation were pervasive throughout psoriasis vulgaris;qi stagnation and blood stasis may be the main elements causing further deterioration and prolonged course of the disease during the active phase in patients.