Psoriatic Arthritis

Psoriatic arthritis is an inflammatory joint disease associated with psoriasis. It is characterized by psoriatic skin lesions and can cause pain, swelling, tenderness, stiffness, and limited movement in the joints and surrounding soft tissues. Some patients may also have sacroiliitis and/or spondylitis. The condition may persist over time and is prone to relapse; in advanced stages, joint ankylosis may develop and lead to disability.

TCM Pattern Differentiation and Medication Information

|Common Symptoms

Traditional description:

Red skin lesions with thick, dirty-looking scales; red, swollen, painful joints; a red tongue with a yellow, greasy coating; and a slippery, rapid pulse.

In plain language:

  • The skin lesions are red, with a pronounced bright-red color.
  • Thick scales build up on the surface of the affected skin.
  • The joints may be red, swollen, and painful, with more discomfort during movement or when pressed.
  • The tongue appears red when extended.
  • The tongue coating is yellow and greasy-looking.
  • The pulse feels smooth and somewhat rapid when taken.

|Treatment Approach

Traditional description:

Clear heat, promote the resolution of dampness, reduce swelling, and relieve pain.

In plain language:

  • Clear heat → In TCM terms, reduce internal heat and ease redness, swelling, a burning sensation, sore throat, thirst, and restlessness.
  • Resolve dampness → Promote the elimination of dampness through urination or sweating, with the aim of easing a heavy, sticky feeling, swelling, oozing, and difficulty urinating.
  • Reduce swelling → Ease tissue swelling and fullness, tenderness, tightness, and restricted movement.
  • Relieve pain → Ease pain, including aching, stabbing, and pulling discomfort.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Si Miao Wan (Four-Marvel Pill)

|Common Symptoms

Traditional description:

Red, swollen, hot, painful joints; bright-red plaques; rapid scale formation; hot, swollen skin; a red tongue with a thin yellow coating; and a slippery, rapid pulse.

In plain language:

  • The joints may be red, swollen, hot, and painful; they may feel warm to the touch.
  • Clearly visible red plaques may appear on the body.
  • Scales on the skin may form quickly, with noticeable flaking.
  • The skin may feel hot and swollen.
  • The tongue appears red when extended.
  • The tongue coating is thin and yellow.
  • The pulse feels smooth and somewhat rapid when taken.

|Treatment Approach

Traditional description:

Clear heat, resolve toxins, unblock painful obstruction, and relieve pain.

In plain language:

  • Clear heat → In TCM terms, reduce internal “heat” signs, such as redness, swelling, burning sensations, sore throat, thirst, and restlessness.
  • Resolve toxins → In TCM terms, address inflammatory “toxic pathogens,” reduce redness and swelling or pus and odor associated with sores, and promote healing.
  • Unblock painful obstruction → “Unblock” means to remove, and “painful obstruction” refers to blockage associated with pain. This approach aims to ease obstruction in the joints and channels, reduce aching, stiffness, and discomfort that worsens with cold or dampness, and improve mobility.
  • Relieve pain → Ease pain, including stabbing, pulling, and tenderness, and improve ease of movement.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Traditional description:

Swollen, painful, deformed joints; pain that remains in one location and worsens at night; purplish-dark discoloration over the affected joint or a dark tongue with purple spots.

In plain language:

  • The joints may be swollen and painful, and may look deformed.
  • The pain stays in one place rather than moving around.
  • The pain may be more noticeable or severe at night.
  • The skin over a joint may look purplish or dark, or the tongue may appear dark rather than bright red.
  • Purple spots may be visible on the tongue.

|Treatment Approach

Traditional description:

Transform phlegm, unblock the channels, invigorate blood, resolve blood stasis, unblock painful obstruction, and relieve pain.

In plain language:

  • Transform phlegm → In TCM terms, transform thick, sticky phlegm so that it is reduced and easier to cough up, easing chest oppression, stickiness, and a sense of blockage.
  • Unblock the channels → Promote the flow of qi and blood through the channels and microcirculation, with the aim of easing numbness, stiffness, and restricted movement.
  • Invigorate blood → Promote blood flow and ease pain, swelling, and pulling discomfort attributed to blood stasis.
  • Resolve blood stasis → Address retained blood stasis, with the aim of gradually easing stabbing or fixed pain and purplish-dark lumps.
  • Unblock painful obstruction → “Unblock” means to remove, and “painful obstruction” refers to blockage associated with pain. This approach aims to ease obstruction in the joints and channels, reducing aching, heaviness, and tightness.
  • Relieve pain → Ease pain and discomfort or limitation during everyday activities.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Traditional description:

Mild joint pain or joint deformity; dry, pale-red skin lesions with fine scales; a pale tongue with little or no coating; and a fine, slippery pulse.

In plain language:

  • Joint pain may be mild, or the joints may look deformed.
  • The skin lesions may be dry and pale red.
  • The scales on the affected skin are small and flaky.
  • The tongue may look pale and have little or no coating.
  • The pulse feels fine and smooth when taken.

|Treatment Approach

Traditional description:

Moisten dryness, dispel wind, nourish blood, and relieve pain; moisten dryness, dispel wind, nourish blood, and relieve pain.

In plain language:

  • Moisten dryness → In TCM terms, increase moisture in the body and skin to ease dry skin, constipation, a dry cough with little sputum, and dryness of the mouth, eyes, or nose.
  • Dispel wind → In TCM terms, dispel “wind pathogen” to ease shifting pain, itching, and discomfort from sensitivity to wind.
  • Nourish blood → Nourish the blood in TCM terms, with the aim of improving a dull complexion, dizziness, palpitations, and numbness in the limbs.
  • Relieve pain → Ease pain, including aching, stabbing, and pulling discomfort, and make movement more comfortable.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Traditional description:

Swollen, painful joints or joint deformity; purplish-dark discoloration of joints and skin lesions; stabbing pain that stays in one place and is tender to pressure; pain that worsens at night; a dark tongue or purple spots on the tongue.

In plain language:

  • The joints may be swollen and painful, or look deformed.
  • The joints and skin lesions may look purplish or dark rather than bright in color.
  • The pain may feel sharp and stabbing, like a needle prick.
  • The pain stays in one place and may be very tender to pressure.
  • The pain may become noticeably worse at night.
  • The joints and skin lesions may have a persistently purplish-dark appearance.
  • The tongue may look dark when extended, or purple spots may be visible on it.

|Treatment Approach

Traditional description:

Invigorate blood, dispel wind, resolve blood stasis, and relieve pain.

In plain language:

  • Invigorate blood → Promote blood flow and ease pain, stiffness, and numbness attributed to blood stasis.
  • Dispel wind → In TCM terms, dispel “wind pathogen” to ease shifting aches, sensitivity to wind, and itching.
  • Resolve blood stasis → Address retained blood stasis, with the aim of gradually easing stabbing or fixed pain and purplish-dark swelling.
  • Relieve pain → Ease pain, pulling discomfort, and restricted movement.

|Related Products

The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

References

  1. Chinese Society of Rheumatology. Guidelines for the diagnosis and treatment of psoriatic arthritis[J]. Chinese Journal of Rheumatology, 2010, 14(9): 631-633.
  2. Ding Xiaolan, Wang Tinglin. Epidemiological survey of psoriasis in six provinces and municipalities in China[J]. Chinese Journal of Dermatovenereology, 2010, 24(7): 600-601.
  3. Zhang Jianzhong. Epidemiology and risk factors of psoriasis[J]. Practical Journal of Clinical Medicine, 2013, 10(1): 4-6.
  4. Zhao Na, Wu Weizhi, Yang Ping. Advances in epidemiological research on psoriasis[J]. Shandong Medical Journal, 2013, 53(39): 95-97.
  5. Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China (Volume on Chinese Patent Medicines)[M]. 2010.
  6. Psoriasis Study Group, Chinese Society of Dermatology, Chinese Medical Association. Chinese expert consensus on psoriasis treatment (2014 edition)[J]. Chinese Journal of Dermatology, 2014, 47(3): 213-215.
  7. Psoriasis Study Group, Chinese Society of Dermatology, Chinese Medical Association. Chinese guidelines for psoriasis treatment (2008 edition)[J]. Chinese Journal of Practical Rural Doctors, 2014, 21(2): 2-5.