Senile pruritus mainly manifests skin irritation without primary skin rash. Its pathogenesis lies in generation of wind due to blood deficiency or stagnation of six exogenous factors in skin. General pruritus and localized itching are both common.
1. Syndrome differentiation and treatment
(1) External attack by wind and cold
It manifests general pruritus without definite site and dry skin covered with squamae which mostly occur in winter or after attack by wind and cold, and of which pruritus is relieved by warmth, or concurrent aversion to cold and wind, whitish and thin fur, floating and tense or floating and slow pulse. It is advisable to eliminate wind, dispel cold and check itching. The prescription used is the modified Wind-Dispelling Powder. In the case of wet scratch and oozing of water due to scratching, add Cangzhu (Rhizoma Atractylodis), Zexie (Rhizoma Alismatis) and Baixianpi (Cortex Dictamni Radicis); in the case of spontaneous sweating due to exterior syndrome of deficiency, add Huangqi (Radix Astragali seu Hedysari) and Baizhu (Rhizoma Atractytodis Macrocephalae). More information, please go on reading Psoriasis in TCM.
(2) Excessive wind due to blood heat
It manifests itching, red skin with calor aggravated by warmth, drinking and eating pungent food, relieved by cold, or concurrent fever and aversion to wind, vexation, dry mouth, yellowish and thin fur, red tongue, floating and slippery or taut and rapid pulse. It is advisable to eliminate wind, clear away heat, cool blood and check itching.
The prescription used is the modified Pruritus-Checking and Wind-Dispelling Decoction which is composed of Shengdihuang (Radix Rehmanniae), Danggui (Radix Angelicae Sinensis), Mudanpi (Cortex Moutan Radicis), Huangqin (Radix Scutellariae), Lianqiao (Fructus Forsythiae), Baijili (Fructus Tribuli), Jingjie (Herba Schizonepetae), Fangfeng (Radix Ledebouriellae), Bohe Herba Menthae), Longgu (Os Draconis) and Gancao (Radix Glycyrrhizae). In the case of severe heat, add Zicao (Radix Arnebiae seu Lithospermi) and Gancao (Radix Pittospori); in the case of constipation, add Dahuang (Radix et Rhizoma Rhei) and Mangxiao (Natrii Sulfas). More information, please go on reading Causes of Psoriasis in TCM.
(3) Dryness of blood due to yin deficiency
It manifests susceptibility to onset in autumn and winter, dry skin covered with squamae, wide-spread scratches, severe nocturnal itching, thickened skin in the scratched area, or concurrent palpitation, insomnia, red or reddish tongue, taut and thready pulse. It is advisable to nourish yin and blood, moisten dryness and check itching. The prescription used is the modified Yangxue Runfu Decoction (Blood-Nourishing and Skin-Moistening Decoction). In the case of purple skin scratches and deep purple tongue, add Sumu (Lignum Sappan), Taoren (Semen Persicae) and Zaojiaoci (Spina Gleditsiae); in the case of itching worsened by emotional changes, add Tianma (Rhizoma Gastrodiae), Gouteng (Ramulus Uncariae cure Uncis), Longgu (Os Draconis) and Muli( Choncha Ostreae). More information, please go on reading Symptoms of Psoriasis in TCM.
(4) Downward flow of dampness and heat
It manifests pruritus mostly occurring around the anus and pudenda suddenly, secondary skin rash, pustulae, oozing of water and pain after scratching, concurrent foul leukorrhea with yellowish colour, red tongue with yellowish and greasy fur, taut, slippery and rapid pulse. It is advisable to clear away heat, promote diuresis, expel wind and check itching.
The prescription used is Longdan Xiegan Decoction (Decoction of Gentiana for Purging the Liver Fire) with additional Muli(Concha Ostreae), Huangbai (Cortex Phellodenclri), Baijili (Fructus Tribuli) and Baixianpi (Cortex Dictamni Radicis). In the case of pruritus vulvae and fishy leukorrhea, add Tufuling (Rhizoma Smilacis Glabrae) and Shechuangzi (Fructus Cnidii); in the case of anal pruritus, add Kushen (Radix Sophorae Flavescentis ) and Difuzi (Fructus Kochiae); in the case of scrotal pruritus, add Chantui (Periostracure Cicadae). More information, please go on reading TCM Diagnosis for Psoriasis.
2. Rehabilitation Methods
(1) Regulating emotions
The disease is closely related to emotional factors. Therefore, the patients should remain a cheerful frame of mind and avoid being in an anxious state of mind.
(2) Recreation therapy
Please refer to the relevant part of the section of "Coronary heart disease".
(3) Acumox
Acupuncture:
Select Quchi (LI 11), Hegu (LI 4), Xuehai (SP 10), Zusanli (ST 36), Fengchi (GB 20), Sanyinjiao (SP 6), Yinlingquan (SP 9) and Fengfu (GV 16). Puncture two to four acupoints each time. In the case of sthenia syndrome, use the reducing manipulation; in the case of asthenia syndrome, use the reinforcing manipulation. Retain the needle for ten to twenty minutes. Puncture the acupoints once a day. Ten times constitute one course of treatment.
Ear acupuncture:
Select shenmen (MA-TF 1), Jiaogan (MA-AH 7), Shenshangxian, Neifenmi (MA-IC3), Feiqu and Yangdian. Each time, select two to three acupoints with the method of embedding the needle on one ear. Change the ears alternately in one week.
(4) Dietary therapy
In the case of downward flow of dampness and heat, select Yiyiren Gruel (Gruel of Semen Coicis); in the case of excessive wind due to blood heat, decoct 30g of rice vinegar and brown sugar respectively and take the decoction in two different times; in the case of dryness of blood due to yin deficiency, select Thick Soup of Wushe (Zao-cys) or Chanchu Shuishe Gruel (Gruel of Bufo and Creas Enhydris); in the case of external attack by wind and cold, pound 500g of fresh chives to juice and take 100ml of the juice orally while applying the rest on the itching part. More information, please go on reading Chinese medicine treatment Psoriasis.
At ordinary times, abstain from pungent food, smoking and drinking as well as seafood and fishy foods such as hot pepper, Chinese prickly ash, Chinese green onion, garlic, fish, shrimp, soft-shelled turtle, milk, mushroom, red bayberry, pet herb mustard, rape, three-colored amaranth, coriander, meat of perk head and cock. Besides, pay attention to the pathogenic foods and avoid eating them.
(5) Empirical recipes
Decoct 30g of Fuping (Herba Spirodelae) and Difuzi (Fructus Kochiae) in water for oral administration; or decoct 30g of Shengdihuang (Radix Rehmanniae), 10g of Danggui (Radix Angelicae Sinensis), 15g of Baijili (Fructus Tribuli), Kushen (Radix Sophorae Flavescentis), Baixianpi (Cortex Dictamni Radicis) and Bohe (Herba Menthae) respectively in water. Use the decoction to fumigate and wash the affected part. More information, please go on reading TCM Treatment Evaluation for Psoriasis.