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Chinese Herbal Medicine for Chronic Urticaria and Psoriasis Vulgaris: Clinical Evidence and Patient Experience

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Chinese Herbal Medicine for Chronic Urticaria and Psoriasis Vulgaris: Clinical Evidence and Patient Experience Chinese Herbal Medicine for Chronic Urticaria and Psoriasis Vulgaris: Clinical Evidence and Patient Experience A thesis submitted in fulfilment of the requirement for the degree of Doctor of Philosophy Jingjie Yu BMed, MMed School of Health & Biomedical Sciences College of Science, Engineering and Health RMIT University August 2017 Declaration I certify that except where due acknowledgement has been made, the work is that of the author alone; the work has not been submitted previously, in whole or in part, to qualify for any other academic award; the content of the thesis is the result of work which has been carried out since the official commencement date of the approved research program; and, any editorial work, paid or unpaid, carried out by a third party is acknowledged. Jingjie Yu __________________ Date 21 August 2017 i Acknowledgements First, I would like to express my deepest gratitude to my parents, Mr Mingzhong Yu and Mrs Fengqiong Lv, for your endless love, encouragement and support throughout these years. I would also like to express my sincere appreciation to my supervisors, Professor Charlie Changli Xue, Professor Chuanjian Lu, Associate Professor Anthony Lin Zhang and Dr Meaghan Coyle. To my joint senior supervisor, Professor Charlie Changli Xue, thank you for providing me the opportunity to undertake a PhD at RMIT University. To my joint senior supervisor, Professor Chuanjian Lu, thank you for teaching me the truth in life and for the guidance you have given me since I stepped into your consultation room in our hospital seven years ago. To my joint associate supervisor Associate Professor Anthony Lin Zhang, I thank you for your continuous guidance and support during my study at RMIT University. To my joint associate supervisor Dr Meaghan Coyle, I express my great gratitude for your considerateness, patience and encouragement along my three years’ PhD journey. You have guided me to think critically, improve my academic writing and oral presentation skills, and establish good time management, which is beneficial for my future research and life in general. I would like to sincerely thank Dr Claire Shuiqing Zhang for her guidance on classical literature research; Dr Kevin Kaiyi Wang, for his assistance in the systematic reviews and editing of the references in this thesis; Dr Xinfeng Guo, for his comments on the systematic reviews; Dr Linda Jones, for her guidance on the data analysis of qualitative study; Dr Lingling Yang, for her help in checking codes for qualitative data; Dr Yiqi Du, for her assistance in Chinese database searches for the systematic reviews; Dr Amy Tan and Dr Songpei Li, for their assistance in Japanese database searches for the systematic reviews; Dr ii Yuhong Yan, for her help in recruiting interview participants in China. I am grateful to all staff and higher-degree-by-research students from the Discipline of Chinese Medicine, School of Biomedical and Health Sciences, RMIT University. I am thankful for the scholarship and support from China-Australia International Research Centre for Chinese Medicine of RMIT University and Guangdong Provincial Hospital of Chinese Medicine. Last, but not least, I would like express my sincere thanks to my dearest friends Yusen Song and Dongmei Wang. Thank you for your companionship and support during my PhD candidature. iii Table of Contents Declaration................................................................................................................................. i Acknowledgements .................................................................................................................. ii Table of Contents .................................................................................................................... iv List of Figures ....................................................................................................................... viii List of Tables ........................................................................................................................... ix Publications ............................................................................................................................. xi Abbreviations ....................................................................................................................... xiii Summary ................................................................................................................................... 1 Background ............................................................................................................................ 1 Objectives ............................................................................................................................... 2 Methods .................................................................................................................................. 2 Results .................................................................................................................................... 3 Conclusions ............................................................................................................................ 4 Chapter 1. Introduction .......................................................................................................... 6 1.1 Introduction ...................................................................................................................... 6 1.2 Rationale of the Research ................................................................................................. 7 1.3 Aim ................................................................................................................................... 9 1.4 Research Questions .......................................................................................................... 9 1.5 Organisation of the Thesis.............................................................................................. 10 Chapter 2. Chronic Urticaria and Psoriasis Vulgaris in Western Medicine .................... 12 2.1 Definition of Chronic Urticaria and Psoriasis Vulgaris ................................................. 12 2.2 Epidemiology of Chronic Urticaria and Psoriasis Vulgaris ........................................... 13 2.2.1 Prevalence of Chronic Urticaria and Psoriasis Vulgaris ......................................... 13 2.2.2 Impact of Chronic Urticaria and Psoriasis Vulgaris on Health-related Quality of Life ....................................................................................................................... 13 2.2.3 Economic Burden of Chronic Urticaria and Psoriasis Vulgaris .............................. 14 2.2.4 Similarities in Chronic Urticaria and Psoriasis Vulgaris ......................................... 14 2.3 Aetiology and Pathophysiology of Chronic Urticaria and Psoriasis Vulgaris ............... 15 2.3.1 Risk Factors ............................................................................................................. 15 2.3.2 Pathophysiological Process of Chronic Urticaria and Psoriasis Vulgaris ............... 16 2.4 Diagnosis of Chronic Urticaria and Psoriasis Vulgaris .................................................. 17 2.4.1 Chronic Urticaria ..................................................................................................... 17 2.4.2 Psoriasis Vulgaris .................................................................................................... 18 2.5 Subtypes/Classification .................................................................................................. 19 2.5.1 Chronic Urticaria ..................................................................................................... 19 2.5.2 Psoriasis Vulgaris .................................................................................................... 19 2.6 Current Management for Chronic Urticaria and Psoriasis Vulgaris .............................. 21 2.6.1 Management for Chronic Urticaria.......................................................................... 21 2.6.2 Management for Psoriasis Vulgaris ......................................................................... 22 2.6.3 Similarities in the Management of Chronic Urticaria and Psoriasis Vulgaris ......... 23 2.7 Limitations of Current Management .............................................................................. 23 2.7.1 Chronic Urticaria ..................................................................................................... 23 2.7.2 Psoriasis Vulgaris .................................................................................................... 24 iv 2.7.3 Similarities in the Limitations of Current Management on Chronic Urticaria and Psoriasis Vulgaris .............................................................................................. 25 2.8 Summary ........................................................................................................................ 25 Chapter 3. Chronic Urticaria and Psoriasis Vulgaris in Chinese Medicine ..................... 26 3.1 Introduction of Chronic Urticaria and Psoriasis Vulgaris .............................................. 26 3.2 Aetiology and Pathophysiology ..................................................................................... 27 3.2.1 Chronic Urticaria ..................................................................................................... 27 3.2.2 Psoriasis Vulgaris ...................................................................................................
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