The effect of leech therapy on the severity and extent of psoriasis: a randomized, blinded clinical trial

Document Type : Original Article

Authors
Mohsen Fasele 1
Ehsan khavare 2
Mohsen Hojat 3
1 . Assistant Professor, Faculty of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
2 Master of Science in Nursing, Faculty of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
3 Assistant Professor, Faculty of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
10.22034/pjms.2024.2042595.1171
Abstract
Introduction: Today, three to eleven percent of the world's population is suffering from psoriasis. This disease causes many physical, psychological, and social complications for patients. Despite the high cost and time of treating this chronic disease, modern medicine has not yet been able to provide a definitive solution for its treatment, however, in most of the old Greek, Iranian, and Indian medical books, complementary medicine and especially leech therapy are introduced as one of the ways to treat this disease. The present study was designed and implemented to determine the effectiveness of leech therapy on the severity and extent of psoriasis.
Materials & Methods: This randomized, blinded, controlled clinical trial was conducted on 60 patients. Patients were randomly assigned to two intervention groups (routine psoriasis care with leech therapy) and control (receiving routine psoriasis care). The data collection tool included a demographic information questionnaire and the Psoriasis Extent and Severity Index (PASI). Data were analyzed with the help of the spss22 program under Windows and using Kolmogorov Smirnov, independent t, chisquare, and paired t-test.
Results: The majority of the patients were men and held a diploma or higher degree. Before the intervention, the background variables and average PASI scores in the two groups did not have statistically significant differences (P=0.83, t=0.26). After the intervention, the mean score of PASI in the two intervention groups was statistically significantly different from the control group (P=0.004, t=2.94). In the two measurement periods (before and after the intervention), the mean scores of the PASI index in intervention group and in control group had a statistically significant difference.
Conclusion: The implementation of leech therapy is effective in improving the symptoms of psoriasis patients and results in a significant decrease in the PASI score of patients undergoing leech therapy, therefore, leech therapy as a cost-effective method in terms of cost and time can be used alongside Common medical treatments help in the recovery of such patients.
Keywords
Keywords: leech therapy
psoriasis
complementary medicine
clinical trial
1. Parisi R, Symmons DP, Griffiths CE, Ashcroft DM.
Global epidemiology of psoriasis: a systematic review
of incidence and prevalence. J Invest Dermatol.
2013;133(2): 377-85.
2. Armstrong AW, Mehta MD, Schupp CW, Gondo GC,
Bell SJ, Griffiths CEM. Psoriasis Prevalence in Adults
in the United States. JAMA Dermatol. 2021;
157(8):940-6.
3. Singh SK, Rajoria K. Medical leech therapy in
Ayurveda and biomedicine - A review. J Ayurveda
Integr Med. 2020;11(4):554-64.
4.Yeung H, Takeshita J, Mehta NN, Kimmel SE, Ogdie
A, Margolis DJ, Shin DB, Attor R, Troxel AB,
Gelfand JM. Psoriasis severity and the prevalence of
major medical comorbidity: a population-based study.
JAMA Dermatol. 2013;149(10):1173-9.
5. Ghafouri-Fard S, Gholipour M, Abak A, Hussen BM,
Kholghi Oskooei V, Taheri M, Rakhshan A.
Association analysis of MALAT1 polymorphisms and
risk of psoriasis among Iranian patients. Int J
Immunogenet. 2022;49(2):83-7.
6. Young PM, Chen AY, Ford AR, Cheng MY, Lane CJ,
Armstrong AW. Effects of online care on functional
and psychological outcomes in patients with psoriasis:
A randomized controlled trial. J Am Acad Dermatol.
2023;88(2):364-70.
7. Koren J, Lambert JLW, Thomsen SF, McAteer H,
Fabbrocini G, Corazza V, Jullien D, Augustin M,
Warren RB, de Rie MA, Lazaridou E, Puig L,
Guillevin L, Grosser M, Boehncke WH. Elevating the
Standard of Care for Patients with Psoriasis: 'Calls to
Action' from Epicensus, a Multistakeholder PanEuropean Initiative. Dermatol Ther (Heidelb). 2023
Jan;13(1):245-68.
8. Iqbal A, Shah A, Quraishi HA, Rather SA, Raheem
A. Effect of leech therapy in the management of
psoriasis. J Res Tradit Med. 2018; 4(1):16-20.
9. Singh AP. Medicinal leech therapy (hirudotherapy): a
brief overview. Complement Ther Clin Pract.
2010;16(4):213-5.
10. Abdualkader AM, Ghawi AM, Alaama M, Awang
M, Merzouk A. Leech therapeutic applications. Indian
J Pharm Sci. 2013;75(2):127-37.
11. Jahangir U, Akram M, Urooj S. Leech therapy in
Dermatology. Jour of Pharma and Phytoch. 2016;
5(3):214-6.
12. Rasanan FM, Kenari HM, Ghassemi M, Sabbagh
AJ, Aliasl J, Ghobadi A. Non-Pharmacological
Treatments of Psoriasis in Persian Medicine a
Narrative Review. J Pharmacopuncture. 2022;25(1):1-
6.
13. Rani R, Siddaram S, Shringi M. A clinical study to
evaluate the efficacy of leech therapy and panchatikta
ghrita in the management of psoriasis. J
Ayurveda.2011; 5(2):39.
14. Tabasum H. Efficacy of Unani medications and
taleeq (leech therapy) in the managment of taqashur
jild (PSORIASIS)-a case report. Worl J Pharm Rese.
2014; 7 (9):832-7.
15. Lopez-Sanchez C, Puig L. Guselkumab in the
treatment of moderate-to-severe plaque psoriasis.
Immunother. 2020; 12 (6):355-71.
16. Langley RG, Ellis CN. Evaluating psoriasis with
psoriasis area and severity index, psoriasis global
assessment, and lattice system physician's global
assessment. J Am Acad Dermatol. .2004; 51(4):563-
9.
17. Kumar RR, Rao M. Efficacy of leech therapy and
Ayurvedic Compound in Vitiligo: A Quasi
Exprimental Study. Int J Res Ayurveda Pharm. 2012;
3 (5):61-4.
18. Ghawi A, Abdualkader A, Merzouk A, Alaama M.
Free radical scavenging activity of the medicinal
Malaysian leech saliva extract, Hirudinaria
manillensis. J Bioequiv Bioav.2012; 1(8):140-6.
19. Sheeraz M, Ahmed NZ, Parvez A, Ahmed H. Anti
Psoriatic Effect of Leech Therapy in Psoriasis-A Case
Report. Hippoc J Unani Med.2017;12 (3):43-50.
20. Shiffa M, Siddiqui MA, Sultana A, Zaman F,
Fahamiya N, Akhtar MU. Comparative clinical
evaluation of leech therapy in the treatment of knee
osteoarthritis. Eur J Integr Med .2013; 3: 261.
21. Lone AH, Ahmad T, Anwar M, Naiyar A. Clinical
evaluation of leech therapy in the management of knee
osteoarthritis: A pilot study. SL-Musculoskelet Dis.
2013;1:86-91.
22. Shankar KM, Rao SD, Umar SN, Gopalakrishnaiah
V. A clinical trial for evaluation of leech application
in the management of Vicarcikā (Eczema). Anc Sci
Life. 2014 ;33(4):236-41.
23.Yousuf AW, Siddiqui MA, Jahangir U, Erum AU.
Leech therapy on the management of knee
osteoarthritis-a review. World J Pharm Res. 2017;6
(9):302-6.
24.Ganjoo N. A Conceptual Study on the Impact of
Medicinal Leech Therapy in Acne. Int J Ayurveda
Herb Med. 2023;13:4325-33.
25.Mojahedi M, Alizadeh M, Kebria AS, Parvizi MM.
Successful maintenance treatment of a patient with
chronic dermatitis with leech therapy. J Res Med Sci.
2023; 28:60-6.