OBJECTIVE: To determine the clinical efficacy and safety of Liangxue Jiedu decoction (LJD) for the treatment of progressive psoriasis vulgaris and to provide the basis for the development of a standardized treatment protocol for psoriasis vulgaris. METHODS: In this multicenter, randomized, controlled study, patients with blood-heat type psoriasis were randomly assigned to receive either Chinese herbal medicine (LJD; treatment group) or Western Medicine (cetirizine hydrochloride, vitamin C, and vitamin B complex; control group). Psoriasis Area and Severity Index (PASI) scores were calculated in addition to the number of patients who achieved >= 50% or >= 75% improvement in PASI score from baseline. The change in symptoms of Chinese medicine (color of rash, burning sensation, itchiness, severity of irritation, and anger) was evaluated and safety was assessed as adverse events and laboratory analysis. t test, independent sample non-parametric test and chi(2) test were used to analyze the results. RESULTS: A total of 238 participants were included in the study [treatment group, n = 122 (PP analysis 117); control group, n = 116 (PP analysis 104)]. LJD treatment was associated with a significant improvement in skin lesions and symptoms compared with Western Medicine treatment. At the end of the 8-week treatment period, 23.77% (PP analysis 24.79%) of patients in the treatment group had achieved PASI75 and 57.38% (PP analysis 58.97%) had achieved PASI50; the corresponding figures in the control group were 9.48% (9.62%) and 25.00% (25.00% ), respectively. The between-group differences were statistically significant (P < 0.05). CONCLUSION: Treatment of psoriasis vulgaris of the blood-heat type using LJD was associated with significantly better outcomes compared with those achieved using standard Western Medicine. (C) 2020 JTCM. All rights reserved.