Recent advances of TCM treatment of childhood atopic dermatitis

Xu Weiwei(徐薇薇), Ci Lingling(蔡玲玲), Zhng Liyun(張歷元),Wu Meicho(吳美超), nd Peng Dengf(彭登發(fā))＊

a: National hospital of Tujia and Miao minority Autonomous prefecture Of Hubei Province, Enshi 445099, China

b: Dongfang Hospital, the Second Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100078, China

HERBAL MEDICINE

TCM has a certain advantage in treatment of AD, and syndrome differentiation can achieve satisfactory results.

Xue Suqin etc.4treated 60 AD children of syndrome of blood deficiency. Children in the observation group received the Shengxue Runfu decoction (Angelica sinensis, Donkey hide gelatin,Atractylodes macrocephala Koidz, Radix Asparagi,Liriope, Peach kernel, Cortex moutan, Rehmanniae,Astragalus, Poria, Cortex dictamni, Safflower,Scutellaria, Glycyrrhiza, Cimicifuga foetida). While the control group received loratadine capsule. Both groups received the Fufang Shezhi ointment and emollient on the skin lesions. After 8 weeks of treatment, results showed that patients in the observation group recovered better than the control group.

Fu Weilan5treated 68 AD children. The observation group took self-designed Jianpi Huashi Daozhi prescription, and the control group took loratadine and vitamin C. After treatment, the score of lesion area,severity of illness, itching degree in the observation group were all better than those in the control group.The total effective rate in the observation group was 94.1%, which was signi fi cantly better than 76.5% in the control group.

Liu Yuan etc.6treated 64 AD children, both groups took loratadine, and the observation group added herbal medicine modified according to the specific situation, like medicine of invigorating spleen to resolve dampness, or medicine of removing damp-heat. After 4 weeks of treatment, the treatment was stopped 12 weeks later, unless there was disease recurrence. The result showed that the cure rate and the effective rate in the observation group were better than the control group,and the recurrence rate in the observation group in 8thweek and 12thweek were lower than the control group.

EXTERNAL THERAPY

At present, the mainstream treatment of the disease is local application of glucocorticoid and CNI. The efficacy is obvious, and the adverse drug reaction is obvious too. Compared with mainstream treatment,the cost of external therapy of Chinese herbs is more inexpensive, the adverse drug reactions were fewer, and the recurrence rate is lower.

Cases in acute stage with much exudation can choose medicine bath. Chen Jianhong etc.7treated 120 AD children of syndrome of damp-heat. Both groups took chlorpheniramine maleate, and the observation group used Jinyu Waixi prescription (honeysuckle,Houttuynia cordata, purple perilla, schisandra chinensis,phellodendron) more. Results showed that the effective rate in the observation group was 100%, which was better than 96.67% in the control group. And the score of SCORAD was better than that of the control group.

Cases in remission stage can use ointment. Chinese herbal ointment was easy to use and apply, and could reduce the loss of skin moisture, inhibit in fl ammation,thus relieve dryness, desquamation, licheni fi cation, and other pathological process, promote the recovery of skin barrier function.

Self-designed Zhiyang ointment had a good effect on children’s AD8. Huang Zhongkui etc.9treated 195 patients, aged from 3 months to 22 years old. The observation group received the Chushi Zhiyang ointment,which was modified from the Shechuangzi decoction,Kushen decoction and Huanglian Jiedu decoction. The control group used clobetasol propionate cream. After 2 weeks, the effective rate in the observation group (95%)was much better than 88% in the control group. Zhang Xiaoyan10used Qiwei Jiedu Huoxue ointment (catechu,houttuynia cordata, yerbadetajo herb, lignum sappan,gallnut, Zanthoxylum nitidum, menthol) in treating 90 AD children. After one week, the observation group achieved a similar clinical efficacy with the control group who received hydrocortisone butyrate cream (85 cases), and had a fewer adverse drug reactions.

ACUPUNCTURE

Cheng Shenrong11treated 60 AD children of syndrome of damp abundance due to spleen asthenia syndrome. Both groups received modi fi ed the Xiaoer Huashi decoction. The observation group were pierced into acupuncture points (LI11, LU5, SP10, ST36, SP9)about 0.5～1 Cun, rotational and fast, which was the technique of Lingnan Chenshi. After developing needle sensation, power was reinforced and reduced, uniform for 30min. After taking acupuncture 3 times per week,for 3 months, symptom scores and index of life quality in two groups were compared. Result showed that acupuncture therapy could significantly improve the effective rate and cure rate.

Feng Chen etc.12treated 25 AD children with catgut embedding therapy in acupuncture point GV9, GV14.The cure rate was 92%. There was no recurrence in 6 months. Chen Xiuhua13used herb-thread pointmoxibustion therapy from Zhuang medicine. The therapy was operated on skin lesions or acupuncture point BL13, BL15, BL16, BL20, in cases of erosion,exudation and fresh red on lesions. This therapy could stop itching quickly and converge wound.

CONCLUSION

In summary, TCM has exact effects on children with AD. The advantages of TCM treatment includes fewer side effects, lower recurrence rate and lower costs.However, there is still great space for improvement.There are limits such as the samples are not being enough, the study is not rigorous enough from the scientific perspective, the treatment cycle is not fixed among these studies, and the dose conversion of herbal medicine is not normative.

The most significant feature of TCM is syndrome differentiation. But some researchers choose drugs only in accordance with the disease. They pursue scientific goal rigorously and ignore features of TCM, which is noteworthy in the future study.

1 Gu H, Yan Y, Chen XS, et al. Survey on Atopic Dermatitis in China. Chin J Dermatol, 2000, 23(6): 379.

2 Liu QH, Xu ZG, Li L, et al. Comparative Study on Skin Barrier Function between Children with Atopic Dermatitis and Healthy Children. Chin J Venereol, 2012, 26(2): 109-111.

3 Zhao Z. Research on treating idiopathic dermatitis in children in TCM medicine. Chin J Inform Tradit Chin Med,2008, 15(7): 102-103.

4 Xue SQ, Tan JH, et al. Clinical observation ontreating atopic dermatitis in children with the Shengxue Runfu decoction. New J Tradit Chin Med, 2011(2): 94-95.

5 Fu WL. The Observation of the Curative Effect of Chinese Medicine in the Treatment of Children with Atopic Dermatitis. Chin and Foreign Medical Research, 2014(18):12-14.

6 Liu Y, Ye QH, Chen JY, et al. A study on treating atopic dermatitis in children in the integrative medicine. J Nangjing Univ Tradit Chin Med Natural Science Edition,2007, 23(2): 93-95.

7 Chen JH, Pan PG, Fan RQ, et al. A study on treating atopic eczema of the Shire type in children with the Jinyu waixi prescription. New J Tradit Chin Med, 2012, 44(8): 113-115.

8 Wu L. Clinical Observation and Pharmacodynamic Study of Zhiyang Cream on Atopic Dermatitis with Children.Nanjing University of Chinese Medicine, 2016.

9 Huang ZK, Chen P, Wei WN. Effective observation on treating atopic dermatitis with the Chushi Zhiyang ointment.Modern J Integr Tradit Chin West Med, 2010, 19(21): 2647-2648.

10 Zhang XY, Yang LY, Yang LJ, et al. The effects of the Qiwei Jiedu Huoxue ointment on atopic dermatitis in children.Chin J Aesthetic Med, 2012, 21(11): 225-226.

11 Cheng SR. A study on treating atopic dermatitis of the Pixu Shiyun type by acupuncture. Guangzhou: Guangzhou Univ Chin Med, 2014.

12 Chen F, Zhuo JC, Zhang JB, et al. Treating 25 children with atopic dermatitis by catgut embedding in Dazhui Zhiyang.Military Med J South China, 2015, 29(9): 718.

13 Quan XH, Li SQ, Li Y, et al. The experience of Professor Chen Xiuhua on treating atopic dermatitis. Chin Acup Moxib, 2017, 37(3): 307-310.