Eczema

Introduction	Back to Top
Eczema is one of the most commonly seen dermatoses, especially among children. About 10 - 30% of the first-time patients seen in the department of dermatology are there for eczema. A commonly encountered allergic inflammatory dermatosis, eczema is characterized by polytypic erythra, symmetrically distributed exudation in the affected skin, intense itching, and liability to recurrence and to being turned into a chronic condition. In traditional Chinese medicine, it falls into the categories of “Yin” (urticcaria), “Xuan” (tinca), “Feng Zhong” (tinea corporis), “Jin Yin” (acute eczema), “Yin Chuang” or “Jin Yin Chuang” (acute eczema), “Shi Xuan” (exudative dermatitis) and “Gan Xuan” (chronic eczema).

Etiology/Pathogenisis	Back to Top
Eczema is one of the most commonly seen dermatoses, especially among children. About 10 - 30% of the first-time patients seen in the department of dermatology are there for eczema. A commonly encountered allergic inflammatory dermatosis, eczema is characterized by polytypic erythra, symmetrically distributed exudation in the affected skin, intense itching, and liability to recurrence and to being turned into a chronic condition. In traditional Chinese medicine, it falls into the categories of “Yin” (urticcaria), “Xuan” (tinca), “Feng Zhong” (tinea corporis), “Jin Yin” (acute eczema), “Yin Chuang” or “Jin Yin Chuang” (acute eczema), “Shi Xuan” (exudative dermatitis) and “Gan Xuan” (chronic eczema).

Primary Treatments with Medicinal Herbs	Back to Top
Long Dan Xie Gan Tang Ingredients: Long Dan Cao (Gentiana Root), Chai Hu (Bupleurum), Gan Cao (Licorice), Huang Qin (Astragalus Root), Zhi Zi (Gardenia), Mu Tong (Akebia), Che Qian Zi (Plaintain Seed), Sheng Di Huang (Rehmannia Root), Ze Xie (Alisma), Dang Gui (Dang Gui) Clinical Application: Dou, et al. used Long Dan Xie Gan Tang to treat 218 cases of anal eczema. The formula consisted of Long Dan Cao (Gentiana Root), Huang Qin (Scutellaria), Zhi Zi (Gardenia), Che Qian Zi (Plaintain Seed), Chai Hu (Bupleurum), Mu Tong (Akebia), Sheng Di Huang (Rehmannia Root), Dang Gui (Dang Gui), Ze Xie (Alisma), and Gan Cao (Licorice). Each dose of the formula was decocted three times. The first two decoctions were administered internally, while the third was used externally to fumigate the affected area twice daily (in the morning and in the evening). One course of treatment lasted seven days. The results: after two courses of treatment, all 218 patients were relieved of the symptoms, with a total effective rate of 100%.(1) Lu treated 29 cases of acute scrotal eczema with a modification of this formula. The modified formula consisted of Long Dan Cao (Gentiana Root), Ze Xie (Alisma), Mu Tong (Akebia), Dang Gui (Dang Gui), Chai Hu (Bupleurum), Huang Qin (Scutellaria), Zhi Zi (Gardenia), Che Qian Zi (Paintain Seed), Ku Shen (Sophora Root), Cang Zhu (Atractylodes), Bai Xian Pi (Dittany Bark), Di Fu Zi (Kochia), Da Huang (Rhubarb), Gan Cao (Licorice), and Sheng Di Huang (Rehmannia Root). The formula was used for washing and oral administration. The results: after 1-3 courses of treatment, all recovered.(2) Huang, et al. treated 27 cases of chronic scrotal eczyma with Long Dan Xie Gan Tang (oral administration, in boluses) and Hua Tuo Gao (external application, in paste). A comparison group of 22 cases was treated with decloxizine (oral administration) and dycloninine cream (external application), etc. After 6 weeks of treatment, all cases in both groups recovered; the amount of time it took for the cases of the treatment group to recover was shorter (P<0.001).(3) Zhou, et al. used Long Dan Xie Gan Tang granular infusion to treat 60 cases of dermatosis (including eczyma, herpes zoster, contact dermatitis). Another 30 cases were treated with decoction of the formula. The results: the two groups had proportionately similar number of cases in different effectiveness categories; specifically, of the group taking granular infusion, 19 cases recovered, 20 cases improved, and 21 cases did not respond to the treatment, with a total effective rate of 65%, and the corresponding numbers for the group taking decoction were 9, 11, 10, 66.6%.(4)

Other Treatments with Medicinal Herbs	Back to Top
Pi Yang Ling He Ji Li treated 132 cases of eczema with Pi Yang Ling He Ji, a formula consisting of Jin Yin Hua (Lonicera Flower), Tu Fu Ling (Smilax), Ku Shen (Sophora Root), Zi Cao (Lithospermum), Bai Xian Pi (Dittany Bark), Mu Dan Pi (Moutan), Wu Gong (Centipede), Gan Cao (Licorice), etc. A comparison group of 48 cases was treated with Western medicine cyproheptadine and vitamin C. The results: of the treatment group, 105 cases recovered, 24 improved, and 3 did not respond to the treatment, with a total effective rate of 97.73%; and of the comparison group, 13 cases recovered, 25 improved, and 10 did not respond to the treatment, with a total effective rate of 79.16% (P<0.01).(5) Qu Feng Zhi Yang Wang treated 45 cases of chronic eczema with Qu Feng Zhi Yang (dispelling wind-pathogen and relieving itching) decoction and external application of Qing Dai San. Qu Feng Zhi Yang, which was administered internally, consisted of Qin Jiao (Gentian Root), Huang Bo (Sophora), Bai Xian Pi (Dittany Bark), Di Fu Zi (Kochia), Sheng Di Huang (Rehmannia Root), Wei Ling Xian (Clematis), Huai Hua (Flos Sophorae), Cang Er Zi (Xanthium), Chen Pi (Citrus Peel), Gan Cao (Licorice), and Ku Shen (Sophora Root). The results: 26 cases recovered, 11 significantly improved, 6 improved, and 2 did not respond to the treatment, with a total effective rate of 95.6%.(6) Shi Zhen Fang Wang, et al. used Shi Zhen Fang to treat 96 cases of infantile eczema. Shi Zhen Fang consisted of Huang Lian (Coptis), Huang Bo (Phellodendron), Bai Xian Pi (Dittany Bark), Zhi Zi (Gardenia), Er Cha (Catechu), Gan Cao (Licorice), Shi Gao (Gypsum), and was decocted and administered internally. In addition, a mixture made from Qing Dai (Natural Indigo), Shi Gao (Gypsum), Bai Fan (Alum), Bing Pian (Borneol), and sesame oil was applied externally to the affected areas. The results: 78 cases recovered, 11 improved, and 7 had no significant changes.(7) Zha Qu Ping Wei San Qian treated 76 cases of eczema with Zha Qu Ping Wei San (Powder for Regulating Stomach Functions) and Zhi Yang Fang (Itchiness-relieving Formula). Zha Qu Ping Wei San, which was administered internally one dose daily, consisted of Shanzha (Fructus Crataegi, Shen Qu (Leaven), Cang Zhu (Atractylodes), Ku Shen (Sophora Root), Hou Pu (Magnolia Bark), Chen Pi (Citrus), Tu Fu Ling (Smilax), Bai Xian Pi (Dittany Bark), Di Fu Zi (Kochia), and Gan Cao (Licorice). Zhi Yang Fang, which was applied externally, was made from Xiong Huang (Realgar), Bai Fan (Alum), Ku Shen (Sophora Root), Cang Zhu (Atractylodes), Wu Bei Zi (Cuttle-bone), Hua Shi (Talc), Bai Xian Pi (Dittany Bark), Di Fu Zi (Kochia), Tu Fu Ling (Smilax), Ren Dong Teng (Lonicera Stem), and Bai Zhi (Angelica). The results: 50 cases recovered, 21 cases improved, and 5 cases did not respond to the treatment, with a total effective rate of 93.3%.(8) Zhi Yang Xiao Zhen Tang Shi, et al. treated 40 cases of acute anal eczema by soaking and washing the local affected area with Zhi Yang Xiao Zhen Tang. The formula consisted of Qin Jiao (Gentian Root), Cang Zhu (Atractylodes), Da Qing Ye (Isatis Leaf), Bai Bu (Stemona), She Chuang Zi (Cnidium Fruit), Di Fu Zi (Kochia), Ku Shen (Sophora Root), Tu Fu Ling (Smilax), Huang Qin (Scutellaria), Ze Xie (Alisma), Ai Ye (Artemisia), and Chi Shao (Peony Red). The herbs were decocted, and the decoction was used to first fumigate and then wash the affected area for fifteen minutes, once or twice a day. One course of treatment lasted seven days. The results: 38 patients recovered, and the remaining 2 cases improved.(9) Tou Gu Cao, Ju Hua, Long Dan Cao, and Chan Tui Liu treated 12 cases of acute infantile eczema with the following herbs: Tou Gu Cao (Impatiens), Ju Hua (Chrysanthemum), Long Dan Cao (Gentiana Root), and Chan Tui (Cicada Slough). The herbs were decocted, and the filtrated decoction was applied to the affected areas, 15-30 minutes at a time, 2-3 times a day. The results: after applying for 5-10 times, all cases recovered.(10) San Huang Lotion Dong, et al. treated 54 cases of sore of damp type with San Huang Lotion. The formula consisted of Xiong Huang (Realgar), Da Feng Zi (Hydnocarpi), Fang Feng (Siler), Bai Xuan Pi (Dittany Bark), Huang Bo (Phellodendrom), Huang Qin (Scutellaria), and Ku Shen (Sophora Root). One dose of the formula was decocted in water daily, the decoction was used for fumigating and washing the local affected areas 15 to 30 minutes every time, and afterwards, the focus was wrapped with a piece of sterilized gauze. Results: after being treated for 5-10 days, 28 cases recovered, 18 improved, and the remaining 8 did not respond to the treatment, with a total effective rate of 85.2%.(11)

Acupuncture & Acupressure	Back to Top
Wang, et al. treated 54 cases of eczema with acupuncture combined with bloodletting and cupping. Acupoints Qu Chi (LI 11), Bai Chong Wo (EX-LE 3), He Gu (LI 4), San Yin Jiao (SP 6), Xing Jian (LR 2), and Nei Ting (SI 44) received acupuncture treatment with either the uniform reinforcing-reducing method or the twirling-reducing method. The treatment was performed once every other day, and 15 sessions constituted one course of treatment. The results: 23 cases recovered, 24 improved, and 7 did not respond to the treatment, with a total effective rate of 87%.(12) Guo, et al. treated 40 cases of chronic eczema by acupoint injection of Compound Dan Shen (Salvia) Injection. The bilateral acupoints Qu Chi (LI 11) and Qi Hai (RN 6) alternated in receiving a daily injection of 2ml of Compound Dan Shen Injection. One course of treatment lasted 10 days. The results: 12 cases recovered, 10 significantly improved, 16 improved, and the remaining 2 did not respond to the treatment, with a total effective rate of 95%.(13)

Footnotes	Back to Top
¹ Dou Xiu Kui, et al. 218 cases of anal eczema treated with Long Dan Xie Gan Tang. Shandong Journal of TCM. 2000;19(4):216. ² Lu Yi Pei, et al. Treating 29 cases of acute scrotal eczema with a modification of Long Dan Xie Gan Tang. Guangxi Journal of Traditional Chinese Medicine. 1998;21(1):37. ³ Huang He Ping, et al. Treating 27 cases of chronic scrotal eczema with Long Dan Xie Gan Tang and Hua Tuo Gao. Journal of Shizhen Medicine. 1999;11(1):48. ⁴ Zhou Yi Qun, et al. Treating 60 cases of dermatosis with Long Dan Xie Gan Tang (granular infusion). Journal of Jiangxi College of TCM. 1999;11(1):48. ⁵ Li Pei, et al. 132 cases of eczema treated with Pi Yang Ling He Ji. Journal of Chengdu University of TMC. 1999;22(2):20-21. ⁶ Wang Yu Ying. 45 cases of chronic eczema treated with Qu Feng Zhi Yang Tang. Heilongiang Journal of Traditional Chinese Medicine and Pharmacology. 2000;(2):27. ⁷ Wang Guo Jie, et al. 96 cases of infantile eczema treated with Shi Zhen Fang. Journal of Traditional Chinese Medicine and Herbs. 1999;27(1):41. ⁸ Qian Su Yu. Treating 86 cases of eczema by oral administration and external application of Chinese herbs. Journal of Applied TCM. 1999;15(9):16. ⁹ Shi Jian Min, et al. Treating 40 cases of acute anal eczema with Zhi Yang Xiao Zhen Tang. Journal of Folk Chinese Medical Treatment. 1999;7(11):15-16. ¹⁰ Liu Hong Yuan. Treating acute infantile eczema with external application of Chinese herbs. Journal of External Application in TCM. 1999;8(6):52. ¹¹ Dong Xin Ting, et al. 54 cases of eczema treated with San Huang Lotion. Journal of Changchun College of TCM. 1999;15(3):43. ¹² Wang Qin, et al. 54 cases of eczema treated with acupuncture, bloodletting, and cupping. Shanghai Journal of Acupuncture. 2000;19(3):16-17. ¹³ Guo Zhi Wei, et al. Treating 40 cases of chronic eczema by acupoint injection of Compound Dan Shen Injection. China Journal of Acupuncture. 2000;20(5):306.