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Treating 3 Cases of Refractory Chronic Eczema with Chinese Herbs


Treating 3 Cases of Refractory Chronic Eczema with Chinese Herbs
He Kuanqi(何宽其)
Traditional Chinese Medicine Department of Xiamen University Medical College (Xiamen, Fujian, 361005)

Subject Words Chronic Eczema TCM Therapy Medical Cases

Chronic eczema is a commonly-encountered dermatological disease which usually harasses people and particularly more easily comes about in the warm and damp area. Chronic eczema is often very refractory and easy to relapse. A western medicine doctor treats chronic eczema mainly with antiallergic agents and glucocorticoid which can get remarkable short-term but bad long-term therapeutic effects. Chronic eczema usually relapses immediately after stopping use of western medicine. Traditional Chinese medicine (TCM) therapy is characteristic of persistent therapeutic effects, wonderful long-term therapeutic effects and less relapse in the treatment of chronic eczema although it needs a relatively longer treatment course. The author successfully treated 3 cases of refractory chronic eczema with Chinese herbs, which got very satisfactory therapeutic effects. The report is as follows.
Case one: Miss Chen, 24.
On Oct 15, 2005: the first medical consultation. Skin rashes and itching all over the body for 2 years, especially severe on the face and four limbs, yellow fluid flowing out after the rashes are scratched to break; bitter taste in the mouth, halitosis; constipation, usually defecation once several days; normal diet, sleep and urination; regular menstrual cycle, dark red menses, with blood clots; normal leucorrhea; red tongue tip, red and purple tongue body, with yellowish and greasy tongue fur; thin and smooth pulse. This patient had ever received treatment in Singapore National Institute for Dermatological Diseases, Fujian Province Institute for the Treatment and Prevention of Dermatological Diseases and several hospitals in Xiamen. The diagnoses were “chronic eczema”, “chronic urticaria” or “chronic folliculitis”. She had ever taken antiallergic agents and glucocorticoid which could only alleviate the disease temporarily. The disease relapsed immediately after stopping taking western medicine. The refractory disease greatly annoyed the patient. Syndrome differentiation: dampness, heat, blood stasis and toxin attacking the skin. Treatment methods: clearing away heat and removing dampness, promoting blood circulation and dispelling toxin, dispersing wind and stopping itching. Prescription: Huanglian(黄连)10g, Shuiniujiao(水牛角)30g, Shengdi(生地)15g, Chishao(赤芍)12g, Danpi(丹皮)12g, Tufulin(土茯苓)30g, Bixie(萆薢)20g, Chanyi(蝉衣)8g, Baixianpi(白藓皮)15g, Baijili(白蒺藜)30g, Kushen(苦参)12g, Shengyiren(生苡仁)30g, Lufengfang(露蜂房)10g, decocted with water, one dose a day. The acrid, spicy, fried, thick-tasted and stimulating food and seafood are prohibited. The diet is as light as possible, and the vegetable, melon and fruit are advisable.
On Nov 22, 2005: the second medical consultation. The skin rashes on the face and upper half body were greatly relieved, but those on the lower half body (especially on the crus) were still severe. Smooth defecation, once a day; bitter taste in the mouth and halitosis relieved; one episode of menstruation during the treatment, with many big blood clots discharged. Prescription: Huanglian(黄连)10g, Shuiniujiao(水牛角)30g, Shengdi(生地)15g, Chishao(赤芍)12g, Danpi(丹皮)12g, Tufulin(土茯苓)30g, Shengshanzha(生山楂)45g, Yimucao(益母草)30g, Baixianpi(白藓皮)15g, Baijili(白蒺藜)30g, Kushen(苦参)12g, Shengyiren(生苡仁)30g, Lufengfang(露蜂房)10g。Meanwhile taking Pifubing Xuedu Pill(皮肤病血毒丸) prepared by Peking Tongrentang(北京同仁堂)。
On Nov 24, 2005: the third medical consultation. Sporadic skin rashes on the upper half body, those on the lower half body markedly alleviated. No special other symptoms. Prescription: Huanglian(黄连)10g, Shuiniujiao(水牛角)30g, Shengdi(生地)15g, Chishao(赤芍)12g, Danpi(丹皮)12g, Tufulin(土茯苓)30g, Shengshanzha(生山楂)50g, Yimucao(益母草)30g, Baixianpi(白藓皮)15g, Baijili(白蒺藜)30g, Kushen(苦参)12g, Shengyiren(生苡仁)30g, Lufengfang(露蜂房)10g, Wugong(蜈蚣)1 item.
Maintaining the treatment with the prescription (mildly modified sometimes) for more than 3 months. All the skin rashes disappeared in the end and the refractory disease was cured successfully. It has not relapsed up to now according to the follow-up survey.
Comment: The syndrome pattern of the patient was identified as dampness, heat, blood stasis and toxin attacking the skin and the patient received the treatment of clearing away heat and removing dampness, promoting blood circulation and dispelling toxin, dispersing wind and stopping itching. In the prescription, Huanglian(黄连),Tufulin(土茯苓),Baixianpi(白藓皮),Kushen(苦参),Shengyiren(生苡仁) and Wugong(蜈蚣) were used for clearing away heat, removing dampness and toxin; Shuiniujiao(水牛角), Shengdi(生地), Chishao(赤芍), Danpi(丹皮),Shengshanzha(生山楂)and Yimucao(益母草) used for cooling blood and promoting blood circulation; Baijili(白蒺藜),Lufengfang(露蜂房)and Chanyi(蝉衣) used for dispersing wind and stopping itching. Large dosage of Shengshanzha(生山楂) and the insect drugs such as Wugong(蜈蚣)and Lufengfang(露蜂房) played an important role in the treatment. The experience of application of large dosage of Shengshanzha(生山楂)in the treatment of eczema, rubella and pruritus was derived from the folk proved recipes. The insect drugs such as Wugong(蜈蚣) and Lufengfang(露蜂房)are very effective in the treatment of refractory skin pruritus. Discharging of many big blood clots in the first menstruation after treatment commenced was a sign of healthful regulation of the human body by which blood stasis and toxin were dispelled out. Chronic eczema is usually lingering and refractory, often in need of longer treatment course. Therefore, the treatment should be maintained for a period after the therapeutic effects begin to unveil, and won’t cease until the pathogenic factors are lustrated. The successful treatment of this case was due to the correspondence of the prescription to the syndrome as well as the persistent treatment of more than 3 months the patient stuck to. In addition, the adjusting of diet was also very important during the treatment.
Case two: Mr. Zhu, 54.
On Oct 3, 2006: the first medical consultation. Skin rashes all over the body for 3 years; bitter taste and dry sensation in the mouth after getting up in the morning, thereafter light taste in the mouth without appetite; normal diet, sleep and stool, yellow urine; reddish eyes; dark red tong body with yellowish and greasy tongue fur; moderate pulse. Syndrome differentiation: dampness, heat, blood stasis and toxin attacking the skin. Treatment methods: clearing away heat and removing dampness, promoting blood circulation and dispelling toxin, dispersing wind and stopping itching. Prescription: Tufulin(土茯苓)100g, Kushen(苦参)20g, Baixianpi(白藓皮)15g,Difuzi(地肤子)12g,Shengshanzha(生山楂)50,Wugong(蜈蚣)1item,Cheqianzi(车前子)15g,Lufengfang(露蜂房)10g,Zexie(泽泻)20g,Huangbai(黄柏)10g,decocted with water, one dose a day. The acrid, spicy, fried, thick-tasted and stimulating food and seafood are prohibited. The diet is as light as possible, and the vegetable, melon and fruit are advisable.
On Oct 28, 2006: the second medical consultation. The patient discharged dark stool like charcoal after having taken 3 doses of decoction, thereafter the dark stool gradually lessened and disappeared when taking the 10th dose. During the course of taking the 7th -10th dose, the itching all over the body aggravated and the skin became reddish, thereafter most skin rashes disappeared and the itching was remarkably relieved. The present symptoms and signs: itching only in the ruga of skin all over the body and the other symptoms greatly alleviated. Prescription: Tufulin(土茯苓)100g, Kushen(苦参)12g, Baixianpi(白藓皮)15g,Difuzi(地肤子)12g,Shengshanzha(生山楂)50g,Wugong(蜈蚣)1item,Cheqianzi(车前子)15g,Lufengfang(露蜂房)10g,Zexie(泽泻)20g,Huangbai(黄柏)10g, Cangzhu(苍术)12g.
Maintaining the treatment with the prescription (mildly modified sometimes) for more than 2 months. All the skin rashes disappeared, no more itching. The disease has not relapsed up to now according to the follow-up survey.
Comment: The syndrome pattern of this case was identified as dampness, heat, blood stasis and toxin attacking the skin. Tufulin(土茯苓), Kushen(苦参), Baixianpi(白藓皮),Cheqianzi(车前子),Zexie(泽泻),Huangbai(黄柏)and Cangzhu(苍术)were used for clearing away heat, removing dampness and toxin; Difuzi(地肤子),Shengshanzha(生山楂)and Lufengfang(露蜂房)used for promoting blood circulation, dispersing wind and stopping itching. In this case, Tufulin(土茯苓) and Shengshanzha(生山楂) are mild-natured with the functions of strengthening the spleen, stimulating the appetite and promoting digestion, therefore very safe and effective despite the large dosage. During the treatment, the patient discharged dark stool like charcoal----a sign of removing blood stasis and toxin inside the body; the skin rashes and itching aggravated----a sign of dispelling the pathogenic factors outward. The symptoms and signs would gradually disappear so long as the treatment went on.
Case three: Miss Xie, 33.
On Dec 12, 2006: the first medical consultation. Skin rashes all over the body for 3 years, itching, more severe at night; sour sensation in the loin, weak knees; hot sensation on the palms and soles; normal diet, sleep, defecation, urination, menstruation and leukorrhea; red and purple tongue body, remarkably red on the tip of tongue, with thin, yellowish and greasy tongue fur; smooth and rapid pulse with weak Chi(尺) part. Syndrome differentiation: dampness-heat accumulating inside, wind-heat invading blood stage, kidney deficiency and blood stasis. Treatment methods: removing dampness and toxin, dispersing wind and stopping itching, cooling blood and promoting blood circulation, accompanied by nourishing kidney. Prescription: Shengdi(生地)50g, Baishao(白芍)20g, Danpi(丹皮)15g, Baijili(白蒺藜)30g, Wumei(乌梅)10g, Shengshanzha(生山楂)50g, Wugong(蜈蚣)2 items, Chanyi(蝉衣)8g, Tufulin(土茯苓)50g, Shudi(熟地)20g, decocted with water, one dose a day.
On Dec.23, 2006: the second medical consultation. All the symptoms and signs were relieved after taking the Chinese herbs. Only feeling difficult in dropping asleep, dreamy and easy to frighten and wake up. Prescription: Shengdi(生地)50g, Baishao(白芍)20g, Danpi(丹皮)15g, Baijili(白蒺藜)30g, Wumei(乌梅)10g, Shengshanzha(生山楂)50g, Wugong(蜈蚣)2 items, Chanyi(蝉衣)8g, Tufulin(土茯苓)50g, Shudi(熟地)20g, Zhenzhumu(珍珠母)50g (cooked in advance), Baiziren(柏子仁)30g, Chenpi(陈皮)10g.
Maintaining the treatment with the prescription (mildly modified sometimes) for 2 months. All the symptoms and signs disappeared. Advising the patient to take Chinese patent drugs to consolidate the therapeutic effects and keep light diet. It has not relapsed up to now according to the follow-up survey.
Comment: In the treatment of this case, Tufulin(土茯苓)and Wugong(蜈蚣)were used for removing dampness and toxin; Baijili(白蒺藜), Wumei(乌梅)and Chanyi(蝉衣)used for dispersing wind and stopping itching; Shengdi(生地), Baishao(白芍),Danpi(丹皮)and Shengshanzha(生山楂)used for cooling blood and promoting blood circulation; Shengdi(生地),Shudi(熟地),Baishao(白芍)and Danpi(丹皮)used for nourishing kidney Yin and clearing away deficient heat. On the second medical consultation, the patient complained of insomnia, so Zhenzhumu(珍珠母)and Baiziren(柏子仁)were added to tranquilize, nourish heart and soothe the nerves. The pathogenic factors of refractory chronic eczema are mainly dampness, heat, toxin, blood stasis and wind at which the TCM therapy must target. As formulating a prescription, the degrees of the five pathogenic factors should be evaluated respectively to put different emphasis upon different kinds of Chinese herbs.

A brief introduction to the author: He Kuanqi(何宽其), male, 34, born in Zigong, Sichuan on Oct. 9, 1972, got Ph.D of traditional Chinese medicine (TCM) from Nanjing University of TCM in 2004, an instructor at TCM Department of Xiamen University Medical College, so far published 7 theses, at present dedicated to the studies of tongue-inspection(舌诊) of TCM. Tel: 0592-2944273, 13860439122. E-mail: kqho@163.com. Address: 168#, Daxue Road, Xiamen, Fujian, Traditional Chinese Medicine Department of Xiamen University Medical College, 361005.
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