| Aim:Investigate the historical evolution of Steroid Dependent Eczema,summarizing the literature and research up to present by Western medicine and Chinese medicine sources.Explore the unique characteristics,according to Chinese medicine pattern differentiation,of Steroid Dependent Eczema Blood Heat Syndrome,proposing an effective treatment strategy using Chinese herbs,with the aim to improve the quality of life for the patient as well as to provide valuable reference for future scholars.Method:Collect and organize prior theory and research done by classical and contemporary scholars in Chinese Medicine.Put forward the clinical presentation of patients with such a condition,while proposing a method of treatment for Steroid Dependent Eczema Blood Heat Syndrome.Employ this method of treatment in the treatment of patients,demonstrating this method with successful case studies,so as to conclude on an effective way to choose herbs and formulate prescriptions for treating Steroid Dependent Eczema using Zi Cao Di Huang Tang as the base formula.Result:Prior research has shown that Dependent Eczema is the rebound phenomenon which happens after cessation of steroid use.Upon cessation,the patient presents with acute dermatitis,and even after the acute flare,remains in a sustained state of dermatitis.This condition is extensive in its presentation,with the patient presenting diffferently at different stages of the disease process;this confounds effective diagnosis and treatment.The cases covered in this paper involve patients who mostly present with whole body dermatitis,and not only on the face,as described in most of the prior research.Dependent Eczema is a condition caused by steroid use,and since Western medicine mostly uses steroids in the treatment of dermatitis,not much recourse has been found with Western medicine.This paper employs the use of pattern differentiation to demonstrate the advantages of using Chinese herbal medicine to treat Dependent Eczema.It is effected through the use of herbs to reduce dermatological inflammation,and does not only treat the inflammatory condition at hand,but also reduce the possibility of further flare cycles from happening,so that recovery from the condition can be achieved.Dependent Eczema Blood Heat Syndrome is treated using Zi Cao Di Huang Tang(Zi Cao,Sheng Di,Dan Pi,Chi Shao)principled on the principle of Cooling Blood.This base formula is further modified with herbs depending on signs and symptoms,to take the unique aspects of this condition into account.The writer's theoretical and clinical research affirms satisfactory clinical results using this approach.Conclusion:Terminating use of steroids after extended or excessive use is the cause of steroid dependent eczema,and this is due to topical steroids causing pathogenic qi to be congested at the level of the skin,entering the blood vessels,transforming into heat-toxins over time,laying dormant at the blood level.Even though steroids are able to help with the cessation of symptoms,discontinuing the use of steroids causing heat-toxin to be dispersed at locally,in the surrounding areas and even to the whole body.Blood Heat Syndrome presents with:erythema(bright or dark)dispersing to the surrounding areas or even to the entire body,sensation of heat beneath the skin,heat effusion and significant cold aversion,intense itch,inability of sleep at night,tongue often peeled or without coat,tongue color tending to purple,pulse bounding or slippery,rapid and sunken.Out of 51 cases of Steroid Dependent Eczema treated,40 cases were of the Blood Heat Syndrome variant,and were effectively treated using Zi Cao Di Huang Tang as the base formulation,with further additions made according to symptomology.This paper shows how useful Chinese herbal medicine can be in the treatment of recalcitrant dermatological diseases,and that this area of work is amenable to esearch in further detail. |
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