Clinical Observation And Experimental Study Of Treatment Of Traditional Chinese Medicine On Tinea Pedis

BACKGROUND:The dermatophytes are a group of taxonomically related fungi whose ability to form molecular attachments to keratin and use it as a source of nutrients allows them to colonize keratinized tissues, including the stratum corneum of the epidermis, hair, nails, and the horny tissues of animals. Superficial infection caused by a dermatophyte is termed dermatophytosis. In 1934, Emmons' critical review of dermatophyte taxonomy resulted in the three genera known today: Epidermophyton, Microsporum, and Trichophyton.. In the current time, the success of laboratory confirmation of clinically diagnosed superficial fungal infection relies on the proper collection of specimens for microscopic examination and culture.But this article just put much more importance on Tinea Pedis, to evaluate the effect of Traditional Chinese Medicine on Tinea Pedis is the main destination. From many conmmon investigations,we know that Trichophyton rubrum, Trichophyton mentagrophyte, Epidermophyton floccosum, Candida albicans, are the main organisms causing Tinea Pedis. Present worldwide, tinea pedis and tinea manuum are the most common dermatophytoses. Tinea pedis has risen from obscurity prior to the twentieth century to a prevalence of approximately 10 percent today primarily as a result of modern occlusive footwear, although increased worldwide travel has also been implicated. The incidence of tinea pedisis higher among those using communal baths, showers, or pools. Whether this is caused by increased maceration or increased transmission remains unclear. Tinea manuum may be acquired by direct contact with an infected person or animal, the soil, or autoinoculation from a distant site. However, it is nearly always associated with tinea pedis and has been shown to occur most commonly following tinea pedis in the hand used to excoriate the feet. Manual labor and preexisting inflammatory conditions of the hand are additional risk factors. Both tinea pedis and tinea manuum are exacerbated by hyperhidrosis, tropical climates, and any anatomic abnormality leading to closed web spaces.Minimizing chronic moisture is important in preventing tinea pedis. This may be achieved through talcum powder, absorbent socks, nonocclusive shoes, and, occasionally, 20% to 25% aluminum chloride hexahydrate powder. Antifungal powders such as undecylenic acid and tolnaftate are also beneficial. Mild interdigital tinea pedis without bacterial involvement can be treated topically with an allylamine, azole, ciclopirox, tolnaftate, or undecenoic acid. Topical terbinafine for 1 week is effective, while the other topicals generally require 4 to 6 weeks of appl ication. The newer oral antifungals have replaced gri.scofulvin as the treatments of choice for severe or refractory tinea pedis. The dosing schedule of terbinafine is 250 mg daily for 2 weeks. Effective regimens of itraconazole for adults are 200 mg twice daily for 1 week, 200 mg daily for 3 weeks, or 100 mg daily for 4 weeks, while children should ree'eive 5 mg/kg per day for 2 weeks. Fluconazole 150 mg weekly for 3 to 4 weeks or 50 mg daily for 30 days is also effective.Finally, because vesiculobullous tinea pedis is the result of a T cell - mediated immune reaction, symptomatic relief with topical or systemic corticosteroids may be warranted during the beginning of antifungal treatment.OBJECTIVE:There many therapies we can appeal to deal with tinea pedis. But high recurrence of tinea pedis results in the economical loss and unfavorable influence on quality of life. With the development of research in TCM, many results have been attained in treatment of tinea pedis. To selectgood methods and achieve a better efficacy we plan to apply the Kang Zhen Jun Ke Li Ji combined with Xiang Lian Wai Xi Ye to treat tinea pedis , and experiments in suoressing test were conducted , so that we can reveal the mechanism and provide the evidence for the application of it.METHODS;In the clinical syudy, the 60 enrolled subjects were randomly assigned to therapeutic group (Kang Zhen Jun Ke Li Ji combined with Xiang Lian Wai Xi Ye) and contrast group (only Xiang Lian Wai Xi Ye) . After 2 weeks' treatment, and 2 weeks' further investigaion, to compare the recovery time , recurrence, and the change of symptom grades. To study the mechanism, experiments in suoressing test were conducted.RESULT:we see the difference, the results showed it is equivalent for two therapies to shorten the recovery time and reduce recurrence. But Symptom Grade decreased more significantly in therapeutic group than contrast group. It suggests that therapeutic group is more effective in treating tinea pcdis than contrast group. To probe the mechanism that TCM can cope with tinea pedis, experiments in suoressing test were conducted. The results also indicate that the Kang Zhen Jun Ke Li Ji has direct effect to suppress the growth of four organisms mentioned above . Of course, Many think TCM can enhance the innate and adaptive immune response,so that the disease maybe lessened indirectly.CONCLUSION:Therefore we can draw a conclusion that therapeutic group takes better advantage in treating tinea pedis , alleviate the symptom and shorten the recovery time, symptom grade decreased more significantly in therapeutic group than contrast group.