| BackgroundAtopic dermatitis (atopic dermatitis, AD) is a chronic, recurrent, inflammatory, hypersensitivity and atopic skin disease. In recent years, the increasing prevalence of AD increases, its pathogenesis is not clear, the current treatment of AD is difficult, yet there is no radical way. From modern medicine, internal medicine such as antihistamines with poor efficacy, other internal medicine such as immunosuppressive agents and external agents like glucocorticoids and calcineurin inhibitors have drug dependence, withdrawal rebound, with poor compliance, when long-term use, the body system might absorb impacting the growth and development of children, all of these side effects limit these drugs widespread adoption.In recent years, Chinese medicine treatment of AD with in-depth research, as a safe and effective treatment, more and more doctors and specialists at home and abroad concern it. Mentor Professor Chen Dacan in the treatment of atopic dermatitis in clinical practice long-term gradual to form a "the Hilling and clearing away heart-fire" theory, meet the AD pathogenesis about "less of the spleen, more of the heart ", Professor Chen Dacan summary traditional Chinese medicine prescription topical treatment of AD, the anti-inflammatory moisturizing washing formula, to the rule of wind-dispersing heat and dampness, spleen Benefitting Moisture Yin and Runzao, and clinical application in AD has a certain effect.At present, most Chinese medicine treatment of AD use dialectical internal therapy, the current literatures in the modern traditional Chinese medicine specifically for external use of AD is still small, so the design and development of rigorous research methods and effective treatment of AD, and safe topical medicine is of great significance. In this study, the effect and mechanism of anti-inflammatory moisturizing washing formula treating AD was disscussed, providing a external Chinese medicine with a economic, easy to use and safe treatment for the majority of AD patients, providing clinical basis for the further promote of anti-inflammatory moisturizing washing formula, providing a theoretical basis for further drug development of Chinese medicine.ObjectivesThe efficacy was evaluated from SCORAD score and quality of life about the further evaluation of anti-inflammatory moisturizing washing formula external treatment of AD;at the same time Antibacterial effects of different concentrations of anti-inflammatory moisturizing washing formula from the common cause of bacterias (Staphylococcus aureus, Candida albicans and Malassezia furfur) was observed. The mechanism of anti-inflammatory moisturizing washing formula external treatment of AD was preliminary studied, and laying a foundation for the further development of external traditional Chinese medicine treating AD.Methods5to 25 years old people with moderate to severe atopic dermatitis were enrolled and divided into 2 groups, Washing with anti-inflammatory moisturizing washing formula and internal Chinese Herbs Treatment about "formula of the Hilling and clearing away heart-fire " was the treatment group, and simply internal Chinese Herbs Treatment about "formula of the Hilling and clearing away heart-fire" the control group. The course of treatment was 12 weeks, before treatment and the time after treatment in the first 4 weeks,8 weeks,12 weeks of illness situation by SCORAD score were evaluated,before and after treatment the quality of life were evaluated; experimental study with different concentrations of a anti-inflammatory moisturizing washing formula.The preliminary study of anti-inflammatory moisturizing washing formula mechanism is by these formula with different concentrationsm (1:1,1:2, 1:4,1:8) inhibiting of Staphylococcus aureus, Candida albicans and Malassezia furfur, the inhibitory effect was observed after 24 hours, measure the MIC evaluation of drug susceptibility.ResultThis clinical study lasted from February 2009 to February 2011 with 52 cases finalized, during the treatment, SCORAD of the two groups of patients continued to decline. and 4 weeks after treatment, the score of group Washing with anti-inflammatory moisturizing washing formula combining with internal Chinese Herbs Treatment about "formula of the Hilling and clearing away heart-fire" was lower than group simple internal Chinese Herbs Treatment, the difference was statistically significant (P<0.05),8 weeks and 12 weeks after treatment, there was no significant difference between the two groups (P>0.05).12 weeks after treatment, comparing the quality of life, the group of external washing combining with internal Chinese Herbs Treatment was much better than the group of internal Chinese Herbs Treatment, the difference was statistically significant (P<0.05), and the clinical course of the study in two Groups had no adverse reactions occurred.Experimental studies have shown that when the Concentration of anti-inflammatory moisturizing washing formula 1:1 (1g/ml) has the strongest inhibitory effect of Staphylococcus aureus. When the concentration of anti-inflammatory moisturizing washing formula less than 1:4 (0.25g/ml/ml) the following has no inhibitory effect of Staphylococcus aureus. its various concentrations has no significant inhibition of Malassezia furfur and Candida albicans.ConclusionWashing with anti-inflammatory moisturizing washing formula combining with internal Chinese Herbs oral Treatment about "formula of the Hilling and clearing away heart-fire" is effective, the efficacy is better than a simple treatment with the lattertwhen in the treatment of acute AD, and may improve patients'quality of life. Security of anti-inflammatory moisturizing washing formula is good, without serious adverse events. According to susceptibility test results, suggesting that one of the major mechanism of anti-inflammatory moisturizing washing formula may be Antibacterial (mainly Staphylococcus aureus)and anti-inflammatory.
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