| Background and purpose:Atopic dermatitis(atopic dermatitis,AD) manifested in severe itching, local skin maculopapules,exudate or xerosis cutis,is one of the relatively common recurrent allergic skin diseases in pediatric and dermatology.The current treatment for AD is mainly focus on the local drug therapy,with glucocorticoid act as a routine medicine. Although the short-term curative effect of glucocorticoid is obvious,but the long time usage will cause a lot of side-effects,patients may be easy to relapse after the treatment.Nowadays the traditional Chinese Medicine(TCM) has achieved great progress in the etiology and pathogenesis of AD,more and more doctors and patients tend to accept and apply the TCM external preparation,which can obtain expected effect with less side-effects.Zhiyang Cream,a pure chinese medicine oinement,used to be known as Zhiyang lotin, has showed remarkable curative effect after the clinical practice for many years.Relative clinical and experimental researches are carried out in order to further probe the effect machanism of Zhiyang cream in treating AD.Method:Clinical research:35 cases of atopic dermatitis children were randomly divided into two groups:the treatment group(Zhiyang cream,15cases) and the control group(Qingpeng,cream,20cases),syndromes change were observed and clinical score sheets were filled out after two weeks’treatment.Pharmacodynamic research:(1)60 guinea pigs were randomly divided into six groups:control group,model group,Qingpeng cream group,Zhiyang cream groups (3 doses).Guinea pigs allergic contact eczema models were built,then the ear thickness,the skin lesions conditions,the inflammatory cell infiltration,pathological changes of skin tissue structure and the visceral index were observed and calculated.(2)30 guinea pigs were randomly divided into six groups as (1).Guinea pigs allergic models were built to find out if there allergic reactions occur.(3)60 mice were randomly divided into six groups as (1)mice itching models were built with ovalbumin(OVA),then the record of the scratching frequency were taken before and after medication. Result:The results of clinical research:①Total effective rate of the treatment group was 93.3%,and the control group was 85%.Compared with each other,there was no significant statistically meaning(P>0.05).②After treatment,main symptoms,second symptoms,TCM syndromes and the disease symptoms scores of both groups were significant lower than before(P< 0.05)③After treatment,comparing the itching symptom scores and skin lesion scores with the control group,there was significant statistical meaning(P<0.05).④No adverse reactions occurred during the clinical research.The results of pharmacodynamic research:①Skin lesion scores:compared with the model group(10.60±1.27fen),Zhiyang cream high、middle、low dose groups(6.20±0.92fen、6.90±1.19fen、7.90±1.19fen) and the Qingpeng cream group(6.90±0.99fen) reduced significantly(P<0.01),Zhiyang cream could repair skin lesions,which was positive correlated with dosage.Comparing all Zhiyang cream groups with the Qingpeng cream group,there was no significant statistical meaning(P>0.05).Efficacy index of Zhiyang cream high、middle、low dose groups(0.53、0.50、0.43) and the Qingpeng cream group(0.45) were all above 40%,the high dose group had the most notable effect.②Ear thickness:compared with the model group(0.42±0.19mm), Zhiyang cream high、middle、low dose groups(0.15±0.08mm、0.16±0.13mm、0.20±0.07mm) and the Qingpeng cream group(0.27±0.09mm) reduced significantly(P<0.01),Zhiyang cream could inhibit swelling,which was positive correlated with dosage,and the high dose group did better in inhibiting swelling than Qingpeng cream group(P<0.05).③Inflammatory cell infiltration:compared with the model group(41.00±3.16HPF),Zhiyang cream high、middle、low dose groups(25.40±3.75HPF、27.90±3.54HPF、28.40±4.83HPF) and the Qingpeng cream group(27.30±4.32HPF) reduced significantly(P< 0.01),Zhiyang cream could inhibit inflammation,which was positive correlated with dosage.Comparing all Zhiyang cream groups with the Qingpeng cream group,there was no significant statistical meaning(P> 0.05).④Scratching frequency:compared with the model group(224.7∥11.56ci),Zhiyang cream high、middle、low dose groups(80.3±3.09ci、98.1±3.03ci、119.5±3.34ci) and the Qingpeng cream group(88.2±4.13ci) reduced significantly(P<0.01),Zhiyang cream could inhibit itching,which was positive correlated with dosage,and the high dose group was better than the Qingpeng cream group(P<0.01).⑤Thymus index:comparing the model group (0.18+0.06mg-g-1) with the blank control group (0.10±0.07mg-g-1),there was significant statistical meaning(P<0.05).Comparing Zhiyang cream high、middle、low dose groups(0.14±0.06mg-g-1、0.13±0.05mg-g-1、0.15± 0.09mg·g-1),Qingpeng cream group(0.18±0.12mg·g-1) with the model group,there was no significant statistical meaning(P>0.05).Spleen index:comparing the model group (1.42±0.34mg·g-1),Zhiyang cream high, middle、low dose groups(1.01± 0.25mg·g-1、1.34±0.32mg-g-1、1.04±0.17mg-g-1),Qingpeng cream group(1.55± 0.27mg-g-1) with the blank control group (1.59±0.47mg-g-1),there was no significant statistical meaning(P> 0.05).Compared with the model group,spleen index of all treatment groups decreased(P<0.01).Comparing all Zhiyang cream groups with the Qingpeng cream group,there was significant statistical meaning(P< 0.01).⑥Both Zhiyang cream and Qingpeng cream won’t result in allergic reactions on experimental animals.Conclusions:Zhiyang cream has a therapeutic effect on children with atopic dermatitis,in the meanwhile it will not lead to adverse reactions, its mechanism may be related to anti-itching,anti-inflammatory and repairing skin lesions and so on... |
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