A Study On The Characteristics Of Traditional Chinese Medicine Treatment For Atopic Rash Of Pregnancy

Atopic eruption of pregnancy(AEP)is a benign dermatosis of pregnancy,characterized by intensely itchy eczematous or papular lesions on patients' skin.Lesions mostly located around the face,neck and chest area.It usually occurs during the first and second trimester of pregnancy.It is the most common specific dermatosis of pregnancy(SDP).This paper discusses the definition of the Atopic eruption of pregnancy(AEP),the etiology and pathogenesis,thetherapeutic principles,the medical treatment and treatment characteristics of traditional Chinese medicine.The paper is divided into three parts.The first part is a literature review which includes:the definition and epidemiology of the AEP,the symptoms,clinical characteristic of AEP,comparison between all the specific dermatosis of pregnancy(SDP),the study of pathogenesis and therapy of traditional Chinese medicine and Western medicine,and the TCM syndrome differentiation and treatment.Eczema in pregnancy(EP)is the most commonly diagnosed specific dermatosis of pregnancy(SDP)before it is categorized as AEP.But the overlapping clinical and histopathological characteristics among patients with Eczema in pregnancy(EP),Prurigo of pregnancy(PP)and Pruritic folliculitis of pregnancy(PF)often means it is difficult to distinguish between the mentioned skin diseases.Thus leads to the misleading and confusing of terminologies for dermatologist until the reclassification and definition in 2006.Although the aetiology of AEP is still not fully understood,some scholars of the Western medical field suggested that there is a possible link to the pregnancy-specific switch towards a dominant Th2 immune response that may act as trigger of AEP.Basic skin care products will be applied on mild cases while glucocorticoid,corticosteroids or antihistamines will be used on severe AEP in the treatment of Western medicine.According to Traditional Chinese medicine,pregnancy brings physical change to women by offering nutritional supplement to fetus through the mothers' Yin and blood,thus the deficiency of Yin and blood leads to the imbalance of Yin and Yang causes the dermatoses of pregnancy.The traditional Chinese medicine is based on therapeutic principle of nourishing blood and dispelling wind.The prognosis of this disease is satisfactory,but it has the possibility of relapse.The second part is the literature research of case studies.References were collected from the CNKI,China Wanfang database,the PubMed,and the library of Beijing University of Chinese Medicine Library.42 documents and 76 decoctions were included in this research.The therapeutic principles,choice of herbs and dosage of herbs used were analysed basing on the results of the TCM inheritance auxiliary software.The results are as follow:(1)the therapeutic principles of AEP include:Wind-dispelling,Heat-clearing,Dampness-dispelling,Blood-nourishing,Spleen-strengthening and Liver-and-kidney-nourishing.(2)The specific herbal treatment for AEP in Chinese medicine usually and frequently include:dried Rehmannia Root,Radix Saposhnikoviae,Schizonepeta,Radix Paeoniae Alba,Licorice Roots,Angelica Sinensis,Belvedere Fruit,Cortex Dictamni,Radix Scutellariae,Periostracum Cicadae,Fructus Arctii,Flos Lonicerae,Fructus Forsythiae,Rhizoma Anemarrhenar,Herba Artmisiae Capillaris.The TCM effect,pharmacological action and medication safety of each herb is discussed.(3)the pairs of herb used frequently include:"Radix Saposhnikoviae and Schizonepeta","dried Rehmannia Root and Radix Saposhnikoviae"," dried Rehmannia Root and Radix Paeoniae Alba","Radix Paeoniae Alba and Radix Saposhnikoviae","Angelica Sinensis and Radix Saposhnikoviae","dried Rehmannia Root and Angelica Sinensis","dried Rehmannia Root and Schizonepeta","dried Rehmannia Root and Licorice Roots" etc.(4)the combination of herbs compose of 3 or more herbs which frequently used to treat AEP included:"dried Rehmannia Root-Angelica Sinensis-Radix Saposhnikoviae","dried Rehmannia Root-Saposhnikoviae-Radix Saposhnikoviae","dried Rehmannia Root-Radix Paeoniae Alba-Radix Saposhnikoviae","Angelica Sinensist-Radix Paeoniae Alba-Radix Saposhnikoviae","Radix Paeoniae Alba-Radix Saposhnikoviae-Schizonepeta".The third part is the comparison of the treatment between the Atopic eruption of pregnancy(AEP)and the Atopic dermatitis(AD).The comparison in TCM pathogenesis,principle of treatment,selection of herbs,medication safety between AEP and AD were analysed by comparing the data collected in this study with another research on TCM treating AD.The differences are as follow:therapeutic principle and selection of herbs of AEP is based on nourishing blood and dispelling wind,while the therapeutic principle and selection of herbs of AD is based on strengthening spleen and dispelling dampness.Moreover,the herbs used to treat AEP is more mild and safe than those of AD.Lastly,the conclusion summarized the findings of this research and addressed the limitation of this paper.