Clinical Study On The Treatment Of Chronic Eczema Of Hands And Feet With Jinqifeng Waixi No. 2 Formula

Chronic eczema is one of the common clinical diseases in dermatology and often occurs in the hands and feet.It is a disease with a complicated etiology,always has a long course and recurs often.lt affects the patients' daily lives and even psychology health.Western medicine recommend external use of glucocorticoids as the main treatment.But adverse reactions of glucocorticoids occurs often,and eczema recurs easily after stop using of glucocorticoids.Traditional Chinese medicine treatment is flexible and varies from person to person.Most of the external prescriptions are mainly based on theories of clearing heat,removing dampness and dispelling wind,promoting blood circulation and removing blood stasis.When combining acupuncture,fire needle and other traditional Chinese medicine therapies,the treatment always achieve a good result.Professor Jin Qifeng of the Dongzhimen Hospital was one of the first batch of famous traditional Chinese medicine doctors with unique academic experience and technical expertise in the country.No matter a normal or a severe skin diseases,his using of herbs had a significant effect.Professor Jin believes that the pathogenesis of local skin lesions in chronic eczema is different from the internal wind-dampness-heat of the whole body.The pathogenesis of local skin lesions are a long-term illness and deficiency of both qi and blood which cannot nourish the skin,resulting the production of pathological products such as blood stasis,phlegm and dampness.Besides,when the skin surface cannot be consolidated due to the qi deficiency and can not resist the external evil,so external wind and damp pathogens will attack the body.The combination of internal and external pathogens end up into chronic eczema.Accordingly,he put forward the empirical external washing formula No.2.The main ingredients are Common cnidium fruit,Xanthium fruit,Flavescent sophora root,Small gleditsia fruit,Pseudolarix amabilis and Zanthoxylum seed.Which can dry dampness and expel wind,promote qi and blood circulation,kill parasites and relieve itching.It has achieved good curative effects in clinical records,but it's still lack of clinical data to support its effectiveness.ObjectiveThe purpose of this study is to explore the clinical effectiveness of Jin Qifeng external washing formula No.2 decoction in the treatment of hands and feet chronic eczema and to explore its effect on the skin barrier of the lesions.MethodAccording to the diagnosis and acceptance criteria,a case series study were adopted to enroll a total of 27 patients with chronic hands and feet eczema.They were treated with Jinqifeng external washing formula No.2 decoction twice a day.After washing,vaseline was applied to the lesions twice a day.The whole process of treatment is 4 weeks.We record the Eczema Area and Severity Index(EASI)score,itching Visual Analogue Scale(VAS)score,of the very same skin lesion and patients'Dermatology Life Quality Index(DLQI)score,use the Italian SOFTPLUS skin tester to detect the moisture,elasticity,pH,melanin,and transdermal water loss(TEWL)value of the very same affected area before treatment,2 weeks of treatment,and 4 weeks of treatment and leave photos for comparison.After 4 weeks of treatment,the patients were followed up online to clarify the recurrence.Apply SPSS20.0 for statistical analysis to data collected before and after treatment.The main outcome indicator was the EASI score.Result(1)The EASI score of the subjects decreased after treatment,and the total effective rate was 81.4%.The recurrence rate was 7.4%.The itching VAS score and DLQI score decreased,and the difference was statistically significant(P<0.05).There was no statistically significant(P>0.05)in the decrease of EASI score and the itching VAS score between a 2 weeks last treatment and a 4 weeks last treatment.(2)There were statistically significant differences(P<0.05)in the water content and TEWL in the skin lesions of patients before and after treatmentBut the differences in melanin,elasticity,and pH were not statistically significant(P>0.05).(3)5 cases(12.5%)of the patients had adverse reactions that are likely to be related to the test herbs,which was considered as an acute attack of chronic eczema at the contact site.Conclusion(1)Jin Qifeng washing formula No.2 decoction is effective in treating chronic hand and foot eczema.The effect of 2 weeks of treatment is equivalent to that of 4 weeks of treatment.(2)Jin Qifeng washing formula No.2 decoction can relieve itching and reduce the impact of the disease on the life of the patient.It also can partially improve the skin barrier function of chronic eczema lesions of hands and feet;(3)Adverse reactions of Jin Qifeng washing formula No.2 decoction in the treatment of hand and foot chronic eczema occur from time to time,and it is worthy of further improvement and in-depth study.