Atopic dermatitis and chinese medicine

Atopic dermatitis (AD) is said to be the most common skin disease among children, which impacts severely on daily life. The etiology has yet to be fully elucidated and current western medicine managements are targeted at symptomatic relief, some of which have unfavorable side effects. According to the traditional Chinese medicine (TCM), AD is said to be related to a congenitally weak constitution, leading to the attack or generation of pathogenic factors. Chinese herbal medicine (CHM) is usually individualized for each and every patient; however, in hope of increasing the scientific evidence of its efficacy and safety in the treatment of AD, several clinical trials have been conducted using non-individualized CHM. This chapter reviews the findings of clinical and laboratory studies of 4 CHM formulae: Zemaphyte, Pentaherbs Capsule, Hochu-ekki-to, and Xiao Feng San. In clinical studies, Zemaphyte had conflicting results, Pentaherb Capsule and Hochu-ekki-to showed no significant difference in disease severity but found improvement in secondary outcomes, and Xiao Feng San had positive results. All in-vitro studies found potential pharmacological effects that may be beneficial in the management of AD. However, aside from evidence still being deemed insufficient, there were one or more flaws in the clinical study designs, leading to concerns of the credibility of the results. The main concerns identified with studies included the general quality of studies, the suitability of the using a scientific, randomized, control methodology for TCM studies, the lack of pharmacological data of CHM, and the lack of assurance regarding the safety of the intervention. Currently, the treatment of AD with TCM is still highly based on historical and empirical evidence; and as the complete pathophysiology of AD remains unknown, it may be difficult to determine which biochemical and pharmacological properties are required in the CHM to allow it to be deemed a potential pharmacotherapy.