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Atopic dermatitis (AD) is a common chronic relapsing disease affecting about 15% of children under the age of 15 years. Atopy (Greek ατοπíα – placelessness) is an allergic hypersensitivity affecting parts of the body not in direct contact with the allergen. It may involve eczema, allergic conjunctivitis, allergic rhinitis and asthma. There appears to be a strong hereditary component. Most children with AD will develop symptoms of eczema before the age of 5 years although some may present later, and the majority will improve at puberty. As there is no definitive cure for the condition, there has been considerable interest in the use of traditional Chinese herbal medicine (TCHM) as a potential adjunct therapy for AD.

In Traditional Chinese Medicine, AD is called “wet sore” and belongs to the syndrome type of Dampness – Heat infusion. The therapeutic principles include removing dampness, strengthening the spleen and dispelling pathogenic wind and dampness. The herbs used in the TCHM have functions of clearing heat, removing dampness and strengthening the spleen.

The Department of Paediatrics and Institute of Chinese Medicine at The Chinese University of Hong Kong conducted a study between February 2004 and July 2005. It aimed to determine the efficacy and tolerability of the TCHM concoction in children with AD. A twice-daily concoction containing five herbal extracts has been found to be beneficial in the open study. The five herbs include Flos lonicerae (Jinyinhua), Herba menthae (Bohe), Cortex moutan (Danpi), Rhizoma atractylodis (Cangzhu) and Cortex phellodendri (Huangbai), and this formulation is based on a widely used ancestral Chinese concoction. We demonstrated that there was no corticosteroid (CS) or CS related compound in this formulation.

Eighty-five children with AD were recruited. Following a 2-week run-in period, children with longstanding moderate-to-severe AD were randomised to receive a 12-week treatment with twice daily dosing of three capsules of either TCHM or placebo. Adverse events, tolerability, haematological and biochemical parameters were monitored during the study.

The quality of life in TCHM treated patients were significantly improved compared with patients receiving placebo at end of the 3-month treatment and 4 weeks after stopping therapy. The total amount of topical corticosteroid used was also significantly reduced by one-third in the TCHM group. No serious adverse effects were observed between the groups.

The TCHM concoction is efficacious in improving quality of life and reducing topical corticosteroid usage in children with moderate-to-severe AD. The formulation was palatable and well tolerated but young children who are unable to swallow the capsule should contraindicate to the treatment with TCHM.

Further research is being planned to investigate its effects in younger children.