| BackgroundAtopic dermatitis (AD) is a chronically relapsing and pruritic inflammatory skin disease. Which has a serious effect on patients'physical,psychological and behavior health. The incidence of the disease is steadily increasing in recent years. While no confirmative mechanism of the disease was generally accepted.the western medicine for atopic dermatitis is just to ameliorate symptoms during the flare of the disease, but for the Serious illness, the Efficacy is not well. As an effective treatment, Chinese medicine can not only relieve symptoms but also improve quality of life. So, Chinese medicine has been used to the treatment of atopic dermatitis in clinical and experimental research, therefore Chinese herb for treatment of atopic dermatitis becomes the warm spot due to its unique superiority. Chinese medicine is currently abroad on more in-depth study, the researchers found that a single Chinese medicine or a limited number of extract composition of traditional Chinese medicine are effective, especially the anti-inflammatory and immune regulating role were confirmed. However, in our country, most researches in this field revolve around clinical observation of therapeutic effects by experiential prescription, the specific mechanism remains to be clarified, formula of hilling and clearing away heart-fire for atopic dermatitis has been proved to be effective.which is experience of Professor Chen Da—can for many years in clinical practice. In recent years about the pathogenesis of AD in the immunization studies have made great progress,at the same time, Researchers found that nutrient metabolic factors in the pathogenesis of AD also has an important role, Serum n-6 essential fatty acids levels before and after treatment of the formula were tested to further explore mechanism related to the treatment. As a psychosomatic disease, severe itching, sleep disorders, as well as the Relapse repeatedly have caused tremendous psychological pressure to AD patients, the abnormal behavior is an outward manifestation of Psychosomatic disorders, which also affects the quality of life of patients. therefore, Abnormal behavior gradually attracted people's attention. we investigate the changes of AD patient in Behavior problems before and after treatment and discuss the effect of the formula of hilling and clearing away heart-fire for atopic dermatitis on behavioral symptoms.Clinical ResearchObjectiveThe purpose of the research was to investigate the behavior problems Of the AD patient, to observe the effects of the formula of hilling and clearing away heart-fire Treatment of atopic dermatitis and its effect on behavioral symptoms.MethodsClinical Observation:patients of 6-11 years old who were diagnosed with atopic dermatitis were selected to this clinical trial. Scores of AD index were collected before treatment and after treatment for three months respectively.The impact on behavior:Behavioral problems were evaluated by the Conners Parent Symptom Questionnaire before and after treatment. Then, compared the index with the Chinese urban norm.The correlation test were calculated to evaluate the correlation between the hyperactivity index and the SCORAD index, between the hyperactivity index and the subjective symptoms index.Results1,36 patients suffered from atopic dermatitis were included to the clinical trial and treated with formula of the Hilling and clearing away heart-fire and adjuvant emollient. SCORAD index was used to evaluated clinical therapeutic outcomes. After treatment, The SCORAD index and Subjective symptoms declined significant (P＜0.01). So it is demonstrates that the method of hilling and clearing away heart-fire had confirmative effects on the atopic dermatitis. 2,before treatment, the impulsivity—hyperactivity index and hyperactivity index of the boys and girls were higher than the norm in China, the differences were statistically significant (P＜0.05).3,Correlation Analysis:there was a moderate positive correlation between hyperactivity index and subjective symptoms index. (boys:r=0.610, P＜0.05; girls:r=0.533, P＜0.05). there was no correlation between hyperactivity index and the SCORAD index.4,After treatment, the impulsivity—hyperactivity index and hyperactivity index of the boys and girls decreased compared with before respectively. The difference was statistically significant respectively (P＜0.05).Which shows the formula of hilling and clearing away heart-fire for the AD can improve hyperactive behavior. The impulsivity—hyperactivity index and the hyperactivity index was still higher than the Chinese norm respectively,The difference was statistically significant (P＜0.05).Conclusions1,The formula of hilling and clearing away heart-fire has confirmative therapeutic effect on AD patients.2,AD patients show hyperactivity behavior. The level of hyperactivity index in AD patients was moderate positive associated with subjective symptom index.3,The formula of hilling and clearing away heart-fire can improve hyperactive behavior of AD patients.Experimental studyObjectiveAD patients with elevated total IgE exist n-6 essential fatty acid metabolism abnormalities. Detect the level of n-6 fatty acid of patients with atopic dermatitis before and after treatment to discuss potential therapeutic mechanisms of formula of hilling and clearing away heart-fire.Methods1,patients who were diagnosed with atopic dermatitis with elevated total serum IgE were selected to this clinical trial. The serum of samples were collected from atopic dermatitis and 20 healthy people. The serum of linoleic acid (LA),γ-linoleic acid (GLA),two high-linoleic acid (DGLA), arachidonic acid(AA) in the patients and health controls were detected by ELISA.2,The Spearman rank correlation test were calculated to evaluate the correlation between n-6 EFA composition and the SCORAD index.Results1,Before treatment, there was no significant difference of LA level between AD patients and control group (P>0.05); serum level of GLA in AD group was lower than the control group, the difference was statistically significant(P <0.01), there was no significant difference of serum levels of DGLA,AA between AD patient and the control group respectively(P>0.05). The GLA/LA ratio was lower than the control group, the difference was statistically significant (P＜0.05), The AA/DGLA ratio not statistically significant between the AD groups and the control group(P>0.05).2,Correlation Analysis:there was a negative correlation between serum level of GLA and the score of SCORAD (r=-0.528, P＜0.05).The SCORAD index did not showed a correlation with serum levels of LA,DGLA and AA (all P>0.05).3,After treatment, the level of serum GLA increased than before, the difference was statistically significant (P<0.01). the GLA/LA ratio was higher than before treatment, the difference was statistically significant(P＜0.05).Conclusions1,It's demonstrated again in this study that AD patients with elevated total IgE exist n-6 EFAs metabolism abnormality. the lower GLA level is one of the pathogenesis of AD.2,The level of GLA in AD patients is moderate positive associated with the score of SCORAD index. And they also has association with severity of AD.3,The serum level of GLA obviously was elevated after treatment with the formula of hilling and clearing away heart-fire compare with before. The GLA/LA ratio increased, therefore, the formula of hilling and clearing away heart-fire can regulate△-6 desaturase, which may be possible mechanism of treat AD. |
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