[Abstract] Objective: To explore the effect of self-prepared itching-relieving powder on chronic eczema. Methods: 80 patients with chronic eczema who received treatment in the hospital from February 2019 to November 2021 were selected as the study object. These patients were divided into control group and observation group according to the random number table method, 40 for each group. The patients in the control group were offered conventional medication regimen, including loratadine, cetirizine hydrochloride tablets and calamine lotion for external use, while the patients in the observation group were offered conventional medication regimen and self-prepared itching-relieving powder. The treatment effects of the two groups were observed. Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05); there was no significant difference in the skin lesion area score and skin itching score between the two groups before treatment (P>0.05), and there was a significant difference between the above indicators between the observation group and the control group after treatment (P<0.05). Conclusion: The self-prepared itching-relieving powder can be used to effectively relieve symptoms of chronic eczema with satisfactory effect, and is worthy of clinical promotion and application.
[Keywords] Self-prepared Itching-Relieving Powder; Chronic Eczema; Clinical Effect; Symptoms
Chronic eczema is a common skin disease, which occurs in the anus, hands, feet, vulva, shanks and other parts. It is diagnosed in men and women at all ages, characterized by recurrent attack. Endocrine disorders, allergic constitutions, neurological dysfunction, genetic factors may lead to chronic eczema. Patients would have difficulty in work and study if the disease is not treated in time [1]. At present, loratadine, cetirizine hydrochloride tablets and calamine lotion for external use are usually adopted to treat chronic eczema according to the Western medicine. However, it is found in clinical practice that it is difficult for most patients to achieve the expected effect after taking the medicine, and it is very easy to relapse after stopping taking the medicine. Traditional Chinese medicine has a long history of treating chronic eczema. It is believed that the disease belongs to the category of eczema. Most people suffer from the chronic eczema due to improper diet, alcohol addiction, or surfeit of spicy and greasy foods that causes damage to the spleen and stomach. Spleen dysfunction leads to retention of damp-heat in the interior, external contraction of pathogenic heat, resulting in skin disease. Eczema-related pathogenic factors give rise to damage to blood and yin and thus lead to dryness. The disease that wouldn’t go away for years becomes chronic as a result [2]. In view of this pathogenesis, the self-prepared itching-reliving powder is utilized to explore an effective scheme for the treatment of chronic eczema. The self-prepared itching-reliving powder is applied to clinical treatment to observe its effect.
1.Data and methods
1.1 General information
80 patients with chronic eczema who received treatment in the hospital from February 2019 to November 2021 were selected as the study object. These patients were divided into control group and observation group according to the random number table method, 40 for each group. Observation group: There were 27 males and 13 females patients in the observation group, at the age of 18-71, with an average age of 47.25 ± 4.28; the course of disease was 6 months to 3 years, with an average course of 1.25 ± 0.11 years. Control group: There were 25 males and 15 females patients in the observation group, at the age of 18-74, with an average age of 47.39 ± 4.11; the course of disease was 6 months to 4 years, with an average course of 1.29 ± 0.15 years. There was no significant difference in the baseline data between the two groups (P>0.05), proving these two groups were comparable.
1.2 Inclusion criteria and exclusion criteria
Inclusion criteria: meeting the diagnostic criteria for chronic eczema; course of disease: 6 months or longer; age ≥18 years; limited skin lesions, clear boundaries; non-facial lesions.
Exclusion criteria: alcoholics or drug addicts; patients with important organ dysfunction; patients with other serious skin diseases; patients taking immunosuppressive or hormonal drugs in the past 3 months; patients with malignant tumors.
1.3 Methods
The patients in the control group were offered conventional drug regimen, including Loratadine (SFDA approval No.: H200700030, Xian Janssen Pharmaceutical Ltd.) (10mg/time, once/day), cetirizine hydrochloride tablets (SFDA approval No.: H2000267, Sanhome Pharmaceutical Limited Company) (10mg/time, once/day) and calamine lotion for external use (SFDA approval No.: H310222790, Shanghai Yunjia Huangpu Pharmaceutical Co., Ltd.), and scrubbed with gauze twice per day.
The patients in the observation group were provided the self-prepared itching-relieving powder (including pearl powder, artificial bezoar and catechu) on the basis of the conventional drug regimen offered to the patients in the control group. The self-prepared itching-relieving powder was prepared into a paste with distilled water, which was applied to the affected area once a day.
The effects were observed after 2-week continuous treatment for the patients in both groups.
1.4 Observation indicators
(1) Efficacy evaluation criteria: After treatment, the eczema area and severity index (EASI) and itching degree score decreased by more than 90%; effective: EASI and itching degree score decreased by 60%-89%; ineffective: the above criteria were not met.
(2) The skin lesion area score and itching degree score were evaluated before and after treatment, respectively. The score was 0~3 points, from no to severe. 0 point for no itching, and 3 points for severe itching.
1.5 Statistical methods
The data were entered into SPSS23.0 software for statistical processing. The measurement data were tested by t-test, expressed with (
±s); the counting data were tested by x2, expressed with the rate (%). The difference was statistically significant (P＜0.05).
- Results
The total effective rate of the observation group was significantly higher than that of the control group (P<0.05), as shown in Table 1.
Table 1 Difference in clinical efficacy between the two groups [n (%)]
| Group | n | Significantly valid | Valid | Invalid | Total effective |
| Observation group | 40 | 30 (75.00) | 9 (22.50) | 1 (2.50) | 39 (97.50) |
| Control group | 40 | 21 (52.50) | 10 (25.00) | 9 (22.50) | 31 (77.50) |
| x2 | 7.314 | ||||
| P | 0.006 |
2.2 Difference in skin lesions
There was no significant difference in skin lesion area score and itching degree score between the two groups before treatment (P>0.05), and the above indicators in the observation group were significantly different from those of the control group after treatment (P<0.05), as shown in Table 2.
Table 2 Difference in skin lesions between the two groups before and after treatment (±s·score)
| Group | Skin lesion area score | Skin lesion & itching score | ||
| Before treatment | After treatment | Before treatment | After treatment | |
| Observation group (n=40) | 2.52±0.32 | 0.29±0.03* | 2.47±0.52 | 0.31±0.05* |
| Control group (n=40) | 2.51±0.33 | 1.15±0.17* | 2.41±0.46 | 1.08±0.11* |
| t | 0.137 | 31.508 | 0.546 | 40.303 |
| P | 0.890 | 0.000 | 0.586 | 0.000 |
Note: *P<0.05 compared with the indicators before treatment.
- Discussion
The clinical manifestation of chronic eczema is polygonal and symmetrical skin lesions, characterized by itching, tendency of exudation and recurrent attacks. Its pathogenesis is complex and may be related to allergic reactions of the body. The increase of eosinophils, excessive secretion of inflammatory mediators, and increase of mast cells in the body may induce eczema [3]. According to the characteristics of this disease, loratadine, cetirizine hydrochloride tablets and calamine lotion (for external use) are usually adopted to treat chronic eczema according to the Western medicine. Loratadine shows strong antagonistic action against the allergic reaction effect of eczema and itching, which can be used to effectively relieve itching symptoms. Cetirizine hydrochloride tablets are selective histamine H1 receptor blockers, which can inhibit histamine transmission and remove inflammatory mediators, thereby inhibiting the allergic reactions. Calamine lotion for external use, with the effect of converging and protecting the skin, can be adopted to relieve itching symptoms. However, in clinical practice, it is found that although the above western medicine can relieve symptoms to some extent, it is very easy to relapse after stopping taking the medicine. The therapeutic effect is therefore affected.
In traditional Chinese medicine, chronic eczema belongs to the category of “eczema” and “acute eczema”. The causes are related to natural endowment weakness and external stimulation from ailment said due to cold or exposure. Dampness, pathogenic factor, heat and wind infiltrate the skin, resulting in skin lesions and itching symptoms. Therefore, de-eczema and itching relieving are priorities [4]. According to the pathogenesis, for the ingredients of the itching-relieving powder prepared by our hospital, the artificial bezoar has the effects of clearing away heat and toxic materials, de-eczema and relieving itching, pearl powder can improve the skin state and promote healing, catechu has the effects of stopping bleeding, promoting muscle regeneration and healing, drying dampness. Modern pharmacological studies show that: catechu contains catechu extract, catechol, catechutanic acid and other components have significant bacteriostatic and immunomodulatory effects; pearl powder contains calcium carbonate, which has significant antiallergic effects and can also promote wound repair; artificial bezoar has significant antibacterial, itching reliving and anti-inflammatory effects [5]. The results of this study showed that the clinical effect and wound recovery of the patients in the observation group were better than those of the control group after treatment (P<0.05), indicating that adding the self-prepared itching-relieving powder to the conventional western medicine treatment regimen worked for chronic eczema. It could be attributed to the significant bacteriostatic effect of the artificial bezoar, pearl powder and catechu in the self-prepared itching-relieving powder. The self-prepared itching-relieving powder can also be used to regulate immune function, prevent recurrent attacks while repairing the eczema wound. In the Wenchuan earthquake in 2008, the self-prepared power was applied to PLA soldiers for the treatment of eczema scroti and was rewarded by the PLA epidemic prevention department.
In conclusion, the self-prepared itching-relieving powder can be used to effectively relieve symptoms of chronic eczema with satisfactory effect, and is worthy of clinical promotion and application.
References:
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[3] Lu Min, Chen Long. Clinical efficacy of de-eczema and itching-relieving ointment on eczema in children [J]. World Latest Medical Information (continuous electronic journal), 2020, 20 (15): 153, 209.
[4] Song Huili, Wang Yuxia, Li Jian, et al. Effect of Compound Kushen Zhiyang Ointment Combined with Mometasone Furoate Cream in Chronic Eczema [J]. CHINESE JOURNAL OF DERMATOVENEREOLOGY OF INTEGRATED TRADITIONAL AND WESTERN WESTERN MEDICINE, 2020, 19(2):133-136.
[5] Shan Hongqiang, Song Feini. Effect of de-eczema and itching-relieving lotion combined with cetirizine on eczema in children [J]. Chinese Journal of Rural Medicine and Pharmacy, 2021, 28(2): 14-15.
Xie Shuangshuang. China Medical News August II, published in September – October.