A new randomized, double-blind, placebo-controlled trial has found
that a traditional Chinese herbal formula may improve the quality of
life and reduce the use of topical corticosteroid (CS) medications
(e.g., ointments containing cortisone) in children and young adults
with moderate to severe atopic dermatitis (AD).1 The study was published in the August issue of the British Journal of Dermatology.
AD, also known as eczema, is a chronic skin disorder characterized
by scaly or itchy rashes. It has no definitive cure and affects about
15% of children under the age of 15.
This 16-week trial (12 weeks for treatment with 4 weeks of
follow-up), conducted by researchers at Chinese University of Hong
Kong, included 85 patients with moderate to severe AD, ranging in age
from 5 to 21. Forty-two patients were given the herbal treatment
capsules. Each capsule contained extracts of herbs based on a
widely-used ancestral Chinese combination (Ermiao San), containing what appears to be the equivalent of 2 g of flowers of honeysuckle (Lonicera spp.) [jinyinhua in Chinese], 1 g mint (Mentha canadensis) [bohe] herb, 2 g root bark of tree peony (Paeonia suffruticosa) [mudanpi], 2 g atractylodes (Atractylodes lancea) [cangzhu] root, and 2 g phellodendron (Phellodendron spp.) [huangbai] stem bark.
Forty-three patients were given matching placebos (capsules
containing capsule shell, corn starch, and caramel). Patients were
advised to take 3 capsules 2 times daily for 12 weeks. They were asked
to keep a journal of the frequency of use of other routine medications,
which included emollients, bath oils, soap substitutes, topical CS, and
oral systemic antihistamine.
By the end of the trial, there was no significant difference in the
SCORing of Atopic Dermatitis (SCORAD) scores between the treatment and
placebo groups. Thus, the trial failed to show any significant benefit
for the herbal formulation in the primary endpoints measured (SCORAD).
However, there was more than 30% improvement in Children’s Dermatology
Life Quality Index (CDLQI) scores in patients taking the herbal
treatment, compared with baseline scores and with the placebo group.
The duration of primary CS use in the treatment group was also
significantly reduced by an average of 4 days per month, while CS use
was reduced by only 1 day in the placebo group. During the 4 weeks of
follow-up study after the treatment period, 2 patients from the
treatment group and 3 from the placebo group began using more potent
topical CS and 7 patients from the treatment group and 5 from the
placebo group began using a more potent antihistamine. Of the 85 trial
participants 71 had been diagnosed with co-existing allergic rhinitis.
Only the symptom of sneezing improved significantly in patients from
the treatment group.
The authors conclude that the herbal formulation could probably be
used as an adjunct treatment for children with refractory AD,
particularly since the treatment was well-tolerated, improved elements
of daily living, and led to a reduction of CS use. The trial was funded
by the Health and Health Services Research Fund of the Health, Welfare
and Food Bureau, Government of the Hong Kong Special Administrative
Region, in the People’s Republic of China.
-Courtney Cavaliere
Reference
1Hon KLE, Leung TF, Ng PC, et al. Efficacy and
tolerability of a Chinese herbal medicine concoction for treatment of
atopic dermatitis: a randomized, double-blind, placebo-controlled
study. Br J Dermatol. 2007;157:357-363. |