Effect of Hochuekkito on dermatological symptoms in patients with atopic dermatitis - Evaluation by the eruption elements

We have previously reported the results of a double-blind, randomized, placebo-controlled study (DB study) in which Hochuekkito (astragalus, bupleurum and ginseng combination formula) or placebo was orally administered to atopic dermatitis patients with Kikyo (delicate constitution). After treatment for 24 weeks, the overall skin severity score was lower in the Hochuekkito group than in the placebo group, although the difference was not statistically significant, and the total equivalent amounts of topical agents (steroids and/or tacrolimus) were significantly lower in the Hochuekkito group than in the placebo group. Two approaches are being used in the treatment with oriental medicine, namely hyouchi (local and symptomatic treatment) and honchi (systemic essential treatment). Honchi is aimed toward improving the patient's overall constitution, which is responsible for local symptoms, and hyouchi is aimed toward ameliorating local symptoms. In the case of therapy directed at atopic dermatitis using Hochuekkito - in which a representative formula using honchi to improve Kikyo was used to clear applicable cutaneous symptoms - a reanalysis of the data in the DB study (Hochuekkito : n=37, placebo : n=40) was expected to serve as a useful reference in the selection of a Kampo formula. Hochuekkito significantly suppressed (p<0.01) each eruption element "( erythema · acute papule","oozing · crust","chronic papule · nodule · lichenification","eruption area"). In contrast, placebo did not significantly suppress"oozing · crust," but the significance level in"erythema · acute papule"was p<0.05. We found a negative correlation between the improvement rate for eruption score and the contribution of"oozing · crust"among three eruption elements before administration, and a positive correlation between the improvement rate for eruption score and the contribution of"chronic papule · nodule · lichenification"(p<0. 05). On the other hand, there were no correlations in the placebo-treated patients. We suggest that Hochuekkito is applicable for treatment of atopic dermatitis patients with a low rate of cutaneous"oozing · crust"and a high rate of"chronic papule · nodule · lichenification".