Research Progress of Cymbaria mongolica Maxim. in the Treatment of Chronic Eczema

Gerile, Jinbao, Wuyuntana, Wulangerile, Sarentuya

Xilin Gol League Mongolian Medical Hospital, Xilin Hot 026000, China

Abstract Chronic eczema is a kind of skin disease which is difficult to treat. It is easy to occur repeatedly, and itching is intolerable during the attack, which seriously affects the daily life of patients. Through the review of the treatment of chronic eczema with Mongolian medicine Cymbaria mongolica Maxim., it has the advantages of improving the cure rate and the quality of life, and reducing the recurrence rate, and so on, which provides a scientific basis for the promotion and further research of traditional Mongolian medicine Cymbaria mongolica Maxim.

Key words Cymbaria mongolica Maxim., Treatment, Chronic eczema, Progress

1 Introduction

Chronic eczema is mostly developed from acute and subacute eczema, and it can also be chronic at the beginning due to continuous stimulation, and skin lesions are mostly localized[1]; most of chronic eczema occurs in the head, ears, breasts, umbilicus fossa, forearms, elbow fossa, thighs, calves, buns, vulva, anus and other places, it often occurs symmetrically with clear boundary, the skin of the affected part is mainly characterized by infiltrative hypertrophy and lichenification, and often accompanied by paroxysmal severe pruritus[2], scratches, blood scabs, and clinical symptoms such as chromatosis or hypopigmentation in the later stage, the disease is mild and severe, difficult to cure and repeated attack, and the disease process is prolonged, which seriously affects the physical and mental health of the patients[3]. It belongs to a kind of type IV allergic disease.

2 Understanding of chronic eczema in Mongolian medicine

In Mongolian medicine, chronic eczema is called "Nu Yi Teng—Gu Bu Du Ru" and "Na Mu Su" disease, which belongs to the category of "Xieri Wusu disease (yellow water disease)". The three elements of human body(Heyi, Xila, Badagan) are disorder, imbalance, and yellow water is too high[4], which prevents normal differentiation of essence and dregs in the body, and caused by the disorder of the essence of bile Xila Wusu, the decrease of liver detoxification function, the accumulation of blood stasis, the blockage of blood vessels, the attack of parasites on the skin, the reproduction of parasites in the skin, the insufficiency of vital energy, the deficiency of blood and the dryness of wind, the loss of skin nourishment[5], the exogenous toxicity, "sticky poison yellow water"[6], the exhaustion of defensive qi, the disorder of blood gas, and the loss of skin nourishment[7]; the skin of the affected area of the patients is dry, rough and thickened, which is often found in the head, ears, breasts, umbilicus fossa, thighs, vulva, anus and forearm, with symptoms in different parts. In fingers, toes, heels and joints,etc., due to the loss of normal elasticity of the skin, coupled with hyperactivity, it is easy to have chapped pain. The treatment should be based on the principles of regulating the complication of the three roots, drying yellow water, and killing the slime when it is combined with the pathogenic slime, at the same time, the methods of detoxification and aid digestion should be adopted. Avoid washing and scratching with hot water, alkaline water or soapy water, avoid contacting with suspected pathogenic sources and eating suspected food, avoid inducing factors, and prevent the recurrence of "Na Mu Su disease" of the skin stimulated by various environmental factors[4].

3 The trend of modern medicine in the treatment of chronic eczema

At present, chronic eczema mostly follows the principle of individualization for symptomatic treatment, mainly including oral antibiotics, antihistamines, topical glucocorticoids and other drugs[8-9], but clinical research has confirmed that most patients are prone to relapse after treatment, so the long-term effect is not ideal[10]. Drug resistance and drug side effects will follow, such as local skin burn, secondary infection of skin[11], skin atrophy, pigmentation, telangiectasia and other aggravating or induced infections[12]. Long-term use of hormone is prone to causing side effects, the internal treatment cycle of Chinese and Mongolian medicine is long, the taste of Mongolian medicine decoction is poor, and the compliance of patients is poor, these are still a very serious problem, which brings great trouble to patients and their families. From the analysis of clinical data in the early stage of this study, it is found that oral Mongolian medicine combined with external use ofCymbariamongolicaMaxim. has better curative effect and high efficiency, especially the low recurrence rate. The vast majority of patients prefer to choose safe and effective external preparation for the treatment of chronic eczema.

4 Research progress of Mongolian medicine in the treatment of chronic eczema

Mongolian medicine has a long history in the treatment of chronic eczema, Mongolian medicineC.mongolicaMaxim. has been used to treat skin diseases since ancient times. Mongolian medical experts have gained satisfactory results in treating chronic eczema with the principles of strengthening vital qi to eliminate pathogenic factors, regulating "three roots and seven elements", removing dampness, drying yellow water, destroying parasites, clearing away heat and toxic materials, dispelling wind and arresting itching, and accumulated many valuable clinical experience, which has formed a regional advantage. In the treatment of "Na Mu Su disease" by Mongolian medicine, the principles of expelling Xi La Wu Su, clearing away heat and toxic materials, tonifying spleen, nourishing liver and kidney, and expelling viscosity were adopted[13]. The Mongolian medicine of drying dampness and destroying parasites, clearing away heat and toxic materials, dispersing trace for entelechy, and dispelling wind and arresting itching was used[7]. The method of internal administration of Mongolian medicine and local external application is used to strengthen vital qi to eliminate pathogenic factors, regulate "three roots and seven elements", remove dampness, dry yellow water and destroy parasites, and achieve the effect of astringent dehumidification. According to the theory of Mongolian medicine verified by clinical practice, it is very important to selectively use external medicine in the treatment of eczema. Using Mongolian medicineC.mongolicaMaxim. to treat chronic eczema not only has definite curative effect, safety, low cost, short course of treatment, low recurrence rate, but also has little side effect, it can effectively regulate the "three roots and seven elements" and physiological function of human, and improve the resistance to the "four factors" that cause eczema[14]. The treatment of chronic eczema by Mongolian medicine can recuperate "three roots", improve the blood circulation, clear away heat and remove dampness, effectively enhance the immunity of patients, and treat the root and tip simultaneously. Some scholars have found that Mongolian medicine is not only effective in the treatment of this disease, but also satisfactory[15].

5 Cymbaria mongolica Maxim.

C.mongolicaMaxim. , also known as "Han Qin Se Ri Gao" and "A La Tan―A Ji", is a natural plant of the family Scrophulariaceae of Angiospermae, and one of the traditional Mongolian medicines with a long history of application, it can be divided into the dried whole grass ofOmbariadahuricaLinn. (commonly known as Dahuang flower, Baihao Cha) orC.mongolicaMaxim. (commonly known as Guangyao Dahuang flower).C. used in this study isO.dahuricaLinn., which is mainly produced in each city of Inner Mongolia, Northeast China, Hebei and other places, its roots, stems, leaves, and flowers are used as medicine, it tastes slightly bitter, astringent, cool and odorless, it is often used alone or together with other herbs, it can be taken orally or used externally, it is mainly used for external use, it has a high medicinal value, and has the functions of drying Xie Ri Wu Su, removing wind and dampness, generating muscle decay, clearing heat, relieving pain, hemostasis, relieving itching, diuresis, detumescence, lowering blood sugar, anti-inflammation, anti-oxidation, anti-tumor, antisepsis, improving hypotension, and promoting wound healing,etc.[16-18]. Clinically, it is mainly used for the treatment of rheumatic arthritis, erysipelas, nephritis edema, eczema, yellow water sore, cowhide addiction and other diseases. One kind of organic acid, 4 kinds of flavonoids and 11 kinds of iridoids have been isolated fromCymbaria[19-20]. Dinda Betal.[21]found that the bioactive chemical components in Mongolian medicineO.dahuricaLinn. are flavonoids, iridoids, sterols, cinnamic acid derivatives, saccharides, organic acids and other nutritional components. Hu Yinghuietal.[22]studied the chemical constituents of the root ofO.dahuricaLinn. Wang Hongyuetal. studied the chemical constituents of the stem ofO.dahuricaLinn., isolated and identified more than 50 compounds (including vitamin E, benzothiazole, limonene, β-ionone, farnesol, dihydroactinidiolide, phytone and other effective ingredients), which showed that it has great application value and is worth further study. Previous studies have shown thatC.mongolicaMaxim. has low toxicity and side effects., is safe and reliable for long-term clinical use, and has obvious efficacy in the treatment of chronic eczema. The medicine has been used to treat skin diseases since ancient times, and has been used in empirical medicine since then, the efficacy is definite. Chao Ketuetal.[23]mentioned that the medicine was used to treat eczema, yellow water sore and other diseases in Mongolian medicine prescription, but up to now, there are few clinical observation and research on the treatment of eczema by Mongolian medicineC.mongolicaMaxim. in the Dermatology Department ofC.mongolicaMaxim. Therefore, observing the clinical efficacy and side effects ofCymbariaon chronic eczema provides a scientific basis for the promotion and application and the next research of traditional Mongolian medicineC.mongolicaMaxim., which will open up a new path for the clinical treatment of patients with chronic eczema.

6 Conclusions

Mongolian medicine, especially for external use, is less known and understood by people, many traditional Mongolian medicine with good effect is used less, the most fundamental reason is that there are few researches on Mongolian medicine nowadays, and the scientific basis for the magical effect of Mongolian medicine has not been clearly stated. In this study, based on the early clinical observation, it found that Mongolian medicineC.mongolicaMaxim. has a special effect in the treatment of chronic eczema, it not only recovers the infiltrative hypertrophy and bryophyte skin lesions to normal skin, but also reduces the pruritus significantly, which is enough to show that the clinical symptoms of the patients improved, and the recurrence rate was significantly reduced after long-term follow-up. Through the observation on 200 cases of patients with chronic eczema before and after the external application of Mongolian medicineC.mongolicaMaxim., the clinical effect of Mongolian medicineC.mongolicaMaxim. in the treatment of chronic eczema was clarified, which filled the blank of Mongolian medicineC.mongolicaMaxim. in the treatment of chronic eczema, meanwhile, it will solve the core problem of chronic eczema with long-term cure and high recurrence rate, this will certainly have a certain contribution to the promotion and application of chronic eczema patients and Mongolian medicineC.mongolicaMaxim. In order to avoid the corticosteroid-dependent dermatitis caused by the previous habit of external use of hormone ointment, and to avoid the side effects of long-term oral antihistamines, the treatment combined with the oral treatment of Mongolian medicine can shorten the cure time, avoid drug resistance and side effects, shorten the cure period of chronic eczema, and effectively control the recurrence. At the same time, this study also lays the foundation and provides reference for promoting the development of national medicine, finding more effective treatment of chronic eczema, and clinically using the Mongolian medicine in dermatology in the future.