Objective

2

To observe the clinical efficacy of kidney-nourishing and heart-clearing method in the treatment of pediatric atopic dermatitis （AD） with heart-spleen heat accumulation syndrome.

Methods

2

A total of 116 children with AD complicated by heart-spleen heat accumulation syndrome who were treated at Beijing Hospital of Traditional Chinese Medicine， Capital Medical University， from September 2023 to May 2025 were enrolled and randomly divided into an observation group and a control group using a random number table method. The observation group received Zishui Qingxin Decoction combined with mometasone furoate cream， while the control group received mometasone furoate cream alone. The Eczema Area and Severity Index （EASI） score， pruritus Peak Pruritus Numerical Rating Scale （PP-NRS） score， Patient-Oriented Eczema Measure （POEM） score， Infant Dermatitis Quality of Life （IDQOL）/Children's Dermatology Life Quality Index （CDLQI）/Dermatology Life Quality Index （DLQI）， traditional Chinese medicine （TCM） syndrome score， laboratory indicators ［immunoglobulin E （IgE）， interleukin-31 （IL-31）， thymic stromal lymphopoietin （TSLP）］， safety indicators， recurrence rate， and overall efficacy were compared between the two groups before and after treatment.

Results

2

After 2， 3， and 4 weeks of treatment， EASI scores in both groups were significantly lower than those before treatment （

P

<

0.05）. Moreover， after 3 and 4 weeks of treatment， EASI scores in the observation group were signific

antly lower than those in the control group （

P

<

0.05）. After 2， 3， and 4 weeks of treatment， pruritus NRS scores in the observation group were significantly lower than those before treatment （

P

<

0.05）. After 3 and 4 weeks， pruritus NRS scores in the observation group were lower than those in the control group （

P

<

0.05，

P

<

0.01）. In the control group， pruritus NRS scores were significantly reduced after 2 and 4 weeks compared with baseline （

P

<

0.05）. After 2 weeks of treatment， POEM scores in both groups were significantly reduced compared with baseline （

P

<

0.05）. After 2， 3， and 4 weeks of treatment， dermatology life quality index scores in the observation group were significantly reduced compared with baseline （

P

<

0.05） and were lower than those in the control group （

P

<

0.01）. In the control group， dermatology life quality index scores were significantly reduced after 3 and 4 weeks compared with baseline （

P

<

0.05）. After 2 weeks of treatment， the TCM syndrome score in the observation group was significantly reduced compared with baseline （

P

<

0.05）. After 2， 3， and 4 weeks of treatment， TCM syndrome scores in the observation group were lower than those in the control group （

P

<

0.01）. After 4 weeks of treatment， serum IL-31 and TSLP levels in the observation group were significantly lower than those in the control group （

P

<

0.05）. No adverse events occurred in either group during treatment， and no abnormalities were observed in liver function， renal function， routine blood tests， or routine urine tests before or after treatment. The total effective rate in the observation group was significantly higher than that in the control group （

P

<

0.05）. At the 4-week follow-up after treatment， the recurrence rate in the observation group was significantly lower than that in the cont

rol group （

P

<

0.05）.

Conclusion

2

The kidney-nourishing and heart-clearing method is effective in relieving pruritus， improving skin lesions， controlling recurrence， and reducing the use of topical corticosteroids in children with atopic dermatitis complicated by heart-spleen heat accumulation heat syndrome， with high safety.