A controlled trial of traditional Chinese medicinal plants in widespread non-exudative atopic eczema.
Sheehan MP, Atherton DJ. A controlled trial of traditional Chinese medicinal plants in widespread non-exudative atopic eczema. Br J Dermatol 1992;126(2):179-84.
Study type: RCT (double-blind, placebo-controlled, crossover) · Added to this library August 23, 2026
What the researchers did
Great Ormond Street (Hospital for Sick Children, London). 47 children with severe, widespread, non-exudative atopic eczema; 8 weeks active decoction vs 8 weeks placebo in random order, 4-week washout. 37 completed. A *specific prescription formulated for this one presentation* (the ten-herb formula later productised as "Zemaphyte" — Dr Luo Dinghui's formula).
What they found
Active treatment superior to placebo and "clinically valuable"; no haematological, renal or hepatic toxicity.
The Chinese-medicine reading
The inclusion criterion *non-exudative* is itself pattern differentiation — they deliberately excluded Damp-Heat (weeping) presentations because the formula was written for a dry, Blood-Heat/Blood-Deficiency-with-Wind picture. This is the first Western RCT to succeed *because* it respected pattern.
Why it matters
The landmark. Western dermatology's first double-blind evidence that TCM herbs work in pediatric eczema — and it worked because the formula was matched to a pattern, not to the diagnosis "eczema."
Relates to the patterns: Blood Heat · Blood Deficiency / Wind-Dryness
This summary is educational and does not replace care from your child's pediatrician. Evidence tiers matter: a finding in cells or animals is a reason a treatment could work, not proof that it does.
More in Trial lineage
Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis.
Sheehan MP, Rustin MH, Atherton DJ, Buckley C, Harris DW, Brostoff J, Ostlere L, Dawson A. Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis. Lancet 1992;340(8810):13-7.
Study type: RCT (double-blind, placebo-controlled, crossover)
What: Royal Free Hospital. 40 adults with longstanding, refractory, widespread AD; same ten-herb daily decoction vs placebo, 2 months each, 4-week washout.
Found: Geometric mean erythema score 12.6 (active) vs 113 (placebo); surface damage 11.3 vs 111.0; ratio CI 0.04-0.22 (p<0.0005). 20 of 31 preferred the active phase vs 4 placebo (p<0.02). Itch improved (p<0.001), sleep trended (p=0.078). No side-effects; decoction unpalatable.
Why it matters: A ~90% reduction in erythema scores in a Lancet double-blind trial is the number to quote when a pediatrician asks "is there any evidence." Also the adult companion to our pediatric case.
Treatment of atopic eczema with traditional Chinese medicinal plants.
Atherton DJ, Sheehan MP, Rustin MH, Whittle B, Guy G. Treatment of atopic eczema with traditional Chinese medicinal plants. Pediatr Dermatol 1992;9(4):373-5.
Study type: Review / commentary (no abstract indexed)
What: The same group's short review for a pediatric dermatology audience, summarising the London experience.
Why it matters: Useful as the "pediatric dermatology journal took this seriously in 1992" citation; the substance is in [SHEEHAN-1992a/b].
One-year follow up of children treated with Chinese medicinal herbs for atopic eczema.
Sheehan MP, Atherton DJ. One-year follow up of children treated with Chinese medicinal herbs for atopic eczema. Br J Dermatol 1994;130(4):488-93.
Study type: Human observational (open-label extension, n=37)
What: All 37 trial completers' parents elected to continue. Goal: reach substantial improvement, then taper while holding the gain.
Found: At 12 months 18/37 had ≥90% reduction in eczema activity scores, 5 lesser improvement; 14 withdrew (10 non-response, 4 palatability/preparation). 7 children discontinued treatment without relapse; 16 needed maintenance but only 4 daily. Two children had asymptomatic AST elevations 7-14× normal on one occasion (therapy stopped because eczema was so well controlled), normal 8 weeks later.
Why it matters: This is the paper that describes *our* clinical arc — improve, taper, some children come off entirely. The roughly 50% sustained responder rate and the "taper, don't stop" design are the honest benchmark for what this medicine can do. The AST finding is why we keep liver safety in the frame for any long-course internal formula.
A controlled trial of traditional Chinese herbal medicine in Chinese patients with recalcitrant atopic dermatitis.
Fung AY, Look PC, Chong LY, But PP, Wong E. A controlled trial of traditional Chinese herbal medicine in Chinese patients with recalcitrant atopic dermatitis. Int J Dermatol 1999;38(5):387-92.
Study type: RCT (double-blind, placebo-controlled, crossover) — NULL RESULT
What: Hong Kong, same Zemaphyte preparation, same design (8 wk/4 wk washout/8 wk), 40 Chinese patients with recalcitrant AD, 37 completed.
Found: Both groups improved over time regardless of order; Zemaphyte offered no significant effect over placebo on erythema, surface damage, lichenification or scaling (except lichenification at week 4). Bloods normal.
Why it matters: Same herbs, no pattern matching, no effect. We show this null result on purpose: it is the clearest evidence that the match between pattern and treatment — not the herbs alone — is the active ingredient of a pattern-based approach.