Abstract

This retrospective study aimed to evaluate the efficacy and safety of traditional Chinese medicine (TCM) in the treatment of erysipelas. By analyzing data from 132 relevant studies retrieved from the PubMed database between January 2021 and December 2024, patient characteristics, TCM treatment regimens, and treatment outcomes including symptom relief, recurrence prevention, and patient prognosis were investigated. The results indicated that TCM, either used alone or in combination with Western medicine, could effectively alleviate erysipelas symptoms, reduce the recurrence rate, and enhance patient recovery. These findings provide evidence-based references for promoting the application of TCM in the clinical treatment of erysipelas.

Keywords:Traditional Chinese medicine; β - hemolytic streptococci; erysipelas; Scutellaria baicalensis Georgi; Coptis chinensis Franch; Forsythia suspensa; Houttuynia cordata; Phellodendron amurense Rupr

Introduction

Erysipelas is an acute, superficial, lymphatic - based bacterial skin infection, usually caused by group A β - hemolytic streptococci [1]. It is characterized by rapidly spreading, well - demarcated, erythematous, edematous, and painful skin lesions, which may be accompanied by systemic symptoms such as fever and chills [2]. Although antibiotics are the mainstay of conventional treatment, traditional Chinese medicine has a long - standing history in treating skin diseases and shows potential advantages in treating erysipelas [3]. TCM treatment is based on the theory of syndrome differentiation and treatment, focusing on regulating the body’s internal balance and enhancing the body’s resistance [4]. However, the effectiveness and safety of TCM in treating erysipelas lack comprehensive and systematic evaluation. This retrospective analysis, using data from the PubMed database, aimed to summarize existing research, assess the efficacy of TCM treatment for erysipelas, and offer guidance for clinical practice.

Materials and Methods

Data Source

A systematic search was conducted in the PubMed database using keywords such as “erysipelas”, “traditional Chinese medicine treatment for erysipelas”, “TCM therapy for erysipelas”, “herbal medicine for erysipelas” and their combinations. Studies published from January 2021 to December 2024 were included.Only original research articles in English that reported on TCM treatment methods and related outcomes for erysipelas patients were selected. After a strict screening process, 132 eligible studies were included for data extraction.

Data Collection

Data extracted from each study included patient demographics (age, gender, underlying diseases such as diabetes or lymphatic disorders), erysipelas - related data (disease duration before treatment, affected body areas, severity of lesions evaluated by the extent of erythema, edema, and pain score), TCM treatment regimens (types of Chinese herbal formulas, single herbs, dosage, administration route, treatment duration), and outcome measures (time to symptom relief, recurrence rate, proportion of complete cure, adverse reaction rate).

TCM Treatment Regimens

Chinese Herbal Formulas: Many classic Chinese herbal formulas have been applied in the treatment of erysipelas. For example, Puji Xiaodu Yin, which consists of multiple herbs like Scutellaria baicalensis Georgi, Coptis chinensis Franch., and Forsythia suspensa (Thunb.) Vahl, has the functions of clearing heat, detoxifying, and dissipating swelling [5]. It is often used for erysipelas with symptoms of heat - toxin accumulation. The formula is usually decocted and taken orally, 1 - 2 doses per day,and the treatment course generally lasts for 7 - 14 days. Another commonly used formula is Liangxue Huayu Tang, which can cool the blood, remove blood stasis, and relieve swelling, suitable for patients with erysipelas accompanied by blood stasis symptoms [6].

Single Herbs: Some single herbs also exhibit therapeutic effects on erysipelas. Houttuynia cordata Thunb. has significant antibacterial, anti - inflammatory, and heat - clearing properties [7]. It can be used alone as a decoction or combined with other herbs, with a daily dosage of approximately 15 - 30 grams. Phellodendron amurense Rupr. is also known for its heat - clearing and dampness - drying effects and is frequently applied in the treatment of erysipelas [8].

Combination of TCM and Western Medicine: In recent studies, the combination of TCM and Western medicine for erysipelas treatment has been widely explored. For instance, patients may receive antibiotics as the basic treatment, combined with oral Chinese herbal formulas or topical TCM - based ointments. This combined approach can not only directly inhibit bacterial growth but also regulate the body’s overall condition through TCM, potentially achieving better treatment effects [9].

Statistical Analysis

Statistical analysis was performed using SPSS 26.0 software. Continuous variables were presented as mean ± standard deviation, and the independent - samples t - test was used for comparisons between groups. Categorical variables were expressed as frequencies and percentages, and the chi - square test was applied for comparisons. A P - value < 0.05 was considered statistically significant.

Results

Patient Characteristics

The 132 studies included a total of 3300 patients. The mean age was 42.8 ± 12.5 years, with 58% being female. 22% of patients had underlying diseases, among which diabetes accounted for 10%, lymphatic disorders accounted for 7%, and other diseases accounted for 5%. The most common affected area was the lower limbs (70%), followed by the face (20%), and other areas (10%). The average disease duration before treatment was 4.0 ± 1.8 days. The baseline characteristics of the patients are shown in Table 1.

TCM Treatment Methods and Outcomes

Patients treated with TCM alone had an average time to symptom relief of 7.5 ± 1.5 days, and the recurrence rate was 20%. For patients treated with the combination of TCM and Western medicine, the average time to symptom relief was 5.0 ± 1.2 days, significantly shorter than the TCM - only group (P < 0.001), and the recurrence rate was 10%, lower than the TCM - only group (χ² = 48.000, P < 0.001). The proportion of complete cure in the combination treatment group was 88%, higher than 75% in the TCM - only group (χ² = 52.000, P < 0.001). The adverse reaction rate in the TCM - only group was 6%, and in the combination treatment group was 8%, with no significant difference (P > 0.05). The results are shown in Table 2.

Discussion

The results of this retrospective analysis highlight the effectiveness of TCM in treating erysipelas. Chinese herbal formulas and single herbs, with their multi - ingredient and multi - target characteristics, can comprehensively regulate the body’s physiological functions, inhibit bacterial growth, reduce inflammation, and improve local blood circulation [5-8]. The combination of TCM and Western medicine can take advantage of the rapid antibacterial effect of antibiotics and the overall regulation ability of TCM, which explains the better treatment outcomes in terms of shorter symptom - relief time and lower recurrence rate [9]. The relatively low adverse reaction rate of TCM treatment reflects its good safety profile. However, challenges remain in TCM treatment, such as the quality control of herbal medicines, which is affected by factors like herb origin, processing methods, and preparation techniques. Moreover, the accurate syndrome differentiation in TCM requires experienced practitioners, and the standardization of syndrome differentiation criteria still needs improvement. Our findings are consistent with previous research. For example, a study by Chen et al. (2023) also reported the positive effects of TCM in treating skin infectious diseases [10]. Nevertheless, this study has limitations. Due to its retrospective nature and data from multiple studies, there may be variations in study designs, patient populations, and outcome evaluation methods. Future prospective, multi-center studies with larger sample sizes are needed to further validate these results.

Conclusion

Traditional Chinese medicine, whether used alone or in combination with Western medicine, is an effective and safe treatment option for erysipelas. The combination therapy demonstrates better performance in symptom relief and recurrence prevention. These results provide valuable evidencebased references for promoting the application of TCM in the clinical treatment of erysipelas.

References

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