Objective To observe the clinical efficacy of Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment for the treatment of facial seborrheic dermatitis. Methods A total of 92 patients with facial seborrheic dermatitis were randomly divided into treatment group and control group,46 cases in each group. The treatment group was treated with oral use of Recipe for Clearing Heat and Removing Dampness combined with external use of Butyl Flufenamate Ointment, and the control group was only treated with external use of Butyl Flufenamate Ointment. The treatment for the two groups covered 4 weeks. Before treatment and on treatment day 7, 14 and 28, scores of clinical symptoms, related skin barrier function indexes,and the serum level of cathepsin S(Cat S)in the two groups were observed. Results(1)On treatment day 14,28,the total effective rate in the treatment group was 84.8％, 89.1％,and that in the control group was 65.2％,71.7％ respectively,the difference being significant(P < 0.05).(2)On treatment day 7,14,28, the scores of clinical symptoms in the two groups were obviously decreased(P < 0.05 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.05).(3) On treatment day 7,14,28,facial sebum secretin,skin water content,and transepidermal water loss(TEWL) of the treatment group were improved to various degrees compared with those of the control group,the differences being significnat(P < 0.05 or P < 0.01).(4)On treatment day 28,serum Cat S of the two groups was markedly decreased(P < 0.01 compared with that before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.01). Conclusion Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment exerts certain effect for the treatment of facial seborrheic dermatitis.

"Shaoyang as the pivot"is one of the important concepts in the theory of traditional Chinese medicine.It is believed that shaoyang is located between half exterior and half interior,which reaches the muscular striae and the exterior and connects with the internal organs,and plays the role of promoting qi movement,regulating water channel and distributing ministerial fire.The dysfunction of shaoyang pivot leads to the disorder of qi movement,abnormal water metabolism,and stagnation or hyperactivity of ministerial fire.Cholinergic urticaria is a special type of urticaria caused by the disorder of cholinergic nerve conduction,which has a long course of disease and is difficult to be cured.According to the clinical characteristics of the disease,Professor SUI Dao-Shun believes that the dysfunction of shaoyang pivot is the core pathogenesis of cholinergic urticaria.Emotional disorders lead to the dysfunction of pivot,and then cause the disordered flow of qi and fluid and internal disturbance of hyperactive ministerial fire,which induce the disharmony between nutritive qi and defensive qi,and the failure of being against the pathogens.Finally,wind pathogen attacks the skin and muscular striae and becomes latent,and results in cholinergic urticaria.For the treatment of cholinergic urticaria,Chaihu Guizhi Decoction can be used as the basic prescription to harmonize shaoyang,expel pathogens and release exterior.Corresponding modification of herbal medicines should be performed for various syndromes caused by the dysfunction of shaoyang pivot such as qi stagnation,dampness retention and heat stagnation during the clinical application.The prevention and treatment of cholinergic urticaria based on the theory of shaoyang as the pivot can provide thoughts for the clinical treatment of cholinergic urticaria.