Gangb Xint Bu ( Eczema)

Gangb Xint Bu ( Eczema)

Overview

In Miao medicine, eczema is known as Gangb Xint Bu. Lesions appear in skin folds of the arms and legs, beginning as red patches or papules that develop into vesicles, pustules, and erosions. Clear fluid oozes and forms crusts with indistinct margins. Intense itching is characteristic, resembling allergic eczema in Western medicine.

Classification in Miao Medicine

Eczema is considered a “minor disorder” and is subdivided into two types: Heat‑Channel Eczema and Cold‑Channel Eczema.

Etiology

Eczema often arises when wind‑borne or heat‑borne toxins invade the skin.

Pathogenesis

Pathogenic wind and heat damage the skin’s defensive qi and blood, first causing rashes and then fluid‑filled blisters. Over time these burst or erode, producing exudate and occasional superficial breakdown.

Diagnostic Criteria

1. Clinical Features
   – Polymorphic, symmetrical skin lesions
   – Intense itching
   – Tendency to flare and become chronic
2. Auxiliary Tests
   – Patch testing may support the diagnosis.

Differential Diagnosis

Niu Pi Xuan (Psoriasis)
Psoriasis begins as red, raised plaques surrounded by scale and small vesicles. After crusting, the scales flake off in silver‑white patches that expand into round lesions. Severe itching and erosions from scratching help distinguish it from eczema.

Pattern Differentiation & Treatment

1. Heat‑Channel Eczema

Presentation: Sudden onset in limb creases; red patches, papules, vesicles or ulcers; oozing fluid that crusts; indistinct borders; intense itching.
Treatment Principle: Clear heat, drain dampness, dispel wind, relieve itching.

Herbal Formula (decoct in water):
– Gentianae Radix (long dan cao) 20 g
– Coix Semen (yi yi ren) 15 g
– Mahoniae Caulis (shi da gong lao) 20 g

long dan cao clears heat, dries dampness, drains liver fire, detoxifies; yi yi ren promotes urination and resolves dampness; shi da gong lao clears heat and relieves toxicity.

2. Cold‑Channel Eczema

Presentation: Chronic eruptions with thickened, rough, scaling skin; color darkens to yellow‑brown; clear lesion margins; severe itching.
Treatment Principle: Dispel wind and cold‑damp, invigorate blood, moisturize skin.

Herbal Formula (decoct in water):
– Sophorae Radix (ku shen) 30 g
– Scolopendra (wu shao she) 100 g
– Sesamum Seed (ye zhi ma) 15 g

ku shen clears heat and dampness, expels wind and parasites; wu shao she dispels wind and unblocks the network vessels; ye zhi ma clears heat and detoxifies.

Preventive Care

1. Avoid scratching to （helps maintain） secondary infection.
2. Exclude spicy and stimulating foods (shellfish, poultry, beef, lamb) and pungent vegetables (cilantro, garlic, ginger, chives).
3. In acute flares, avoid hot water or harsh soaps. Delay vaccines and cowpox inoculations until the acute phase subsides.

Commentary

In Miao medicine, eczema is caused by wind‑borne or heat‑borne toxins invading the skin and injuring qi and blood. Treatment focuses on clearing heat, eliminating dampness, dispelling wind, and relieving itching. Ongoing self‑care and avoiding triggers help maintain healthy skin.