Chinese herbal medicine bath has gradually become one of the methods of external treatment of skin diseases commonly used in dermatology clinics, and has achieved certain curative effects in the clinic, but there are some differences in the application, which need to be further summarized and improved. A. Definition and classification of herbal medicine bath Definition: herbal medicine bath (referred to as herbal bath) is an external treatment method that adds a certain amount of herbal medicine to the bath water and washes the whole body or the local area at an appropriate temperature through a certain method to relieve the disease. Broadly speaking, herbal bath is a method of bathing the whole body or local area through wet compress, fumigation, fumigation, bathing and drenching, etc.; narrowly speaking, herbal bath is a method of soaking the body and limbs in the medicinal solution by using the decoction of Chinese herbs to extract the juice. Classification: ①, according to the scope of different, can be divided into the whole body bath and local bath, local bath is divided into sitting bath, hand and foot bath, head and face bath, eye bath, etc.; ②, according to the use of different methods, can be divided into wet compress, fumigation, fumigation, bath, drenching, etc.; ③, according to the effective ingredients, such as starch bath, sulfur bath, bran bath, etc.. Second, the operation of the bath 1, wet compress therapy: basic operation: 6 ~ 8 layers of gauze (can be made in advance wet compress pad spare) immersed in freshly configured liquid, to be absorbed through the liquid and then removed, screwed to the degree of no drip, then put on the affected area, be sure to make close contact with the lesion, the size of the lesion with the equivalent, each 30 ~ 40 min, every 5 ~ 10 min to replace a wet compress gauze, 1 ~ 2 times a day 1 to 2 times a day. ①, cold wet dressing method: wet dressing pad immersed in liquid, the temperature of 0 ~ 10 ℃ is appropriate, the wet dressing pad screwed to the degree of no drip, put on the affected area, keep the dressing wet for a long time, every 10 min change 1 time; ②, hot wet dressing method: wet dressing pad immersed in liquid, the temperature of 30 ~ 40 ℃ is appropriate, the operation method is the same as above; ③, open wet dressing: wet dressing pad covered in the skin lesion without bandage, every 5 ~ 10 min ③, open wet dressing: wet dressing pad covered in the skin lesion without wrapping, every 5 to 10 min to remove the wet pad, and then dipped into the liquid, repeat the basic operation; ④, closed wet dressing: wet pad covered in the skin lesion, and then covered with oil paper or plastic cloth, etc., every 30 min to remove the wet pad, and then dipped into the liquid, repeat the basic operation. 2, fumigation therapy: ①, the bathroom temperature is adjusted to 20 ~ 22 ℃, according to the patient’s condition, identify the selection of Chinese medicine, the boiling liquid into the container, so that the drug vapor effect on the affected area; ②, to the liquid temperature down to about 38 ~ 40 ℃, add the appropriate amount of warm water, the ratio of liquid to water is 3: 10, the patient will be immersed in the body and limbs in the liquid, each fumigation 20 ~ 30 min, to Sweating is appropriate, 1 to 2 times a day. 3, fumigation therapy: ①, whole body fumigation therapy: the use of Chinese medicine vapor therapy instrument for treatment. Preheat the cabin temperature 30 min before treatment, take out the decoction pot, add 1500-2000 ml of water, then put it on the heating plate, press the heating key on the controller, when the temperature shows 33 ℃ the patient enters the treatment room; prepare the medicine decoction according to the doctor’s prescription; set the treatment temperature (37-42 ℃) and treatment time (15-20 min) on the controller; when the treatment reaches the set time, assist the patient to leave the cabin, dry the skin ②, local fumigation therapy: the prescription of herbs boiled and placed in the mouth, nose or affected area, so that the drug vapor effect on the affected area, 10 ~ 15 min each time, 1 ~ 2 times a day. 4.Bath therapy: Adjust the temperature of the bathroom to 20 ~ 22 ℃, select the herbal medicine according to the patient’s condition, pour the decoction into a wooden bucket or bathtub, add an appropriate amount of warm boiled water, and the ratio of the medicine to water is 3:10. ①.Bath for the whole body: adjust the water temperature to 38 ~ 40 ℃; immerse the patient’s body and limbs in the medicine, once or twice a day, 20 ~ 30 min each time; ②.Local bath: put the decoction into the bath. Put the decoction into a wooden bucket or foot basin, then add an appropriate amount of warm water, soak the affected area in the solution, 1 to 2 times a day, each time about 20 ~ 30 min. 5, drenching therapy: ①, according to the method of decoction of drugs, decoction of 1000 ~ 2000 ml concentration of 10% to 30% of the liquid, you can put the liquid into a small spray bottle with a fine eye, drench the affected area on the body surface; ②, 6 ~ 8 layers of gauze Soak 6 to 8 layers of gauze, and then wring and squeeze the gauze to drench the affected area on the body surface. You can also use a small basin with the liquid, slowly pour the liquid on the affected areas of the body surface, 10 ~ 15 min each time, 1 ~ 2 times a day. Third, the indications of the bath 1, wet compress therapy indications: open cold wet compress is mainly used for skin flushing, swelling, vesicles and exudate obvious, such as acute dermatitis, acute eczema, purulent or infectious skin disease; closed hot wet compress is mainly used for chronic hypertrophy, keratosis lesions, or mild vesicles, a small amount of exudate, such as chronic simple moss, chronic eczema, etc.. 2, fumigation therapy indications: systemic fumigation: pruritus, chronic simple moss, chronic eczema, atopic dermatitis, systemic scleroderma, psoriasis, urticaria, pityriasis rosea, lichen planus, scabies, etc.; local fumigation: chaps, ringworm, hand eczema, sweat pimples, asbestos pityriasis, baldness, folliculitis, seborrheic dermatitis, seborrheic alopecia, perianal eczema, eczema of the pubic area, vulva pruritus, perianal pruritus, etc. 3, fumigation therapy indications: systemic skin diseases: pruritus, systemic scleroderma, scleroderma, psoriasis, etc.; limited skin diseases: scrotal eczema, breast eczema, hand eczema, perianal eczema, ringworm, skin amyloidosis, perianal pruritus, limited scleroderma, calf ulcers, bruising dermatitis, etc. 4, bath therapy indications: whole body bath: pruritus, pityriasis rosea, psoriasis, exfoliative dermatitis, chronic eczema, atopic dermatitis, ichthyosis, systemic scleroderma, scleroderma, chronic simple moss, etc.; local bath: skin amyloidosis, seborrheic dermatitis, fungal dermatosis, chancroid, sweat rash, seborrheic alopecia, perianal eczema, eczema of the pubic area, pruritus vulvae, perianal pruritus, etc. 5, shower therapy indications: a variety of infectious skin diseases, such as impetigo, scabies, impetigo, interdigital erosions, ringworm secondary infection; chronic hypertrophic, keratotic skin diseases, such as chronic simple moss, skin amyloidosis, etc.; exudate, scab more skin diseases, such as erythema multiforme, etc. Fourth, the contraindications of the bath patients with active tuberculosis, acute and chronic hepatitis and other infectious diseases, patients with severe heart disease or combined with cardiac insufficiency, patients with advanced cirrhosis and hepatic insufficiency, patients with hyperthermia and septic tendencies, patients with mental illness, epilepsy and other patients who can not self-restrain fumigation therapy, fumigation therapy is prohibited; patients with bleeding tendencies, patients at risk of cerebrovascular accidents Patients with bleeding tendency, patients at risk of cerebrovascular accident and unstable period, women in menstruation and pregnancy are contraindicated in medicated bath therapy. Fifth, the drug selection of the bath Commonly used drugs: ①, to dispel wind and relieve itching class: snake bed seeds, cicada molting, white fresh skin, thornbush, wind, Tribulus terrestris; ②, clearing heat and detoxification class: heavy floor, fishy grass, septoria, Huang Lian, scutellaria, cypress, bitter ginseng, rhubarb, amaranth, honeysuckle, big blue leaf, purple flowers, dandelion; ③, strengthen the spleen and dry dampness class: atractylodes, patchouli, Dioscorea Z, alum, Che Qian Zi, pomegranate peel, raw coix seeds, Poria, atractylodes; ④, the spleen and dry dampness class: atractylodes, patchouli, Dioscorea Z, alum, Che Qian Zi, pomegranate peel, raw coix seeds, Poria, atractylodes. Poria, Atractylodes; ④, clearing heat and cooling the blood: Lingxiaohua, Bupleurum, Peony bark, Xianhecao, Sophora, Artichoke, Little thistle; ⑤, activating blood circulation and resolving blood stasis: Trigonella, Curcuma, Clove, Panax notoginseng, Angelica, Peach kernel, Danshen, Chicken blood vine; ⑥, nourishing blood and moisturizing the skin: Angelica, Chicken blood vine, Radix et Rhizoma, Flaxseed, Angelica dahurica, Almond, Peach kernel; ⑦, killing insects and relieving itching: Quercus, Sulfur, Alum, Botrytis, Pepper, Hibiscus, Phyllanthus. (7) insecticide and anti-itch: quinoa, sulfur, alum, botrytis, pepper, hibiscus, lily, maple. Principles of selection: In acute cases, more drugs are used to dispel wind and relieve itching, clear heat and detoxify the body, clear heat and cool the blood, and kill insects and relieve itching; in chronic cases, more drugs are used to strengthen the spleen and dry dampness, invigorate blood circulation and remove blood stasis, and nourish blood and moisten the skin. Recommended prescriptions 1, prescriptions: ①, snake bed seed soup: Wei Ling Xian, snake bed seed, angelica tail 15 g each, shrinking sand shell 9 g, earth rhubarb, bitter ginseng 15 g, etc., treatment of eczema dermatitis; ②, elimination of nettle formula: Fang Feng 20 g, mugwort 20 g, bitter ginseng 30 g, thorn 20 g, white fresh skin 20 g, snake bed seed 20 g, ocimum sanctum 30 g, treatment of urticaria; ③, elimination of silver soup: angelica 15 g, mugwort 15 g g, Bed of Serpentine 30 g, Radix et Rhizoma Dioscorea 30 g, White Fresh Peel 30 g, Tu Fu Ling 30 g, Gui Zhi 15 g, Epilobium 15 g, Gentiana 15 g, Hesperus 30 g, Nightshade 40 g, for the treatment of psoriasis; ④, Wart Removal Formula: Chai Hu 20 g, Aromatic Herb 20 g, Mucuna Pruriens 20 g, Da Qing Ye 30 g, Panax quinquefolium 50 g, Raw Job’s Tear 50 g, for the treatment of flat warts. 2, “Zhao Bingnan clinical medical case collection”: horsetail water: clear heat, reduce swelling, stop itching and astringency; horsetail 30 g, water 1000 ml, mainly for acute eczema, dermatitis and other exudative skin diseases; usage: wet compress, fumigation, fumigation, bathing, drenching. Cang Shu Skin Lotion: Dampness and moistening of the skin, killing insects and relieving itching; Cang Er Zi 15 g, Di Shen Zi 15 g, Serpentine 15 g, Bitter Ginseng 15 g, Bai Bai 15 g, Tu Ge Bi 15 g, mainly for the treatment of chronic eczema, ringworm, palmoplantar keratosis and other hypertrophic and keratotic skin diseases; usage: wet compress, fumigation, fumigation. Gentian Herb Water: Clearing heat and detoxifying, astringent and antipruritic; Gentian Herb 30 g, 1000 ml of water, mainly for acute eczema, dermatitis and other exudative skin diseases; usage: wet compress. Bedstraw aqueous: dispelling wind and dampness, killing worms and relieving itching; Wei Ling Xian 15 g, Bedstraw 15 g, Radix Angelicae Sinensis 15 g, Rhizoma Polygonatum 15 g, Radix et Rhizoma Bitter 15 g, Shrubshell 9 g, 7 old onion heads, mainly for scrotal eczema, vulvar itching, etc.; usage: wet compresses, local baths. Broussonetia kozoensis leaf aqueous solution: antipruritic, emollient; Broussonetia kozoensis leaf 500 g, water 5000 ml, mainly for the treatment of pruritus, chronic urticaria, etc.; usage: wet compress, whole body bath. Lobelia aurea: Clearing heat and detoxifying, killing insects and relieving itch; Lobelia 30 g, 1000 ml of water, mainly for treating pruritus, septic skin disease, etc.; usage: wet compress. 3, “Zhu Renkang Clinical Experience Collection”: vinegar soak formula: sterilize and relieve itch, 18 g of thornbush, 18 g of windbreak, 18 g of safflower, 18 g of ground bark, 30 g of soapberry, 30 g of big maple, 18 g of alum, mainly for the treatment of goosefoot (ringworm); usage: wet compress, local bath. Warts wash formula: remove warts, horsetail 60 g, beehive 9 g, Chen Pi 15 g, Atractylodes Macrocephalae 15 g, Hesperidin 9 g, Serpentine 9 g, Angelica dahurica 9 g, bitter ginseng 15 g, mainly for flat warts; usage: wet compress. Seborrheic wash formula: astringent and anti-itch, Cang Er Zi 30 g, Bitter Ginseng 15 g, Wang Bu Li Xing 30 g, Alum 9 g, mainly for scalp seborrheic dermatitis; usage: wet compress, local fumigation. Anti-itch wash formula: softening and relieving itch, 30 g of Cyperus rotundus, 15 g of safflower, 30 g of bitter ginseng, 15 g of staminaria, 15 g of alum, mainly for neurodermatitis and amyloidosis of the skin; usage: wet compress, local fumigation. Chinese herbal baths are effective in unblocking meridians, activating blood circulation, dispersing wind and cold, clearing heat and detoxifying, relieving swelling and pain, moistening and relieving itching, killing insects, harmonizing yin and yang, coordinating the internal organs, passing qi and blood, moisturizing the whole body, etc. They are safe, simple, easy to implement and have significant curative effects. In the clinical treatment, we must choose the external treatment method reasonably according to the characteristics of the patient, the site, scope and nature of the lesion, and cooperate with the corresponding characteristic treatment and physical therapy to achieve satisfactory results.