Since the establishment of the People’s Republic of China, under the leadership of the Party and the government, Western medicine has been advocated to learn from Chinese medicine, and organized and planned research on the combination of Chinese and Western medicine has been carried out, and dermatology is no exception. Over the past 50 years since the founding of the People’s Republic of China, we have made significant achievements in the research of clinical dermatology combining Chinese and Western medicine. In the past, the treatment of this kind of diseases by Chinese medicine only remained in the general efficacy observation. In recent years: ① Professor Zhang Zhili from the Department of Dermatology of Beijing Hospital of Traditional Chinese Medicine used Chinese medicine Shi Lan Cao Combination for the treatment of dermatitis and eczema, and systematically observed 440 cases. (2) Chen Deyu et al. formulated the Chinese herbal medicine acid-glycolic antipruritic combination according to the theory of Chinese medicine to treat 395 cases of pruritic allergic skin diseases, and achieved better efficacy. ③ Chen Xuerong et al. used bitter ginseng injection to treat eczema dermatitis effectively, and further found through experimental research that bitter ginseng total alkaloids and oxidized bitter ginseng alkaloids, both of which can inhibit cyclic nucleotide diesterase activity, have anti-metabolic effects. All of the above prescriptions provide an important way to treat dermatitis and eczema-like skin diseases by combining traditional Chinese medicine and Chinese and Western medicine. (B) Anti-allergic reaction monomeric Chinese medicine research: ①Legongtang: recent research has proved that there are more than 10 kinds of monomeric for acute generalized eczema and other allergic reaction diseases have broad application prospects. For example, Lei Gong Deng Lactone can significantly inhibit DNFB (dinitrofluorobenzene) induced allergic contact dermatitis in mice; in vitro experiments have shown that it can significantly inhibit ConA (knife-turf A) and lipopolysaccharide (LPS) induced T and B lymphocyte proliferative reactions. Glycyrrhiza glabra: Glycyrrhizic acid monoamine injection developed from its active ingredients has been used to treat eczema, drug rash, contact dermatitis, urticaria and allergic purpura with good efficacy. Studies have shown that glycyrrhizic acid amine is an extract of licorice, which can induce serum γ-interferon, inhibit viral replication, and has corticosteroid-like effects. It is believed that it is the drug of choice for recurrent allergic skin diseases. Comfrey: The active ingredient in comfrey, comfreyin, can inhibit capillary hyperpermeability, reduce local edema, and reduce inflammatory exudation. The use of comfrey oil for the treatment of infant diaper dermatitis; reuse comfrey for the treatment of allergic purpura have good efficacy. ④ Lycium barbarum: In the study of the regulatory effect of Lycium barbarum on IgE antibody response in mice, it was found that Lycium barbarum not only has immunomodulatory effect, but also can inhibit IgE synthesis in mice. In addition, according to preliminary studies, Scutellaria baicalensis, mugwort oil, Artemisia annua, Dioscorea and wild chrysanthemum have anti-metabolic effects, which deserve further study. Autoimmune diseases In recent years, the combination of Chinese and Western medicine has made certain achievements in the treatment of autoimmune diseases such as aspergillosis, systemic lupus erythematosus and dermatomyositis. （In recent years, there have been many reports on the treatment of aspergillosis. Zhang Zhili et al. reported 30 cases treated with the combination of Chinese and Western medicine, of which 18 cases were clinically cured and 9 cases were effective. Yuan Zhaozhuang et al. reported 22 cases, 17 of which were effective, and 7 were controlled for more than 4 years without recurrence. It proves that the use of Chinese herbal medicine to strengthen the spleen and remove dampness, nourish Yin and benefit Qi, and detoxify the toxin with hormone treatment can greatly reduce the amount of hormone, reduce the generation of comorbidities and side effects caused by the massive use of hormone, and delay the recurrence. (2) SLE is treated by combining evidence and disease identification and Chinese and Western medicine. We believe that this disease is a deficiency, and according to the principle of supporting the proper body and strengthening the root, activating the blood and detoxifying the toxin, western corticosteroids are mainly used in the acute stage, supplemented by Chinese medicine to control the acute symptoms first, and then gradually reduce to gradually stop using hormones mainly by Chinese medicine. Practice proved. (According to the analysis of 828 cases in 54 papers nationwide) long-term adherence to combined Chinese and Western medicine treatment is more effective than simple Chinese medicine or simple Western medicine treatment, with low mortality, fewer comorbidities, and significantly longer survival time, and statistically significant. In recent years, traditional Chinese medicines with immunosuppressive and anti-inflammatory effects, such as Lei Gong Tang, Kunming Shan Hai Tang and Artemisinin, have been discovered one after another, which are very effective in treating lupus erythematosus. Professor Xu Deqing has been exploring various options for the combined treatment of SLE since the 1970s and has summarized his experience in three aspects: ①Individualization of treatment and evidence-based treatment; SLE is quite complex, invading various human organs and tissues, and the focus of lesions often changes, so treatment should be individualized, which is in line with the principle of evidence-based treatment. According to the principle of evidence-based treatment, SLE is basically divided into those with predominantly skin and joint disease, those with predominantly cardiopulmonary disease, those with predominantly liver damage, and those with predominantly chronic kidney disease; different treatment plans are used for different individuals and different lesion priorities. In addition, treatment is given in stages (acute progressive stage, remission stage, stable stage) according to the development of the disease. ② Views on the identification and staging of lupus erythematosus. From the observations of the four diagnostic examinations, tongue and pulse, etc., we believe that SLE is mostly characterized by deficiency evidence, and the real evidence manifests only during the acute progressive stage or when the disease is complicated by infection. In the acute progressive stage, hormone shock therapy in extra large doses is required, and in the remission stage and stable stage, a combination of Chinese and Western medicines is given. (③Experience in the use of Leigongtang-like herbs. Xu used hormone therapy in the early stage while often giving Kunming Shanhai-tang tablets, and made comparative observations on the efficacy of each type of SLE, and found no good effect. Later, he switched to Leigongtang or Leigongtang polyglucoside tablets, and some patients with lupus nephritis received better results, with disappearance of proteinuria, decrease in antinuclear antibody potency, and overall improvement, but still failed to achieve results in refractory nephritis. In recent years, the combined treatment of refractory lupus nephritis with torch flower root, azathioprine and hormone has received peculiar results, and is still effective in some cases where cyclophosphamide shock is ineffective. Third, pigmented dermatoses Pigmented dermatoses can be divided into two categories: hypopigmentation and increased pigmentation, which manifest as whitening or darkening of skin color. The common ones are vitiligo, chloasma, nevus of Ota, etc. (A) Vitiligo Vitiligo is the most common hypopigmented skin disease (1%). It is clinically divided into two types: common type (① limited; ② scattered; ③ induced; ④ limbic); segmental type. Two types: complete leukoplakia, incomplete leukoplakia. Two stages: progressive stage, stable stage. Wang Shanglan et al. treated 72 cases of vitiligo in the progressive stage with a combination of Chinese and Western medicine (Chinese herbal medicine Dan Tao punch, together with Huang Qi oral liquid and Skykang treatment), with a significant rate of 62.5% and an effective rate of 80.6%. It opened up a new way for the combination of Chinese and Western medicine to treat active vitiligo. Zhang Shuyuan et al. used red light therapy instrument (Beihang University Jinqiu new technology company) to treat 68 cases of vitiligo, the results appear pigmented 50 cases (73.5%): cured 14 cases (20.6%); apparent effect 15 cases (22.1%). Through the thermal and photochemical effects of red light on the skin and mucous membrane, the deep tissue vasodilation, blood flow is accelerated, cellular vitality is enhanced, material metabolism is vigorous, and local tissue nutrition is improved to facilitate the growth and functional recovery of pigment cells. Cheng Dongqing et al. used the effect of compound Chinese medicine on intracellular tyrosinase of rat Bl6 melanoma cell line and its effect on cell proliferation and melanin synthesis experiment, the results showed that liver and kidney tonic Chinese medicine has pro-proliferative effect on melanocytes. Therefore, in the treatment of vitiligo, the role of liver and kidney tonic Chinese medicine cannot be ignored. (ii) Melasma Melasma is the most common skin disease with increased pigmentation. Its etiology is mostly related to endocrine, pregnancy, drugs, cosmetics, heredity and certain chronic diseases. According to the etiology, it can be divided into two types: primary and secondary; according to the location of lesions, it can be divided into four types: butterfly-shaped, facial, subfacial and panniculitis. The treatment of this disease is based on topical drugs, with internal drugs or other treatment methods when necessary. Zhu Tiejun et al. treated the disease with evidence: (i) liver-depression and qi-stagnation type: Chai Hu Diversified Liver San with additional flavor to dredge the liver and regulate qi and activate blood. ②Spleen-dampness type: treated with herbs to strengthen the cards, remove dampness and invigorate blood. ③ liver and kidney deficiency type: treated with medicines that nourish the liver and kidney, such as raw earth, rehmannia, chasteberry, cuscuta, angelica, henbane, mulberry and dampness. Combined with oral vitamin C, external application of 3% hydroquinone cream, 0.1% retinoic acid cream, 3% tretinoin cream and 0.1% SOD cream, etc., received better results. In the experimental study, Lei Tiechi et al. used B16F10 murine melanoma cells cultured in vitro as a model to compare the effects of the active ingredients of licorice, 18a-glycyrrhetinic acid diamine salt, arbutin and hydroquinone on the morphology, tyrosinase activity, melanin content and cell proliferation rate of B16F10 cells. The results showed that the three compounds showed an inhibitory effect on melanin production. Arbutin and glycyrrhetinic acid showed significant inhibitory effects on tyrosinase activity and melanin content; hydroquinone showed biphasic effects on melanin production in B16Fl0 cells. IV. Psoriasis Psoriasis is a common chronic recurrent clinical skin disease. There are many views on the etiology and pathogenesis of psoriasis in Chinese medicine, and most scholars support the following two views: First, the blood-heat theory. Zhu Renkang believes that “heat in the blood” is the main cause of psoriasis. Zhao Bingnan believes that blood heat is the main basis for the development of psoriasis, and the formation of blood heat is related to a variety of factors. Secondly, blood stasis is said: “When blood is subjected to heat, it is tormented and becomes lumpy (《醫林改错》)”, so that the blood does not flow smoothly, and stasis turns into heat, resulting in heat and stasis being intertwined. Therefore, blood stasis is the product of blood heat, and at the same time, it is one of the causes of blood heat. Patients with psoriasis have microcirculation and blood rheology changes in the nail wrinkles, which manifest as microvascular loop malformation, dilation of tube diameter and slow blood flow. Immunological studies confirm that patients with this disease have low cellular immune function and significant abnormalities in humoral immunity. According to the above etiology and experimental study, the application of heat-clearing, blood cooling, detoxification, blood circulation and antipruritic formulas, combined with the administration of drugs to inhibit cell proliferation (differentiation) and drugs to enhance or adjust immune function, has been clinically proven to be effective. For example, Lu Yongtian et al. treated 159 cases of common psoriasis with compound Qing Dai Wan and ethyleneimine tablets, and evaluated the recent efficacy after 3 months. The total effective rates of the two groups after treatment were 86.8% and 89.5%, respectively, with similar recent efficacy. The long-term efficacy was 25.4% and 58.3% respectively after 2 years of follow-up, indicating that Chinese medicine has obvious advantages in the treatment of common psoriasis; it has the functions of clearing heat and detoxifying, activating blood circulation and removing blood stasis, dispelling wind and relieving itching; research shows that its mechanism may be through inhibiting mitosis of epithelial cells. It has been shown that its mechanism may achieve therapeutic effects by inhibiting the mitosis of epithelial cells, reducing blood viscosity and anti-inflammation. Wang Xiumin et al. treated 228 cases of psoriasis with compound Danshen injection (each 2ml is equivalent to 2g each of Radix et Rhizoma and Danshen) in combination with penicillin; 109 cases were cured, 95 cases were effective, 15 cases were effective and 9 cases were ineffective, with a total effective rate of 96.05%. It is believed that the compound Danshen injection, which activates blood circulation and resolves blood stasis, regulates qi and opens the orifices, improves the microcirculation and hemodynamics of patients, which relieves their hyperviscosity and reduces the adhesion of inflammatory cells to vascular endothelial cells, while penicillin is chosen to control bacterial infection (psoriasis is mostly associated with infection). In addition, Salvia miltiorrhiza may modulate the immune function of patients. Sun Fengchun et al. treated 30 cases of common psoriasis with poria polysaccharide injection, 4 ml of which was injected intramuscularly daily for 20 days, with a break of 10 days, for a course of 3 months, with a total efficiency of 90%. The experiment proved that poria polysaccharide injection can enhance the immune function of the body, so it can effectively treat psoriasis. Lin Xiran et al. treated 40 patients with isoindigo A (25mg per tablet), 75~150mg per day in 3~5 oral doses. The results were basically cured in 12 cases, with a total effective rate of 80%; isoindigo nail is a structural analogue of indigo red, while indigo red is the main active ingredient of Qing Dai, which has the effect of cooling the blood and detoxifying the toxin; therefore, the mechanism of action of isoindigo nail in treating psoriasis lies in clearing heat and cooling the blood. Ni Xiao et al. treated 49 cases of psoriasis with Astragalus germanium oral solution, each l0ml (containing 30mg of hydroxyethylgermanium, the content of Astragalus is equivalent to 10g of raw herb), twice a day, and one course of treatment was taken for one month. The result was that 5 cases were cured, 9 cases were effective, 25 cases were effective, and 10 cases were ineffective, with an overall efficiency of 80%. Superoxide dismutase was measured before and after treatment, suggesting that Astragalus germanium oral solution could suggest the ability of the patient’s organism to scavenge superoxide anion free radicals. V. Leukoaraiosis (or Leukoaraiosis syndrome) The concept includes three major features: ① oral ulcers. ② Genital ulcers (recurrent). (iii) Recurrent iridocyclitis; pus accumulation in the anterior chamber or uveal laminitis. In addition, skin vasculitis (erythema nodosum), synovitis, thrombophlebitis, meningitis, and intestinal ulcers are also quite characteristic. This disease is equivalent to the fox confusion disease in Chinese medicine (Jin Kui Yao Yao says: “Fox confusion is a disease, …… eats in the throat as confusion, eats in the yin as fox, …… Glycyrrhiza glabra diarrhea heart soup is the main one”). Wang Zihe et al. used Glycyrrhiza glabra diarrhea heart soup plus reduction to treat leucorrhea and received better results. Japanese scholar Kisho Arai et al. treated 38 cases of leukoaraiosis with the Chinese formula “Washing Liver and Bright Eyes Soup, Han Xia Diarrhea Heart Soup and Gentian Diarrhea Liver Soup”, including 18 cases in the active stage and 20 cases in the inactive stage. Lymphocyte subpopulation counts were measured by mobile blood count. The results showed that T cells were significantly suppressed in 18 active patients and no significant changes were observed in 20 inactive patients, which proved that T cell suppression in Chinese medicine has a benign effect on improving the prognosis of leukoaraiosis. Li Xuejun et al. proposed a trial of mecamylguanidine for the treatment of the disease. Some people also proposed the integrated treatment of anti-TB, hormone and immunosuppressive methods. Sixth, the combination of Chinese and Western medicine dermatology monographs Through the use of modern medical experimental methods to study the theory, methods, prescriptions and medicines of Chinese medicine, remarkable achievements have been made, and many high-level combined Chinese and Western medicine dermatology monographs have been written and published, the most representative of which are: ① “Practical Dermatology” (Liu Furen, Zhang Zhili, 1984). ② “Combined Chinese and Western Medicine Dermatology” (Bian Tian Yu and Gui Xi Chun, 1987). ③Dermatology Research (Qin Wanzhang et al., 1990) ④”Dermatology” in “The Complete Clinical Book of Chinese and Western Medicine” (Zhang Zhili and Bian Tianyu, 1996), etc. The appearance of the above monographs has played a positive role in promoting the development of dermatology in China.