Objective To investigate the effect of Jianpi Qufeng Decoction on intestinal flora in patients with atopic dermatitis (AD).

Methods A total of 30 AD children were selected as treatment group (abbreviated as TB group before treatment, TA group after treatment). They were orally taken Jianpi Qufeng Decoction combined with external application of urea cream for 6 weeks. Twenty-seven healthy children were selected as healthy control group (N group). Fecal samples were collected before and after treatment in the treatment group and in the N group without intervention. SCORAD score and clinical efficacy were evaluated before and after treatment; Illumina Miseq sequencing platform was used to perform high-throughput sequencing of V3 to V4 region of 16SrRNA gene of fecal bacteria; Wilcoxon rank sum test was used to analyze differences in species abundance.

Results The total effective rate of Jianpi Qufeng Decoction in the treatment of AD was 96.67%, and the SCORAD score was significantly decreased after treatment (P < 0.001). Intestinal microbiota analysis showed that at the phylum level, the abundance of Firmicutes increased and the abundance of Bacteroidetes decreased after treatment, but the difference was not statistically significant (P>0.05). At the genus level, the abundance of Blautia showed an increasing trend (P < 0.05); the abundance of Bacteroides showed a decreasing trend, but the difference was not statistically significant (P>0.05). At species level, under the phylum of Firmicutes, the abundance of unclassified_g_Faecalibacterium, unclassified_g_Eubacterium_rectale_group, Ruminococcus_sp._5_1_39BFAA showedincreasing trend, under the phylum of Bacteroidetes, the abundance of Bacteroides_vulgatus_ATCC_8482, Bacteroides_Xylanisolvens_g_Bacteroides, Bacteroides_uniformis showed decreasing trend, but the differences were not statistically significant (P>0.05).

Conclusion The effect of Jianpi Qufeng Decoction in treating AD may be related to the changes in the abundance of Firmicutes and Bacteroidetes.