Abstract: Objective To explore the curative effect of medicated bath of TCM combined with tacrolimus in the treatment of children moderate to severe atopic dermatitis(AD) and their influence on the serum inflammatory mediator. Methods Total 102 children with moderate to severe AD were selected and randomly divided into group A,B and C with 34 cases in each group.The patients in group A were given 0.05% desonide ointment,group B were given 0.03% tacrolimus ointment,and group C were given medicated both of TCM and tacrolimus.The treatment in three groups was all lasted until 1 week after skin lesion elimination or for 3 weeks.EASI were evaluated before the treatment,1 week,2 weeks and 3 weeks after the treatment/treatment finished.Serum LTB₄ and LTC₄,and DLQI were detected before the treatment,3 weeks after the treatment/treatment finished.The curative effects were evaluated 3 weeks after treatment/treatment finished.The adverse reactions wererecorded and follow-up for 3 months to record the recurrence. Results Comparing with the conditions before the treatment,three groups’ EASI scores were all decreased 1 week after the treatment,2 weeks after the treatment,and 3 weeks after the treatment/treatment finished(P＜0.05 or P＜0.01),and EASI score in group C was lower than those in both group A and B(P＜0.05 or P＜0.01).The effective rate in Group A,B and C was 65.63%,63.64% and 87.10%,respectively,and the effective rate in group C was higher than those in both group A and B(P＜0.05).The serum LTB₄ and LTC₄ in group B and C were both decreased 3 weeks after treatment/treatment finished(P＜0.05 or P＜0.01).By the order of group A,B and C,serum LTB₄ and LTC₄ and DLQI scores were all decreased successively(P＜0.05).The incidence of adverse reaction in group A,B and C was 40.63%,36.36%,12.90%,respectively,and the rate both in group A and B were higher than that in group C(P＜0.05).In 3 months following-up,the recurrence rate in group A,B and C was 34.38%,9.09%,3.23%,respectively,and the recurrence rate group A was higher than that in both group B and C(P＜0.01). Conclusion The medicated bath of TCM combined with tacrolimus have a good curative effect on moderate to severe AD in children,it can effectively eliminates the skin lesion,decrease serum LTB₄ and LTC₄ level,improve life quality,also has lower side effects and recurrence rate,and it is superior to simple glucocorticoid or tacrolimus in curative effect.