Complementary and alternative medicine for treatment of atopic eczema in children under 14 years old: a systematic review and meta-analysis of randomized controlled trials
Background: Due to limitations of conventional medicine for atopic eczema (AE),complementary and alternative medicine (CAM) is widely used as an alternative,maintaining,or simultaneous treatment for AE.We aimed to evaluate the beneficial and harmful effects of CAM for children with AE under 14 years old.Methods: We searched for randomized trials on CAM in 12 Chinese and English databases from their inception to May 2018.We included children (< 14 years) diagnosed with AE,who received CAM therapy alone or combined with conventional medicine.We extracted data,and used the Cochrane Risk of bias tool to assess methodological quality.Effect was presented as relative risk (RR) or mean difference (MD) with 95% confidence interval (CI) using RevMan 5.3.Results: Twenty-four randomized controlled trials involving 2233 children with AE were included.Methodological quality was of unclear or high risk of bias in general.The trials tested 5 different types of CAM therapies,including probiotics,diet,biofilm,borage oil,and swimming.Compared to placebo,probiotics showed improved effect for the SCORAD index (MD 9.01,95% CI 7.12-10.90;n =5).For symptoms and signs such as itching,skin lesions,CAM combined with usual care was more effective for symptom relief >95% (RR 1.47,95% CI 1.30-1.68;n =8),and for >50% symptoms improvement (RR 1.34,1.25-1.45;n =9) compared to usual care.There was no statistic significant difference between CAM and usual care on >95% improvement or > 50% improvement of symptoms.However,swimming,diet and biofilm showed improvement of clinical symptoms compared with usual care.At follow-up of 8 weeks to 3 years,CAM alone or combined with usual care showed lower relapse rate (RR 0.38,0.28-0.51,n =2;RR 0.31,0.24-0.40,n =7;respectively) compared to usual care.Twelve out of 24 trials reported no occurrence of severe adverse events.
Chun-li Lu Xue-han Liu Trine Stub Agnete E.Kristoffersen Shi-bing Liang Xiao Wang Xue Bai Arne Johan Norheim Frauke Musial Terje Araek Vinjar Fonnebo Jian-ping Liu
Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Commu Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029,
国际会议
北京
英文
58-66
2019-03-30（万方平台首次上网日期，不代表论文的发表时间）