Ernst Edzard, Pittler Max H, Stevinson Clare
Department of Complementary Medicine, School of Sport and Health Sciences, University of Exeter, UK.
Am J Clin Dermatol. 2002;3(5):341-8. doi: 10.2165/00128071-200203050-00006.
The objective of this article is to provide a brief, but critical, overview of the evidence related to complementary/alternative medicine (CAM) use, and to offer valid and useful information for dermatologists in clinical practice. Systematic literature searches were conducted on these databases: Medline, EMBASE, The Cochrane Library, CISCOM and AMED (until October 2000). Where appropriate, the evaluation of the published literature was based on systematic reviews and randomized controlled trials. After scanning the literature it was decided to focus on a selection of two conditions (atopic dermatitis and chronic venous insufficiency) and two treatment modalities (aloe vera gel and tea tree oil). Data for the life-time prevalence of CAM use by patients with dermatological disease ranges between 35 to 69%. The most popular modalities include herablism and (other) dietary supplements, while atopic dermatitis is one of the conditions most frequently treated with CAM. For patients with atopic dermatitis the evidence relates to autogenic training, hypnotherapy, diet, herbal medicine, and dietary supplements. Compelling evidence of effectiveness exists for none of these therapies. However, some promising data have been reported for those with a psychological component: autogenic training, biofeedback and hypnotherapy. For chronic venous insufficiency there is relatively convincing evidence for the effectiveness of oral horse chestnut seed extract. The data for aloe vera gel and tea tree oil indicate that for neither is there compelling evidence of effectiveness. The use of CAM treatments is not free of risk; direct and indirect risks associated with CAM must be considered.
本文的目的是对与补充/替代医学（CAM）使用相关的证据进行简要但批判性的概述，并为皮肤科医生在临床实践中提供有效且有用的信息。我们在以下数据库进行了系统的文献检索：医学文献数据库（Medline）、荷兰医学文摘数据库（EMBASE）、考克兰图书馆（The Cochrane Library）、补充医学数据库（CISCOM）和澳大利亚医学文献数据库（AMED）（截至2000年10月）。在适当情况下，对已发表文献的评估基于系统评价和随机对照试验。在浏览文献后，决定重点关注两种病症（特应性皮炎和慢性静脉功能不全）以及两种治疗方式（芦荟凝胶和茶树油）。皮肤病患者使用补充/替代医学的终生患病率数据在35%至69%之间。最常用的方式包括草药疗法和（其他）膳食补充剂，而特应性皮炎是补充/替代医学最常治疗的病症之一。对于特应性皮炎患者，相关证据涉及自生训练、催眠疗法、饮食、草药和膳食补充剂。这些疗法均不存在令人信服的有效性证据。然而，对于那些有心理因素的疗法，如自生训练、生物反馈和催眠疗法，已有一些有前景的数据报道。对于慢性静脉功能不全，口服欧洲七叶树籽提取物有效性的证据相对令人信服。关于芦荟凝胶和茶树油的数据表明，两者均不存在令人信服的有效性证据。补充/替代医学治疗并非没有风险；必须考虑与补充/替代医学相关的直接和间接风险。
