Johnston G A, Bilbao R M, Graham-Brown R A C
Department of Dermatology, Leicester Royal Infirmary, LE1 5WW, U.K.
Br J Dermatol. 2004 Jun;150(6):1186-9. doi: 10.1111/j.1365-2133.2004.05888.x.
In 1989 we demonstrated that 71% of children referred to our paediatric dermatology clinic with atopic dermatitis (AD) had been subject to dietary manipulation by their parents in order to manage their disease. We have re-examined our clinic population to determine whether the documented rise in the use of complementary therapy in children with skin disease has been accompanied by a rise in dietary manipulation.
To qualify and quantify the usage of dietary manipulation in children with AD in secondary care.
A face-to-face structured questionnaire study of 100 children with AD.
The mean age of the children interviewed was 7.3 years (median 5.9, range 0.6-17.1) and ethnic origin was 59% white, 35% Indo-Asian, 3% Afro-Caribbean and 3% mixed race. Seventy-five per cent of patients (75 of 100) had tried some form of dietary exclusion; the most common foods omitted were dairy products in 48% (36 of 75), eggs in 27% (20 of 75) and cow's milk in 25% (19 of 75). Forty-one per cent of patients (41 of 100) had tried some form of dietary supplementation. The most common dietary supplement was evening primrose oil in 59% (24 of 41), of whom 13% (three of 24) felt this had helped their skin. Only 51% (38 of 75) had consulted a doctor or dietician before commencing any dietary change, but 39% (29 of 75) felt that their skin had improved as a result of this dietary manipulation.
In comparison with our previous study, the proportion of patients excluding foods from their diet had increased from 71% to 75%. The proportion of these dietary changes that are unsupervised has remained the same, as have the food types avoided. The proportion of patients who report that unsupervised dietary manipulation is beneficial has increased from 10% to 39%.
1989年我们证实，因特应性皮炎（AD）转诊至我们儿科皮肤科门诊的儿童中，71%的患儿家长曾对其饮食进行调整以控制病情。我们重新调查了门诊患者，以确定皮肤病患儿使用辅助疗法的记录增加的同时，饮食调整的情况是否也有所增加。
对二级护理中AD患儿饮食调整的使用情况进行定性和定量分析。
对100例AD患儿进行面对面的结构化问卷调查。
接受访谈的患儿平均年龄为7.3岁（中位数5.9岁，范围0.6 - 17.1岁），种族构成如下：59%为白人，35%为印裔亚洲人，3%为非裔加勒比人，3%为混血儿。75%的患者（100例中的75例）尝试过某种形式的饮食排除；最常被排除的食物是乳制品，占48%（75例中的36例），鸡蛋占27%（75例中的20例），牛奶占25%（75例中的19例）。41%的患者（100例中的41例）尝试过某种形式的饮食补充。最常见的饮食补充剂是月见草油，占59%（41例中的24例），其中13%（24例中的3例）认为这对他们的皮肤有帮助。开始任何饮食改变之前，只有51%（75例中的38例）咨询过医生或营养师，但39%（75例中的29例）认为饮食调整使他们的皮肤有所改善。
与我们之前的研究相比，饮食中排除食物的患者比例从71%增加到了75%。这些饮食改变中未受监督的比例保持不变，所避免的食物种类也一样。报告称未受监督的饮食调整有益的患者比例从10%增加到了39%。
