Klövekorn W, Tepe A, Danesch U
Dermatology Practice, Gilching, Germany.
Int J Clin Pharmacol Ther. 2007 Nov;45(11):583-91. doi: 10.5414/cpp45583.
Only a few clinical trials have been published on the topical treatment of atopic dermatitis with herbal ointments. An ointment containing extracts from Mahonia aquifolium, Viola tricolor and Centella asiatica has previously been studied in open uncontrolled trials with children. However, no data exist on adult patients in a randomized controlled trial.
A total of 88 patients with mild-to-moderate atopic dermatitis were enrolled in a double-blind, vehicle-controlled, randomized, half-side comparison. Patients between 18 and 65 years of age were treated for 4 weeks with an ointment containing Mahonia aquifolium, Viola tricolor and Centella asiatica. The primary endpoint was a summary score for erythema, edema/papulation, oozing/crust, excoriation and lichenification according to a 4-point scale. Secondary efficacy variables were assessment of pruritus severity (10 cm VAS) and a global assessment of effectiveness as well as tolerability.
The study ointment reduced the primary and secondary endpoints slightly more than the base cream which was used as vehicle; the differences were not statistically significant. Since the climatic conditions during the study duration varied from very mild and sunny to very cold and dry, a post-hoc subanalysis was performed with a subset of 64 patients whose treatment was at a mean outside temperature of 10 degrees C or less. Under these conditions the primary endpoint showed high statistical significance.
In this trial, an ointment containing Mahonia aquifolium, Viola tricolor and Centella asiatica could not be proven to be superior to a base cream for patients with mild-to-moderate atopic dermatitis. However, a subanalysis indicated that the cream might be effective under conditions of cold and dry weather.
关于草药软膏局部治疗特应性皮炎的临床试验仅有少数发表。一种含有阔叶十大功劳、三色堇和积雪草提取物的软膏此前已在儿童开放性非对照试验中进行了研究。然而,尚无关于成年患者的随机对照试验数据。
总共88例轻至中度特应性皮炎患者参与了一项双盲、赋形剂对照、随机、半侧比较试验。年龄在18至65岁之间的患者用一种含有阔叶十大功劳、三色堇和积雪草的软膏治疗4周。主要终点是根据4分制对红斑、水肿/丘疹、渗出/结痂、擦伤和苔藓化进行的综合评分。次要疗效变量是瘙痒严重程度评估(10厘米视觉模拟评分)以及对有效性和耐受性的整体评估。
研究用软膏在降低主要和次要终点方面比用作赋形剂的基础乳膏略有更多效果;差异无统计学意义。由于研究期间的气候条件从非常温和晴朗到非常寒冷干燥不等,因此对64例患者进行了事后亚组分析,这些患者治疗时的平均室外温度为10摄氏度或更低。在这些条件下,主要终点显示出高度统计学意义。
在本试验中,对于轻至中度特应性皮炎患者,含有阔叶十大功劳、三色堇和积雪草的软膏未被证明优于基础乳膏。然而,一项亚组分析表明,该乳膏在寒冷干燥天气条件下可能有效。