Bath-Hextall F, Delamere F M, Williams H C
Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
Allergy. 2009 Feb;64(2):258-64. doi: 10.1111/j.1398-9995.2008.01917.x.
Atopic eczema is the most common inflammatory skin disease of childhood in developed countries. We performed a systematic review of randomized controlled trials to assess the effects of dietary exclusions for the treatment of established atopic eczema. Nine trials (421 participants) were included, most of which were poorly reported. Six were studies of egg and milk exclusion (n = 288), one was a study of few foods (n = 85) and two were studies of an elemental diet (n = 48). There appears to be no benefit of an egg- and milk-free diet in unselected participants with atopic eczema. There is also no evidence of benefit in the use of an elemental or few-foods diet in unselected cases of atopic eczema. There may be some benefit in using an egg-free diet in infants with suspected egg allergy who have positive specific IgE to eggs - one study found 51% of the children had a significant improvement in body surface area with the exclusion diet as compared with normal diet (95% CI 1.07-2.11) and change in surface area and severity score was significantly improved in the exclusion diet as compared with the normal diet at the end of 6 weeks (MD 5.50, 95% CI 0.19-10.81) and end of treatment (MD 6.10, 95% CI 0.06-12.14). Despite their frequent use, we find little good quality evidence to support the use of exclusion diets in atopic eczema.
在发达国家，特应性湿疹是儿童中最常见的炎症性皮肤病。我们对随机对照试验进行了系统评价，以评估饮食排除法对已确诊的特应性湿疹的治疗效果。纳入了9项试验（421名参与者），其中大多数报告质量较差。6项是关于排除鸡蛋和牛奶的研究（n = 288），1项是关于少量食物的研究（n = 85），2项是关于要素饮食的研究（n = 48）。对于未经过挑选的特应性湿疹患者，无蛋无奶饮食似乎并无益处。在未经过挑选的特应性湿疹病例中，也没有证据表明使用要素饮食或少量食物饮食有益。对于疑似对鸡蛋过敏且鸡蛋特异性IgE呈阳性的婴儿，采用无蛋饮食可能有一些益处——一项研究发现，与正常饮食相比，51%的儿童在采用排除饮食后体表面积有显著改善（95%CI 1.07 - 2.11），并且在6周结束时（MD 5.50，95%CI 0.19 - 10.81）以及治疗结束时（MD 6.10，95%CI 0.06 - 12.14），排除饮食组的体表面积变化和严重程度评分与正常饮食组相比有显著改善。尽管排除饮食法被频繁使用，但我们发现几乎没有高质量证据支持在特应性湿疹中使用排除饮食法。
