Department of Internal Medicine, Mayo Clinic, 200 First Street South West, Rochester, MN 55905, USA.
Immunol Allergy Clin North Am. 2010 Aug;30(3):411-24. doi: 10.1016/j.iac.2010.06.006.
The burden of atopic diseases, including atopic dermatitis (AD), is significant and far-reaching. In addition to cost of care and therapies, it affects the quality of life for those affected as well as their caretakers. Complementary and alternative therapies are commonly used because of concerns about potential adverse effects of conventional therapies and frustration with the lack of response to prescribed medications, be it due to the severity of the AD or the lack of appropriate regular use. Despite the promising results reported with various herbal medicines and biologic products, the clinical efficacy of such alternative therapies remains to be determined. Physicians need to be educated about alternative therapies and discuss benefits and potential adverse effects or limitations with patients. A systematic approach and awareness of reputable and easily accessible resources are helpful in dealing with complementary and alternative medicine (CAM). The use of CAM interventions is common among individuals with AD. Epidemiologic data have been a motivating drive for better elucidation of the efficacy of CAM interventions for allergic disease. Herbal medicines and biologics for AD treatment and, more recently, prevention comprise a major area of clinical investigation. Potential mechanisms of therapeutic effect elucidated by animal models and human clinical studies implicate modulation of TH2-type allergic inflammation and induction of immune tolerance. Population-based research regarding the use of CAM for allergic diseases underscores the increasing challenge for care providers with respect to identifying CAM use and ensuring safe use of allopathic and complementary medicines in disease management.
特应性疾病（包括特应性皮炎）的负担巨大且影响深远。除了治疗的费用和疗法外，它还影响到受影响者及其照顾者的生活质量。由于对传统疗法的潜在不良反应的担忧以及对处方药物缺乏反应（无论是由于 AD 的严重程度还是缺乏适当的常规使用）感到沮丧，因此经常使用补充和替代疗法。尽管各种草药和生物制品的报告结果令人鼓舞，但此类替代疗法的临床疗效仍有待确定。医生需要接受替代疗法的教育，并与患者讨论其益处、潜在的不良反应或局限性。系统的方法和对信誉良好且易于获取的资源的认识有助于处理补充和替代医学（CAM）。CAM 干预措施在 AD 患者中很常见。流行病学数据一直是更好地阐明 CAM 干预措施对过敏性疾病疗效的动力。草药药物和生物制剂用于 AD 的治疗，最近也用于预防，构成了临床研究的主要领域。动物模型和人体临床研究阐明的潜在治疗作用机制表明，TH2 型过敏炎症的调节和免疫耐受的诱导。关于 CAM 用于过敏性疾病的基于人群的研究强调了对护理提供者的日益挑战，即识别 CAM 的使用，并确保在疾病管理中安全使用全效药物和补充药物。
