Schmitt Jochen, Apfelbacher Christian J, Flohr Carsten
Department of Dermatology, Medical Faculty, Technische Universitat Dresden, Dresden, Germany.
BMJ Clin Evid. 2011 May 17;2011:1716.
Eczema, as defined by the World Allergy Organization (WAO) revised nomenclature in 2003, affects 15% to 20% of school children and 2% to 5% of adults worldwide. About 50% of people with eczema demonstrate atopy, with specific immunoglobulin E responses to allergens.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of topical medical treatments, and dietary interventions in adults and children with established eczema? What are the effects of breastfeeding, reducing allergens, or dietary interventions for primary prevention of eczema in predisposed infants? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 54 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: breastfeeding, controlling house dust mites, corticosteroids, dietary exclusion of eggs or cow's milk, elementary diets, emollients, essential fatty oils, few-foods diet, multivitamins, pimecrolimus, probiotics, pyridoxine, reducing maternal dietary allergens, tacrolimus, vitamin E, and zinc supplements.
根据世界过敏组织（WAO）2003年修订的命名法，湿疹影响着全球15%至20%的学龄儿童和2%至5%的成年人。约50%的湿疹患者表现出特应性，即对过敏原产生特异性免疫球蛋白E反应。
我们进行了一项系统评价，旨在回答以下临床问题：局部药物治疗以及饮食干预对已患湿疹的成人和儿童有何影响？母乳喂养、减少过敏原或饮食干预对易患湿疹的婴儿进行湿疹一级预防有何影响？我们检索了：截至2009年5月的医学文献数据库（Medline）、荷兰医学文摘数据库（Embase）、考克兰图书馆以及其他重要数据库（临床证据综述会定期更新，请查看我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品及医疗保健产品监管局（MHRA）等相关组织的危害警示。
我们找到了54项符合我们纳入标准的系统评价、随机对照试验或观察性研究。我们对干预措施的证据质量进行了GRADE评估。
在本系统评价中，我们提供了以下干预措施的有效性和安全性相关信息：母乳喂养、控制屋尘螨、使用皮质类固醇、饮食中排除鸡蛋或牛奶、基础饮食、润肤剂、必需脂肪酸油、少量食物饮食、多种维生素、吡美莫司、益生菌、维生素B6、减少母亲饮食中的过敏原、他克莫司、维生素E以及锌补充剂。
