Futamura Masaki, Masuko Ikuyo, Hayashi Keiichi, Ohya Yukihiro, Ito Komei
Division of Allergy, Department of Medical Specialties, National Center for Child Health and Development, Tokyo, Japan.
Pediatr Dermatol. 2013 Jul-Aug;30(4):438-43. doi: 10.1111/pde.12105. Epub 2013 Mar 5.
Parental education is important in managing childhood atopic dermatitis (AD). We evaluated the long-term effects of a 2-day parental education program (PEP) on childhood AD. In an investigator-blinded, randomized controlled trial, 59 children age 6 months to 6 years with moderate to severe AD and their mothers were recruited in Japan. Participants were given a booklet about AD and received conventional treatment alone or in combination with a 2-day PEP comprising three lectures, three practical sessions, and a group discussion. The primary outcome was evaluation of eczema severity using SCORing Atopic Dermatitis (SCORAD) at 6 months. Secondary outcomes included changes in symptom scores, amount of corticosteroid used, parental quality of life as determined according to the Dermatitis Family Impact questionnaire, and change in parental anxiety regarding the use of corticosteroids in their children. Participants in the PEP group had a significantly lower SCORAD score than those in the control group at 6 months (mean difference 10.0, 95% confidence interval [CI] = 2.3-17.7, p = 0.01) and objective SCORAD score (mean difference 7.1, 95% CI = 0.8-13.5, p = 0.03). The sleeplessness symptom score (mean difference 1.6, 95% CI = 0.0-3.1, p = 0.048) and corticosteroid anxiety score (p = 0.02) in the PEP group were significantly better than in the control group at 6 months. There was no significant difference between groups in the amount of corticosteroid used or quality of life. The PEP had positive long-term effects on eczema severity and parental anxiety about corticosteroid usage.
家长教育在儿童特应性皮炎(AD)的管理中很重要。我们评估了一项为期两天的家长教育计划(PEP)对儿童AD的长期影响。在一项研究者盲法、随机对照试验中,日本招募了59名6个月至6岁患有中度至重度AD的儿童及其母亲。参与者收到一本关于AD的手册,并单独接受常规治疗,或与为期两天的PEP联合接受治疗,该计划包括三场讲座、三场实践课程和一次小组讨论。主要结局是在6个月时使用特应性皮炎评分(SCORAD)评估湿疹严重程度。次要结局包括症状评分的变化、皮质类固醇的使用量、根据皮炎家庭影响问卷确定的家长生活质量,以及家长对其子女使用皮质类固醇的焦虑变化。在6个月时,PEP组的SCORAD评分显著低于对照组(平均差值10.0,95%置信区间[CI]=2.3-17.7,p=0.01),客观SCORAD评分也显著低于对照组(平均差值7.1,95%CI=0.8-13.5,p=0.03)。在6个月时,PEP组的失眠症状评分(平均差值1.6,95%CI=0.0-3.1,p=0.048)和皮质类固醇焦虑评分(p=0.02)显著优于对照组。两组在皮质类固醇使用量或生活质量方面没有显著差异。PEP对湿疹严重程度和家长对皮质类固醇使用的焦虑有积极的长期影响。