Madhok V, Futamura M, Thomas K S, Barbarot S
Division of Population Health Sciences, University of Dundee, Dundee, UK.
Division of Allergy, National Center for Child Health and Development, Tokyo, Japan.
Clin Exp Dermatol. 2015 Jun;40(4):349-54; quiz 354-5. doi: 10.1111/ced.12591. Epub 2015 Jan 27.
This review provides a summary of key findings from 22 systematic reviews on atopic eczema (AE) published over the 2-year period from January 2012 to 31 December 2013, focusing on prevention and treatment of AE. For an update of systematic reviews on the epidemiology, mechanisms of disease and methodological issues, see Part 1 of this update. Based on current systematic review evidence, the most promising intervention for the prevention of AE is the use of probiotics (and possibly prebiotics) during the late stages of pregnancy and early life. Exposure to household pets, especially dogs, may also be protective, but exclusive breastfeeding for up to 7 months does not confer benefit. The role of vitamin D in preventing AE is currently unclear. Very few of the systematic reviews provided additional evidence for the use of specific treatments for AE. Further research is required to establish the role of desensitization, Chinese herbal medicines, homeopathy and specialist clothing. Nevertheless, there is now clear evidence that evening primrose oil and borage oil are not effective for the treatment of AE. There have been no randomized controlled trials on the use of H1 anti-histamines as monotherapy for the treatment of AE.
本综述总结了2012年1月至2013年12月这两年期间发表的22篇关于特应性皮炎（AE）的系统评价的主要发现，重点关注AE的预防和治疗。关于AE流行病学、疾病机制和方法学问题的系统评价更新内容，见本更新的第1部分。基于目前的系统评价证据，预防AE最有前景的干预措施是在妊娠后期和生命早期使用益生菌（可能还有益生元）。接触家养宠物，尤其是狗，也可能具有保护作用，但纯母乳喂养长达7个月并无益处。维生素D在预防AE中的作用目前尚不清楚。很少有系统评价为AE的特定治疗方法提供额外证据。需要进一步研究以确定脱敏、中药、顺势疗法和特制服装的作用。然而，现在有明确证据表明月见草油和琉璃苣油对治疗AE无效。尚无关于使用H1抗组胺药作为AE单一疗法的随机对照试验。
