Kwon Chan-Young, Lee Boram, Kim Suran, Lee Jaesuk, Park Minjung, Kim Namkwen
Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, 62 Yangjeong-ro, Busanjin-gu, Busan 47227, Republic of Korea.
Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Republic of Korea.
Evid Based Complement Alternat Med. 2020 Jul 17;2020:4140692. doi: 10.1155/2020/4140692. eCollection 2020.
Herbal medicine (HM) is attracting attention for treating atopic dermatitis (AD). This overview was conducted to summarize and critically evaluate the current systematic reviews (SRs) on HM for the treatment of AD.
Through comprehensive searches, all relevant SRs on HM for AD published until May 2020 were included. The quality of included SRs was assessed using the AMSTAR-2 tool. Moreover, original randomized controlled trials (RCTs) included in the SRs were resynthesized to investigate the efficacy and safety of oral HM for AD. The quality of evidence for the main findings was evaluated using the GRADE approach.
Nine SRs were included in this overview. HM showed significantly better efficacy in terms of total effective rate (TER), itching and sleep symptom scores, quality of life, and the dose of topical treatment used compared with placebo. HM as a monotherapy and/or an adjunctive therapy to conventional medication (CM) showed significantly better results on the efficacy, symptom relief, and some laboratory parameters related to the inflammatory response. The methodological quality was generally low. When 58 original RCTs were reanalyzed, HM showed significantly lower SCORing Atopic Dermatitis (SCORAD) score and higher TER than the placebo or CM. In terms of the safety profile, HM was not significantly different from the placebo and was better than CM. The quality of evidence ranged from "moderate" to "very low."
The results suggested that HM as a monotherapy or an adjunctive therapy is promising for the treatment of AD. However, due to low methodological quality and low quality of evidence, further rigorous, well-designed, high-quality SRs, and RCTs are needed to make clinical recommendations on HM use.
草药医学（HM）在治疗特应性皮炎（AD）方面正受到关注。本综述旨在总结并批判性评价当前关于HM治疗AD的系统评价（SRs）。
通过全面检索，纳入了截至2020年5月发表的所有关于HM治疗AD的相关SRs。使用AMSTAR - 2工具评估纳入SRs的质量。此外，对SRs中纳入的原始随机对照试验（RCTs）进行重新分析，以研究口服HM治疗AD的疗效和安全性。使用GRADE方法评估主要研究结果的证据质量。
本综述纳入了9项SRs。与安慰剂相比，HM在总有效率（TER）、瘙痒和睡眠症状评分、生活质量以及外用治疗药物剂量方面显示出显著更好的疗效。HM作为单一疗法和/或传统药物（CM）的辅助疗法，在疗效、症状缓解以及一些与炎症反应相关的实验室参数方面显示出显著更好的结果。方法学质量总体较低。当对58项原始RCTs进行重新分析时，与安慰剂或CM相比，HM显示出显著更低的特应性皮炎评分（SCORAD）和更高的TER。在安全性方面，HM与安慰剂无显著差异，且优于CM。证据质量从“中等”到“极低”不等。
结果表明，HM作为单一疗法或辅助疗法在治疗AD方面具有前景。然而，由于方法学质量低和证据质量差，需要进一步进行严谨、设计良好的高质量SRs和RCTs，以便就HM的使用提出临床建议。
