Integrated Western and Chinese Medicine Interventions for Atopic Dermatitis: A Systematic Review and Meta-analysis

Abstract

\n BackgroundAtopic Dermatitis (AD) is a chronic relapsing skin disease characterized by recurring episodes of itchiness with skin erythema and surface damages. Chinese medicine (CM) is widely used for the management of AD in China not only by its own, but also used in combination with conventional therapy (integrated Western-Chinese medicine, ICWM) in China. Although many clinical trials on the effectiveness of ICWM on AD have been reported; however, up to date, no sound evidence has been established on the clinical effectiveness and safety of ICWM for AD. ObjectivesTo systematically review the currently available clinical evidence on the clinical effectiveness and safety of ICWM for AD. MethodsRandomized and quasi-randomized controlled trials, which investigated ICWM interventions with at least one control group using the same conventional interventions, no treatment or placebo treatment, were included. Four English (CENTRAL, MEDLINE, EMBASE, AMED) and three Chinese (CNKI, CBM, WanFang Med) databases were searched. Risk of bias was assessed according to the Cochrane’s tool. Meta-analysis were performed to pool the data. ResultsFrom 1473 database entries, 55 studies were included, of which 5953 participants aged between 35 days to 67 years old were involved. Duration of treatment ranged from 1 to 24 weeks. Only 2 studies were judged to be at low risk of bias, 3 studies at unclear risk of bias, and the other 50 studies at high risk of bias. The research findings suggested that ICWM was superior over WM alone in improving clinical severity of AD (measured by EASI, SCORAD), health-related quality of life (measured by CDLQI, DLQI), long term control of AD (recurrence rate), patients/ investigator global score (effectiveness rate), and serum IgE level. No more adverse events associated with ICWM was found when compared with WM alone. ConclusionAdopting ICWM may be superior to using WM alone in managing AD without risk of more adverse events. However, the current available evidence is still too weak to generate conclusive results.