ABSTRACT
Herbal medicine is widely used for dermatological diseases, particularly atopic dermatitis. This study aims to systematically review existing literature on the efficacy of both topical and systemic herbal interventions for atopic dermatitis across various age groups. Conducting a comprehensive search on MEDLINE/PubMed, Scopus, and the Cochrane Central Register of Controlled Trials (Central) until April 12, 2023, only randomized controlled trials (RCTs) were included. The review is reported following the PRISMA guidelines and was conducted in accordance to Cochrane recommendations. Two authors independently extracted details, including demographics, medication, control/placebo groups, outcomes, adverse events, and results, with quality assessment using the Cochrane risk of bias tool 2.0. A meta-analysis, utilizing the random-effects model, was conducted, and publication bias was assessed through funnel plot inspection. The quality of evidence adhered to GRADE working group recommendations. The primary focus was evaluating atopic dermatitis or pruritus severity. The review encompassed 51 RCTs (3763 participants). Of these, 31 RCTs explored 19 distinct herbs and five complex remedies, whereas 20 RCTs (1088 participants) specifically investigated evening primrose oil (EPO). Herbs such as sunflower, licorice, figs, coconut, EPO, indigo naturalis, licorice, mauve, St. John's wort, and a combination of aloe vera and olive oil were found to have evidence of efficacy in the local treatment of atopic dermatitis. A meta-analysis on systemic used EPO, involving 13 RCTs, found no significant difference in atopic dermatitis severity compared with placebo (SMD: 0.14; 95% CI [-0.45; 0.73], 13 RCTs). In conclusion, this review provides a nuanced perspective on herbal substance efficacy for atopic dermatitis. While the EPO meta-analysis failed to show a discernible benefit beyond placebo, individual herbal preparations showed promising results in RCTs included in this review. Nevertheless, larger, methodologically rigorous studies are essential to establish evidence for herbal remedies in atopic dermatitis treatment.
ABSTRACT
Pain that persists or recurs over a period of at least 3 months in childhood and adolescence is referred to as chronic pain. The primary localization of pain changes according to age: abdominal pain is more common at a younger age, headache is more common in adolescents and later back pain as well as muscle and joint pain. In the multimodal and interdisciplinary treatment of chronic pain, complementary procedures can expand the treatment spectrum. This article provides an overview of the existing evidence that for childhood and adolescence can at best be evaluated as readily understandable. In addition, the experiences of two children's hospitals show that complementary medicine can be used as a low-threshold and easily implemented therapy.
Subject(s)
Chronic Pain , Child , Adolescent , Humans , Chronic Pain/therapy , Abdominal Pain/therapy , Back Pain/therapy , Headache/therapy , Pain Management/methodsABSTRACT
BACKGROUND: In Germany, there is hardly any institutionalization of pediatric complementary and integrative medicine (CIM) present, which is one reason why the statutory health insurance companies usually do not cover the costs. Which in turn serves as an obstacle for integrating CIM into routine pediatric care. Within the present study, we assessed existing demand for CIM methods in parents of children in clinical primary care and whether the parents would be willing to cover the costs privately. METHODS: Parents who visited the Pediatric Department of the Elisabeth Hospital, Essen, Germany and the Children's Hospital St. Marien, Landshut, Germany with their children in 2015 and 2016 were asked to take part in a paper-pencil survey. Both outpatients and inpatients were interviewed. RESULTS: 1323 parents took part in the survey. 40 % of them stated that they already use CIM for their children. Homeopathy was the most frequently mentioned with almost 60 %, followed by osteopathy and phytotherapy. More than 80 % of the participants endorsed the expansion of the CIM offers in respective hospitals. Homeopathy was the method most desired by the parents, followed by osteopathy, phytotherapy and massage therapies. The majority (88 %) of the parents stated that they would like to take advantage of an extended range of services, including extra services that they would have to pay privately for. CONCLUSION: Many parents are already using CIM for their children and are looking forward to CIM being incorporated in clinical primary care. They would also be willing to bear the costs themselves if the therapy in question is not covered by their insurance. pay for the costs themselves if the therapy is not covered by their insurance.
Subject(s)
Complementary Therapies , Integrative Medicine , Pediatrics , Child , Hospitals , Humans , ParentsABSTRACT
Pediatric integrative medicine focuses on the whole child and the environment in which the child grows up during the treatment of a child's illness. Nowadays, many different treatment modalities are applied even in children, and doctors need to know about them and, ideally, be able to apply different approaches in the process of treating a child themselves. The program Pediatric Integrative Medicine in Residency (PIMR) already provides residents with several tools to provide this kind of service for the child. In our PIMR pilot program in Germany, we chose to diversify our knowledge about treatment and prevention options by visiting a Kneipp-certified kindergarten in Germany. The philosophy of Sebastian Kneipp focuses on five pillars of health, which incorporate aspects of prevention, self-awareness, self-responsibility, and consciousness of health by means of hydrotherapy, herbal medicine, exercise, nutrition, and lifestyle-medicine. These are being taught to the children during the early years they spend in kindergarten, and represent integral parts of integrative medicine. Integration of Kneipp-based health programs within a kindergarten setting can work well and provides an effective means of early prevention education in childhood.