Background

Despite high use of complementary and alternative medicine (CAM) for alopecia areata (AA), efficacy and safety remain unclear.

Objective

To identify all CAM therapies studied for treatment of AA. Outcomes of interest included disease course and psychologic well-being.

Methods

PubMed and Embase were searched to identify English articles containing original data investigating CAM in individuals with AA from 1950-2018. Quality was assessed with Oxford Centre for Evidence Based Medicine criteria.

Results

Of 1015 initial citations, 16 articles met inclusion criteria: 5 randomized controlled trials, 5 prospective controlled cohorts, 4 prospective noncontrolled cohorts, 1 retrospective cohort, and 1 case series. CAM therapies with best evidence and efficacy for hair growth in AA include essential oil aromatherapy, topical garlic, and oral glucosides of peony with compound glycyrrhizin. Hypnosis and mindfulness psychotherapy represent low-quality evidence for improvement of psychologic and quality of life outcomes. Adverse events were rare and mild for all therapies evaluated.

Limitations

Inconsistent or poorly reported study methodology and nonstandardized outcomes limit the conclusions that can be made from these studies.

Conclusions

This work serves to inform physician treatment of patients with AA seeking CAM while encouraging further investigation into these therapies to address some of the therapeutic challenges of AA.

中文翻译：

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斑秃的补充和替代医学：系统评价

背景

尽管大量使用补充和替代药物 (CAM) 治疗斑秃 (AA)，但疗效和安全性仍不清楚。

客观的

确定所有研究用于治疗 AA 的 CAM 疗法。感兴趣的结果包括病程和心理健康。

方法

搜索 PubMed 和 Embase 以识别包含 1950-2018 年 AA 患者 CAM 调查原始数据的英文文章。质量根据牛津循证医学中心标准进行评估。

结果

在 1015 篇初始引用中，有 16 篇文章符合纳入标准：5 篇随机对照试验、5 篇前瞻性对照队列、4 篇前瞻性非对照队列、1 篇回顾性队列和 1 个病例系列。对 AA 的头发生长具有最佳证据和疗效的 CAM 疗法包括精油芳香疗法、外用大蒜和口服牡丹苷和复方甘草甜素。催眠和正念心理治疗是改善心理和生活质量结果的低质量证据。对于所有评估的疗法，不良事件很少见且轻微。

限制

不一致或报告不佳的研究方法和非标准化结果限制了可以从这些研究中得出的结论。

结论

这项工作有助于为寻求 CAM 的 AA 患者的医生治疗提供信息，同时鼓励进一步研究这些疗法以解决 AA 的一些治疗挑战。