The positive effects of habit reversal treatment of scratching in children with atopic dermatitis: a randomized controlled study
The positive effects of habit reversal treatment of scratching in children with atopic dermatitis: a randomized controlled study
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DOI：
10.1111/bjd.16009
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发表时间：
2018-03-01
影响因子：
10.3
通讯作者：
Melin, L.
中科院分区：
文献类型：
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作者：
Noren, P.;Hagstromer, L.;Melin, L.
背景瘙痒和痉挛是特应性皮炎（AD）常见的临床表现。对成年患者的研究表明，减少抓挠行为导致炎症消退和皮肤愈合改善。ObjectivesTo调查是否可以使用改良的习惯逆转（HR）治疗方案治疗儿童抓挠，以改善皮肤状况。随机对照试验，39名患者在随机分为两组（干预组或对照组）之一前一周开始登记。干预组的参与者除了接受强效类固醇（糠酸莫米松）外，还接受了对其抓挠行为（即HR）的习惯打破疗法，而对照组的患者仅接受类固醇。患者在登记第一周后（基线评估）以及治疗3周和8周后由独立皮肤科医生进行评估。主要疗效变量是一个客观的特应性皮炎评分（SCORAD）的变化。结果在3周的治疗期结束时，平均客观SCORAD的变化显着（P=0027）高于干预组（-31995）比对照组（-238101）。8周随访后，干预组（-317104）的平均客观SCORAD变化显著（P=00038）高于对照组（-19794）。ConclusionsThe treatment of scratching with the HR method in combination with a potent steroid was found to improve skin status significantly after 3 and 11 weeks. What's already known about this topic？以前的研究表明，习惯逆转（HR）方法（最初用于神经习惯，如咬指甲），结合局部类固醇，可以成功地用于减少成人特应性湿疹的抓挠，并促进比单独类固醇更好的愈合。这项研究补充了什么？一种有效的类固醇与HR一起可用于治疗儿童特应性湿疹的抓挠。结果是上级的类固醇单独在3周的试验。Br J Dermatol 2018; 178：584-585。在线提供简明语言摘要回复本文
BackgroundScratching and itch are common clinical signs of atopic dermatitis (AD). Studies of adult patients have shown that a decrease in scratching behaviour results in regression of inflammation and improved healing of the skin.ObjectivesTo investigate whether a modified habit reversal (HR) treatment protocol could be used for the treatment of scratching in children to improve skin status.MethodsThe study is a single-blind, randomized controlled trial of 39 patients who started with registration a week before randomization into one of two groups (intervention or control). The participants in the intervention group received a habit-breaking therapy of their scratching behaviour (i.e. HR) in addition to a potent steroid (mometasone furoate), whereas the patients in the control group received the steroid alone. The patients were assessed by an independent dermatologist after the first week of registration (baseline assessment) and then after 3 and 8weeks of treatment. The primary efficacy variable was a change in objective Scoring Atopic Dermatitis (SCORAD).ResultsAt the end of the 3-week treatment period, the change in mean objective SCORAD was significantly (P=0027) higher in the intervention group (-31995) than in the control group (-238101). After the 8-week follow-up, the change in mean objective SCORAD was significantly (P=00038) higher in the intervention group (-317104) than in the control group (-19794).ConclusionsThe treatment of scratching with the HR method in combination with a potent steroid was found to improve skin status significantly after 3 and 11weeks.What's already known about this topic?Previous studies have shown that the habit reversal (HR) method (initially used for nervous habits like nail biting), in combination with local steroids, can be successfully used to decrease scratching in adult atopic eczema and to promote better healing than a steroid alone.What does this study add?A potent steroid together with HR can be used to treat scratching in children's atopic eczema. The results were superior to the steroid alone in a 3-week trial.Linked Comment:Bewley. Br J Dermatol 2018; 178:584-585. Plain language summary available online Respond to this article