Clinical evidence on integrated Chinese-Western medicine for atopic dermatitis

Atopic dermatitis (AD) is a common chronic inflammatory skin disorder with substantial global burden. In some regions, Chinese medicine (CM) and integrated Chinese-Western medicine (ICWM) are widely used, but the overall clinical evidence remains unclear. This study aimed to systematically map and synthesize evidence on CM and ICWM for AD.

A structured literature review was conducted using 14 predefined clinical questions to guide evidence mapping. CNKI, Wanfang Data, PubMed, Cochrane Database of Systematic Reviews, and CENTRAL were searched from inception to September 6, 2025. Included studies comprised clinical practice guidelines/consensus statements (CPGs/CSs), systematic reviews/meta-analyses (SR/MAs), and randomized controlled trials (RCTs) evaluating CM versus conventional Western therapy (CWT), or CM plus CWT versus CWT. Risk of bias and methodological quality were assessed using AGREE II, AMSTAR 2, and ROBUST-RCT tools.

A total of 285 studies were included (19 CPGs/CSs, 16 SR/MAs, 250 RCTs). Evidence was most abundant for oral Chinese herbal medicine (CHM) combined with CWT and for external CHM therapies. Integrated oral CHM plus CWT generally improved disease severity, pruritus, and quality of life compared with CWT alone. External CHM therapies showed comparable or superior efficacy to topical corticosteroids, with similar or fewer adverse events. Methodological quality was heterogeneous, and outcome reporting was often incomplete.

The current evidence suggests potential benefits of CM and ICWM for AD, particularly for oral CHM combined with conventional therapy and external CHM interventions. However, the overall certainty of evidence is limited by methodological weaknesses and incomplete reporting.