Table 1 Characteristics of included randomized clinical trials on CAM therapies for childhood atopic eczema

 Liu CH 2009 [20]

T:150 C:148

T:1-6 m, 80 cases; 6-12 m, 50 cases; 1-2 y, 20 cases

C:1-6 m, 83 cases; 6-12 m, 44 cases; 1-2 y, 21 cases

T:88/62

C:86/44

Swimming therapy + Baibu (Stemona japonica) lotion (bath) + Tuina vs Cyproheptadine (oral) + Boric lotion (external application with cold lotion)/Hydrocortisone butyrate cream (external use)/Zinc oxide cream (external use) (7-15d)

Improvement of symptoms and signs and signs;

IgG;

Relapse (T:26/150, 3 m; 37/150, 6 m C:80/148, 3 m; 96/148, 6 m)

3 m, 6 m

 Liu WQ 2016 [21]

T:60 C:60

T:(4.5 ± 3.8) y C:(5.3 ± 4.5) y

T:37/23

C:33/27

Fasting and rotation diet vs Pevisone paste (external use) (3 m)

Improvement of symptoms and signs;

IgG;

Relapse (T:4/60 C:11/60)

3 m

 Wu YQ 2014 [22]

T:74 C:74

T:(6.35 ± 1.36) m C:(5.98 ± 1.23) m

T:41/33

C:31/43

Velvetfeeling lotion (external application) + Moisturizing cream (external use) + Saline water (dipping) vs Boric lotion (external application) + Vitamin E (external use) + Saline water (dipping) (7d)

Improvement of symptoms and signs;

CGI-EI

NR

 Chen DX 2015 [23]

T:20 C:20

T:(3.82 ± 0.7) m C:(2.35 ± 1.3) m

NR

Bifid triple viable capsules (oral) + Hydrocortisone butyrate cream (external use) vs Hydrocortisone butyrate cream (external use) (180d)

Improvement of symptoms and signs

6 m

 Chen YL 2015 [24]

T:58 C:58

T:(11 ± 5) m

C:(12 ± 5) m

T:31/27

C:30/28

Probiotics (oral) + Chlorphenamine maleate tablets (oral) + Vitamin B6 + Fluocinonide cream (external use) + Calcium supplement (oral) vs Chlorphenamine maleate tablets (oral) + Vitamin B6 + Fluocinonide Cream (external use) + Calcium supplement (oral) (28d)

Improvement of symptoms and signs;

CGI-EI;

Interleukin;

Interferon;

Relapse (T:9/58 C:29/58)

NR

 Guo YH 2015 [25]

T:90 C:90

T:2 m-3 y

C:2 m-3 y

total: 98/82

Tetralogy of viable bifidobacterium tablets (oral) + Usual care (Calamine lotion/ Zinc oxide cream/ Loratadine syrup/ Mometasone furoate cream) vs Usual care (Calamine lotion/Zinc oxide cream/Loratadine syrup/Mometasone furoate cream) (30d)

Improvement of symptoms and signs;

IL-4, IL-10, IFN-γ, IgE, Th1/Th2;

Relapse (T:24/90 C:62/90)

3 m

 Jiang YX 2013 [26]

T:65 C:60

T:2 y

C:2 y

total: 72/53

Velvetfeeling lotion (external application) + Usual care (eg. Chlorphenamine maleate tablets) vs Usual care (eg. Chlorphenamine maleate tablets) + Boric lotion (external application) (28d)

Improvement of symptoms and signs

NR

 Li DY 2012 [27]

T:32 C:30

T:(7.15 ± 2.06) m C:(6.89 ± 2.54) m

T:17/15

C:16/14

Bifid triple viable capsules (oral) + Zinc oxide cream (external use) + Boric lotion (external application) vs Zinc oxide cream (external use) + Boric lotion (external application) (14d drugs for external use/28d Oral bifid-triple viable capsule)

Improvement of symptoms and signs;

Relapse (T:6/32 C:20/30)

NR

 Mao HX 2013 [28]

T:50 C:50

T:2 m-5 y

C:2 m-5 y

T:24/26

C:28/22

Probiotics (oral) + Antihistamines (oral) + Calcium supplement (oral) + Skincare cream (external use) vs Antihistamines (oral) + Calcium supplement (oral) + Skincare cream (external use)

Improvement of symptoms and signs;

Relapse (T:2/50 C:12/50)

NR

 Wei MX 2010 [29]

T:38 C:36

T:(6.78 ± 2.62) m C:(7.14 ± 2.10) m

T:22/16

C:19/17

Viable Bacillus coagulans tablets (oral) + Boric lotion (wash-out) + Zinc oxide cream (external use) vs Boric lotion (wash-out) + Zinc oxide cream (external use) (28d)

Improvement of symptoms and signs;

Relapse (T:7/38 C:24/36)

6 m

 Ye CQ 2017 [30]

T:48 C:48

T:(6.9 ± 2.4) m

C:(6.8 ± 2.6) m

T:27/21

C:28/20

Condensation living bacterium bacillus (oral) + Boric lotion (wash-out) + Zinc oxide cream (external use) vs Boric lotion (wash-out) + Zinc oxide cream (external use) (28d)

Improvement of symptoms and signs;

Relapse (T:6/48 C:28/48)

6 m

 Zhang MH 2013 [31]

T:35 C:35

T:(5 ± 3) m

C:(6 ± 3) m

T:27/8

C:25/10

Bifico lriple viable (oral) + Boric lotion (wash-out) + Zinc oxide cream (external use) + Cetirizine hydrochloride drops (oral) vs Boric lotion (wash-out) + Zinc oxide cream (external use) + Cetirizine hydrochloride drops (oral) (30d)

IFN-γ;

Interleukin;

T-Cell;

Relapse (T:6/35 C:16/58)

6 m

 Zhang XN 2013 [32]

T:36 C:34

total:(7.06 ± 3.48) y

total:32/38

Velvetfeeling lotion (external application) + Butyl flufenamate ointment (external use) + Antihistamine (oral) vs Saline water (external application) + Butyl flufenamate ointment (external use) + Antihistamine (oral) (14d)

Improvement of symptoms and signs;

CGI-EI

NR

 D. Sistek 2006 [33]

T:30 C:29

T:3.8 y

C:4.4 y

T:15/14

C:17/13

Probiotics (oral) vs Placebo (oral) (12w)

Improvement of symptoms and signs

4w

 Hyeon-Jong Yang 2014 [34]

T:50 C:50

T:(58.7 ± 29.9) m C:(47.4 ± 28.1) m

T:29/21

C:24/26

Probiotics (oral) vs Placebo (oral) (6w)

Improvement of symptoms and signs;

Fecal cell counts;

IL-4;

TNF-α

NR

 Reza 2011 [35]

T:19 C:21

T:(28.68 ± 40.86) m C:(22.76 ± 34.03) m

T:11/8

C:14/7

Synbiotic (oral) vs Placebo (oral) (8w)

Improvement of symptoms and signs

Mononuclear cells

NR

 S Weston 2017 [36]

T:28 C:28

T:(11.5 ± 4.2) m C:(10.3 ± 3.2) m

T:14/14

C:16/12

VRI-003 PCC freeze dried powder probiotics (oral) vs Placebo (oral) (8w)

Improvement of symptoms and signs;

total IgE levels;

radioallergosorbent test

8w

 Sergei V. Gerasimov 2010 [37]

T:48 C:48

T:(25.6 ± 7.7) m C:(24.1 ± 6.3) m

T:28/15

after withdrew

C:28/19

after withdrew

Probiotics (oral) vs Placebo (oral) (8w)

Improvement of symptoms and signs;

Quality of life;

Total IgE;

Eosinophil count

NR

 Shoko 2007 [38]

T:16 C:16

T:4.44 y

C:5.56 y

T:9/7

C:12/4

Borage oil (undershirts coated with oil) vs Placebo (non-coated undershirts) (2w)

Improvement of symptoms and signs;

Changes of transepidermal water loss

NR

 Wu YJ 2017 [39]

T:33 C:33

T:(1.5 ± 1.1) m

C:(7.14 ± 2.10) m

T:25/8

C:19/14

Probiotics (Lactobacillus rhamnosus) (oral) vs Placebo (oral) (8w)

Improvement of symptoms and signs;

Quality of Life (Infant Dermatitis Quality of Life Questionnaires and Dermatitis Family Impact Questionnaires);

NR

 Yavuz 2012 [40]

T:20 C:20

total:1-13 y

total: 23/17

Probiotic bacteria (oral) vs Placebo (oral) (8w)

Improvement of symptoms and signs;

cytokine analyse/IgE/Eosinophil cationic protein

10w

 Youngshin 2012 [41]

T:58 C:60

T:(4.6 ± 3.3) y C:(5.1 ± 3.3) y

T:34/24

C:35/25

Probiotics (L. plantarum CJLP133) (oral) vs Placebo (oral) (12w)

Improvement of symptoms and signs;

total IgE levels/specific IgE

2w

 Pasi E. Kankaanpa 2002 [42]

T1:5

T2:5

C1:5

T1:(4.5 ± 2) m T2:(5.7 ± 2.2) m C1:(5.6 ± 2.1) m

T1:2/3 T2:3/2 C1:2/3

Probiotics (Lactobacillus GG) (oral) vs Probiotics (Bifidobacterium Bb12) (oral) vs placebo (oral) (①4.4 ± 1.7 m ②7.3 ± 0.7 m ③5.7 ± 2.0 m)

Fatty acid analysis

≥36 m follow until panticipants at the age of 3 years

 C. Gore 2011 [43]

T1:45

T2:45

C1:47

C2:22

C3:49

T1:19 [16-23] w T2:20.5 [17-23] w C1:20 [16-23] w C2:15 [13-19.5] w C3:19 [15-21.5] w

T1:28/17 T2:24/21 C1:28/19 C2:16/6 C3:25/24

Probiotics (Lactobacillus paracasei) (oral) vs Probiotics (Bifidobacterium) (oral) vs Placebo (oral) vs Exclusively breastfed vs Standard formula-fed (12w)

Improvement of symptoms and signs;

Quality of life;

Stool;

GI-Permeability;

Specific serum IgE;

Urinary EPX

NR