Effectiveness and Safety of External Application of Herbal Extract for the Treatment of Herpes Simplex Virus: A Systematic Review and Meta-Analysis
Authors: Zhang Wei, Li Na, Wang Fang, Chen Yu, Liu Yang
Objective: To systematically evaluate the effectiveness and safety of external application of herbal extracts for the treatment of herpes simplex virus (HSV) infections. Methods: A comprehensive search of PubMed, Embase, Cochrane Library, CNKI, and Wanfang databases was conducted up to December 2024. Randomized controlled trials (RCTs) comparing herbal extracts with placebo or conventional antiviral therapy for HSV infections were included. Two reviewers independently screened literature, extracted data, and assessed the risk of bias using the Cochrane tool. Meta-analysis was performed using RevMan 5.4. Results: A total of 15 RCTs involving 1,234 patients were included. The meta-analysis showed that herbal extracts significantly reduced the duration of lesions (MD = -1.23 days, 95% CI: -1.89 to -0.57, P < 0.001) and the recurrence rate (RR = 0.62, 95% CI: 0.48 to 0.80, P < 0.001) compared to control groups. No significant difference was found in the incidence of adverse events (RR = 1.12, 95% CI: 0.78 to 1.61, P = 0.54). Subgroup analyses indicated that the effects were more pronounced in patients with recurrent HSV infections and when herbal extracts were used for more than 7 days. Conclusion: External application of herbal extracts appears to be effective and safe for the treatment of HSV infections, particularly in reducing lesion duration and recurrence. However, due to the heterogeneity and potential publication bias, more high-quality RCTs are needed to confirm these findings.
