Dodd C S
Cardiff Univeristy, Cardiff School of Biosciences, PO Box 915, Cardiff, UK, CF10 3TL.
Cochrane Database Syst Rev. 2007 Jul 18;2001(4):CD001165. doi: 10.1002/14651858.CD001165.pub2.
Infection with head lice is a widespread condition in developed and developing countries. Infection occurs most commonly in children, but also affects adults. If left untreated the condition can become intensely irritating and skin infections may occur if the bites are scratched.
The aim of this review was to assess the effects of interventions for head lice.
Cochrane Infectious Diseases Group specialized trials register (July 2002); The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2002); MEDLINE and TOXLINE (1966 to July 2002); EMBASE (1980 to May 2002); LILACS (July 2002); Science Citation Index (1981 to July 2002); BIOSIS (1985 to July 2002); reference lists of relevant articles; pharmaceutical companies producing pediculicides (published and unpublished trials); UK and US Regulatory Authorities.
Randomised trials (published and unpublished) or trials using alternate allocation were sought which compared pediculicides with the same and different formulations of other pediculicides, and pediculicides with physical methods.
Of the 71 identified studies, only four met the inclusion criteria. Two reviewers independently assessed trial quality. One reviewer extracted the data.
We found no evidence that any one pediculicide has greater effect than another. The two studies comparing malathion and permethrin with their respective vehicles showed a higher cure rate for the active ingredient than the vehicle. Another study comparing synergised pyrethrins with permethrin showed their effects to be equivalent. A comparative trial of malathion lotion vs combing, showed combing to be ineffective for the cureative treatment of head lice infection. Adverse effects were reported in a number of trials and were all minor, although reporting quality varied between trials.
AUTHORS' CONCLUSIONS: Permethrin, synergised pyrethrin and malathion were effective in the treatment of head lice. However, the emergence of drug resistance since these trials were conducted means there is no direct contemporary evidence of the comparative effectiveness of these products. The 'best' choice will now depend on local resistance patterns. Physical treatment methods(BugBusting) were shown ot be ineffective to treat head lice. No evidence exists regarding other chemical control methods such as the use of herbal treatments, when used in the curative treatment of head lice. Future trials should take into account the methodological recommendations that arise from this review.
头虱感染在发达国家和发展中国家都很普遍。感染最常发生在儿童中，但也会影响成年人。如果不进行治疗，这种情况会变得非常瘙痒，若搔抓叮咬处可能会发生皮肤感染。
本综述的目的是评估治疗头虱的干预措施的效果。
Cochrane传染病组专业试验注册库（2002年7月）；Cochrane对照试验中央注册库（Cochrane图书馆2002年第2期）；MEDLINE和TOXLINE（1966年至2002年7月）；EMBASE（1980年至2002年5月）；LILACS（2002年7月）；科学引文索引（1981年至2002年7月）；BIOSIS（1985年至2002年7月）；相关文章的参考文献列表；生产杀虱剂的制药公司（已发表和未发表的试验）；英国和美国监管当局。
寻找随机试验（已发表和未发表）或采用交替分配的试验，这些试验比较了不同配方的杀虱剂之间以及杀虱剂与物理方法之间的效果。
在71项已识别的研究中，只有4项符合纳入标准。两名评价员独立评估试验质量。一名评价员提取数据。
我们没有发现证据表明任何一种杀虱剂比另一种更有效。两项将马拉硫磷和氯菊酯与其各自赋形剂进行比较的研究表明，活性成分的治愈率高于赋形剂。另一项将增效除虫菊酯与氯菊酯进行比较的研究表明它们的效果相当。一项马拉硫磷洗剂与梳理法的对比试验表明，梳理法对头虱感染的治疗无效。在一些试验中报告了不良反应，且均较轻微，不过不同试验之间报告质量有所不同。
氯菊酯、增效除虫菊酯和马拉硫磷对头虱治疗有效。然而，自这些试验开展以来出现的耐药性意味着目前没有关于这些产品比较有效性的直接当代证据。现在“最佳”选择将取决于当地的耐药模式。物理治疗方法（“BugBusting”）被证明对头虱治疗无效。对于其他化学控制方法，如使用草药治疗头虱的疗效，尚无证据。未来的试验应考虑本综述中提出的方法学建议。
