Average measures: 14-day follow-ups (n = 11).

Pediculosis capitis is a worldwide prevalent public health issue, mostly involving children. Resistance has been increasingly identified with conventional treatments such as permethrin or malathion. We aimed to evaluate the therapeutic potential of plant-based therapies for pediculosis capitis. PubMed, MEDLINE, Embase, EmCare, Web of Science, Cochrane, and ScienceDirect were searched for studies. Google Scholar was used to identify relevant gray literature from inception until 30th July 2023. Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) in English language evaluating a plant-based head lice treatment were considered for inclusion. This review was registered with the International Prospective Register of Systematic Reviews (CRD42023428674). Study characteristics, detection method, outcomes including final cure rate at 1–14 days following last treatment and adverse events were identified. Statistical analysis was performed with one sample t-test and linear mixed models. Random effects meta-analysis using forest-plots were used to describe intervention odds ratio. From 881 records, 20 studies were included comprising 13 RCTs and 7 NRCTs. All 20 studies were qualitatively analyzed and 9 RCTs were quantitatively analyzed. Based on RCT data, certain plant-based interventions may offer improved cure rates with overall higher mean final cure rate 0.86 (95% CI 0.73, 0.99) compared to conventional treatment 0.60 (95% CI 0.25, 0.95), however findings were limited by study heterogeneity (I2 = 83.2%) and methodological constraints. Local cutaneous irritation was the most frequent adverse event. Several limitations were identified, including confounding variables (e.g., inconsistent combing technique and variable plant-based interventions with multiple active ingredients and formulations), small sample sizes and lack of blinding. The risk of bias was high for NRCTs, while RCTs had some concerns. In conclusion, results should be interpreted cautiously in the context of study limitations. Further research is required to elucidate the efficacy and clinical role of plant-based therapies in PC.

头虱病（Pediculosis capitis）是一种全球范围内流行的公共卫生问题，主要累及儿童群体。目前，氯菊酯（permethrin）、马拉硫磷（malathion）等常规治疗方案的耐药性问题日益凸显。本研究旨在评估植物源性疗法治疗头虱病的应用潜力。本研究检索了PubMed、MEDLINE、Embase、EmCare、Web of Science、Cochrane图书馆及ScienceDirect数据库，并通过Google Scholar检索了截至2023年7月30日的相关灰色文献。纳入标准为以英语发表的、评估植物源性头虱治疗方案的随机对照试验（Randomized Controlled Trials, RCTs）与非随机对照试验（Non-randomized Controlled Trials, NRCTs）。本系统评价已在国际系统评价前瞻性注册平台（International Prospective Register of Systematic Reviews, CRD42023428674）完成注册。本研究提取了研究基本特征、检测方法、结局指标（包括末次治疗后1~14天的最终治愈率及不良事件）等相关数据。统计学分析采用单样本t检验与线性混合模型，并通过森林图进行随机效应meta分析以报告干预措施的比值比。本研究初检出881条文献记录，最终纳入20项研究，其中13项为随机对照试验，7项为非随机对照试验。所有20项研究均完成定性分析，其中9项随机对照试验完成定量分析。基于随机对照试验数据，部分植物源性干预方案可提供更优的治愈率：整体平均最终治愈率为0.86（95%CI：0.73~0.99），显著高于常规治疗的0.60（95%CI：0.25~0.95）；但该结果受研究间异质性（I²=83.2%）及方法学局限的限制。局部皮肤刺激是最常见的不良事件。本研究存在若干局限性，包括混杂变量（如梳虱操作方法不统一、植物源性干预方案的活性成分与制剂类型各异）、样本量偏小及未实施盲法。非随机对照试验的偏倚风险较高，而随机对照试验则存在一定方法学顾虑。综上，鉴于本研究存在诸多局限，对结果的解读应持谨慎态度。未来仍需开展进一步研究，以明确植物源性疗法治疗头虱病的有效性及临床应用价值。