Evidence-based evaluation of therapeutic measures for herpes simplex virus encephalitis

Abstract

Objective To evaluate the therapeutic efficacy and side effects of various treatment for herpes simplex virus encephalitis (HSE) in order to formulate the best therapeutic regimen. Methods Encephalitis, viral encephalitis, herpes simplex virus or HSV, antivirus, adreno-cortical hormone or ACH, treatment were appointed as retrieval words. MEDLINE, Cochrane Library, Wanfang Database for Scientific Journals in China and Chinese National Knowledge Infrastructure (CNKI) for Scientific Journals Database were used for retrieval. Manual searching was also used. Related clinical guidelines, systematic reviews, randomised controlled trials, controlled clinical trials and case - observation studies were collected and evaluated by Jadad Scale. Results After screening, 11 related articals were selected as follow: 2 clinical guidelines, 2 systematic reviews, 2 randomised controlled trials, 2 controlled clinical trials, and 3 case - observation studies. Nine articals were of high quality (according to Jadad Scale, 3 with score 4, 5 with score 5, and one with score 7), while 2 were of low quality with score 3. According to the evaluation of therapeutic efficacy and side effects of various therapies, it is suggested that 1) antiviral therapy is the first choice for HSE treatment; 2) when the patients' condition is not relieved, the pros and cons should be considered before the application of ACH therapy; 3) if the condition is still not improved, immune therapy can be considered to alleviate symptoms; 4) surgical treatment is not usually recommended, with the exception of high intracranial pressure. Conclusion Evidence-based medicine can provide best clinical evidence on HSE treatment.

DOI：10.3969/j.issn.1672-6731.2011.05.009