title: Combined herbal preparation for topical treatment of Herpes labialis.
abstract: BACKGROUND
  The efficacy of many preparations for topical use in herpes infections have remained rather disappointing. The development of new antiviral drugs, especially herbal preparations, thus remains desirable. In a screening study with plant extracts, a rhubarb root extract and a sage extract showed a promising activity.
  
  
  OBJECTIVE
  The efficacy of a combined topical preparation with rhubarb and sage extracts, of a single-agent preparation with sage extract and of a reference treatment was investigated in a double-blind, comparative, randomised trial.
  
  
  METHODS
  A total of 149 patients participated, and 145 patients (111 female, 34 male) of whom 64 received the rhubarb-sage cream, 40 the sage cream and 41 Zovirax cream could be evaluated by intention-to-treat analysis. The dried rhubarb extract (23 mg/g) is a standardised aqueous- ethanolic extract according to the German Pharmacopoeia (DAB) with 4.0-6.0% hydroxyanthracene derivatives. The dried sage extract (23 mg/g) is an aqueous extract. The reference product was Zovirax cream (Zovirax(R) Creme) with the active ingredient aciclovir (50 mg/g).
  
  
  RESULTS
  The mean time to healing in all cured patients was 7.6 days with the sage cream, 6.7 days with the rhubarb-sage cream and 6.5 days with Zovirax cream. There were statistically significant differences in the course of the symptoms. For the parameter 'swelling', at the 1st followup visit there was a significant advantage for Zovirax cream compared to sage cream, and for the parameter 'pain', at the 2nd follow-up visit there was a significant difference in favour of the rhubarb-sage cream compared to the sage cream.
  
  
  CONCLUSIONS
  The combined topical sage-rhubarb preparation proved to be as effective as topical aciclovir cream and tended to be more active than the sage cream.
authors.affiliation: Departement für Innere Medizin, Naturheilkunde, Universitätsspital Zürich.
authors.forename: R
authors.initials: R
authors.lastname: Saller
authors.forename: S
authors.initials: S
authors.lastname: Büechi
authors.forename: R
authors.initials: R
authors.lastname: Meyrat
authors.forename: C
authors.initials: C
authors.lastname: Schmidhauser
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000627:therapeutic use; D000287:Administration, Topical; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006560:Herpes Labialis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008517:Phytotherapy; D010936:Plant Extracts / Q000008:administration & dosage / Q000627:therapeutic use*; D012250:Rheum / Q000737:chemistry; D027543:Salvia officinalis / Q000737:chemistry; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004338:Drug Combinations; D010936:Plant Extracts; D000212:Acyclovir