Phytotherapy of acute and chronic rhinosinusitis from the position of evidence-based medicine

Abstract

The article highlights the problem of using phytotherapy in the treatment of the most topical inflammatory diseases of the ENT organs, namely acute and chronic rhinosinusitis. Phytotherapy of ENT diseases has always attracted both doctors and patients. However, from the standpoint of evidence-based medicine there were a lot of questions about most herbal remedies due to the small number of reliable, well-controlled studies. This article presents the data of evidence-based studies on phytotherapy of acute and chronic rhinosinusitis. They allow us to speak about secretolytic, secretomotor, anti-inflammatory, anti-edema, moderate antibacterial and antiviral effects of phytopreparations. A common pharmacological property of plants included in phytopreparations is the ability to block the phase of exudation and reduce the permeability of the vascular wall. Phytotherapy is a good alternative method of treatment of patients with chronic rhinosinusitis (CRS). Data on the complex therapy of rhinosinusitis are given. Nevertheless, the safety and efficacy of phytotherapy for the treatment of patients with CRS are currently uncertain. The clinical guidelines of the Russian Ministry of Health 2021 on the treatment of acute rhinosinusitis (ARS) note the following: any patient with ARS can be prescribed herbal remedies with proven anti-inflammatory and mucolytic effects in the absence of contraindications to accelerate resolution of the disease symptoms. The results of works devoted to the use of preparations of plant origin for the treatment of patients with acute and chronic sinusitis allow to estimate them as rather effective in the complex treatment of this group of patients. However, further controlled studies are required to obtain additional data on the effectiveness of phytotherapy.