PATHOGENETIC AND CLINICAL ASPECTS OF PHYTOTHERAPY IN ACUTE RHINOSINUSITIS

Abstract

Introduction: The success of a treatment strategy for acute rhinosinusitis (ARS) is determined not only by the correct choice of pharmacological agent, but also by the overall quality of medical care. An essential condition is comprehensive patient counseling regarding the specific mechanism of action of the medication, the regimen of its administration (routes of introduction, dosing intervals, dosage schedule, and total duration of therapy), as well as the prevention of adverse reactions and assessment of interactions with other drugs or dietary factors. The classification of medicines into "effective" and "ineffective" is to some extent relative. Even a pharmacological agent with a solid evidence base may demonstrate poor clinical outcomes in cases of misdiagnosis or insufficient knowledge of its proper use. Addressing these factors makes it possible to substantially enhance therapeutic success and improve the safety profile in the management of ARS.

Relevance of the Problem: Modern otorhinolaryngology is actively incorporating phytoengineering agents into evidence-based treatment protocols for ARS. According to the provisions of the EPOS 2020 international consensus, specific herbal formulas have been integrated into the management algorithms for viral and post-viral forms of rhinosinusitis, with an evidence level of 1b according to GRADE criteria. In this context, the Sinus Herbal Stick product line from the domestic manufacturer "Georg Biosystems" is of particular scientific interest.

This product is based on a standardized complex of eleven phytoextracts: dry extract of St. John's wort (50 mg), licorice (50 mg), nettle leaf (40 mg), calendula (40 mg), sorrel herb (36 mg), verbena (36 mg), elderflower (36 mg), primrose (36 mg), plantain (36 mg), stevia (25 mg), and gentian (12 mg). The therapeutic potential of each component has been verified by long-standing practice, and their synergistic interaction has substantial scientific justification.

Pathogenetic Rationale: Through the accumulation of biologically active nutrients, Sinus Herbal Stick exerts a multi-vector effect aimed at disrupting the "vicious cycle" of rhinosinusitis pathogenesis. The pharmacodynamic activity of the preparation encompasses secretolytic, anti-inflammatory, anti-infective, and immunomodulatory vectors. The use of this agent makes it possible to avoid excessive polypharmacy — a situation in which several duplicative drugs are prescribed to address the same symptom. This issue is particularly acute with regard to irrational antibiotic therapy, which drives the global development of antimicrobial resistance.

Conclusions: Given the available compelling evidence-based data, the Sinus Herbal Stick product line may be considered as an alternative treatment option for patients with uncomplicated acute rhinosinusitis.