Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial

European Journal of Medical Research

A Suter⁴  P Klein²  D Berger³  A Schapowal¹ 

[1] Allergy Clinic, Landquart, Switzerland;d.s.h. statistical services GmbH, Rohrbach, Germany;Schüpfen Switzerland;Medical Department, A. Vogel Bioforce AG, Roggwil, Switzerland

关键词: lidocaine;    chlorhexidine;    salvia;    echinacea;    sore throat;    Clinical trial;   

Others  :  1093566
DOI  :  10.1186/2047-783X-14-9-406

 received in 2008-12-08, accepted in 2009-07-21,  发布年份 2009

【 摘 要 】

Background

The aim of this trial was to assess the relative efficacy of a sage/echinacea spray and a chlorhexidine/lidocaine spray in the treatment of acute sore throats.

Methods

This was a multicenter, randomized, double-blind, double-dummy controlled trial carried out in eleven general practices in Switzerland. A total of 154 patients (133 analyzed in per protocol collective) at least 12 years old with acute sore throat present for not more than 72 hours prior to inclusion and with a throat score ≥6 participated in the study. They used either an echinacea/sage spray or a chlorhexidine/lidocaine spray with two puffs every 2 hours, in a double-dummy blinded manner, up to 10 times daily until they were symptom-free, for a maximum of 5 days. The main outcome measures was the comparison of response rates during the first three days. A response was defined as a decrease of at least 50% of the total symptoms compared to baseline.

Results

The echinacea/sage treatment exhibited similar efficacy to the chlorhexidine/lidocaine treatment in reducing sore throat symptoms during the first 3 days (P(x < Y) = .5083). Response rates after 3 days were 63.8% in the echinacea/sage group and 57.8% in the chlorhexidine/lidocaine group. For all secondary parameters, such as time to becoming symptom free, throat pain, and global assessments of efficacy by the physician and patient, no difference between the two treatments was seen. They were both very well tolerated.

Conclusion

An echinacea/sage preparation is as efficacious and well tolerated as a chlorhexidine/lidocaine spray in the treatment of acute sore throats.

【 授权许可】

   
2009 I. Holzapfel Publishers

【 图 表 】

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【 参考文献 】

• [1]Wei JL, Kasperbauer JL, Weaver AL, Boggust AJ: Efficacy of single-dose dexamethasone as adjuvant therapy for acute pharyngitis. Laryngoscope 2002, 112(1):87-93.
• [2]van Driel ML, De Sutter A, Deveugele M, Peersman W, Butler CC, De Meyere M, De Maeseneer J, Christiaens T: Are sore throat patients who hope for antibiotics actually asking for pain relief? Ann Fam Med 2006, 4(6):494-499.
• [3]Vincent MT, Celestin N, Hussain AN: Pharyngitis. Am Fam Physician 2004, 69(6):1465-1470. Review
• [4]Bertin L, Pons G, d'Athis P, et al.: Randomized, double-blind, multicenter, controlled trial of ibuprofen versus acetaminophen (paracetamol) and placebo for treatment of symptoms of tonsillitis and pharyngitis in children. J Pediatr 1991, 119(5):811-814.
• [5]Eccles R, Loose I, Jawad M, Nyman L: Effects of acetylsalicylic acid on sore throat pain and other pain symptoms associated with acute upper respiratory tract infection. Pain Med 2003, 4(2):118-124.
• [6]Moshrefi A: Chlorhexidine. J West Soc Periodontol Periodontal Abstr 2002, 50(1):5-9.
• [7]Shah SA, Sander S, White CM, Rinaldi M, Coleman CI: Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis 2007, 7(7):473-80. Review
• [8]Gertsch J, Schoop R, Kuenzle U, Suter A: Echinacea alkylamides modulate TNF-alpha gene expression via cannabinoid receptor CB2 and multiple signal transduction pathways. FEBS Lett 2004, 577(3):563-9.
• [9]Hudson J, Altamirano M: The application of DNA micro-arrays (gene arrays) to the study of herbal medicines. J Ethnopharmacol 2006, 108(1):2-15.
• [10]ESCOP: Sage leaf, Salviae officinalis folium. ESCOP monographs. 2nd edition. Exeter, Stuttgart, New York: ESCOP, Georg Thieme Verlag, Thieme New York; 2003:339-344.
• [11]Bereznoy VV, Riley DS, Wassmer G, Heger M: Efficacy of extract of Pelargonium sidoides in children with acute non-group A beta-hemolytic streptococcus tonsillopharyngitis: a randomized, double-blind, placebo-controlled trial. Altern Ther Health Med 2003, 9(5):68-79.
• [12]Wei LJ, Lachin JM: Two-sample asymptotically distribution-free tests for incomplete multivariate obeservations. Journal of the American Statistical Association 1984, 79(387):653-661.
• [13]European Medicines Agency EMEA: CPMP/ICH/363/96. ICH Topic E 9 Statistical Principles for Clinical Trials. Note for guidance on statistical principles for clinical trials (CPMP/ICH/363/96) 1998.
• [14]MacKenzie TA, Young ER: Local anesthetic update. Anesth Prog 1993, 40(2):29-34.
• [15]Holst A, Evers H: Experimental studies of new topical anaesthetics on the oral mucosa. Swed Dent J 1985, 9(5):185-191.
• [16]Wonnemann M, Helm I, Stauss-Grabo M, et al.: Lidocaine 8 mg sore throat lozenges in the treatment of acute pharyngitis. A new therapeutic option investigated in comparison to placebo treatment. Arzneimittelforschung 2007, 57(11):689-697.
• [17]Hubbert M, Sievers H, Lehnfeld R, Kehrl W: Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis -a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Eur J Med Res 2006, 11(1):20-26.
• [18]Schulten B, Bulitta M, Ballering-Brühl B, Köster U, Schäfer M: Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 2001, 51(7):563-568.
• [19]Goel V, Lovlin R, Barton R, Lyon MR, Bauer R, Lee TD, Basu TK: Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther 2004, 29(1):75-83.
• [20]Sperber SJ, Shah LP, Gilbert RD, Ritchey TW, Monto AS: Echinacea purpurea for prevention of experimental rhinovirus colds. Clin Infect Dis 2004, 38(10):1367-1371.
• [21]Braunig B: Echinacea purpurea radix for strengthening the immune response in flu-like infections. Z Phytother 1992, 13:7-13.
• [22]McIsaac WJ, White D, Tannenbaum D, Low DE: A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 1998, 158(1):75-83.
• [23]Moore N, Le Parc JM, van Ganse E, Wall R, Schneid H, Cairns R: Tolerability of ibuprofen, aspirin and paracetamol for the treatment of cold and flu symptoms and sore throat pain. Int J Clin Pract 2002, 56(10):732-734.
• [24]Hamre HJ, Fischer M, Heger M, et al.: Anthroposophic vs. conventional therapy of acute respiratory and ear infections: a prospective outcomes study. Wien Klin Wochenschr 2005, 117(7-8):256-268.
• [25]Barnes P, Powell-Griner E, McFann K, Nahin R: Complementary and alternative medicine use among adults: United States. CDC Advance Data Report #343 2004.