Рассмотрены аспекты клинического применения растительных препаратов при остром риносинусите (ОРС), в патогенезе которого ключевую роль играет отек слизистой оболочки полости носа и околоносовых пазух. Нерациональное использование антибактериальных препаратов для лечения неосложненного ОРС привело к появлению резистентных к антибиотикам штаммов бактерий и необходимости поиска альтернативных методов лечения. Представлены убедительные доказательства необходимости использования фитопрепаратов как в комплексном лечении, так и в монотерапии ОРС вирусного и бактериального генеза. В обзоре оценено качество доказательств применения фитотерапии при ОРС с целью определения ее позиции среди других методов лечения и будущих направлений исследований. Приведены клинические исследования эффективности применения препарата Синупрет экстракт, который способствует оттоку экссудата из придаточных пазух носа и верхних дыхательных путей, что предупреждает развитие осложнений.
Aspects of the clinical use of herbal preparations for acute rhinosinusitis (ARS) are considered, in the pathogenesis of which swelling of the mucous membrane of the nasal cavity and paranasal sinuses plays a key role. The irrational use of antibacterial drugs for the treatment of uncomplicated ARS has led to the emergence of antibiotic-resistant strains of bacteria and the need to search for alternative treatment methods. Convincing evidence is presented for the need to use herbal medicines in both complex and monotherapy of ARS of viral and bacterial origin. This review assessed the quality of the evidence for the use of herbal medicine for acute rhinosinusitis to determine its position among other treatments and future directions for research. Clinical studies of the effectiveness of the drug Sinupret extract are presented, the use of which promotes the outflow of exudate from the paranasal sinuses and upper respiratory tract, preventing the development of complications.
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2. Anand VK. Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 2004;193:3-5. DOI:10.1177/00034894041130s502
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9. Truitt KN, Brown T, Lee JY, Linder JA. Appropriateness of Antibiotic Prescribing for Acute Sinusitis in Primary Care: A Cross-sectional Study. Clin Infect Dis. 2021;72(2):311-4. DOI:10.1093/cid/ciaa736
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14. Pouwels KB, Dolk FCK, Smith DRM, et al. Actual versus 'ideal' antibiotic prescribing for common conditions in English primary care. J Antimicrob Chemother. 2018;73(Suppl. 2):19-26. DOI:10.1093/jac/dkx502
15. Guo R, Canter PH, Ernst E. Herbal medicines for the treatment of rhinosinusitis: a systematic review. Otolaryngol Head Neck Surg. 2006;135(4):496-506. DOI:10.1016/j.otohns.2006.06.1254
16. Reden J, El-Hifnawi D, Zahnert T, Hummel T. The effect of a herbal combination of primrose, gentian root, vervain, elder flowers, and sorrel on olfactory function in patients with a sinonasal olfactory dysfunction. Rhinology. 2011;49(3):342-6. DOI:10.4193/Rhino10.151
17. Ismail C. Pharmakologische Effekte von Sinupret. Neue Erkenntnisse zur Rationalen für die Zusammensetzung von Sinupret [Pharmacology of Sinupret. Recent results on the rational for the Sinupret compound]. HNO. 2005;53(Suppl. 1):S38-42 (in German). DOI:10.1007/s00106-005-1235-0
18. Jund R, Mondigler M, Steindl H, et al. Clinical efficacy of a dry extract of five herbal drugs in acute viral rhinosinusitis. Rhinology. 2012;50(4):417-26. DOI:10.4193/Rhino.12.015
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20. Киселев А.Б., Чаукина В.А., Андамова О.В., Автушко А.С. Влияние комбинированной секретолитической и противовоспалительной терапии на течение восстановительного периода после риносептопластики. Вестник оториноларингологии. 2023;88(3):8-12 [Kiselev AB, Chaukina VA, Andamova OV, Avtushko AS. The effect of increased secretory activity of the nasal mucosa on the duration of the recovery period after anterior tamponade with gauze tampons during surgery of the nasal septum. Russian Bulletin of Otorhinolaryngology. 2023;88(3):8-12 (in Russian)]. DOI:10.17116/otorino2022880318
21. Rathmann W, Bongaerts B, Carius HJ, et al. Basic characteristics and representativeness of the German Disease Analyzer database. Int J Clin Pharmacol Ther. 2018;56(10):459-66. DOI:10.5414/CP203320
22. Bittner CB, Steindl H, Abramov-Sommariva D, et al. Efficacy and effectiveness of the herbal medicinal product BNO 1016 in the management of acute rhinosinusitis in the context of antibiotic stewardship. Postgrad Med. 2023;135(6):607-14. DOI:10.1080/00325481.2023.2234274
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1. Brooks I, Gooch WM 3rd, Jenkins SG, et al. Medical management of acute bacterial sinusitis. Recommendations of a clinical advisory committee on pediatric and adult sinusitis. Ann Otol Rhinol Laryngol Suppl. 2000;182:2-20.
2. Anand VK. Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 2004;193:3-5. DOI:10.1177/00034894041130s502
3. Kriukov AI, Turovskii AB. Antibakterial'naia terapiia ostrogo srednego otita i sinusita u vzroslykh v ambulatornoi praktike. RMZh. 2004;(21):1188 (in Russian).
4. Bittner CB, Plach M, Steindl H, et al. Prevalence of Antibiotic Prescription in Patients with Acute Rhinosinusitis Treated by General Practitioners and Otolaryngologists in Germany-A Retrospective Cohort Study. Antibiotics (Basel). 2022;11(11):1576. DOI:10.3390/antibiotics11111576
5. Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl. S29):1-464. DOI:10.4193/Rhin20.600
6. DeBoer DL, Kwon E. Acute sinusitis. StatPearls. Treasure Island. Florida, USA: StatPearls Publishing LLC, 2022.
7. Hopkins C, Surda P, Walker A, et al. EPOS 4 Patients. Rhinology. 2021. DOI:10.4193/Rhin20.950
8. Wiebringhaus R, Haubner F. Acute Rhinosinusitis – an update on therapy. MMW Fortschr Med. 2022;164(5):40-3 (in German). DOI:10.1007/s15006-022-0777-3
9. Truitt KN, Brown T, Lee JY, Linder JA. Appropriateness of Antibiotic Prescribing for Acute Sinusitis in Primary Care: A Cross-sectional Study. Clin Infect Dis. 2021;72(2):311-4. DOI:10.1093/cid/ciaa736
10. Svistushkin VM, Nikiforova GN, Shevchik EA, et al. Ispol'zovanie innovatsionnykh form antibiotikov v lechenii vospalitel'nykh zabolevanii okolonosovykh pazukh. Lechashchii Vrach. 2014;(2):25 (in Russian).
11. Maestre JR, Mateo M, Méndez ML, et al. In vitro interference of beta-lactams with biofilm development by prevalent community respiratory tract isolates. Int J Antimicrob Agents. 2010;35(3):274-7. DOI:10.1016/j.ijantimicag.2009.10.020
12. Daikhes NA. Printsipy etiopatogeneticheskoi terapii ostrykh sinusitov. Metodicheskie rekomendatsii. 2014. Available at: https://cr.minzdrav.gov.ru. Accessed: 23.08.2024 (in Russian).
13. Ostryi sinusit. Klinicheskie rekomendatsii. 2021. Available at: https://cr.minzdrav.gov.ru/recomend/313_2. Accessed: 23.08.2024 (in Russian).
14. Pouwels KB, Dolk FCK, Smith DRM, et al. Actual versus 'ideal' antibiotic prescribing for common conditions in English primary care. J Antimicrob Chemother. 2018;73(Suppl. 2):19-26. DOI:10.1093/jac/dkx502
15. Guo R, Canter PH, Ernst E. Herbal medicines for the treatment of rhinosinusitis: a systematic review. Otolaryngol Head Neck Surg. 2006;135(4):496-506. DOI:10.1016/j.otohns.2006.06.1254
16. Reden J, El-Hifnawi D, Zahnert T, Hummel T. The effect of a herbal combination of primrose, gentian root, vervain, elder flowers, and sorrel on olfactory function in patients with a sinonasal olfactory dysfunction. Rhinology. 2011;49(3):342-6. DOI:10.4193/Rhino10.151
17. Ismail C. Pharmakologische Effekte von Sinupret. Neue Erkenntnisse zur Rationalen für die Zusammensetzung von Sinupret [Pharmacology of Sinupret. Recent results on the rational for the Sinupret compound]. HNO. 2005;53(Suppl. 1):S38-42 (in German). DOI:10.1007/s00106-005-1235-0
18. Jund R, Mondigler M, Steindl H, et al. Clinical efficacy of a dry extract of five herbal drugs in acute viral rhinosinusitis. Rhinology. 2012;50(4):417-26. DOI:10.4193/Rhino.12.015
19. Svistushkin VM, Nikiforova GN. Vozmozhnosti sovremennykh rastitel'nykh lekarstvennykh sredstv v lechenii patsientov s ostrym rinosinusitom. Vestnik Otorinolaringologii. 2023;89(4):49-57 (in Russian).
20. Kiselev AB, Chaukina VA, Andamova OV, Avtushko AS. The effect of increased secretory activity of the nasal mucosa on the duration of the recovery period after anterior tamponade with gauze tampons during surgery of the nasal septum. Russian Bulletin of Otorhinolaryngology. 2023;88(3):8-12 (in Russian). DOI:10.17116/otorino2022880318
21. Rathmann W, Bongaerts B, Carius HJ, et al. Basic characteristics and representativeness of the German Disease Analyzer database. Int J Clin Pharmacol Ther. 2018;56(10):459-66. DOI:10.5414/CP203320
22. Bittner CB, Steindl H, Abramov-Sommariva D, et al. Efficacy and effectiveness of the herbal medicinal product BNO 1016 in the management of acute rhinosinusitis in the context of antibiotic stewardship. Postgrad Med. 2023;135(6):607-14. DOI:10.1080/00325481.2023.2234274
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*swistushkin@yandex.ru
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Valery M. Svistushkin, Liliya V. Selezneva, Mikhail V. Svistushkin*, Gaya V. Lebedeva, Igor A. Zinchenko
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*swistushkin@yandex.ru