Comparative evaluation of herbal medicines in the treatment of acute rhinosinusitis
Abstract. Relevance of the problem of acute rhinosinusitis (ARS) requires constant introduction of new diagnostic technologies and medications into everyday clinical practice. Thus, in diagnostics of such kind of pathology the olfactometry methodic is advisable, and herbal remedies should be used more widely in its treatment. Among the medications in this group, ORVIS Rhino and Sinupret, which contain identical active phytocomponents, are introduced at the Russian pharmaceutical market. However, a comparative evaluation of these drugs has not previously been performed.K.G. Dobretsov, D.V. Kashirskiy, A.V. Sazhin, G.A. Sazhina, E.E. Rumyantseva, R.Yu. Yurov, A.S. Nikulina, A.K. Verevkina
The aim: to compare the efficacy of ORVIS Rhino and Sinupret medicines in the treatment of patients with ARS.
Material and methods. 70 patients with ARS (36 female and 34 male individuals) aged 18 to 60 years were treated. They were randomized into two equal groups: the first group received ORVIS Rhino in addition to standard ARS therapy, while the other group received Sinupret. Treatment outcomes were assessed using visual analog scale scores, endoscopic examination of the nasal cavity and olfactory cleft, Olfactory Threshold Test and olfactory index values.
Results. After 7 days of treatment, no statistically significant differences were found between the groups for any of the five assessed parameters. Significance levels for all statistical tests ranged from 0.277 to 1.000, significantly exceeding the generally accepted significance level of 0.05. Effect sizes were extremely small (close to zero), indicating the clinical insignificance of any observed differences in means or ranks. Interpretation of effect sizes using probability estimates revealed that the obtained P values were very close to 0.5 (range, 0.485 to 0.570), indicating that any observed differences between the two study groups had a random character.
Conclusion. Herbal remedies ORVIS Rino and Sinupret demonstrated statistically indistinguishable efficacy when added to standard ARS therapy. Obtained results confirm the therapeutic equivalence of the studied medicines, which is reflected in the List of Interchangeable Medicinal Products for Medical Use of the Ministry of Healthcare of Russia, allowing ORVIS Rino to be recommended for ARS treatment.
Keywords
acute rhinosinusitis
hyposmia
anosmia
Russian version of Sniffin Stix
olfactometry
olfactory cleft
sense of smell
herbal remedies
Gentian roots + Primrose flowers + Sorrel herb + Black elder flowers + Verbena herb
References
1. Янов Ю.К., Рязанцев С.В., Страчунский Л.С., Стецюк О.У., Каманин Е.И. с соавт. Практические рекомендации по антибактериальной терапии синусита (пособие для врачей). Клиническая микробиология и антимикробная химиотерапия. 2003;5(2):167–174. (Yanov YuK, Ryazantsev SV, Strachunsky LS, Stetsyuk OU, Kamanin EI et al. Practical guidelines on antimicrobial therapy of sinusitis (guidelines for clinicians). Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya = Clinical Microbiology and Antimicrobial Chemotherapy. 2003;5(2):167–174 (In Russ.)). EDN: GQCMLL.
2. Носуля Е.В., Крюков А.И., Кунельская Н.Л., Ким И.А. Острый синусит: актуальные вопросы терминологии и диагностики. Вестник оториноларингологии. 2021;86(3):72–77. (Nosulya EV, Kryukov AI, Kunelskaya NL, Kim IA. Acute sinusitis: topical issues of terminology and diagnosis. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology. 2021;86(3):72–77 (In Russ.)).
EDN: OSEWRQ. https://doi.org/10.17116/otorino20218603172
3. Добрецов К.Г., Каширский Д.В. Изучение порога обоняния с помощью Российской версии Сниффин Стикс теста. Российская ринология. 2024;32(1):6–10. (Dobretsov KG, Kashirskiy DV. Study of olfactory threshold using Russian version of Sniffin’ Sticks test. Rossiyskaya rinologiya = Russian Rhinology. 2024;32(1):6–10 (In Russ.)).
EDN: JAYDQC. https://doi.org/10.17116/rosrino2024320116
4. Добрецов К.Г., Каширский Д.В. Оценка обоняния при остром синусите. Российская ринология. 2025;33(1):6–11. (Dobretsov KG, Kashirskiy DV. Assessment of olfactory level in acute sinusitis. Rossiyskaya rinologiya = Russian Rhinology. 2025;33(1):6–11 (In Russ.)).
EDN: VATNUM. https://doi.org/10.17116/rosrino2025330116
5. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F et al. EPOS 2012: European Position Paper on rhinosinusitis and nasal polyps 2012. Rhinology. 2012;50 (1):1–12.
PMID: 22469599. https://doi.org/10.4193/Rhino12.000
6. Аковбян В.А., Андреева А.С., Андреева И.В., Анкирская А.С., Беденков А.В., Белобородов В.Б. с соавт. Практическое руководство по антиинфекционной химиотерапии. Под ред. Ю.Б. Белоусова, С.Н. Козлова, Л.С. Страчунского. Смоленск: Межрегиональная ассоциация общественных объединений «Межрегиональная ассоциация по клинической микробиологии и антимикробной химиотерапии». 2007; 462 с. (Akobyan VA, Andreeva AS, Andreeva IV, Ankirskaya AS, Bedenkov AV, Beloborodov VB et al. Practical guide for anti-infectious chemotherapy. Ed. by Belousov YuB, Kozlov SN, Strachunsky LS. Smolensk: Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. 2007; 462 pp. (In Russ.)).
EDN: QLOYZJ. ISBN: 5-86064-115-X.
7. Яковлев В.П., Яковлев С.В., Александрова И.А., Асцатурова О.Р., Белобородов В.Б., Белов Б.С. с соавт. Рациональная антимикробная фармакотерапия. Руководство для практикующих врачей. Том 2. М.: Литтерра. 2003; 1001 с. (Yakovlev VP, Yakovlev SV, Alexandrova IA, Astsaturova OR, Beloborodov VB, Belov BS et al. Rational antimicrobial pharmacotherapy. Guide for practicing physicians. Vol. 2. Moscow: Litterra. 2003; 1001 pp. (In Russ.)).
EDN: QLERTR. ISBN: 5-98216-002-4.
8. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S et al. EPOS 2020: European Position Paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58(Suppl S29):1–464.
PMID: 32077450. https://doi.org/10.4193/Rhin20.600
9. Goh YH, Goode RL. Current status of topical nasal antimicrobial agents. Laryngoscope. 2000;110(6):875–80.
PMID: 10852500. https://doi.org/10.1097/00005537-200006000-00001
10. Orlandi RR, Kingdom TT, Hwang PH, Smith TL, Alt JA, Baroody FM et al. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol. 2016;6(Suppl 1):S22–209.
PMID: 26889651. https://doi.org/10.1002/alr.21695
11. Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJ, Hicks LA et al.; Infectious Diseases Society of America. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012;54(8):e72–e112.
PMID: 22438350. https://doi.org/10.1093/cid/cir1043
12. Оториноларингология. Национальное руководство. Под ред. В.П. Пальчуна. М.: ГЭОТАР-Медиа, 2009; 960 с. (Серия «Национальные руководства»). Otolaryngology. National guide. Ed. by Palchun VP. Moscow: GEOTAR-Media. 2009; 960 pp. (Series “National Guidelines”) (In Russ.)). ISBN: 978-5-9704-1358-6.
13. Melzer J, Saller R, Schapowal A, Brignoli R. Systematic review of clinical data with BNO-101 (Sinupret) in the treatment of sinusitis. Forsch Komplementmed. 2006;13(2):78–87.
PMID: 16645287. https://doi.org/10.1159/000091969
14. Passali D, Cambi J, Passali FM, Bellussi LM. Phytoneering: A new way of therapy for rhinosinusitis. Acta Otorhinolaryngol Ital. 2015;35(1):1–8. PMID: 26015644. PMCID: PMC4443571.
15. Свистушкин В.М., Никифорова Г.Н., Шевчик Е.А., Золотова А.Н., Никифорова А.Н., Сивохин Д.А. Эффективность растительных лекарственных препаратов при лечении острых респираторных инфекций в реальной клинической практике. Consilium Medicum. 2022;24(9):579–587. (Svistushkin VM, Nikiforova GN, Shevchik EA, Zolotova AN, Nikiforova AN, Sivokhin DA. Efficiency of herbal medicines in the treatment of acute respiratory infections in real clinical practice. Consilium Medicum. 2022;24(9):579–587 (In Russ.)).
EDN: CZZEWS. https://doi.org/10.26442/20751753.2022.9.201944
16. Стремоухов А.А., Заплатников А.Л., Власова Н.Л., Смирнова М.А. Фитотерапия инфекционно-воспалительных заболеваний верхних дыхательных путей в амбулаторной терапевтической и общей врачебной практике. РМЖ. Медицинское обозрение. 2022;6(8):419–426. (Stremoukhov AA, Zaplatnikov AL, Vlasova NL, Smirnova MA. Phytotherapy of infectious & inflammatory upper airway diseases in outpatient care and general practitioner settings. Russkiy meditsinskiy zhurnal. Meditsinskoye obozreniye = Russian Medical Inquiry. 2022;6(8):419–426 (In Russ.)).
EDN: ALYWBK. https://doi.org/10.32364/2587-6821-2022-6-8-419-426
17. Клинические рекомендации. Острый синусит. Национальная медицинская ассоциация оториноларингологов. Рубрикатор клинических рекомендаций Минздрава России. 2025. ID: 313_3. Доступ: https://cr.minzdrav.gov.ru/view-cr/313_3 (дата обращения – 11.10.2025). (Clinical practice guidelines. Acute sinusitis. National Association of Otolaryngologists. Rubricator of clinical guidelines of the Ministry of Healthcare of Russia. 2025. ID: 313_3. URL: https://cr.minzdrav.gov.ru/view-cr/313_3 (date of access – 11.10.2025)
18. Кузьменков А.Ю., Виноградова А.Г., Трушин И.В., Эйдельштейн М.В., Авраменко А.А., Дехнич А.В., Козлов Р.С. AMRmap – система мониторинга антибиотикорезистентности в России. Клиническая микробиология и антимикробная химиотерапия. 2021;23(2):198–204. (Kuzmenkov AYu, Vinogradova AG, Trushin IV, Eidelshtein MV, Avramenko AA, Dekhnich AV, Kozlov RS. AMRmap – antibiotic resistance surveillance system in Russia. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya = Clinical Microbiology and Antimicrobial Chemotherapy. 2021;23(2):198–204 (In Russ.)).
EDN: MCLEON. https://doi.org/10.36488/cmac.2021.2.198-204
19. Козлов Р.С., Иванчик Н.В., Склеенова Е.Ю., Микотина А.В., Азизов И.С., Трушин И.В., Дехнич А.В. In vitro активность цефподоксима в отношении клинических изолятов Haemophilus influenzae, Streptococcus pneumoniae и Streptococcus pyogenes. Клиническая микробиология и антимикробная химиотерапия. 2023;25(4):372–378. (Kozlov RS, Ivanchik NV, Skleenova EYu, Mikotina AV, Azizov IS, Trushin IV, Dekhnich AV. In vitro activity of cefpodoxime against Russian clinical isolates of Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya = Clinical Microbiology and Antimicrobial Chemotherapy. 2023;25(4):372–378 (In Russ.)).
EDN: YGDEAG. https://doi.org/10.36488/cmac.2023.4.372-378
20. Oleszkiewicz A, Schriever VA, Croy I, Hahner A., Hummel T. Updated Sniffin’ Sticks normative data based on an extended sample of 9139 subjects. Eur Arch Otorhinolaryngol. 2019;276(3):719–28.
PMID: 30554358. PMCID: PMC6411676. https://doi.org/10.1007/s00405-018-5248-1
About the Authors
Konstantin G. Dobretsov, MD, Dr. Sci. (Medicine), director of the Research Institute of Olfaction and Olfactory Pathology, professor of the Department of clinical medicine, “Reaviz” Moscow Medical University, Moscow, Russian Federation.E-mail: kdobretsov@gmail.com
ORCID: https://orcid.org/0000-0002-7468-9117. eLibrary SPIN: 1017-7664. Author ID: 599141
Dmitry V. Kashirsky, Dr. Sci. (Psychology), professor, head of the Department of general psychology of L.S. Vygotsky Institute of Psychology, Russian State Humanitarian University; professor of the Department of psychology and human capital development, Financial University under the Government of the Russian Federation, Moscow, Russian Federation.
E-mail: psymath@mail.ru
ORCID: https://orcid.org/0000-0002-8251-2653. eLibrary SPIN: 4389-5243. Scopus ID: 6506320819.
Alexander V. Sazhin, MD, otolaryngologist, director of “LOR Plus Medical Center” LLC, Perm, Russian Federation.
ORCID: https://orcid.org/0000-0001-9069-7304. eLibrary SPIN: 4314-9356
Galina A. Sazhina, MD, chief physician of “LOR Plus Medical Center” LLC, Perm, Russian Federation.
ORCID: https://orcid.org/0009-0008-7871-8166
Elena E. Rumyantseva, MD, otolaryngologist, audiologist, researcher at the Research Institute of Olfaction and Olfactory Pathology, Moscow, Russian Federation.
E-mail: rum_e@mail.ru
ORCID: https://orcid.org/0000-0002-0923-8424
Ruslan Yu. Yurov, MD, head of the Otolaryngology service, “Expert-Tver” LLC, Tver, Russian Federation.
E-mail: ryurov@mrtexpert.ru
ORCID: https://orcid.org/009-0008-1480-1681
Alexandra S. Nikulina, MD, pediatrician, S.I. Spasokukotsky Moscow Scientific and Practical Center For Medical Rehabilitation, Restorative, and Sports Medicine, Moscow, Russian Federation.
E-mail: detskiydooktor@mail.ru
ORCID: https://orcid.org/0009-0000-1624-9271
Alena K. Verevkina, MD, otolaryngologist at “Ear, Throat, and Nose Clinic” LLC, Moscow, Russian Federation.
E-mail: Alena_doc@mail.ru
ORCID: https://orcid.org/0009-0009-8780-7571
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