Pediatrics. Consilium MedicumPediatrics. Consilium Medicum2658-66302658-6622Consilium Medicum10955110.26442/26586630.2022.2.201719Research ArticleEfficacy of the extract of marshmallow root, chamomile flowers, horsetail herb, walnut leaves, yarrow herb, oak bark, and dandelion herb in preschool children with pharyngeal and/or palatine tonsil disorders and frequent recurrent respiratory infectionsVavilovaVera P.<p>D. Sci. (Med.), Kemerovo State Medical University</p>vavilovavp@mail.ruhttps://orcid.org/0000-0001-8056-7274VavilovAleksandr M.<p>D. Sci. (Med.), Kemerovo State Medical University</p>vavilovavp@mail.ruCherkaevaAsia Kh.<p>Cand. Sci. (Med.), Kemerovo State Medical University</p>vavilovavp@mail.ruNechaevaIrina A.<p>Cand. Sci. (Med.), Family Medicine Center “Nadezhda”</p>vavilovavp@mail.ruKemerovo State Medical UniversityFamily Medicine Center “Nadezhda”3007202221601652907202229072022Copyright © 2022, Consilium Medicum2022<p><strong>Background</strong>. Acute upper respiratory tract infections (AURTIs) are common in children and can become recurrent, especially in patients with pharyngeal and/or palatine tonsil disorders.</p>
<p><strong>Aim</strong>. To evaluate the efficacy and safety of the herbal medicine of marshmallow root, chamomile flowers, horsetail herb, walnut leaves, yarrow herb, oak bark and dandelion herb (Tonsilgon N) in preschool children with adenotonsillar disorders.</p>
<p><strong>Materials and methods</strong>. The study included 1876 children aged 2 to 5 years with a history of pharyngeal and/or palatine tonsil disorders and frequent recurrent respiratory infections. The subjects were randomized into two groups: Group 1 (n=940) received herbal medicine (10 drops 56 times daily) for 30 days, and Group 2 (n=936) received no additional medication. Efficacy and safety were evaluated after the therapy course and during the follow-up (3, 6, and 12 months after the treatment started). The assessment included nasopharyngeal endoscopy, cytological examination of nasal mucosa smears, measurement of soluble immunoglobulin A (sIgA) levels and lysozyme activity in nasal secretion.</p>
<p><strong>Results</strong>. After a course of therapy, a significant decrease in the incidence of AURTIs (<em>p</em>0.05), associated with a local immunity improvement, estimated by sIgA levels and lysozyme activity (<em>p</em>0.001 for both values versus the control group), was noted. By the end of the study, in 86.5% of patients of Group 1, the pharyngeal tonsil volume decreased from grade 2 to grade 1 of hypertrophy (<em>p=</em>0.000). The pharyngeal and palatine tonsil hypertrophy worsened in 83.6% of Group 2 patients.</p>
<p><strong>Conclusion</strong>. The study results showed that Tonsilgon N significantly reduced the incidence of AURTIs in children with pharyngeal and/or palatine tonsil disorders and frequent recurrent respiratory infections. This effect was associated with an increase in sIgA and lysozyme levels in the nasal secretion and a decrease in neutrophil counts, indicating an improvement in local immunity.</p>acute upper respiratory tract infectionspediatricsherbal medicinephytotherapytonsil disordersrecurrent infectionsострые инфекции верхних дыхательных путейпедиатрияфитотерапияпатология миндалинрецидивирующие инфекцииТонзилгон Н[Hostanska K, Melzer J, Amon A, Saller R. Suppression of interleukin (IL)-8 and human beta defensin-2 secretion in LPS-and/or IL-1β-stimulated airway epithelial A549 cells by a herbal formulation against respiratory infections (BNO 1030). J Ethnopharmacol. 2011;134(2):228-33. DOI:10.1016/j.jep.2010.12.006][Popovych V, Koshel I, Malofiichuk A, et al. A randomized, open-label, multicenter, comparative study of therapeutic efficacy, safety and tolerability of BNO 1030 extract, containing marshmallow root, chamomile flowers, horsetail herb, walnut leaves, yarrow herb, oak bark, dandelion herb in the treatment of acute non-bacterial tonsillitis in children aged 6 to 18 years. Am J Otolaryngol. 2019;40(2):265-73. DOI:10.1016/j.amjoto.2018.10.012][Klimova II, Bazhenov DV. Effectiveness of a herbal preparation tonsilgon N for the treatment of children presenting with chronic adenoiditis. Vestn Otorinolaringol. 2014;2:75-8.][Abdulkerimov KT, Kartashova KI, Davydov RS, et al. The comparative evaluation of the effectiveness of the treatment of the patients presenting with the sub-compensated form of chronic tonsillitis making use of the antiseptic herbal medicinal product in the combination with the standard conservative therapy: the results of the open randomized study. Vestn Otorinolaringol. 2018;83(3):45-9. DOI:10.17116/otorino201883345][Vavilova VP, Abramov-Sommariva D, Steindl H, et al. Effectiveness and tolerability of Tonsilgon® N in the treatment of recurrent upper respiratory tract infections in children: a non-interventional study in Russia. Clin Phytosci. 2016;2(1):6.][Godovanets OI, Kotelban АV, Moroz PV, et al. Clinical and immunologic assessment of a complex of therapeutic-preventive measures concerning chronic catarrhal gingivitis in children with comorbid diabetes mellitus. Wiad Lek. 2020;73(2):298-301.][Kotelban А, Moroz P, Hrynkevych L, et al. Microbiological and immunological assessment of a complex of therapeutic-preventive measures for chronic catarrhal gingivitis in children with diabetes mellitus. Georgian Med News. 2019;294:72-6.]