Nasal Irrigation with Chinese Herbal Medicine as an Adjunctive Treatment in Allergic Rhinitis: A Phase 2 Randomized, Double-Blind, Placebo-Controlled Trial

Introduction: Chinese herbal medicine (CHM) has been utilized for centuries to manage Allergic Rhinitis (AR), proposing benefits through immune modulation and anti-inflammatory effects. This study aims to investigate the safety and preliminary effects of nasal irrigation with CHM in the treatment of AR. Methods: A total of 29 AR patients were randomly assigned to either the CHM group, receiving nasal irrigation with a saline-CHM solution, saline with a pack of CHM (1 gram of Szechwan Lovage Rhizome, 1 gram of Biod Magnolia Bud, 0.5 gram of Taiwan Angelica Root, 0.5 gram of Wild Mint Herb, 1.5 gram of Baikal Skullcap Root, and 0.5 gram of Borneo), or the placebo group, receiving saline with edible caramel. Evaluations included questionnaires, anterior rhinoscopy, rhinomanometry, acoustic rhinometry, and Eustachian tube function tests. Results: No major side effects were reported after two months, and Eustachian tube function remained unaffected. Both groups showed significant improvement in AR severity. However, no significant differences were observed between the two groups. Discussion: While the CHM regimen is deemed safe for nasal irrigation in AR patients, its efficacy in symptom reduction does not surpass that of normal saline. The duration of nasal irrigation in this study may be too short to observe significant changes. Conclusion: Our CHM regimen, dissolved in warm saline, is safe for washing the nasal cavity in patients with AR. Further research is warranted to explore the potential benefits of CHM in AR management. Graphic Abstract. Patients with allergic rhinitis were divided into two groups. The nasal cavity was rinsed with Szechwan Lovage Rhizome, Biod Magnolia Bud, Taiwan Angelica Root, Wild Mint Herb, Baikal Skullcap Root in the Chinese herbal medicine group, and Borneo and caramel in the placebo group. After nasal irrigation, all patients received an efficacy and safety assessment.