Colds, Flu & Sinusitis: Herbal Relief

References

Cold, influenza (flu) and sinusitis are three common upper respiratory conditions that affect a great many people. In addition to being upper respiratory infections, they also share a commonality in that three particular herbs— Andrographis, Eleuthero and Echinacea—have been shown to be effective in their treatment.

Most people contract one or more colds every year. A cold is caused by viruses that infect cells of the upper respiratory tract. Since there are more than 200 different species and strains of these viruses, a cold caused by one virus does not protect a person from catching a cold caused by a different one. This explains why colds can occur one after another or several times a year.

Influenza, or “flu”, is a highly contagious viral respiratory infection. It is caused by orthomyxovirus types A, B and C, which are spread by direct person-to-person contact or by airborne droplet spray. Flu generally occurs in the late fall and early winter and can reach epidemic proportions upon emergence of a modified form of the virus for which the population has no immunity. All age groups are susceptible, but the prevalence is highest in school-age children. Its clinical manifestations often resemble a severe form of the common cold.

Sinusitis is a swelling of one or more nasal sinuses. It is caused by bacteria (streptococci, staphylococci, pneumococci, Haemophilus influenzae); viruses (rhinovirus, influenza virus, parainfluenza virus); and fungi (aspergilli, Dematiaceae, Mucoraceae, Penicillium sp.). Onset frequently occurs after an acute respiratory infection but may also be triggered by a dental procedure or gum infection, allergic rhinitis, diving or swimming episode, or sudden drop in temperature.

These botanicals have interesting histories, and more recent studies have underscored their historical usage. Andrographis paniculata has a history of use in both Ayurvedic and traditional Chinese medicine. It contains a number of bitter constituents which appear to have both immune-stimulating and anti-inflammatory activity.¹ Double blind studies have found andrographis may help reduce the severity of symptoms in individuals suffering from the common cold.^2,3,4,5

In the very recent past, Eleutherococcus senticosus was commonly called “Siberian Ginseng.” Although this name was botanically incorrect since eleuthero is not even in the same genus as Panax ginseng, it was an understandable appellation since many of its functions were the same. For example, like panax, eleuthero shows excellent adaptogenic activity. Russian explorers, divers, sailors and miners also used eleuthero to prevent stressrelated illness.⁶ In addition, evidence also suggests eleuthero may prove valuable in the long-term management of various diseases of the immune system, including HIV infection and chronic fatigue syndrome.⁷ Referred to as “ci wu jia” in Chinese medicine, it was used to prevent respiratory tract infections, colds and flu.

Finally, Echinacea purpurea is an immune stimulant/supporter, and is excellent in the prevention and treatment of colds and influenza. Research suggests echinacea supports the immune system by activating white blood cells (lymphocytes and macrophages).⁸ In addition, echinacea appears to increase the production of interferon, which is important to the immune response of viral infections.⁹ In any case, a number of double blind, clinical studies have confirmed echinacea’s effectiveness in treating colds and flu^{10,11,12,13,14} However, some research suggests that echinacea may be more effective if used at the onset of these conditions.^15,16

Besides colds and flu, Germany’s Commission E Monographs (an internationally authoritative source of credible information on the use of herbs for various disorders) indicates echinacea can be used to treat chronic infections of the respiratory tract.¹⁷

Combinations of these botanicals also appear quite effective in fighting these upper respiratory conditions. For example, a combination of andrographis and eleuthero was studied in two randomized, parallel-group clinical studies using patients diagnosed with influenza (540 patients and 66 patients, respectively).¹⁸ In both studies, the differences in the duration of sick leave (7.2 days vs. 9.8 days in the control group) and frequency of post-influenza complications indicated that the andrographis/eleuthero combination contributed to quicker recovery and reduced the risk of post-influenza complications. The results showed in andrographis/ eleuthero-treated patients, the symptoms had become less pronounced and the temperature had returned more rapidly to normal values. In addition, symptoms such as headache, muscle pain and conjunctivitis disappeared sooner than in control patients.

Similar findings were reported from two randomized double blind, placebo-controlled parallel group clinical trials examining the impact of the andrographis/ eleuthero combination in the treatment of uncomplicated upper-respiratory tract infections.¹⁹ This includes common cold, rhinitis, nasopharyngitis (inflammation of the nasal passages and of upper sore throat) and pharyngitis (sore throat). There were 46 patients in one study, and 179 patients in another. In both studies, the total symptom score and total diagnosis score showed highly significant improvement in the andrographis/eleuthero group as compared with the placebo. Throat symptoms/signs were found to show the most significant improvement, with a 55-percent improvement in symptom score compared with the placebo group.

The same combination was also evaluated in a double blind, placebo-controlled, parallel-group clinical study on the treatment of acute upper respiratory tract infections, including sinusitis.²⁰ Ninety-five individuals in the treatment group and 90 individuals in the placebo group completed the study according to the protocol. Temperature, headache, muscle aches, throat symptoms, cough, nasal symptoms, general malaise and eye symptoms were taken as outcome measures with given scores. The total score analysis showed a highly significant improvement in the andrographis/eleuthero combination group versus the placebo. The individual symptoms of headache and nasal and throat symptoms together with general malaise showed the most significant improvement, while cough and eye symptoms did not differ significantly between the groups. Temperature was moderately reduced in the andrographis/eleuthero combination group. The authors of the study concluded the andrographis/eleuthero combination had a positive effect in the treatment of acute upper respiratory tract infections and also relieved the inflammatory symptoms of sinusitis.

Finally, the andrographis/eleuthero combination was compared to echinacea in treatment of the common cold.²¹ The study group included 130 children aged 4 to 11 over a period of 10 days, using either botanical extract plus standard treatment or just the standard treatment (control). Treatment with the andrographis/eleuthero combination was significantly more effective than treatment with echinacea when started at an early stage of uncomplicated common colds. The cold symptoms were less severe in the andrographis/eleuthero group, with benefits particularly pronounced in the amount of nasal secretion and congestion. Although echinacea was not as effective as the andrographis/ eleuthero combination in this study, it was still more effective than standard treatment alone.

Individually or in combination, andrographis, eleuthero and echincacea have significant potential for treating upper respiratory infections, including colds, flu and sinusitis. For an acute infection, doses in the range of 340 mg Andrographis paniculata extract (providing 21 mg andrographolide and deoxyandrographolide), 39 mg eleuthero extract (providing 2-percent total Eleutheroside B and Eleutheroside E) and 800 mg Echinacea purpurea herb extract, three times daily, will likely yield good results.

February 2006 Health Supplement Retailer
"Colds, Flu & Sinusitis: Herbal Relief" References

1. Bone K. Clinical Applications of Ayurvedic and Chinese Herbs: Monographs for the Western Herbal Practitioner. Queensland, Australia: Phytotherapy Press; 1996:96-100.

2. Thamlikitkul V et al. "Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults." J Med Assoc Thai. 74:437-42, 1991.

3. Melchior J, Palm S, Wikman G. "Controlled clinical study of standardized Andrographis paniculata extract in common cold--a pilot trial." Phytomedicine. 3:314-8, 1996.

4. Hancke J et al. "A double-blind study with a new monodrug Kan Jang: Decrease of symptoms and improvement in recovery from common colds." Phytother Res. 9:559-62, 1995.

5. Cáceres DD et al. "Use of visual analogue scale measurements (VAS) to assess the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study." Phytomedicine. 6:217-23, 1999.

6. Mills S, Bone K. Principles and Practice of Phytotherapy. Edinburgh:Churchill Livingstone; 2000:534-541.

7. Bohn B, Nebe CT, Birr C. "Flow cytometric studies with Eleutherococcus senticosus extract as an immunomodulating agent." Arzneim-Forsch Drug Res. 37:1193-6, 1987.

8. See DM et al. "In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients." Immunpharmacol. 35:229-35, 1997.

9. Leuttig B et al. "Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea." J Natl Cancer Inst. 81:669-75, 1989.

10. Melchart D et al. "Immunomodulation with Echinacea--a systematic review of controlled clinical trials." Phytomedicine. 1:245-54, 1994.

11. Dorn M, Knick E, Lewith G. "Placebo-controlled, double-blind study of Echinacea pallida redix in upper respiratory tract infections." Comp Ther Med. 5:40-2, 1997.

12. Hoheisel O et al. "Echinacea shortens the course of the common cold: a double-blind, placebo-controlled clinical trial." Eur J Clin Res. 9:261-8, 1997.

13. Braunig B, Dorn M, Knick E. "Echinacea purpurea root for strengthening the immune response to flu-like infections." Zeitschrift Phytotherapie. 13:7-13, 1992.

14. Brikenborn RM, Shah DV, Degenring FH. "Echinaforce® and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo-controlled, double-blind clinical trial." Phytomedicine. 6:1-5, 1999.

15. Melchart D et al. "Echinacea root extracts for the prevention of upper respiratory tract infections: A double-blind, placebo-controlled randomized trial." Arch Fam Med. 7:541-5, 1998.

16. Grimm W, Müller HH. "A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory tract infections." Am J Med. 106:138-43, 1999.

17. Blumenthal M (ed), et al. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicine. Austin, Texas: American Botanical Council; 1998.

18. Kulichenko LL et al. "A Randomized, Controlled Study of Kan Jang versus Amantadine in the Treatment of Influenza in Volgograd." J Herbal Pharmacother. 3, 1:77-93, 2003.

19. Melchior J et al. "Double-blind, placebo-controlled pilot and Phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection." Phytomedicine. 7, 5:341-350, 2000.

20. Gabrielian ES et al. "A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis." Phytomedicine. 9:589-597, 2002.

21. Spasov AA et al. "Comparative Controlled Study of Andrographis paniculata Fixed Combination, Kan Jang® and an Echinacea Preparation as Adjuvant, in the Treatment of Uncomplicated Respiratory Disease in Children." Phytother Res. 18:47-53, 2004.

Share this article: Email, Slashdot, Digg, Del.icio.us, Yahoo!MyWeb, Windows Live Favorites, Furl
Add this article feed to: RSS, My Yahoo, Newsgator, Bloglines

Read Comments [0]