{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:58:41Z","timestamp":1790873921967,"version":"4.1.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> In clinical practice, antibiotics and\/or inhaled or oral hormone preparations are the first line of treatment for chronic pharyngitis. However, this therapeutic regimen is not satisfactory enough. At present, medicinal plants as dietary supplements or functional foods are widely recognized for the treatment and prevention of different diseases.<\/jats:p><jats:p><jats:bold>Purpose:<\/jats:bold> This study aimed to evaluate the efficacy of the botanical lozenge made from several medicinal plant extracts in the treatment of chronic pharyngitis and its effects on patients\u2019 illness perception and adherence to treatment.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Patients with chronic pharyngitis were randomly assigned to the experimental group (n = 52) or the control group (n = 51). Patients were given botanical lozenges prepared from the extracts of medicinal plants such as <jats:italic>Siraitia grosvenorii<\/jats:italic> (Swingle) C. Jeffrey ex A.M.Lu and Zhi Y. Zhang [Cucurbitaceae; Siraitiae fructus], <jats:italic>Lonicera japonica<\/jats:italic> Thunb [Caprifoliaceae; Lonicerae japonicae flos], <jats:italic>Platycodon grandiflorus<\/jats:italic> (Jacq.) A. DC [Campanulaceae; Platycodon radix], and <jats:italic>Glycyrrhiza uralensis<\/jats:italic> Fisch. ex DC [Fabaceae; Glycyrrhizae radix et rhizoma] or placebos made of starch for 15 days. The improvement of pharyngeal symptoms and signs, illness perception, and adherence to treatment were evaluated at the end of the intervention.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The total score of pharyngeal symptoms of patients in the experimental group (3.33 \u00b1 2.33) was significantly lower than that in the control group (5.20 \u00b1 2.93) (<jats:italic>p<\/jats:italic> &amp;lt; 0.01). In comparison to the control group (3.43 \u00b1 1.43), the total pharyngeal signs score of patients in the experimental group (2.69 \u00b1 1.59) was considerably lower (<jats:italic>p &amp;lt;<\/jats:italic> 0.01). The improvement rates of pharyngeal itching, dry throat, pharyngeal foreign body sensation, aggravation due to excessive speaking, and congestion of pharyngeal mucosa in the experimental group were 73.81%, 67.50%, 67.57%, 65.22% and 44%, respectively, which were significantly higher than those in the control group (<jats:italic>p &amp;lt;<\/jats:italic> 0.05). In addition, patients taking botanical lozenges had better illness perception and adherence to treatment than those taking placebos (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). Patients with low adherence to treatment showed less personal control, concerns, and understanding of chronic pharyngitis (<jats:italic>p<\/jats:italic> &amp;lt; 0.05).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Botanical lozenges not only aided patients in recovering from chronic pharyngitis but also improved their positive perceptions of the disease, which helped them adhere to their treatment regimen.<\/jats:p><jats:p><jats:bold>Clinical Trial Registration<\/jats:bold>: [<jats:ext-link>https:\/\/www.chictr.org.cn\/<\/jats:ext-link>], identifier [ChiCTR2200062139].<\/jats:p>","DOI":"10.3389\/fphar.2024.1162883","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T04:28:40Z","timestamp":1710390520000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of botanical lozenges in the treatment of chronic pharyngitis: a randomized controlled trial"],"prefix":"10.3389","volume":"15","author":[{"given":"Yi","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Kuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiai","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinyue","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiran","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e0221756","DOI":"10.1371\/journal.pone.0221756","article-title":"Lollipop containing Glycyrrhiza uralensis extract reduces Streptococcus mutans colonization and maintains oral microbial diversity in Chinese preschool children","volume":"14","author":"Chen","year":"2019","journal-title":"PLoS One"},{"key":"B2","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s12874-017-0394-5","article-title":"Validity and reliability of a Malay version of the brief illness perception questionnaire for patients with type 2 diabetes mellitus","volume":"17","author":"Chew","year":"2017","journal-title":"BMC Med. Res. Methodol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1007\/s00405-019-05324-9","article-title":"Ectoine lozenges in the treatment of acute viral pharyngitis: a prospective, active-controlled clinical study","volume":"276","author":"Dao","year":"2019","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.3390\/foods12071373","article-title":"Siraitia grosvenorii (swingle) C. Jeffrey: research progress of its active components, pharmacological effects, and extraction methods","volume":"12","author":"Duan","year":"2023","journal-title":"Foods"},{"key":"B5","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/j.jsps.2018.09.005","article-title":"Adherence to oral glucose lowering drugs, quality of life, treatment satisfaction and illness perception: a cross-sectional study in patients with type 2 diabetes","volume":"27","author":"Farhat","year":"2019","journal-title":"Saudi Pharm. J."},{"key":"B6","doi-asserted-by":"publisher","first-page":"219","DOI":"10.7429\/pi.2021.744226","article-title":"Description and analysis of disease representation in chronic patients through the Illness Perception Questionnaire (IPQ-r): implications for clinical practice","volume":"74","author":"Giuffrida","year":"2021","journal-title":"Prof. Inferm."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.3389\/fphar.2019.01400","article-title":"The fruits of Siraitia grosvenorii: a review of a Chinese food-medicine","volume":"10","author":"Gong","year":"2019","journal-title":"Front. Pharmacol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"5507003","DOI":"10.1155\/2021\/5507003","article-title":"Network pharmacology-based identification of potential targets of Lonicerae japonicae flos acting on anti-inflammatory effects","volume":"2021","author":"Guo","year":"2021","journal-title":"Biomed. Res. Int."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1001\/jama.2017.3417","article-title":"Effect of oral dexamethasone without immediate antibiotics vs placebo on acute sore throat in adults: a randomized clinical trial","volume":"317","author":"Hayward","year":"2017","journal-title":"Jama"},{"key":"B10","doi-asserted-by":"publisher","first-page":"112230","DOI":"10.1016\/j.jep.2019.112230","article-title":"Best practice in research - overcoming common challenges in phytopharmacological research","volume":"246","author":"Heinrich","year":"2020","journal-title":"J. Ethnopharmacol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e0187835","DOI":"10.1371\/journal.pone.0187835","article-title":"Criterion validity of 8-item Morisky medication adherence scale in patients with asthma","volume":"12","author":"Jane\u017ei\u010d","year":"2017","journal-title":"PLoS One"},{"key":"B12","doi-asserted-by":"publisher","first-page":"4413","DOI":"10.2147\/DDDT.S324139","article-title":"Mechanism of yinqin oral liquid in the treatment of chronic pharyngitis based on network Pharmacology","volume":"15","author":"Ji","year":"2021","journal-title":"Drug Des. Devel Ther."},{"key":"B13","doi-asserted-by":"publisher","first-page":"112439","DOI":"10.1016\/j.jep.2019.112439","article-title":"An \"essential herbal medicine\"-licorice: a review of phytochemicals and its effects in combination preparations","volume":"249","author":"Jiang","year":"2020","journal-title":"J. Ethnopharmacol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"2010","DOI":"10.3390\/nu14102010","article-title":"A novel herbal extract blend product prevents particulate matters-induced inflammation by improving gut microbiota and maintaining the integrity of the intestinal barrier","volume":"14","author":"Jin","year":"2022","journal-title":"Nutrients"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.1021\/acs.jafc.8b06399","article-title":"Biotransformation of food-derived saponins, platycosides, into deglucosylated saponins including deglucosylated platycodin D and their anti-inflammatory activities","volume":"67","author":"Kang","year":"2019","journal-title":"J. Agric. Food Chem."},{"key":"B16","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1097\/JCN.0000000000000675","article-title":"Illness perceptions, self-efficacy, and self-reported medication adherence in persons aged 50 and older with type 2 diabetes","volume":"36","author":"Kim","year":"2021","journal-title":"J. Cardiovasc Nurs."},{"key":"B17","doi-asserted-by":"publisher","first-page":"e934931","DOI":"10.12659\/MSM.934931","article-title":"Effect of antibiotic exposure on upper respiratory tract bacterial flora","volume":"28","author":"Korkmaz","year":"2022","journal-title":"Med. Sci. Monit."},{"key":"B18","doi-asserted-by":"publisher","first-page":"9458676","DOI":"10.1155\/2019\/9458676","article-title":"Systematic review of herbal tea (a traditional Chinese treatment method) in the therapy of chronic simple pharyngitis and preliminary exploration about its medication rules","volume":"2019","author":"Li","year":"","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1080691","DOI":"10.3389\/fpls.2023.1080691","article-title":"Construction of SNP fingerprint and population genetic analysis of honeysuckle germplasm resources in China","volume":"14","author":"Li","year":"2023","journal-title":"Front. Plant Sci."},{"key":"B20","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1093\/abbs\/gmz014","article-title":"Mogroside V inhibits LPS-induced COX-2 expression\/ROS production and overexpression of HO-1 by blocking phosphorylation of AKT1 in RAW264.7 cells","volume":"51","author":"Li","year":"","journal-title":"Acta Biochim. Biophys. Sin. (Shanghai)."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1688","DOI":"10.3390\/ijerph16101688","article-title":"Screening and diagnosis of chronic pharyngitis based on deep learning","volume":"16","author":"Li","year":"","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"130610","DOI":"10.1016\/j.foodchem.2021.130610","article-title":"Ingredients with anti-inflammatory effect from medicine food homology plants","volume":"368","author":"Lu","year":"2022","journal-title":"Food Chem."},{"key":"B23","doi-asserted-by":"publisher","first-page":"10814","DOI":"10.1039\/d0ra09443a","article-title":"Platycodon grandiflorum extract: chemical composition and whitening, antioxidant, and anti-inflammatory effects","volume":"11","author":"Ma","year":"2021","journal-title":"RSC Adv."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2591","DOI":"10.1007\/s00405-016-4060-z","article-title":"Efficacy and tolerability of an ectoine mouth and throat spray compared with those of saline lozenges in the treatment of acute pharyngitis and\/or laryngitis: a prospective, controlled, observational clinical trial","volume":"273","author":"M\u00fcller","year":"2016","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12979-018-0114-y","article-title":"Gene and protein expression of CXCR4 in adult and elderly patients with chronic rhinitis, pharyngitis or sinusitis undergoing thermal water nasal inhalations","volume":"15","author":"Neri","year":"2018","journal-title":"Immun. Ageing"},{"key":"B26","doi-asserted-by":"publisher","first-page":"111787","DOI":"10.1016\/j.biopha.2021.111787","article-title":"High or low temperature extraction, which is more conducive to Triphala against chronic pharyngitis?","volume":"140","author":"Ran","year":"2021","journal-title":"Biomed. Pharmacother."},{"key":"B27","doi-asserted-by":"publisher","first-page":"7571132","DOI":"10.1155\/2021\/7571132","article-title":"Glycyrrhiza genus: enlightening phytochemical components for pharmacological and health-promoting abilities","volume":"2021","author":"Sharifi-Rad","year":"2021","journal-title":"Oxid. Med. Cell Longev."},{"key":"B28","doi-asserted-by":"publisher","first-page":"729","DOI":"10.3109\/13880209.2013.867451","article-title":"Protective effects and mechanisms of mogroside V on LPS-induced acute lung injury in mice","volume":"52","author":"Shi","year":"2014","journal-title":"Pharm. Biol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"113685","DOI":"10.1016\/j.jep.2020.113685","article-title":"Medicinal plants from the 14(th) edition of the Russian Pharmacopoeia, recent updates","volume":"268","author":"Shikov","year":"2021","journal-title":"J. Ethnopharmacol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"841","DOI":"10.3389\/fphar.2017.00841","article-title":"Traditional and current food use of wild plants listed in the Russian Pharmacopoeia","volume":"8","author":"Shikov","year":"2017","journal-title":"Front. Pharmacol."},{"key":"B31","first-page":"2213","article-title":"Platycodon grandiflorum extract attenuates lipopolysaccharide-induced acute lung injury via TLR4\/NF-\u03baBp65 pathway in rats","volume":"34","author":"Si-Cong","year":"2021","journal-title":"Pak J. Pharm. Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"Cd004406","DOI":"10.1002\/14651858.CD004406.pub3","article-title":"Different antibiotic treatments for group A streptococcal pharyngitis","volume":"10","author":"van Driel","year":"2010","journal-title":"Cochrane Database Syst. Rev."},{"key":"B33","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1891\/1541-6577.31.3.247","article-title":"Emotion regulation in chronic disease populations: an integrative review","volume":"31","author":"Wierenga","year":"2017","journal-title":"Res. Theory Nurs. Pract."},{"key":"B34","doi-asserted-by":"publisher","first-page":"63","DOI":"10.3390\/biomedicines7030063","article-title":"Herbal tea for the management of pharyngitis: inhibition of Streptococcus pyogenes growth and biofilm formation by herbal infusions","volume":"7","author":"Wijesundara","year":"2019","journal-title":"Biomedicines"},{"key":"B35","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1080\/03602532.2020.1718691","article-title":"The metabolic effect of gut microbiota on drugs","volume":"52","author":"Xie","year":"2020","journal-title":"Drug Metab. Rev."},{"key":"B36","doi-asserted-by":"publisher","first-page":"e19922","DOI":"10.1097\/MD.0000000000019922","article-title":"The efficacy and safety of Banxia-Houpo-Tang for chronic pharyngitis: a protocol for systematic review and meta analysis","volume":"99","author":"Xu","year":"2020","journal-title":"Med. Baltim."},{"key":"B37","doi-asserted-by":"publisher","first-page":"4529","DOI":"10.19540\/j.cnki.cjcmm.20220419.601","article-title":"Preparation regularity of Chinese patent medicine in Chinese Pharmacopoeia (2020 edition, Vol.\u2160)","volume":"47","author":"Yin","year":"2022","journal-title":"Zhongguo Zhong yao za zhi"},{"key":"B38","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1038\/s41597-022-01385-4","article-title":"Chromosome-scale genome assembly of an important medicinal plant honeysuckle","volume":"9","author":"Yu","year":"2022","journal-title":"Sci. Data"},{"key":"B39","doi-asserted-by":"publisher","first-page":"13041","DOI":"10.3390\/molecules200713041","article-title":"Anti-Inflammatory activities of licorice extract and its active compounds, glycyrrhizic acid, liquiritin and liquiritigenin, in BV2 cells and mice liver","volume":"20","author":"Yu","year":"2015","journal-title":"Molecules"},{"key":"B40","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.jep.2015.01.052","article-title":"Platycodon grandiflorus - an ethnopharmacological, phytochemical and pharmacological review","volume":"164","author":"Zhang","year":"2015","journal-title":"J. Ethnopharmacol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"3819","DOI":"10.19540\/j.cnki.cjcmm.20170901.002","article-title":"Advantages and problems of traditional Chinese medicine in treatment of acute pharyngitis","volume":"42","author":"Zhang","year":"2017","journal-title":"Zhongguo Zhong Yao Za Zhi"},{"key":"B42","doi-asserted-by":"publisher","first-page":"157","DOI":"10.3390\/pharmaceutics10030157","article-title":"Developments in taste-masking techniques for traditional Chinese medicines","volume":"10","author":"Zheng","year":"2018","journal-title":"Pharmaceutics"}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1162883\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T04:28:45Z","timestamp":1710390525000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1162883\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,14]]},"references-count":42,"alternative-id":["10.3389\/fphar.2024.1162883"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2024.1162883","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,14]]},"article-number":"1162883"}}