Tos (espasmódica)

Allicin, the principal bioactive organosulfur compound of garlic, exhibits potent antimicrobial activity against pathogens causing sinusitis and anti-inflammatory properties reducing nasal mucosal inflammation. A pharmacognosy review (rjpharmacognosy.ir, 2024) identified allicin as one of five primary bioactives validated for nasal congestion treatment. Traditional use of garlic and allicin-containing preparations for nasal and sinus ailments is extensively documented.

Allyl isothiocyanate (AITC), the TRPA1-active pungent compound from mustard and horseradish, is explicitly covered in US Patent 5,248,504 for treatment of nasal and sinus dysfunction including allergic and vasomotor rhinitis. It stimulates mucociliary secretion and exhibits antimicrobial activity against sinus infection-associated bacteria. The licensed German preparation Angocin (containing AITC-precursor sinigrin from horseradish) has been clinically evaluated for acute sinusitis.

Andrographis paniculata has clinical evidence from multiple RCTs for reducing upper respiratory tract infection symptoms including nasal congestion and rhinitis. A 2023 PMC systematic review confirmed mechanistic evidence for immunomodulation and anti-inflammatory effects in acute URTIs. The ESCOP and European Pharmacopoeia recognize it for upper respiratory symptom relief including nasal congestion.

Andrographolide, the principal diterpene of Andrographis paniculata, inhibits NF-κB and reduces pro-inflammatory cytokine production in nasal epithelial cells, exhibiting antiviral and immunomodulatory activity against URTI pathogens. A 2023 PMC systematic review confirmed its mechanistic role in URTI treatment including nasal symptom relief. It is the pharmacological basis for Andrographis's clinical efficacy.

Black seed (Nigella sativa) and its active compound thymoquinone have been evaluated in a double-blind RCT showing significant reduction in nasal congestion and other allergic rhinitis symptoms versus placebo. It inhibits 5-lipoxygenase, histamine release, and Th2 cytokines driving nasal mucosal congestion. Long traditional use in Islamic medicine for nasal obstruction and respiratory ailments is well-documented.

Bromelain, a proteolytic enzyme from pineapple, has multiple clinical trials supporting its use in sinusitis. A pilot study (n=12 chronic rhinosinusitis patients) showed improved symptom scores and quality of life with 500 FIP tablets. A trial of 116 children with acute sinusitis found faster recovery in the bromelain group (6.66 vs. 7.95 days). A Cochrane-indexed systematic review rated it as having encouraging evidence as an adjunctive treatment for acute rhinosinusitis.

Butterbur (Petasites hybridus) contains petasines that block leukotriene and histamine synthesis, reducing nasal congestion in allergic rhinitis. A landmark RCT published in the BMJ found one tablet of Ze 339 (CO2 extract of butterbur) four times daily was as effective as cetirizine for seasonal allergic rhinitis, with less sedation. It is included in several evidence-based guidelines as an option for allergic rhinitis.

Cajuput oil's major constituent 1,8-cineole is pharmacologically documented to stimulate nasal TRPM8 cold receptors, relieving the subjective sensation of congestion. Cajuput oil is an active ingredient in licensed OTC decongestant products (Olbas Oil, Olbas Inhaler Nasal Stick). Placebo-controlled trials on oral 1,8-cineole in rhinosinusitis support the mechanism, though trials specific to cajuput as a standalone agent are lacking.

Camphor-containing OTC products are listed on FDA DailyMed for temporary nasal and chest congestion relief from the common cold. A 2023 PMC bibliometric review included URI symptoms among clinically studied camphor applications. However, the FDA has determined that data for camphor as a standalone nasal decongestant are insufficient, and it is used in multi-ingredient products.

Intranasal capsaicin desensitizes TRPV1 nociceptors on nasal sensory nerve endings, persistently reducing neurogenic inflammation, rhinorrhea, sneezing, and nasal congestion. Clinical studies document approximately 60% reduction in nasal airway resistance following intranasal application, with benefit lasting more than 4 months in most patients. It is particularly studied and effective for idiopathic non-allergic rhinitis where conventional antihistamines are ineffective.

Capsaicinoids (the group including capsaicin and dihydrocapsaicin) in chili peppers act as TRPV1 agonists that desensitize nasal sensory nerve endings, reducing neurogenic nasal congestion, rhinorrhea, and sneezing. Clinical studies show ~60% reduction in nasal airway resistance with intranasal application, with benefit lasting >4 months. Traditional use of spicy foods and peppers to clear nasal passages is documented worldwide.

Intranasal capsaicin desensitizes TRPV1-expressing neurons in the nasal mucosa, providing clinically demonstrated relief from non-allergic (idiopathic) rhinitis including congestion, rhinorrhoea, and sneezing. A Cochrane review concluded capsaicin is a reasonable option for non-allergic rhinitis.

Cayenne pepper contains capsaicin and capsaicinoids that irritate then desensitize TRPV1 nociceptors in nasal mucosa, reducing neurogenic nasal congestion. Clinical studies of intranasal capsaicin (the active constituent) document ~60% reduction in nasal airway resistance with benefit lasting >4 months. Traditional use of cayenne across multiple cultures for sinus clearing is extensively documented.

Cineole (1,8-cineole, eucalyptol) is the primary mucolytic and anti-inflammatory compound of eucalyptus with robust clinical evidence for rhinosinusitis. A 310-patient non-interventional survey showed significant improvements in all rhinosinusitis symptom dimensions (p<0.001) with oral cineole over 7 days, with 90% rating efficacy as good or very good. It is used in licensed oral preparations in Germany for rhinosinusitis treatment.

Curcumin, the bioactive phenol of turmeric, reduces nasal mucosal inflammation via NF-κB and COX/LOX pathway inhibition, with demonstrated efficacy in murine allergic rhinitis models for reducing nasal symptoms and eosinophil infiltration. A pilot RCT testing curcumin nasal spray in perennial allergic rhinitis patients showed improvements in nasal congestion and airflow scores. Bioavailability is low without piperine co-administration.

Echinacea species (particularly E. purpurea) have been evaluated in multiple RCTs for upper respiratory tract infections in which nasal congestion is a primary symptom. A 2019 systematic review and meta-analysis found echinacea modestly reduces cold incidence (~35%) and duration (~1.4 days). NCCIH states some preparations may be superior to placebo for treating colds, though overall clinically relevant evidence is weak.

Echinacea purpurea is the most studied echinacea species for upper respiratory tract infections with nasal congestion. Multiple RCTs, a 2019 meta-analysis, and NCCIH acknowledge that some E. purpurea preparations may be more effective than placebo for reducing cold symptoms including nasal congestion, though overall evidence is weak. Native American traditional use for respiratory infections and nasal symptoms is well-documented.

Black elderberry (Sambucus nigra) significantly reduced duration and severity of upper respiratory symptoms versus placebo in a 2019 meta-analysis of four RCTs. A 2016 double-blind RCT in air travelers confirmed reduced cold symptom duration and severity. NCCIH acknowledges these findings while noting overall conclusive evidence from high-quality trials remains preliminary.

Ephedra (Ma Huang) contains ephedrine and pseudoephedrine, sympathomimetic alkaloids that are pharmacologically established nasal decongestants acting via vasoconstriction of nasal submucosal blood vessels. Ephedra sinica has been used in Traditional Chinese Medicine for over 5,000 years for nasal congestion and respiratory conditions. Its alkaloids form the basis of multiple approved pharmaceutical nasal decongestants.

Ephedrine is a pharmacologically established sympathomimetic amine indicated for nasal congestion, causing vasoconstriction of nasal mucosal blood vessels and reducing mucosal thickness. It is listed by DrugBank as indicated for nasal congestion and allergic conditions, and is available as a licensed nasal drop formulation. It is the principal active alkaloid of Ephedra sinica, used in TCM for millennia.

Eucalyptus oil's active compound 1,8-cineole (eucalyptol) has documented mucolytic, anti-inflammatory, and decongestant properties in clinical studies. A non-interventional survey of 310 rhinosinusitis patients treated with oral cineole showed significant improvements in symptom frequency (64%), bothersomeness (52%), and impact (54%) over seven days (p<0.001 each). The WHO has noted eucalyptus's decongestant properties, and it has been used across Aboriginal Australian, European, and Asian ethnomedicine for centuries for nasal and sinus congestion.

Elderberry's established benefits for cold and flu symptom relief—including nasal congestion—are documented in RCTs and the EMA monograph for elderflower. Traditional use specifically identifies elderflower preparations for nasal congestion and mucous discharge. The anti-inflammatory and antiviral properties are the plausible mechanisms.

Garlic and its bioactive compound allicin display antimicrobial activity against bacteria associated with sinusitis (S. aureus, H. influenzae, S. pyogenes) and anti-inflammatory properties reducing nasal mucosal swelling. A peer-reviewed pharmacognosy review identified allicin as one of five bioactives validated for nasal congestion treatment. Traditional use for sinus clearing spans Ayurvedic, TCM, and European medicine.

Ginger extract demonstrated efficacy comparable to loratadine for allergic rhinitis symptoms including nasal congestion in a registered double-blind RCT (n=80, 500 mg/day for 6 weeks). Acoustic rhinometry confirmed objectively improved nasal cavity volume in the ginger group. Gingerols and shogaols reduce mast cell infiltration, suppress IgE, and inhibit T-cell activation in nasal mucosa.

Green chiretta reduces nasal secretion and congestion in clinical trials of URTI and sinusitis. The 2000 Caceres RCT specifically measured nasal secretion as a primary endpoint and found statistically significant improvement. Anti-inflammatory and anti-edematous effects of andrographolide underlie this action.

Horseradish contains sinigrin and allyl isothiocyanate (AITC), a TRPA1 agonist that stimulates mucociliary secretion and exhibits antimicrobial properties against sinus infection-associated bacteria. It is explicitly covered in US Patent 5,385,734 for treatment of nasal and sinus dysfunction including allergic rhinitis. A licensed German combination preparation (Angocin) containing horseradish isothiocyanates has been evaluated clinically for acute sinusitis.

Nasal congestion is among the symptom parameters that improved significantly in the KanJang RCTs involving Adhatoda vasica. Traditional Ayurvedic use also documents A. vasica for nasal congestion and bronchial inflammation.

Menthol oil activates TRPM8 cold receptors in nasal mucosa to create a strong subjective sensation of nasal decongestion, documented in multiple clinical trials. A double-blind RCT (n=62, PMID 1981905) confirmed significant improvement in nasal airflow sensation with 11 mg menthol versus placebo (p<0.001) in cold patients. It is the active ingredient in multiple approved OTC nasal decongestant products worldwide.

Menthol from peppermint stimulates nasal cold receptors (TRPM8), producing a powerful sensation of increased nasal airflow and subjective decongestion, even without objectively reducing nasal resistance. This sensory effect is well-documented in human studies. Menthol is a standard ingredient in OTC decongestant products.

NAC is a well-established mucolytic agent used clinically to reduce mucus viscosity in respiratory and sinus conditions. Its mucolytic action on airway and nasal secretions is the basis of decades of clinical use in COPD and cystic fibrosis, and it has been applied to chronic rhinosinusitis. A 2026 expert consensus document (NECTAR) affirmed NAC's role in reducing mucus burden across respiratory phenotypes.

Stinging nettle (Urtica dioica) root extract was tested in a double-blind placebo-controlled RCT (n=74 allergic rhinitis patients) and showed significant improvement in clinical symptom severity (SNOT-22, p<0.001) and significant reduction in nasal eosinophil counts (p<0.01) versus placebo. It inhibits mast cell degranulation, NF-κB, COX-1/2, leukotriene synthesis, and histamine release in nasal mucosa. Traditional use in Ayurveda and European herbalism for rhinitis and sinus congestion is extensive.

Dexpanthenol nasal formulations are clinically used for rhinitis sicca and nasal congestion, including in combination with decongestants such as oxymetazoline and xylometazoline. A PubMed study (PMID 23120592) found oxymetazoline plus dexpanthenol reduced nasal irritation compared to oxymetazoline alone. Dexpanthenol is also noted to reduce nasal congestion via mucosal healing.

Peppermint contains menthol, which activates TRPM8 cold receptors in nasal mucosa, producing a well-documented subjective sensation of nasal decongestion. A double-blind RCT (n=62, PubMed PMID 1981905) showed 11 mg oral menthol significantly improved subjective nasal airflow sensation (p<0.001) versus placebo in common cold patients. Both traditional Asian medicine and modern OTC products use peppermint/menthol specifically for nasal congestion relief.

Perilla extract significantly reduced nasal inflammatory cell counts (neutrophils and eosinophils) in a human RCT of seasonal allergic rhinitis, providing direct evidence for benefit in sinus and nasal inflammatory conditions. In TCM, perilla is a classic herb for wind-cold cold patterns with nasal congestion.

Petasines (petasin and isopetasin) are the active sesquiterpene compounds in butterbur responsible for inhibiting 5-lipoxygenase and histamine synthesis, reducing leukotriene-driven nasal congestion and allergic rhinitis symptoms. Their efficacy has been confirmed in double-blind RCTs showing equivalence to cetirizine for seasonal allergic rhinitis. They are the mechanistic basis for butterbur's clinical effects.

Clinical trials and a pharmacoepidemiological cohort study support bromelain's effectiveness in reducing nasal congestion and mucus accumulation in sinusitis. Bromelain reduces nasal swelling, decreases mucus production, and improves sinus drainage through prostaglandin inhibition and mucolytic action.

Quercetin inhibits mast cell degranulation, reduces histamine and pro-inflammatory cytokine production, and has demonstrated efficacy in murine allergic rhinitis models for reducing nasal congestion, sneezing, and rhinorrhea. Two clinical trials reported symptom reduction in allergic disease; it is regarded as a supportive treatment for allergy-related nasal congestion. Mechanistic evidence is robust though large-scale human RCTs are still limited.

Clinical trials have investigated serratiopeptidase for sinusitis and related nasal congestion, finding reductions in mucus viscosity and symptom severity. A prospective open-label study (Majima et al., 1988) showed SRP reduced viscosity of nasal mucus in chronic sinusitis. A multicenter double-blind placebo-controlled trial (Mazzone et al., 1990, n=193) reported significant regression of ear, nose, and throat symptoms including nasal obstruction within 3–4 days.

Thyme (Thymus vulgaris) contains thymol and carvacrol with antimicrobial, expectorant, and mucociliary-stimulating properties for sinus and nasal congestion management. A pharmacognosy review identified thymol as one of five primary bioactives validated for nasal congestion treatment. Thyme is included in a licensed European phytomedicine combination for upper respiratory infections, with promising clinical mechanistic evidence (PMC10537612, 2023).

Thymol, the principal phenolic monoterpene of thyme, is identified by a pharmacognosy review as one of five primary bioactives validated for nasal congestion treatment, exhibiting strong antimicrobial activity against sinus infection-associated bacteria and expectorant properties. It is included in licensed European phytomedicines for respiratory catarrh and endorsed by the German Commission E for upper respiratory tract symptoms.

Thymoquinone (the principal bioactive of Nigella sativa/black seed) inhibits 5-lipoxygenase, histamine release, and pro-inflammatory cytokines driving nasal mucosal congestion. An RCT of Nigella sativa oil (containing thymoquinone) in allergic rhinitis patients showed significant reduction in nasal congestion versus placebo. It is the mechanistic basis for black seed's clinical effects on rhinitis symptoms.

Turmeric (Curcuma longa) rhizome contains curcuminoids that inhibit NF-κB, COX-2, and leukotriene pathways to reduce nasal mucosal inflammation and congestion. Murine allergic rhinitis models confirm reduction in nasal symptoms; traditional Ayurvedic use for respiratory and sinus ailments is millennia-old. It is identified in pharmacognosy literature as a plant traditionally used for nasal congestion treatment.

The essential oil extracted from A. spectabilis leaves is used in Himalayan folk medicine to relieve nasal congestion. This application is recorded in ethnobotanical sources from Nepal. The aromatic monoterpene content of the oil provides pharmacological plausibility.

Steam inhalation with ajwain is one of the most widely practiced traditional home remedies for nasal congestion and sinusitis across South Asia. Its volatile oils (thymol, terpinene) have decongestant and antimicrobial properties. Clinical trial evidence is absent but traditional use is extensively documented.

Bayberry was a traditional ingredient in remedies for sinus and nasal congestion, including as a component of composition powder used for sinusitis. Its astringent and decongestant properties are cited in herbal medicine for reducing mucous membrane swelling and congestion. No clinical trial evidence exists.

Black pepper is used in Ayurvedic, traditional Chinese, and folk medicine as a decongestant and sinus-clearing agent. Its pungent irritant action stimulates nasal secretion and may temporarily open nasal passages. Piperine activates TRPV1 channels in nasal mucosa, providing mechanistic plausibility.

Black spruce essential oil is traditionally used for sinus congestion. Modern aromatherapy sources describe it as a decongestant effective for sinus and nasal clearing. Its α-pinene component has been studied for anti-inflammatory effects in allergic rhinitis models.

Eyebright (Euphrasia officinalis) has been used in European herbal medicine for nasal catarrh and rhinitis since the Middle Ages, with German Commission E and ESCOP endorsement for nasal catarrh treatment. Aucubin, iridoid glycosides, and flavonoids contribute to its anti-inflammatory activity on nasal mucosa. Rigorous clinical trial evidence specifically for nasal congestion is absent; support is traditional/commission-based.

Goldenrod has a documented traditional role as an anticatarrhal herb for sinus congestion and nasal catarrh, recognized in European herbal medicine. It is described as a 'premier decongestant' in traditional herbal practice, used to reduce excess mucus and congestion of the sinus mucosa. No clinical trials have specifically evaluated goldenrod for sinus congestion in isolation.

Goldenseal (Hydrastis canadensis) is used in North American and Native American herbal medicine for nasal and sinus congestion, catarrh, and rhinitis, with berberine providing antimicrobial and anti-inflammatory activity on nasal mucosa, and hydrastine acting as a mucous membrane astringent. NCCIH databases and official compendia reference it for mucous membrane inflammation. Formal RCT evidence specifically for nasal congestion is lacking.

Honeysuckle is used in TCM for wind-heat presentations including sinus congestion with thick yellow nasal discharge, and is part of formulas used for sinusitis and upper respiratory infection. It is traditionally considered to clear nasal heat and resolve toxin in the respiratory tract.

Horehound is traditionally used for sinus congestion and catarrh as part of its broader respiratory folk medicine application. Its expectorant and mucolytic properties are proposed to assist in clearing nasal and sinus passages. No clinical studies targeting sinus or nasal outcomes specifically have been conducted.

Hyssop is traditionally used for sinus infections, nasal congestion, and post-nasal catarrh. Its expectorant and mucolytic properties via volatile oil components are cited across European herbal tradition. Traditional preparations include teas and steam inhalations.

Marjoram is used in traditional medicine for nasal congestion and is classified as a decongestant in herbal aromatherapy. Inhalation of marjoram essential oil is a documented traditional practice for sinus congestion.

Mullein (Verbascum thapsus) has extensive traditional use across European and Native American medicine as an expectorant and demulcent for respiratory catarrh and nasal stuffiness. It is listed in the British Herbal Pharmacopoeia for respiratory catarrh. Saponins (verbascoside) provide expectorant and mucociliary-stimulating properties. No rigorous clinical trials for nasal congestion specifically have been published.

Mustard's pungent AITC activates nasal TRPA1 receptors, causing a reflexive increase in nasal secretions and a decongestant-like clearing effect. This property is the basis for its traditional use as a sinus decongestant in folk medicine and naturopathic practice. No clinical trials have quantified this effect in humans.

Pine has a documented traditional use across Native American and aromatic medicine traditions as herbal steam and incense for clearing sinuses and relieving nasal congestion. The volatile compounds in pine essential oils, including α-terpineol and limonene, are recognized for decongestant and mucolytic properties.

Plantago lanceolata is used in European and Asian folk medicine for nasal catarrh and sinus congestion. Commission E endorses it for upper respiratory catarrh, which includes nasal congestion. The plant's anti-inflammatory and mucilage properties provide theoretical support for nasal mucosal soothing.

Plantago is used traditionally for sinus and nasal complaints. Its anti-inflammatory and antimicrobial properties are relevant to sinusitis. Traditional use for hoarseness, rhinitis, and nasal congestion is documented in European and Asian folk medicine. Mucilage may soothe inflamed nasal mucosa. No dedicated human clinical trial for sinusitis with plantain has been published.

Platycodon is used in TCM formulas addressing nasal congestion and upper respiratory stuffiness, leveraging its expectorant, anti-inflammatory, and 'lung-opening' properties. Traditional formulas such as those for acute rhinitis and sinusitis commonly include Jiegeng. Clinical trial evidence specific to sinus and nasal congestion is not available.

TCM texts, including the Ming Dynasty Bencao Mengquan, describe platycodon root as 'clearing the nasal passages.' Its expectorant saponins promote secretion clearance. Platycodin D inhibits mucus production in nasal epithelial cells in vitro. Traditional Pharmacopoeia classification as a phlegm-clearing herb supports this use.

TCM sources list Schizonepeta for nasal congestion, sinusitis, and related wind-invasion symptoms. It is included in classical formulas for stuffy and runny nose. Preclinical anti-inflammatory effects provide mechanistic plausibility. No isolated human clinical trials have been conducted for this indication.

Sheep's sorrel has traditionally been used as an astringent remedy to reduce mucus and nasal inflammation. Its tannins are proposed to reduce mucus membrane secretions. No clinical evidence exists.

Respiratory and nasal congestion support is a traditional use of smartweed documented particularly in American folk medicine and across Peruvian traditional use. The plant's volatile oils and pungent compounds (polygodial) provide a plausible mucolytic and decongestant basis.

Spruce needle oil used in aromatic steam inhalation is a traditional remedy for clearing sinus and nasal congestion. The needles are rich in volatile terpenes that act as decongestants and antiseptics. This use is documented in folk and commercial herbal medicine across Europe and North America.

A. calamus is traditionally classified as sirovirectana (cleansing nasal therapy) in Ayurveda and used for sinusitis across multiple traditional systems. Decongestant and mucolytic mechanisms are attributed to its aromatic volatile oil. Traditional documentation of its use in sinusitis is consistent.

Wood betony has documented traditional use for sinus headaches and nasal congestion, including a practice of snuffing the powdered herb to induce sneezing and clear nasal passages. It is also combined with other herbs for head colds.

Treating rhinitis, nasal obstruction, and sinusitis is the most historically entrenched use of X. strumarium (Cang-Er-Zi) in TCM, documented from the earliest Han dynasty materia medica to the current Chinese Pharmacopoeia. It is regarded as a wind-cold-dispersing herb that opens nasal passages. Contemporary use in Chinese clinical practice for this indication is widespread though human trial evidence is lacking.