Cocklebur (Xanthium strumarium) has a long history of use in traditional Chinese medicine (TCM), where it is known as "Cang Er Zi." It is commonly included in herbal formulas to treat nasal and sinus congestion, particularly in conditions like rhinitis and sinusitis. The classic TCM formula "Cang Er Zi San" combines Cocklebur with other herbs to address symptoms such as nasal obstruction, headache, and thick nasal discharge. This traditional use is based on the herb's reputed ability to "dispel wind" and "open nasal passages," according to TCM theory.

Scientific evidence for Cocklebur's efficacy in supporting the sinuses is limited and primarily based on animal studies or in vitro research. Some studies suggest that extracts may have anti-inflammatory and anti-allergic properties, which could theoretically benefit sinus health. However, robust clinical trials in humans are lacking, and safety concerns exist—particularly regarding toxicity if the seeds are not processed properly.

In summary, while Cocklebur is widely used in traditional medicine for sinus support, scientific validation is currently insufficient. Its traditional role is well-documented, which is why it is still found in many herbal formulations targeting the sinuses.