Herbal tea helps reduce the pain of acute pharyngitis

Question Can herbal tea help reduce the symptoms of pain associated with acute pharyngitis?

Synopsis Demulcents have been used for many years to treat sore throat. They are not topical anaesthetics but are soothing and relieve irritation. This double blinded randomised controlled study evaluated the effectiveness of a demulcent mixture containing licorice root, elm inner bark, marshmallow root, and licorice root aqueous dry extract (a herbal tea called Throat Coat). Sixty outpatients with acute pharyngitis were randomly assigned to use the herbal tea, or a placebo tea that tasted and smelled similar, four to six times daily for as long as symptoms remained. No other treatment was allowed. Treatment allocation was concealed from the enrolling physician. Patients rated pain relief after 1 minute then every 5 minutes for 30 minutes, then at 3 and 24 hours after the first dose, and then daily using a scale from 0 to 10. Analysis was by intention to treat and compared the degree of change in pain scores at each period, as well as the total amount of pain relief by using the total area under the curve of changes in pain. Details on the statistics that were used are sketchy, which is odd considering the great detail in which other aspects of the study were reported.

Changes from baseline pain after the first dose differed significantly at 5 and 10 minutes: the sum of differences in pain intensity occurring in the first 30 minutes of treatment was about twice as good in the treatment group (P = 0.041). Pain relief was also greater in treated patients at 10 minutes after the first dose. By intention to treat analysis, however, total pain relief over the first 30 minutes was not different between the two groups.

Bottom line A herbal tea containing a mixture of traditional demulcents (soothing agents) was more effective than a placebo tea in the short term relief of pain in patients with acute pharyngitis. The effect does not last long—less than 30 minutes—so requires frequent tea drinking throughout the day. For my next sore throat, I'm going to reach for an analgesic and a topical anaesthetic, but herbal tea may be useful for patients who prefer a more active approach and who wish to avoid the feeling of a partially anaesthetised mouth.

Level of evidence 1c (see www.infopoems.com/resources/levels.html); all or nothing randomised controlled trial.