Individualized homeopathic medicines in the treatment of chronic tonsillitis in adults: Randomized, double-blind, placebo-controlled trial

One of the most prevalent otolaryngologic illnesses, chronic tonsillitis is triggered by recurrent acute tonsillitis episodes that result in permanent damage to the tonsils or cause the tonsils to fail to recover completely [1]. Recurrent tonsillitis had an 11.7 percent lifetime frequency, with considerable female predominance [2]. Presenting symptoms of chronic tonsillitis are sore throat, difficulty in deglutition, halitosis, bad taste in the mouth, snoring, food faddism, and enlargement of the regional lymph node (jugulodigastric). Chronic tonsillitis may lead to complications like quinsy, parapharyngeal abscess, intra-tonsillar abscess, tonsillolith, and cysts in the tonsil [3]. Appropriate intervention is warranted to avoid the recurrence of tonsillitis having a substantial negative influence on the patient’s quality of life [4].

Aspirin or paracetamol are used as analgesics in conventional treatment to reduce fever and relieve local pain in chronic tonsillitis [1]. Several conservative care regimens are still administered in spite of strong evidence of their modest clinical benefit [5]. A proven method for treating recurring tonsillitis and averting possible complications is tonsillectomy [6]. However, the relatively high prevalence of complications associated with tonsillectomy in adults is well-known [7]. Although there are currently no consensus criteria, surgery is advised based on a formula that calls for seven tonsillitis episodes in a single year, five episodes in two years, or three episodes in three consecutive years [8]. Recent studies suggest that compared with conservative management, immediate tonsillectomy is clinically effective and cost-effective in adults with recurrent acute tonsillitis [9], [10]. As a result, complementary and alternative medicine therapies, including homeopathy are gaining popularity. However, the evidence for homeopathy in treating chronic tonsillitis has remained inadequate and inconclusive. Several trials of homeopathy focused on evaluating the efficacy of different homeopathic complexes in tonsillitis in children [11], [12], [13], [14]. One trial explored the efficacy of Arnica montana in post-tonsillectomy analgesia [15]. Individualized homeopathic medicines (IHMs) were evaluated in a single-arm trial and double-blind, randomized controlled trial (RCT) designs in chronic tonsillitis in children with promising outcomes [16], [17]. One non-inferiority trial compared the homeopathic remedy Agraphis nutans with IHMs in chronic tonsilitis in adults [18].

Thus, the overall evidence remains compromised supporting the recommendations of IHMs in the treatment of chronic tonsillitis in adults. In this double-blind RCT, the efficacy of IHMs in treating adults with chronic tonsillitis was compared to placebos. The primary objective was to detect the group difference in the sore throat pain model (STPM), while the secondary objectives were to detect group differences in the Tonsil and adenoid health status instrument (TAHSI) and the Glasgow benefit inventory (GBI) after 3 months of intervention.

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