Glycyrrhiza Glabra and Platycodon Grandiflorus are Alternative Treatment Options for Vocal Fold Nodules
Abstract Background: Vocal fold nodules (VFN) are one of the main causes of hoarseness. In this study, we try to figure out an alternative treatment from our clinical experience summary.Methods: We retrospectively reviewed VFN patients who received traditional Chinese medicine (TCM) treatments from July 2018 to August 2020 and traced their Chinese Voice Handicap Index-10 (VHI-C10) and multidimensional voice program (MDVP) analysis results. Also, we induce inflammatory response of porcine vocal fold epithelial (PVFE) cells with 50 ng/mL TNF-alpha. The inflamed PVFE cells were separately cultured in the aqueous extract of Glycyrrhiza glabra and Platycodon grandiflorus. Results: For these patients (n = 22), the average VHI-C10 score decreased from 17.6 to 6.6 (p < 0.001). MDVP analysis revealed improvements in jitter, shimmer, noise–harmonic ratio, and GRBAS scoring system. Analysis of prescription patterns revealed that the most commonly used herbs were Licorice and Platycodon grandiflorus. In the MTT assay of PVFE cells, no adverse effects of our extracts were observed at doses of 1–200 ug/mL. Western blot analysis revealed downregulation of p65 and mitogen-activated protein kinase pathway proteins.Conclusions: The results from both the clinical and in vitro aspects of this study revealed that the herbs G. glabra and P. grandiflorus may offer beneficial outcomes as alternative treatments for VFNs.