Vol. 2, Issue 2, Part A (2025)

Background: Recurrent pharyngitis is a common cause of morbidity and antibiotic use, despite guideline recommendations to restrict antimicrobials to selected cases. In Ayurveda, recurrent sore throat can be correlated with Kaṇṭha-roga entities such as Galagraha and Tundikeri, for which Shalakya Tantra recommends localized procedures (kriyākalpa) including Kaṇṭha Gargaṇa (medicated gargling) and Dhūmapāna (medicated smoke inhalation).
Objectives: To evaluate the therapeutic efficacy of a standardized Kaṇṭha Gargaṇa-Dhūmapāna protocol, integrated with conventional care, on recurrence, symptom burden and antibiotic consumption in adults with recurrent pharyngitis.
Methods: In this prospective, randomized, controlled, parallel-group clinical trial, 80 adults (18-60 years) with ≥3 physician-diagnosed pharyngitis episodes in the preceding year were allocated (1:1) to either Kaṇṭha Gargaṇa + Dhūmapāna + standard care (intervention) or standard care alone (control) and followed for 6 months. The intervention group performed warm herbal Kaṇṭha Gargaṇa three times daily during acute episodes and once daily as prophylaxis, plus supervised procedure-specific Dhūmapāna, in addition to guideline-based pharmacotherapy. Primary outcome was the number of recurrent pharyngitis episodes; secondary outcomes included time to symptom resolution, pain scores, antibiotic courses, sore-throat-related health-care visits and days off work/school. Analyses were conducted on an intention-to-treat basis.
Results: Baseline characteristics were comparable between groups. Over 6 months, mean recurrent episodes per patient were significantly lower in the intervention group than in controls (1.2 ± 1.0 vs 3.1 ± 1.4; p < 0.001), and a greater proportion achieved ≥50% reduction in episode frequency (77.5% vs 35.0%; p < 0.001). Time to complete pain resolution for the index episode was shorter (3.0 ± 1.2 vs 4.7 ± 1.5 days; p < 0.001), with steeper declines in daily VAS scores. Mean antibiotic courses (0.6 ± 0.8 vs 1.4 ± 1.0; p < 0.001), sore-throat-related ENT/primary-care visits (1.0 ± 0.9 vs 2.2 ± 1.3; p < 0.001) and days off work/school (2.1 ± 2.0 vs 4.8 ± 3.1; p < 0.001) were also significantly reduced. No serious adverse events were observed.
Conclusion: Integrating a standardized Kaṇṭha Gargaṇa and Dhūmapāna protocol with standard guideline-based management significantly reduced recurrence, symptom burden, antibiotic use and health-care utilization in adults with recurrent pharyngitis. These findings support the incorporation of evidence-informed Shalakya Tantra kriyākalpa as pragmatic, low-cost adjuncts within modern ENT and primary-care practice.