Bromelain for Allergic Rhinitis
Verdict: Published with Warning
Across 5 PubMed studies, the evidence for Bromelain in Allergic Rhinitis grades Tier C — weak evidence. Effective, but with safety or population caveats.
C 🟠 C Weak Evidence Published with Warning
Why this grade7-layer evidence engine
⚖️
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditableRaw score 0.61
D
C
B
A
S
← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
C · Published with Warning
Confidence
80%
Highly consistent evidence
Evidence level
E2
Multiple high-quality MAs (≥2 independent, consistent)
▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.613
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高階證據未達主導 (1 positive vs 1 negative)，由 raw_score 決定
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
PubMed studies (5)L2 · primary research & systematic reviews
Herbal medicines for the treatment of rhinosinusitis: a systematic review
Finding: Of 10 RCTs reviewed, 3 tested bromelain. For acute sinusitis, the review concluded that adjunctive use of bromelain significantly improves some symptoms of acute rhinosinusitis. No separate positive evidence was found for chronic rhinosinusitis; overall evidence base described as limited.
View on PubMed Therapeutic use, efficiency and safety of the proteolytic pineapple enzyme Bromelain-POS in children with acute sinusitis in Germany
Finding: Bromelain monotherapy showed shortest mean symptom duration (6.66 days) versus standard therapy alone (7.95 days) and combination therapy (9.06 days); statistically significant faster recovery for monotherapy (p=0.005). One mild self-limiting allergic reaction in a patient with known pineapple allergy.
View on PubMed Efficacy and tolerability of bromelain in patients with chronic rhinosinusitis - a pilot study
Finding: TSS, TRS and SNOT-20 GAV improved on average over 3 months; effect greater for chronic rhinosinusitis without nasal polyps than with polyps. No adverse events observed. Small uncontrolled pilot — no placebo arm.
View on PubMed Efficacy and safety of bromelain: A systematic review and meta-analysis
Finding: Included 54 articles qualitatively and 39 in meta-analysis. Concluded bromelain may be effective against sinusitis; oral adverse events were mainly flatulence, nausea and headache; major health risks were not reported. Not effective for cardiovascular disease.
View on PubMed A double-blind clinical evaluation of bromelains in the treatment of acute sinusitis
Finding: Early double-blind trial of bromelain as adjunct in acute sinusitis. No structured abstract available on PubMed; cited in later reviews as one of the supportive early acute-sinusitis trials, but full outcome data could not be verified from the PubMed record.
View on PubMed Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …
L4a US FDA
Neutral
Bromelain (CAS Reg. No. 9001-00-7) ... ENZYME, FLAVOR ENHANCER, FLAVORING AGENT OR ADJUVANT, PROCESSING AID, TEXTURIZER; GRAS, 21 CFR 184.1024 source↗
L4b EU EFSA
Against
L4d TW TFDA / 衛福部
Neutral
酵素製劑屬食品添加物第（十七）類「其他」，可於各類食品中視實際需要適量使用，限於食品製造或加工必須時使用。 source↗
L5a NIH Office of Dietary Supplements
Cautious
L5e Specialty Society (condition-mapped)
Not addressed