SOME EXPERIMENTALLY PROVED HERBS IN PEPTIC ULCER DISEASEHTML Full Text
SOME EXPERIMENTALLY PROVED HERBS IN PEPTIC ULCER DISEASE
Shagufta Nikhat 1, Javed Ahmad Khan*2 and Ghufran Ahmad 3
Department of Ilmul Advia, Deoband Unani Medical College, Deoband, Uttar Pradesh, India
Department of Ilaj-bit-Tadbeer, Deoband Unani Medical College, Deoband, Uttar Pradesh, India
AKTC, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
Peptic ulcer is a worldwide health problem because of its high morbidity, mortality and enormous financial implication. An estimated 15,000 deaths per year occur as a consequence of complicated PUD.A large number of drugs for peptic ulcer disease are available in mainstream medicine but they are associated with numerous side effects like arrhythmias, impotence, gynaecomastia and haematopoietic changes and the recurrence is also very common. In recent times, focus on plant research has increased all over the world and a large body of evidence has been collected to show immense potential of medicinal plants used in various traditional systems. Here, an attempt is made to summarise experimentally proved herbs used in PUD during last decade.
INTRODUCTION:Peptic ulcer disease (PUD) is one of the most common gastrointestinal disorders, which causes a high rate of morbidity 1. It comprises both gastric and duodenal ulcers. These are benign defects in the gastrointestinal mucosa that extends beyond the muscularis mucosa, and are perpetuated by acid peptic activity. They occur commonly in the proximal duodenum or in the stomach and also occur in other areas exposed to gastric juice such as lower end of the oesophagus, Meckel’s diverticulum or at the site of gastro-jejunal anastomosis 2. In India, peptic ulcer is more prevalent in Jammu and Kashmir, followed by Southern India. North India comes next, and East and North East have comparatively lower prevalence 3.The lifetime prevalence of peptic ulcer disease is 5 to 10 percent, with about equal prevalence in men and women.
Peptic ulcer is a worldwide health problem because of its high morbidity, mortality and enormous financial implication. An estimated 15,000 deaths per year occur as a consequence of complicated PUD 1.Some studies have shown that duodenal ulcer is more common in the Southern part of India compared to the North 4, 5.Peptic ulcers are uncommon in children, but the risk increases with age. Ulcers are caused by an imbalance between aggressive and defensive factors of the gastric mucosa. Gastric acid and pepsin make up the offensive factors whose proteolytic effect is buffered by mucin production, mucosal glycoprotein, cell shedding, cell proliferation and prostaglandins 6.
In India, PUD is common and the Indian Pharmaceutical industries share 6.2 billion rupees and occupy 4.3% of the market share in consuming the antacids and antiulcer drugs 5. The incidence of ulcer disease increases with age, due to excessive use of NSAIDs and the reduction in tissue prostaglandins 6.The therapy of peptic ulcer involves decreasing the secretion of acid with H2-receptor antagonist or proton pump inhibitor, neutralizing secreted acid with antacids and enhancing the mucosal protection mechanism by cytoprotective agents. The later one is being appreciated and taken up as equally important measure to that of anti-secretory agents in the management of peptic ulcer 7. It has also become a customary that aforesaid treatments are coupled to eradicate H. pylori 8. Although these drugs have brought about remarkable changes in ulcer therapy but efficacy and safety of these drugs are still debatable. Reports on clinical evaluation of these drugs show that there are incidences of relapses, adverse effects and danger of drug interactions during ulcer therapy 5, 9.
In recent times, focus on plant research has increased all over the world and a large body of evidence has been collected to show immense potential of medicinal plants used in various traditional systems. More than 13,000 plants have been studied during the last few years 10.According to the World Health Organization, more than 80% of the world’s population - primarily those of developing countries relies on plants and plant derived medicines for their health care 11. Most of the herbal drugs used in the management of peptic ulcer have been reported to reduce the offensive factors, proved to be safe, effective and showed better patient tolerance 9, 12.
Hence, use of natural drugs alone or in combination with other drugs should be seriously considered in the management of PUD 13. The first drug reported effective against ulcer was carbenoxolone, discovered as a result of research on a commonly used indigenous plant, Glycyrrhiza glabra (Mulethi) 14.
A large number of drugs for peptic ulcer disease are available in mainstream medicine but they are associated with numerous side effects like arrhythmias, impotence, gynaecomastia and haematopoietic changes and the recurrence is also very common 15. Therefore, development of drugs which can be used safely in peptic ulcer and associated disorders assumes tremendous significance.
In modern system of medicine a number of drugs including proton pump inhibitors and H2 receptor antagonists are available for the treatment of peptic ulcer, but clinical evaluation of these drugs has shown incidence of relapses, side effects, and drug interactions. Herbal drugs afford better protection and decrease the incidence of relapses that’s why they are preferable.
In Table 1 and 2, an attempt has been made to summarize some of the important antiulcer studies done with herbal plants during the last few decades.
TABLE 1: EXTRACTS OF SOME MEDICINAL PLANTS POSSESSING ANTI-ULCEROGENIC ACTIVITY
|S. No||Plant||Extracts||Models||Mode of action||Year|
|SagwanTectona grandis L. (Trunk Bark & wood chips) 16||Ethanolic fraction||PL, RS &prednisolone induced GU in rats. HIST- induced GU & DU in GP||No effect on acid secretion but caused an increase in mucin secretion.||1982|
|SG-1 [total methanol -H2O (1:1)] SG-2 (sitoindosides VII, VIII& withaferin-A)||RS- induced GU in rats||Anti-stress activity||1987|
|Acetone extract||HCl/ ethanol induced gastric ulceration||-||1988|
|HaldiCurcuma longa Linn. 19||Ethanol extract||RS & PL, Indomethacine & Reserpine induced gastric ulceration||-||1990|
|SanjeevaniSelaginella Bryopteris 20||Ethanolic extract||RS ulcers in rats||-||1993|
|ChaiCamellia sinensis 21||Hot water extract||Cold + Restraintstress induced ulcers in rats||-||1995|
|Aqueous and ethanolic extracts||ASP- and RS- induced (antiulcer)& acetic acid (healing)- induced GU in rats||-||1996|
(Seeds 23 & Roots) 24
|PE, AE, CE andEE extracts||RS- induced GU in miceRS & PL- induced GU in rats||Decrease in acid- pepsin & increase in mucin secretionby ethanolic extract||1997|
|Asal alsoosGlycyrrhiza glabra 25||Water decoction||PL- and CRS- induced GU in rats||Mucosal defensive factors by enhancing mucin secretion & life span of mucosal cells||1997|
|TaleespattarAbies pindrow Royle(Leaves) 26||CE, AE & EE extracts||CRS- induced GU in rats||Antistress activity||1998|
|KutkiPicrorhiza Kurroa 27||Ethenolic extract||HCl/ethanol induced||1999|
|Cissampelos muronata 28||Methanolic extract||Indomethacin-, HIST-, stress-induced GU||1999|
|BrahmiBacopa monniera 29
|Fresh juice||CRS-, ethanol-, ASP- and PL-induced GU in rats||No effect on acid-pepsin secretion, increase in mucin secretion, life span of mucosal cells.||2000|
|KarelaMomordica charantia Linn. 30||Olive oil extract||Ethanol induced||2000|
|BrahmiCentella asiatica 31(Whole plant)||Fresh juice||CRS-, ethanol-, ASP- and PL- induced GU in rats||No effect on acid-pepsin secretion, increase in mucin secretion & life span of mucosal cells.||2001|
|Heel KalanA. subulatum 32||Methanolic extract||Ethanol induced||2001|
|KelaMusa paradisiaca 33||Methanolic extract||CRS- induced||2001|
|Sankh pushpi Convolvulus Pluricaulis 34(Whole plant)||Fresh juice||CRS-, ethanol-, ASP- and PL- induced GU in rat||No effect on acid-pepsin secretion, increase in mucin secretion & life span of mucosal cells.||2001|
|Sanbhalo 35Vitex negundo||Aq. Extract||Piroxicam-induced GU||2001|
|AmlaEmblica officinalis 36||Fresh juice||CRS-, ethanol-, ASP- and PL- induced GU in rat||No effect on acid-pepsin secretion, increase in mucin secretion & life span of mucosal cells.||2002|
|SatawarAsparagus racemosus 37||Fresh juice||PL- and CRS- induced GU in rats||No effect on acid-pepsin secretion, increase in mucin secretion & life span of mucosal cells.||2003|
|Ushba HindiHemidesmus indicus 38||Ethanolic extract||ASP, PL||Increased mucin secretion||2003|
|TulsiOcimum sanctum Linn.39||Ethanolic extract||CRU, AL, ASP, PL, AA, cysteamine||Has no effect on acid & pepsin but increases mucin secretion||2004|
|Terminalia pallida Brandis 40||Ethanolic extract||Indomethacin, HIST, AL||Decreases acid secretion & potent antioxidant||2005|
|Allophylus serratus Kurz 41||Ethanolic extract||CRU,AL,ASP,PL||Decreases acid secretion & peptic activity & increases mucin secretion||2005|
|Desmodium gangeticum 42||Ethanolic extract||CRU,AL,ASP,PL||Increases mucin secretion||2005|
|Heele KhurdElletaria cardamomum Maton 43||Methanolic extract||ASP, ethanol, PL-induced||-||2006|
AE-Acetone; ASP-Aspirin; CE-Chloroform; CRS-Cold restraint stress; CYS- Cysteamine; DU-Duodenal ulcer; EE-Ethanolic; GP-Guinea pig; GU-Gastric ulcer; HIST-Histamine; PE-Petroleum ether; PL-Pylorus ligation; RS-Restraint stress.
TABLE 2: ULCER PROTECTIVE EFFECT OF SOME ACTIVE CONSTITUENTS ISOLATED FROM HERBAL DRUGS
|S. No.||Plants||Active constituents||Models||Mode of action||Year|
|NeemAzadirachta Indica 44||Nimbidin||ASP-, prednisolone, indomethacin-, serotonin stress- & acetic acid induced GU in rats. HIST- induced DU in GP.||-||1984|
|2||SagwanTectona grandis Linn. (Trunk bark & wood chips) 45||Lapachol||IS- and ASP -induced GU in rats. CYS- and HIST- induced DU in rats and GP respectively.||per se no significant effect on both offensive &defensive factors, but reversed the ASP- induced increase in peptic activity & decrease in sialic acid & mucin secretion.||1987|
(Whole plant) 46, 47
|Kaempferol||PL-, ethanol, IS-and CRS- induced GU in rats & HIST-induced GU & DU in GP.||Decrease in acid-pepsin secretion & increase in mucin secretion, Endogenous increase in PGs & decrease in LTs4||1988|
|Shilajit 48||Fulvic acid, 4/-methoxy 6-carbomethoxy bi phenyl||PL-, PL+ ASP-and RS- induced GU and CYS-induced DU in rats.||per se decrease in acid-pepsin secretion & cell shedding, tendency to increase mucin secretion but reversed the increase in cell shedding & decrease in mucin secretion induced by ASP.||1988|
| Rhamnus triquerta Wall
(Whole plant) 49
|Emodin||RS-, PL- and IS- induced GU in rats||Decrease in acid-pepsin secretion & increase in mucin secretion in ASP- treated group.||1991|
|Picrasma quassioides 50||MeOH extract,CHCl3 soluble fraction, Nigakilacetone , Methynigakinone||ASP- induced GU in rats||-||1994|
|Dhatura Datura fastuosa(Leaves) 51, 52||Withafastuosin-E||CRS-, PL- and ASP induced GU in rats||per se decrease in acid-pepsin and no effectson mucin secretion, mucosal cell shedding, proliferation and glycoproteins significant increase in endogenous PGs.||1997|
(Seeds ) 53
|Luvangetin||PL-and ASP- induced GU in rats and CRS- induced GU in rats and GP.||-||1997|
| Flueggea microcarpa
(Leaves & roots) 53
|Bergenin/Norbergenin||PL-and ASP- induced GU in rats and CRS- induced GU in rats and GP.||Increase in endogenous PGs.||1997|
|TulsiOcimum basilum 54||Fixed oil||ASP-, indomethacin-, ethanol, HIST-, reserpine, Serotonin- PL- and stress induced, GU in rats||Antisecretory||1999|
(Whole plant) 55
|Standardized extract of bacoside A (35%)||CRS-, ethanol, ASP- and PL-induced GU in rats||No effect on acid-pepsin secretion, increase in mucin secretion and life span of mucosal cells.||2001|
AE-Acetone; ASP-Aspirin; CE-Chloroform; CRS-Cold restraint stress; CYS-Cysteamine; DU-Duodenal ulcer; EE-Ethanolic; GP-Guinea pig; GU-Gastric ulcer; HIST-Histamine; IS-Immobilization stress; PE-Petroleum ether; PL-Pylorus ligation; RS-Restraint stress;
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How to cite this article:
Nikhat S, Khan JA and Ahmad G. Some Experimentally Proved Herbs in Peptic Ulcer Disease. Int J Pharm Sci Res, 2012; Vol. 3(8): 2387-2392.
Shagufta Nikhat , Javed Ahmad Khan* and Ghufran Ahmad
Assistant Professor, Department of Ilmul Advia, Deoband Unani Medical College, Deoband, Uttar Pradesh, India
10 April, 2012
15 May, 2012
09 July, 2012
01 August, 2012