SOME EXPERIMENTALLY PROVED HERBS IN PEPTIC ULCER DISEASE

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

ABSTRACT

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.

Herbs

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

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

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.

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