IJCRR - Vol 02 Issue 03, March
Date of Publication: 30-Nov--0001
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HERBAL DRUG COMPREHENSIVE APPROACH FOR TREATING LIVER DISEASE AND FOCUS TOWARDS HERBAL MEDICINE
Author: Kugaler Ganesan Parthiban, Balakrishnan Senthil Kumar, Rangasamy Manivannan Natesan Senthil Kumar
Abstract:A western allopathic medicine is excellent in handling acute medical crises. Herbal drug demonstrate an ability to manage chronic disorders of livers since from traditional people. That western medicine has been unable to. It may be projected as herbal drug comprehensive approach, emphasis on prevention and ability to manage chronic disorder that its widespread use would improve the health. The spectacular rise of thepharmaceutical industry had tremendous impact on disease management. There is doubt that in extreme situations, the treatments devised by conventional/modern medicine can offer an unparalleled opportunity to relieve symptoms and save lives. Today herbal medicines are coming back into prominence because of decreasing efficacy of the modern medicines such as antibiotics, which once had universal effectiveness against serious infections. Besides, many synthetic drugs are also causing serious side effects. The knowledge of valuable herbal plant remedies have not been documented and were orally dissipated by the triable populations. But these tribal possessed remarkably accurate knowledge about the medicinal use of the herbal plants around them. Herbal medicines often complement the conventional modern treatments providing safe, well-tolerated remedies for many chronic diseases like disorder, rheumatoid arthritis,diabetes, cardiovascular and disorders and asthma. With the tremendous increase in the global useof medicinal plants, several concerns regarding the efficacy and safety of the herbal medicines have also been raised. Hence it has become necessary to standardize the efficacy and safety measures so as to ensure supply of medicinal plant materials with good quality.
Keywords: Herbal Medicine, Hepatitis, Cirrhosis.
Herbal drugs have become increasingly popular and their use is widespread. Licensing regulations and pharmacovigilance regarding herbal products are still incomplete and clearcut proof of their efficacy in liver diseases is sparse. Its main objective is to achieve optimal health and well-being through a comprehensive approach that addresses mind body, behavior and environment. Herbal drug emphasizes prevention and health promotion and provides treatment for liver disease it considers the development of consciousness to be essential for optimal health and meditation as the main technique for achieving this1 . A western allopathic medicine is excellent in handling acute medical crises. Herbal drug demonstrate an ability to manage chronic disorders of livers .that western medicine has been unable to. It may be projected as herbal drug comprehensive approach, emphasis on prevention and ability to manage chronic disorder that its widespread use would improve the health statious of the world's population2 . Ethanobotany is an ever-growing field and forms the manstay in establishing the therapeutic potential and medicinal use of hearbs growing in the interior areas of India, where a tribal people use plants of that region as medicine has already diverted the attention of the people towards herbal medicines to increase the herbal acceptability and awareness among the people/there is an urgent need to develop trust and faith towards the safer indigenous system by establishing its validity in treatment for various diseases. Government of India should encourage the field of herbal plant. This in turn will help in elevating and growing the economy of the country by increasing herbal trade with the major courage around the world. This will also improve the health and quality of life of the entire nation3 . The twentieth century became a triumph for the synthetic chemistry dominated pharmaceutical industry, which replaced the natural extracts with synthetic molecules. The spectacular rise of the pharmaceutical industry had tremendous impact on disease management. There is no doubt that in extreme situations, the treatments devised by conventional/modern medicine can offer an unparalleled opportunity to relieve symptoms and save lives. Today herbal medicines are coming back into prominence because of decreasing efficacy of the modern medicines such as antibiotics, which once had universal effectiveness against serious infections. Over the years infectious organisms have developed resistance to synthetic drugs. Besides, many synthetic drugs are also causing serious side effects4 . The knowledge of valuable herbal plant remedies have not been documented and were orally dissipated by the triable populations. But these tribal possessed remarkably accurate knowledge about the medicinal use of the herbal plants around them.
The liver is the master organ of the body, and most people consider the liver to be more important in the normal functioning of the body than even the brain and the heart. The liver is the largest glandular organ in the body and has more functions than any other human organ5-6 . The Liver has a pivotal role in human metabolism.
- The liver produces and secretes bile that is used to break down and digest fatty acids.
- It also produces prothrombin and fibrinogen, both blood-clotting factors, and heparin, a mucopolysaccharide sulfuric acid ester that helps keeps blood from clotting within the circulatory system.
- The liver convert's sugar into glycogen, synthesizes proteins and cholesterol and converts carbohydrates and proteins into fats
- It also produces blood protein and hundreds of enzymes needed for digestion and other bodily functions.
- The liver also produces urea, while breaking down proteins, stores critical trace elements such as iron and copper, as well as vitamins A, D, and B12.
The maintenance of a healthy liver is vital to overall health and well being. Unfortunately, the liver is often abused by environmental toxins, poor eating habits, alcohol, and prescription and over the counter drug use, which can damage and weaken the liver and eventually lead to hepatitis, cirrhosis and alcoholic liver didysfunction. Conventional medicine is now pursuing the use of natural products such as herbs to provide the support that the liver needs on a daily basis. Many ayurvedic herbs have a long history of traditional use in revitalizing the liver and treating liver dysfunction and disease Problems associated with liver dysfunction can ultimately lead to serious illness such as hepatitis, Jaundice cirrhosis, fatty liver, alcoholic liver disease, and biliary cirrhosis. Symptoms and signs of liver disease include yellow discoloration of the skin and eyes, dark urine, gray, yellow or light colored stools, nausea, vomiting and/or loss of appetite, vomiting of blood, bloody or black stools, abdominal swelling, prolonged generalized itching, unusual change of weight, abdominal pain, sleep disturbances, mental confusion, and fatigue or loss of stamina.
Hepatitis refers to an inflammation the liver and is usually but not always the result of virus. Infect hepatitis can be caused by alcohol and chemical as well as auto immune hypersensitivity reaction. The most common hepatitis viruses affecting the liver are named for letters of the alphabet: hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E7 .
It is transmitted through food. Once infected with HAV, some symptoms such as dark yellow urine and fatigue will begin to appear within 25 days.
Hepatitis B: It is on the increase world-wide. It is transmitted through direct contact with blood, serum, saliva, faeces, urine, and sexual contact.
Hepatitis C: It is transmitted through blood and body fluids in transfusions, injections, the sharing of IV needles with drug users, and possibly by sexual contact with exposed partners.
Hepatitis D Only occurs in the presence of Hepatitis B virus. Hepatitis E It is another common type of hepatitis in developing countries. It occurs in epidemics. The infection route for it is faecal-oral, the same as the route for Hepatitis A virus.
Jaundice is a general condition that results from abnormal metabolism or retention of bilirubin.It can occur when there is an obstruction in the bile duct, or if there is destruction of the red blood corpuscles. When a person has jaundice, their skin becomes yellow in color. This characteristic yellowness is seen even in the eyes and the fingernails. Stools and urine also get colored. The yellow color is an indication that the circulation of bile is in excess. Along with the yellowness of the skin, there are other symptoms associated with jaundice. Indigestion occurs and the person becomes very weak. Jaundice may also cause the body to itch 7 .
The three principle types of jaundice are prehepatic, hepatic and post hepatic
1. Prehepatic jaundice: This is the result of acute and chronic hemolytic anemia.
2. Hepatic jaundice: This includes disorders of bilirubin metabolism and transport defects. Levels of unconjugated bilirubin are elevated in this disorder.
3. Post hepatic jaundice: It is also known as cholestatic and obstructive jaundice. This is generally caused by biliary obstructive disease resulting from spasms of the biliary tract, ductal occlusions by stones or compression by neoplastic disease. The major increase is in the conjugated fractions.
Cirrhosis of the liver is a chronic, diffuse degenerative liver disease in which the parenchyma (the functional organ tissue) degenerates, the lobules are infiltrated with fat and structurally altered, dense perilobular connective tissue forms, and areas of regeneration often develop. In most cases, though, there is a loss of liver cell function, and an increased resistance to blood flow through the damaged liver tissue (a condition known as portal hypertension) leading to oesophageal varices. Severe cirrhosis leads to ammonia toxicity, hepatic coma, gastrointestinal haemorrhage, and kidney failure 8 .
Traditional Herbal Plant Treating
For treating liver complaints, an herbal decoction that consists of multiple herbs that may individually have a tremendous variety of properties is commonly used. The majority of herbs such as those listed below are reported to work on multiple biochemical pathways capable of influencing several organ systems simultaneously. The benefit of an herbal decoction is that one can nourish the body as a whole by supporting various organ systems, yet its main focus will be on support of the liver9, 10, 11, 12 .
Andographis Aerial Parts
Traditionally used for a variety of ailments including liver disorders and has also been shown to protect against toxin - induced hepatotoxicity. The diterpenes of andrographis were shown to increase glutathione (GSH), which may decrease suspectibility of the tissue to oxidative damage.
Hellebore Root (Picrorhiza Kurroa):
Used traditionally in Ayurveda for centuries as a general liver tonic and for liver cleansing, hepatitis, biliousness, fevers and poisoning. In a randomized, double-blind, placebo-controlled trial in patients with acute viral hepatitis, hellebore root(375 mg/3 times daily for 14 days) led to rapid fall in serum bilirubin levels toward normal range and quicker clinical recovery with no side effects. Current evidence also indicates hellebore root protects against alcoholinduced hepatotoxicity.
Ginger Rhizome (Zingiberofficinale):
Traditionally used to promote digestion. Ginger has been found to have a stimulatory effect on gastric secretions and has a metabolic circulatory enhancing effect which reinforces the therapeutic activity of other herbs.
Trailing Eclipta Leaf and Root (Ecliptaalba):
Traditionally used as a cholagogue (aids bile secretion) and deobstruent (removes functional obstructions in the body) in hepatic enlargement, for jaundice, and other ailments of the liver and gall bladder. Two coumestans, wedelolactone and demethylwedelolactone, were isolated as the main active principles present in trailing eclipta. Both constituents showed antihepatotoxic activity in assays using liver enzyme-induced cytotoxicity in cultured rat hepatocytes. These constituents also showed a significant stimulatory effect on liver cell regeneration.
Indian Gall Fruit (Terminalia chebula):
Traditionally used in chronic diarrhea and dysentery, flatulence, vomiting, colic, and enlarged spleen and liver. In a study conducted on rabbits, Indian gall fruit had a hypocholesterolemic effect on cholesterol-induced hypercholesterolemia.
Chicory Seed (Cichorium intybus)
Traditionally used for hepatic conditions and liver rejuvenation and has shown protective effects in mice with high levels of liver damaging enzymes. Chicory is one of the most useful herbs in treatment of liver problems. Almost all parts of the herb are important - flowers, seeds and roots. The juice of the chicory plant promotes the secretion of the bile. Hence it is used in different ways in treating liver problems such as bilary stasis, sluggishness of the liver, bile obstruction, jaundice and enlargement of the spleen.
Long Pepper Fruit (Piper longum):
Piperine, an active alkaloid constituent, has been shown to exert a significant protection against liver toxicity induced by tert-butyl hydro peroxide and carbon tetrachloride by reducing in both vitro and vivo lipid peroxidation by decreasing the reduction of GSH.
Arjuna Myrobalan Bark (Terminalia arjuna):
The powdered bark is traditionally used as a diuretic and general tonic in cases of cirrhosis of the liver.
Amla Fruit (Emblica officinalis):
Traditionally used for enlarged liver and for liver revitalizing.
Spreading Hog Weed Whole Plant (Boerhaavia diffusa):
Traditionally used for hepatic disorders and for internal inflammation.
Phylanthus Aerial Parts (Phyllanthus niruri):
The fresh root is traditionally given in jaundice
Berberis (Berberis vulgaris):
Berberis is nicknamed as the jaundice berry for its beneficial effects on the treatment of jaundice. It is a bitter tonic which is made from the bark of the berberis tree. It is taken in amounts of quarter teaspoon when jaundice strikes.
Dandelion (Taraxacum officinale):
Dandelion stimulates the liver and the gall bladder for the proper utilization of fats within the body. It also helps in the detoxification of the liver. Its juice is used in treatment of most liver problems. Even for people with hepatitis, dandelion tea is very beneficial.
Gokulakanta (Hygrophila spinosa):
This herb is used for treatment of several liver problems including jaundice, hepatitis and derangement of the liver. Its root is prescribed in such conditions. A specially prepared decoction of the root (60 grams root powder mixed in half a liter of water and boiled for about half an hour) is given in doses of 30 to 60 milliliters twice or thrice daily.
Henna (Lawsonia inermis):
The cooling effect of the henna is also beneficial in the treatment of liver problems. Its bark is effective in the treatment of liver problems such as jaundice and enlargement of the liver.
Indian Aloe (Aloe barbadensis):
The Indian aloe stimulates the liver into carrying out its functions normally. It is used in the treatment of jaundice and enlargement of the liver.
indian sorrel is used in the treatment of jaundice. It is taken in the form of fresh juice mixed with buttermilk made from cow's milk. It is to be taken once daily during jaundice.
The trailing eclipta has beneficial results in several liver problems. It can be used for the treatment of catarrhal jaundice and liver enlargement. A decoction of the juice of the herb is prescribed in doses of one teaspoon twice a day. To make the juice more effective, it can be added with essences of cardamom and cinnamon. The herb is also beneficial if there is mucus discharge accompanied with the catarrhal jaundice. In that case the juice of a few leaves is mixed with crushed peppercorns and taken with curds early in the morning for seven successive days.
Turpeth (Operculina turpethum):
Treatment of jaundice is usually started in Ayurveda with the medication of turpeth. It is given in the form of a powder in quantities of one to two teaspoons in hot water twice a day.
Liquorice (Glycyrrhiza glabra)
Liquorice root and root powder use for hepatitis,Demulcent,expectorant, antiulcer; tonic; antiviral, antiinflammatory and show hepatoprotective activity from ancient time.
Focus towards Herbal Medicine
In the last few decades there has been an exponential growth in the field of herbal medicine. It is getting popularized in developing as well as in developed countries owing to its natural origin and lesser side effect. In olden times, vaidyas used to treat patients on individual basis, and prepare drug according to the requirement of the patient. But the scenario has changed now; herbal medicines are being manufactured on the large scale in Pharmaceutical units, where manufacturers come across many problems such as availability of good quality raw material, authentication of raw material, availability of standards, proper standardization methodology of single drugs and formulation, quality control parameters. Ayurveda emphasis the relationship between man and plants throughout the development of human culture. The use of herbal medicine due to toxicity and side effects of allopathic medicines, has led to sudden increase in the number of herbal drug manufactures.Herbal medicines as the major remedy in traditional system of medicine have been used in medical practices since antiquity. The practices continue today because of its biomedical benefits as well as place in cultural beliefs in many parts of world and have made a great contribution towards maintaining human health 13 . Herbal medicines often complement the conventional modern treatments providing safe, well-tolerated remedies for many chronic diseases like liver disorder, rheumatoid arthritis, diabetes, obesity cardiovascular and neurological disorders and asthma. The ability of herbal medicines to affect the body systems depends on the chemical constituents they contains. Research into the isolated plant constituents is of great importance. Many of today's medicines are either obtained directly from a natural source or were developed from a lead compound originally obtained from a natural source14 . The use of traditional medicine has increased in developed countries also, mainly due to the failure of modern medicine to provide effective treatment for chronic diseases and emergence of multi-drug resistant bacteria and parasites. The adverse effects of chemical drugs, questioning of the approaches and assumptions of allopathic medicine, their increasing costs and greater public access to information on traditional medicine has also led to an increase in interest in alternative treatments (WHO 2002). Plant extracts have become a source of hope as a wide group of medicinal plant preparations are available that have been used over the centuries almost exclusively on the basis of empirical evidence. Hence, it has become necessary to revisit the importance of these herbal medicines. Increasing interest by multinational pharmaceutical companies and domestic manufacturers of herbal-based medicines is contributing to a significant economic growth of the global medicinal plants sector. It is generally believed that standardization of the plant material is not required when used by the rural communities for their primary health care. But, regardless of whether the medicinal plant is to be used by local communities or by industry, a systematic approach is required for a plant identified from traditional medicine, as is done in modern medicine. It is necessary to focus on all aspects of medicinal plant research: from cultivation, ethno-pharmacology, utilization, isolation and identification of active constituents to efficacy evaluation, pharmacology, safety, standardization, formulation and clinical evaluation. Animal toxicity studies are required to establish the potential adverse effects. With the tremendous increase in the global use of medicinal plants, several concerns regarding the efficacy and safety of the herbal medicines have also been raised. Hence it has become necessary to standardize the efficacy and safety measures so as to ensure supply of medicinal plant materials with good quality15 . For exploring traditional knowledge of herbal medicinal plant government of India should focus on3.
1. Government and non government organization through various media increase awarness and acceptability among the major population of the country.
2. Government should increase awarness about herbal medicine plant by various development programs.
3. In every state of India, there should be quality control laboratories and research center facilate for carrying out chemical and biological testing of crude drug along with their finish product and arrange training program Farmers should in courage to participate in training programme.
4. The government organization and research should maintain complet documentation and record of such crude drug s,which will help in conserving and preserving indigenous knowledge of the medicinal flora of our country.
5. In educational institutions,awarness should increase among the students regarding significance of the medicinal plant in safe guarding restoring overall health of the people and nation and research benefit to nation.
6. Government of India encourages research in the field of medicenal and herbal drug development by appreciating appropriate fund so as to nature and foster countries economy at the international level.
The knowledge of valuable herbal plant remedies have not been documented and were orally dissipated by the triable populations. But these tribal possessed remarkably accurate knowledge about the medicinal use of the herbal plants around them government should take any action and documented. Herbal medicines often complement the conventional modern treatments providing safe, well-tolerated remedies for many chronic diseases like liver disorder, rheumatoid arthritis, diabetes, obesity cardiovascular and neurological disorders and asthma. The use of traditional medicine has increased in developed countries also, mainly due to the failure of modern medicine to provide effective treatment for chronic diseases and emergence of multi-drug resistant bacteria and parasites. Government should increase awarness about herbal medicine plant by various development programs and encourage about herbal drug treatment as it is safety and effective and familiar with treatment treat.
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