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Volumen 2, Ausgabe 6 (2013)

Rezensionsartikel

Use of Herbal Medicines and Implications for Conventional Drug Therapy Medical Sciences

Rivera JO, Loya AM and Ceballos R

Herbal medicines are an important part of healthcare throughout the world. In many countries including the U.S., herbal medicines are not regulated as extensively as conventional drug therapy. At present, there is a dearth of research evaluating the use of herbal medicines, especially in clinical trials. This, together with the ongoing development of new conventional drug therapies, compounds the number of unknown outcomes when using elements of these two treatment approaches together. Although many benefits can be derived from the use of herbs, potential areas of concern include possible product contamination and/or adulterations, potential toxicity, high potential of known and unknown drug/herb interactions, and substituting proven conventional medicine with herbal medicine. Mechanisms involved in herb-drug interactions are not fully understood, but both pharmacokinetic and pharmacodynamic processes may play a role. Because these can occur in 30-40% of older adults, health care providers and patients must be aware of potential interactions in order to monitor for alterations in therapeutic efficacy and/or potential toxicity. With the advances of the internet and increased emphasis on a global economy, consumers have much greater access to herbal products from anywhere in the world. A number of concerns arise when obtaining herbal medicines from the internet, as currently there is no system in place to verify legitimacy of sites. Additionally, there are cost implications with a worldwide herbal medicine market estimated at US $83 billion annually. The worldwide implementation of standards for growing, selecting, manufacturing, conducting appropriate clinical trials, and treating patients with herbal medicines is necessary. The World Health Organizations has provided a number of technical guidelines to standardized herbal medicines throughout the world. Pharmacists are in prime position to help and monitor the use of herbal medicines, especially in older adults. Strategies for the safe use of herbs should include educational efforts directed at both the consumers and healthcare providers about the benefits and dangers of herbs and encouraging providers to ask their patients about their use of herbs without being judgmental, ensuring open communication with patients. Integrative Medicine, which is defined in the U.S. by the National Center for Complementary and Alternative Medicine as “a practice that combines both conventional and CAM treatments for which there is evidence of safety and effectiveness” has been gradually gaining acceptance within conventional medicine and should be considered the model of the future of healthcare

Forschungsartikel

Utilization of Acupuncture Therapy among Pediatric Oncology Patients at a Tertiary Care Pediatric Hospital

Ralston-Wilson J, Tseng A, Oberg E, Sasagawa M, Doorenbos AZ and Kundu A

Background: Acupuncture is infrequently studied in the pediatric oncology population. However its potential as a complementary cancer care modality in the reduction of treatment-related side effects and improvements in quality of life has been demonstrated in adults. Our study aims to characterize the patients and utilization of acupuncture therapy among the pediatric population.

Methods: A retrospective analysis of medical records for patients between the ages of 0-18 years, undergoing treatment for an oncological diagnosis and had received acupuncture therapy between January 2004 and September 2012 was conducted.

Results: A total of 133 patients, comprising 3.2% of our pediatric oncology population, utilized acupuncture therapy. A cumulative of 523 acupuncture treatments was provided. Treatments were tolerated well by patients, perceived as beneficial, and without any serious adverse events. Acupuncture treatments addressed a wide variety of patients’ complaints and cancer treatment-related side effects.

Conclusions: Acupuncture use among the pediatric oncology population is relatively low; however, our findings demonstrate its potential as a complementary cancer care modality in clinical practice for this unique population in the future.

Kurze Kommunikation

To Age or Not to Age-Modern versus Traditional Concepts

Marilena Gilca

The modern oxidative hypothesis of ageing states that oxidative stress is a significant marker of senescence. This age related-oxidative stress is generated by a combination of increased free radicals production, decreased antioxidants levels and impaired repair of oxidative damages. Modern scientific anti-aging strategies delay the loss of physiological functions by modulating the activity of antioxidants and oxidants in the body. Various redox-dependent gerontomodulatory approaches include: (I) nutritional and pharmacological intervention by free radical scavengers (antioxidant therapy); (II) hormesis based interventions (caloric restriction, fasting, pro-oxidants). On the other hand, traditional Rasayana chikitsa (ayurvedic rejuvenation therapy) also provides certain dietary and therapeutic measures which are able to arrest process of ageing and can even rejuvenate whole functional dynamics of the body system. According to Ayurveda, reversal of ageing process is possible if Rasayana therapy is applied before a critical age (which depends upon the organ involved in sequential ageing process). Correlations between redox-dependent gerontomodulatory approaches and ayurvedic antiageing strategies (Rasayana chikitsa, preparatory procedures for Rasayana chikitsa) are presented and discussed in this paper. A literature search was conducted to collect data from studies on Rasayana drugs and fasting available up to November 2012 using PubMed and High wire. Based on this review, it appears that Rasayana drugs have cytoprotective and antioxidant effects, while fasting therapy has a direct effect on the modulation of free radicals synthesis. Thus, this integrative approach including modern and traditional concepts can be a lead towards future rejuvenative therapy research in the management of ageing.

Forschungsartikel

Metabolomics Study of Protective Effects of Shexiang Baoxin Pill and its Bioactive Constitutes Combination in Treating the Early Period of Acute Myocardial Infarction in Rats

Xiang L, Han L, Jiang P, Wang S, Hu Y, Zhang W and Liu R

Ginsenoside Re, ginsenoside Rb1, muscone, cinnamic acid, bufalin, cholic acid and borneol are the main active ingredients of Shexiang Baoxin Pill (SBP) for protective effects on acute myocardial infarction (AMI). In this study, the protective effects of SBP, single component treatments and combination treatment of 7 bioactive ingredients of SBP (SFSBP) were investigated by metabolomics technology. Liquid chromatography/quadrupole time-of-flight mass spectrometry (LC-Q-TOF/MS) has been used to analyze the plasma samples of AMI rats. Partial least squares discriminate analysis (PLS-DA) models were built to evaluate the protective effects of different treatments at whole level. Reverse effect on mean levels of 19 identified biomarkers were also carried out to investigate the protective effects of different treatments. The results showed that the protective effect of multi-component medicines (SBP and SFSBP) was superior to 7 single-component treatments, demonstrated the multi-effective advantages of multicomponent treatments (SBP and SFSBP). Meanwhile, the reverse effects of SFSBP were inferior to SBP, indicating that there might be other bioactive components in SBP taking responsibility for the protection effect on AMI rats, and the simplified formula of SBP should be further optimized, while also revealed the rationality of TCM formula, and it cannot be simply substituted by a combination of bioactive ingredients.

Fallbericht

Acupuncture and Low Dose Gabapentin Effectively Treat Paclitaxel Induced Peripheral Neuropathy and Prevent Chemotherapy Dose Reduction

Bhatnagar B, Pelser C, Gilmore S, Tait Nand and Bao T

Peripheral neuropathy is a frequent and well-recognized debilitating complication of taxanes, often necessitating dose-reduction of these effective agents. Here, we present a case in which acupuncture treatments were successfully used in combination with low dose gabapentin to alleviate PIPN symptoms and prevent chemotherapy dose reduction.

Rezensionsartikel

Fingerprint Profile of Selected Ayurvedic Churnas/Preparations: An Overview

Garg S, Mishra A and Gupta R

Ayurvedic formulations [such as solid dosage (vati, churna), semisolid (avaleha, ghritas), liquid (asava, arishta)] have numerous uses in Ayurveda. They effect or help to rectify the three doshas in the body, and restore homeostatic balance that builds up in the body’s digestive system and spreads to the tissues. Standardization and analysis of the chemical marker of the Ayurvedic and other poly herbal formulation has always been a concern. For Researchers, Standardization is the need of hour for the present era to set standards for maintaining the quality and efficacy of the herbal products. HPTLC offers major advantages over other conventional chromatographic techniques such as unsurpassed flexibility (esp. stationary and mobile phase), choice of detection wavelength, user friendly, rapid and cost effective/economical. The present study compiles the progress made on the development of optimized and validated HPTLC/HPLC method for the simultaneous estimation of markers in different ayurvedic churnas/ preparations. HPTLC/HPLC profile is quite helpful in setting up of standards. The present study is an attempt to compile the major studies carried out on Ayurvedic preparations like: Churnas, avaleha, asava, arishta, vati, rasa, taila, ghritas and herbal capsules etc. which may be of use to develop/compile the fingerprint profile for evaluating the purity & quality of ayurvedic formulations, thus helpful as a reference in developing pharmacopoeial standards.

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