Effect of Zingiber officinale Roscoe rhizome (ginger) capsule on postpartum pain: Double-blind randomized clinical trial

Ethnopharmacological analysis based on Thai traditional medicine theory and anti-inflammatory activity of Sa-Tri-Lhung-Klod remedy as a post-partum anti-inflammatory drug

ETHNOPHARMACOLOGICAL RELEVANCE

Sa-Tri-Lhung-Klod (ST) remedy is a Thai traditional remedy used in obstetrics and gynecology to reduce inflammation and nourish the body post-partum. In Thai traditional medicine (TTM), there is a theory of formulating drugs based on the four elements and the tastes of herbs for use in treating diseases.

AIMS OF STUDY

To determine relationships between taste theory and pharmacological properties for the anti-inflammatory effect of ST remedy and its chemical constituent components. To evaluate anti-inflammatory activity and also investigate the HPLC fingerprint of ST extracts.

MATERIALS AND METHODS

ST remedy was extracted by maceration in 95% ethanol (STE) and decoction in distilled water (STW). ST extracts were evaluated for anti-inflammatory activity by nitric oxide inhibitory assay in RAW264.7 cells, carrageenan-induced rat paw edema, and prostaglandin E2 inhibitory assay in inflamed rat paw tissue. In addition, the chemical constituent fingerprints of ST extracts were examined using HPLC.

RESULTS

STE contained seven main chemical compounds, and STW demonstrated only one identifiable chemical compound. The STE and STW displayed potent NO inhibitory activity with an IC50 value of 20.59 ± 0.03 and 52.93 ± 0.90 μg/mL, respectively. Moreover, the STE and STW (at doses of 100 - 400 mg/kg) promoted significant inhibition of inflammation in carrageenan-induced paw edema in rats (20.81 - 38.25%). Additionally, the STE (200 - 400 mg/kg) and STW (100 - 400 mg/kg) significantly reduced PGE2 levels in inflamed rat paw tissue.

CONCLUSION

These findings suggest that the spicy, astringent, sweet, and fragrant taste of the ST remedy used to treat post-partum inflammation encompass constituents with potent anti-inflammatory activity. STE and STW possess anti-inflammatory properties and effectively inhibit the production of NO and PGE2. Results confirm the use of the ST remedy for treating inflammatory diseases in the post-partum period according to TTM knowledge.

The Effects of Ginger (Zingiber officinale) Extract Ointment on Pain and Episiotomy Wound Healing in Nulliparous Women: A Randomized Clinical Trial

Introduction

Episiotomy is a usual midwifery surgery. Iran is a country with an abundant source of medicinal plants. This study aimed to investigate ginger extract ointment's effects on the pain and recovery of episiotomy incisions in nulliparous women.

Methods

This randomized clinical trial was conducted in a public hospital in Iran on 70 nulliparous women with an episiotomy incision. The women were randomly assigned to ginger extract ointment and placebo groups. The primary outcomes included pain and wound healing that were assessed using a visual analog scale (VAS), redness, edema, ecchymosis/bruising, discharge, and an approximation scale (REEDA). The participants were followed up before discharge from the hospital and 5×1 and 10×1 days after the intervention. The secondary outcome was the number of painkillers used during the study. Data were analyzed by chi-square, independent t test, and the Mann-Whitney U via SPSS-13. The significance levels were determined to be P≤0.05.

Results

There was no significant difference between participants treated with ginger extract ointment and placebo in the pain and wound healing scores before the intervention, 5×1 and 10×1 days after the intervention. But, the pain intensity decreased, and the recovery speed increased clinically. Also, regarding the secondary outcome of this study, no significant difference between the placebo and intervention groups in the number of painkillers participants took.

Conclusion

The ginger ointment could not significantly improve episiotomy wounds' pain and healing rate, but it was clinically helpful. So more studies with different doses of this ointment are needed.

Natural Herbal Non-Opioid Topical Pain Relievers-Comparison with Traditional Therapy

Pain is the predominant symptom of many clinical diseases and is frequently associated with neurological and musculoskeletal problems. Chronic pain is frequent in the elderly, causing suffering, disability, social isolation, and increased healthcare expenses. Chronic pain medication is often ineffective and has many side effects. Nonsteroidal over-the-counter and prescription drugs are frequently recommended as first-line therapies for pain control; however, long-term safety issues must not be neglected. Herbs and nutritional supplements may be a safer and more effective alternative to nonsteroidal pharmaceuticals for pain management, especially when used long-term. Recently, topical analgesic therapies have gained attention as an innovative approach due to their sufficient efficacy and comparatively fewer systemic side effects and drug-drug interactions. In this paper, we overview the main natural herbal pain relievers, their efficacy and safety, and their potential use as topical agents for pain control. Although herbal-derived medications are not appropriate for providing quick relief for acute pain problems, they could be used as potent alternative remedies in managing chronic persistent pain with minimal side effects.