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Nematollahi MH, Ahmadianmoghadam MA, Mehrabani M, Moghadari M, Ghorani-Azam A, Mehrbani M. Herbal therapy in opioid withdrawal syndrome: A systematic review of randomized clinical trials. ADDICTION & HEALTH 2022; 14:152-163. [PMID: 36544511 PMCID: PMC9743811 DOI: 10.22122/ahj.2022.195961.1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/30/2021] [Indexed: 12/24/2022]
Abstract
Background Medicinal plants have revealed much attention as an alternative or complementary treatment for opioid withdrawal syndrome. The current review collects all available literature to verify the efficiency of herbal remedies in the management of symptoms associated with opioid withdrawal. Methods A systematic literature search was conducted from January 1990 to May 2021 on four bibliographic databases (Scopus, PubMed, Embase, and Web of Science) using the search terms "medicinal plant", "withdrawal syndrome", "opioid", and all their equivalents. All randomized controlled trials (RCTs), published in the English language were included for data synthesis. The search was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). The Cochrane risk of bias tool was used to verify the quality of the included clinical trials. Findings A total of 12 RCTs were collected and used for data synthesis. The results of these studies indicated that herbal medicines were effective in treating opioid withdrawal syndrome and could alleviate the withdrawal symptoms, such as abdominal constrictions, diarrhea, bone pain, perspiration, and insomnia, when compared to conventional medications such as buprenorphine, clonidine, and methadone. However, more than 30% of RCTs were found to be at high risk of bias in the areas of selection, performance, detection, attrition, and reporting. Conclusion Although several RCTs have proven that herbal remedies are effective in reducing opioid withdrawal symptoms, the findings need to be viewed more carefully. Further RCTs with more participants, longer duration, and less risk of bias are needed in the claimed cases.
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Affiliation(s)
- Mohammad Hadi Nematollahi
- Student Research Committee, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran,Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Ahmadianmoghadam
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran,Department of Traditional Medicine, Faculty of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrnaz Mehrabani
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Moghadari
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Adel Ghorani-Azam
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mehrzad Mehrbani
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran,Correspondence to: Mehrzad Mehrbani; Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran;
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Balarastaghi S, Delirrad M, Jafari A, Majidi M, Sadeghi M, Zare-Zardini H, Karimi G, Ghorani-Azam A. Potential benefits versus hazards of herbal therapy during pregnancy; a systematic review of available literature. Phytother Res 2022; 36:824-841. [PMID: 35023227 DOI: 10.1002/ptr.7363] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 11/03/2021] [Accepted: 12/10/2021] [Indexed: 11/07/2022]
Abstract
The use of herbal medicine has considerably grown worldwide in the past two decades. Studies have shown that the prevalence of herbal diet therapy in pregnancy ranged from 1% to 60% in different societies. Many clinical reports have shown that some herbal medicines may have toxic effects on pregnant women and their fetuses because active ingredients of some medicinal plants can readily pass through the biological barriers (e.g., placental barrier). In the present study, we aimed to systematically review the literature to discover potential benefits versus the hazards of herbal therapy during pregnancy. For this purpose, a comprehensive literature review was performed, and after the literature search and selection of the appropriate documents, the desired data were extracted and reported. From 35 articles with a total of 39,950 study population, the results showed that some medicinal plants could cause severe toxicity on mothers and fetuses, in addition to abortion during pregnancy. It was also shown that some plants may lead to developmental abnormalities or fetal death. Findings of this survey showed that some herbal medicines have toxic, teratogenic, and abortive potential, particularly in the first trimester of pregnancy because active ingredients of some medicinal plants are able to pass through the placental barrier and reach the fetus.
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Affiliation(s)
- Soudabeh Balarastaghi
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Delirrad
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Abbas Jafari
- Department of Clinical Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Cellular and Molecular Research Center, Research Institute on Cellular and Molecular Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Majidi
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahmood Sadeghi
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Hadi Zare-Zardini
- Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Sciences, Farhangian University, Isfahan, Iran
| | - Gholamreza Karimi
- Pharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Adel Ghorani-Azam
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Taleb S, Saeedi M. The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial. BMC Complement Med Ther 2021; 21:166. [PMID: 34103042 PMCID: PMC8186151 DOI: 10.1186/s12906-021-03339-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/31/2021] [Indexed: 02/05/2023] Open
Abstract
Background The pain and discomfort caused by episiotomy affect the quality of life of the mothers, so rapid and complete repair of the episiotomy is very important. Due to the effective ingredients of Verbascum Thapsus, it has been used since ancient times to treat wounds. Therefore, this study aimed to evaluate the effect of Verbascum Thapsus on episiotomy wound healing. Methods The study was designed as a randomized, double-blind, controlled clinical trial. Ninety-three primiparous women who were referred to Fatemeh Zahra Hospital in Saveh in 2015 were randomly divided into two groups of intervention (Verbascum Thapsus) and control (placebo). Both groups covered the episiotomy wound twice a day for 10 days with 2 cm of prescribed creams. Wound healing was assessed using the REEDA scale before the intervention and on days 1,3 and 10 after the intervention. Results Before the intervention, there was no statistically significant difference in terms of demographic characteristics, obstetrics, and REEDA scores between the two groups (p < 0.05). The mean scores of REEDA on days 1 and 3 in the intervention group were better than the control group but were not statistically significant. However, on the tenth day after the intervention, the mean scores of REEDA were significantly better in the Verbascum group than the placebo (p = 0.01). Conclusions According to the results of this study, it seems that Verbascum Thapsus is effective in repairing episiotomy wounds. The researchers hope that the results of this study can provide clinical evidence for the use of this herbal medicine in the wound healing process. Trial registration This study was registered in the Iranian Registry of Clinical Trials (IRCT) with the code “IRCT201404073106N15” on 02/12/2015.
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Affiliation(s)
- Sahar Taleb
- Saveh University of Medical Sciences, Saveh, Iran
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Phytochemistry of Verbascum Species Growing in Iraqi Kurdistan and Bioactive Iridoids from the Flowers of Verbascum calvum. PLANTS 2020; 9:plants9091066. [PMID: 32825214 PMCID: PMC7569995 DOI: 10.3390/plants9091066] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 12/22/2022]
Abstract
Traditional medicine is still widely practiced in Iraqi Kurdistan, especially by people living in villages on mountainous regions; medicinal plants are also sold in the markets of the large towns, such as at Erbil, the capital of the Kurdistan Autonomous Region. About a dozen of Verbascum species (Scrophulariaceae) are commonly employed in the Kurdish traditional medicine, especially for treating burns and other skin diseases. However, the isolation of bioactive secondary metabolites from these plants has not been the subject of intense scientific investigations in Iraq. Therefore, the information reported in the literature about the species growing in Kurdistan has been summarized in the first part of this paper, although investigations have been performed on vegetable samples collected in neighbouring countries, such as Turkey and Iran. In the second part of the work, we have investigated, for the first time, the contents of a methanol and a hydromethanol extract of V. calvum flowers. The extracts exhibited weak antimicrobial activities, whereas the methanol extract showed significant antiproliferative effects against an A549 lung cancer cell line. Moreover, both extracts exhibited a significant dose-dependent free radical scavenging action against the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical, comparable to that of ascorbic acid. In the subsequent phytochemical study, a high phenolic content was determined in both extracts by the Folin–Ciocalteu assay and medium-pressure liquid chromatographic (MPLC) separation led to the isolation of iridoid glucosides ajugol and aucubin from the methanol extract. In conclusion, the high anti-inflammatory effects of aucubin and the remarkable antioxidant (antiradical) properties of the extracts give scientific support to the traditional use of V. calvum flowers for the preparation in Kurdistan of remedies to cure skin burns and inflammations.
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Buso P, Manfredini S, Reza Ahmadi-Ashtiani H, Sciabica S, Buzzi R, Vertuani S, Baldisserotto A. Iranian Medicinal Plants: From Ethnomedicine to Actual Studies. ACTA ACUST UNITED AC 2020; 56:medicina56030097. [PMID: 32110920 PMCID: PMC7143749 DOI: 10.3390/medicina56030097] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/10/2020] [Accepted: 02/21/2020] [Indexed: 01/22/2023]
Abstract
Iran has a rich and diverse cultural heritage, consisting of a complex traditional medicine deeply rooted in the history of the territory that goes back to the Assyrian and Babylonian civilizations. The ethnomedical practices that can be identifiable nowadays derive from the experience of local people who have developed remedies against a wide range of diseases handing down the knowledge from generation to generation over the millennia. Traditional medicine practices represent an important source of inspiration in the process of the development of new drugs and therapeutic strategies. In this context, it is useful to determine the state of the art of ethnomedical studies, concerning the Iranian territory, and of scientific studies on plants used in traditional Iranian medicine. Data regarding 245 plants used in Iranian ethnomedical practices and scientific studies conducted on 89 plants collected in the Iranian territory have been reported. All of the scientific studies here reported draw inspiration from traditional medicine. The World Health Organization (WHO) has repeatedly called for an intensification of the scientific validation processes of traditional medicines intended as an important contribution to public health in various parts of the world. The process of study and validation of Iranian ethnomedical practices appears to be at an early stage.
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Affiliation(s)
- Piergiacomo Buso
- Department of Life Sciences and Biotechnology, Master Course in Cosmetic Sciences, University of Ferrara, Via Luigi Borsari 43, 44121 Ferrara, Italy; (P.B.); (S.M.); (S.S.); (R.B.); (A.B.)
| | - Stefano Manfredini
- Department of Life Sciences and Biotechnology, Master Course in Cosmetic Sciences, University of Ferrara, Via Luigi Borsari 43, 44121 Ferrara, Italy; (P.B.); (S.M.); (S.S.); (R.B.); (A.B.)
| | - Hamid Reza Ahmadi-Ashtiani
- Department of Basic Sciences, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran 194193311, Iran;
- Cosmetic, Hygienic and Detergent Sciences and Technology Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran 194193311, Iran
| | - Sabrina Sciabica
- Department of Life Sciences and Biotechnology, Master Course in Cosmetic Sciences, University of Ferrara, Via Luigi Borsari 43, 44121 Ferrara, Italy; (P.B.); (S.M.); (S.S.); (R.B.); (A.B.)
| | - Raissa Buzzi
- Department of Life Sciences and Biotechnology, Master Course in Cosmetic Sciences, University of Ferrara, Via Luigi Borsari 43, 44121 Ferrara, Italy; (P.B.); (S.M.); (S.S.); (R.B.); (A.B.)
- Ambrosialab S.r.l. University of Ferrara Spinof Company, Via Mortara 171, 44121 Ferrara, Italy
| | - Silvia Vertuani
- Department of Life Sciences and Biotechnology, Master Course in Cosmetic Sciences, University of Ferrara, Via Luigi Borsari 43, 44121 Ferrara, Italy; (P.B.); (S.M.); (S.S.); (R.B.); (A.B.)
- Correspondence:
| | - Anna Baldisserotto
- Department of Life Sciences and Biotechnology, Master Course in Cosmetic Sciences, University of Ferrara, Via Luigi Borsari 43, 44121 Ferrara, Italy; (P.B.); (S.M.); (S.S.); (R.B.); (A.B.)
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Ghorani-Azam A, Sepahi S, Riahi-Zanjani B, Alizadeh Ghamsari A, Mohajeri SA, Balali-Mood M. Plant toxins and acute medicinal plant poisoning in children: A systematic literature review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2018; 23:26. [PMID: 29692823 PMCID: PMC5894275 DOI: 10.4103/jrms.jrms_629_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/21/2017] [Accepted: 12/29/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND For many years, medicinal plants and herbal therapy have been widely used in different societies for the treatment of various diseases. Besides their therapeutic potency, some of the medicinal plants have strong toxicity in human, especially in children and elderly. Despite common beliefs that natural products are safe, there have been few reports on their toxicities. MATERIALS AND METHODS In the present study, we aimed to systematically review the literature wherein acute plant poisoning and herbal intoxication have been reported in pediatric patients. After literature search and selection of the appropriate documents, the desired data were extracted and described qualitatively. RESULTS A total of 127 articles with overall 1453 intoxicated cases were collected. The results of this study showed that some medicinal plants can cause acute poisoning and complications such as hepatic and renal failure in children. CONCLUSION The findings of this survey showed that acute plant poisoning can be life?threatening in children, and since a single?ingested dose of toxic plants can cause acute poisoning, parents should be aware of these toxic effects and compare the side effects of self?medication with its potential benefits.
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Affiliation(s)
- Adel Ghorani-Azam
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samaneh Sepahi
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bamdad Riahi-Zanjani
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Seyed Ahmad Mohajeri
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Balali-Mood
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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