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1.
PLoS One ; 19(5): e0302792, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38728345

RESUMO

Mizoram has a diverse range of ethnic and cultural groups, including the Lushai, Mara, Lai, Bawm, Hmar, Chakma, and Bru. Through practice and experience in their protracted battles with disease and the harsh natural environment, they have amassed rich folk medicine knowledge. The preservation of indigenous knowledge, identification of bioactive compounds, and the eventual discovery of novel medicinal plant species all depend on the documentation of the traditional uses of medicinal plants. Therefore, the present study was designed to document the ethnomedicinal knowledge related to the usage of medicinal plants in Mizoram, India. An ethnobotanical study of medicinal plants was carried out in 17 villages of 5 districts in Mizoram between September 2022 and January 2023. A total of 128 informants (77 males and 51 females) were interviewed. Information was gathered through field observations, group discussions, and semistructured interviews. The data were presented using descriptive statistics. To assess the importance of medicinal plant species, quantitative indices such as the informant consensus factor (ICF), fidelity level (FL), use value (UV), and cultural index (CI) was used. In our ethnobotanical investigation, 102 medicinal plant species from 95 genera and 58 families were recorded and documented. The majority of them (90 species) were obtained from wild habitats. The majority of the documented species were trees (48), followed by herbs (23 species) and shrubs (21 species). The most common method of preparation was decoction (67 species). Diabetes had the highest ICF value (0.81), followed by cancer, liver problems, and hypertension (0.8). The fidelity level (FL) of indigenous communities in the study area was evaluated to determine the dependability and consistency of herbal drug use. Indigenous knowledge and the variety of medicinal plant species that are used are of great values. The therapeutic applications of documented plants provide fundamental information for additional studies centered on pharmacological investigations and the preservation of the most significant species.


Assuntos
Etnicidade , Etnobotânica , Medicina Tradicional , Plantas Medicinais , Plantas Medicinais/química , Índia , Humanos , Masculino , Feminino , Medicina Tradicional/métodos , Pessoa de Meia-Idade , Adulto , Idoso , Inquéritos e Questionários , Fitoterapia/métodos , Conhecimentos, Atitudes e Prática em Saúde
2.
J Ethnobiol Ethnomed ; 20(1): 47, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38693543

RESUMO

BACKGROUND: Child malnutrition is a major public health challenge, affecting millions of children worldwide, with alarming proportions of children under five in Benin. The complexity of managing this condition is increased by its potential association with opportunistic pathologies. An interesting approach arises from the use of medicinal plants, to address child malnutrition and its associated pathologies. This study aimed to document the knowledge and practices of Beninese mothers and traditional practitioners with regard to the use of medicinal plants to treat child malnutrition and associated diseases. METHODS: A total of 844 Beninese mothers and 201 traditional healers were surveyed between March 2022 and August 2023 in the communes of Karimama, Bopa and Za-Kpota in Benin. The respondents' knowledge of child malnutrition and associated pathologies was explored. The ethnobotanical data collected from the subjects concerned the medicinal recipes used to treat child malnutrition, the medicinal plants that make them up and the methods of use. These data were analyzed using ethnobotanical indices such as the Informant Consensus Factor, the frequency of citation of medicinal recipes types and medicinal plants, and the contribution of plants to medicinal recipes. RESULTS: All respondents cited a total of 82 plant species used to treat child malnutrition and associated diseases. These plants were grouped into 37 botanical families, the most common of which were Fabaceae, Malvaceae and Annonaceae. The leaves were the most commonly used part of the plant species identified. The mothers shared 122 medicinal recipes, ranging from recipes based on a single plant to more complex compositions involving five plants. The most notable plants were Moringa oleifera Lam, Phyllanthus amarus Schumach & Thonn, Senna siamea (Lam.) H.S.Irwin & Barneby, Carica papaya L. and Ocimum gratissimum L. Traditional healers provided 52 plants in 71 recipes, with Moringa oleifera featuring prominently in both single-plant and multiplant formulations. CONCLUSION: This study made it possible to constitute a rich base of medicinal recipes used against malnutrition and associated pathologies, with the preponderant involvement of certain plant species. It is therefore necessary to deepen research on these different identified species in order to scientifically assess their potential.


Assuntos
Transtornos da Nutrição Infantil , Conhecimentos, Atitudes e Prática em Saúde , Medicinas Tradicionais Africanas , Fitoterapia , Plantas Medicinais , Humanos , Benin , Feminino , Medicinas Tradicionais Africanas/métodos , Masculino , Fitoterapia/métodos , Transtornos da Nutrição Infantil/terapia , Adulto , Etnobotânica , Pessoa de Meia-Idade , Mães , Pré-Escolar , Adulto Jovem
4.
J Cancer Res Clin Oncol ; 150(4): 219, 2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38679615

RESUMO

PURPOSE: Mistletoe treatment in cancer patients is controversial, and a Cochrane review concluded that due to heterogeneity, performing a meta-analysis was not suitable. However, several systematic reviews included meta-analyses in favor of mistletoe. The aim of this work was to assess the influence of the methodological quality of controlled studies on the results of a meta-analysis regarding overall survival. METHODS: Between April and August 2022, Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL and Web of Science were systematically searched. In addition, reference lists of previously published meta-analyses were checked for relevant publications. A random effects meta-analysis with clustering was performed. The risk of bias within the studies was assessed using ROB 2.0 and ROBINS-I. RESULTS: The search identified 4685 hits, and 28 publications reporting on 28 298 patients were included in the quantitative analysis. Overall, the analysis led to a significant result in favor of mistletoe therapy (overall HR = 0.61 with 95% CI [0.53;0.7]). According to our subgroup analysis of randomized studies, studies of higher quality (lower risk of bias) did not lead to a significant result in favor of mistletoe therapy (HR = 0.78; CI = [0.30; 2.00]). CONCLUSIONS: In the case of mistletoe therapy, the results of the meta-analysis strongly depended on the methodological quality of the included studies. Calculating meta-analyses that include low-quality studies may lead to severe misinterpretation of the data.


Assuntos
Erva-de-Passarinho , Neoplasias , Humanos , Neoplasias/mortalidade , Neoplasias/tratamento farmacológico , Neoplasias/terapia , Fitoterapia/métodos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Int J Mol Sci ; 25(8)2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38674046

RESUMO

Thyroid cancer, particularly undifferentiated tumors, poses a significant challenge due to its limited response to standard therapies. The incidence of thyroid cancer, predominantly differentiated carcinomas, is on the rise globally. Anaplastic thyroid carcinoma (ATC), though rare, is highly aggressive and challenging to treat. Therefore, this study aimed to collect data and explore alternative treatments, focusing on the efficacy of photodynamic therapy (PDT) combined with natural compounds as well as the potential role of phytochemicals, including quercetin, kaempferol, apigenin, genistein, daidzein, naringenin, hesperitin, anthocyanidins, epigallocatechin gallate (EGCG), resveratrol, ellagic acid, ferulic acid, caffeic acid, curcumin, saponins, ursolic acid, indole-3-carbinol (I3C), capsaicin, and piperine in thyroid cancer treatment. PDT, utilizing sensitizers activated by tumor-directed light, demonstrates promising specificity compared to traditional treatments. Combining PDT with natural photosensitizers, such as hypericin and genistein, enhances cytotoxicity against thyroid carcinoma cells. This literature review summarizes the current knowledge on phytochemicals and their anti-proliferative effects in in vitro and in vivo studies, emphasizing their effectiveness and mechanism of action as a novel therapeutic approach for thyroid cancers, especially those refractory to standard treatments.


Assuntos
Compostos Fitoquímicos , Neoplasias da Glândula Tireoide , Humanos , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/terapia , Compostos Fitoquímicos/uso terapêutico , Compostos Fitoquímicos/farmacologia , Animais , Fotoquimioterapia/métodos , Fitoterapia/métodos , Ensaios Clínicos como Assunto , Extratos Vegetais/uso terapêutico , Extratos Vegetais/farmacologia
7.
J Ethnopharmacol ; 330: 118207, 2024 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-38636573

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Benign prostatic hyperplasia (BPH), characterized by prostate enlargement due to cell proliferation, is a common urinary disorder in men over 50, manifesting as lower urinary tract symptoms (LUTS). Currently, several therapeutic options are accessible for treating BPH, including medication therapy, surgery and watchful waiting. Conventional drugs such as finasteride and dutasteride are used as 5α-reductase inhibitors for the treatment of BPH. However long-term use of these drugs is restricted due to their unpleasant side effects. Despite the range of available medical therapies, the effective treatment against BPH is still inadequate. Certain therapeutic plants and their phytochemicals have the aforementioned goals and work by regulating this enzyme. AIM OF THE STUDY: This review aims to provide a comprehensive insight to advancements in diagnosis of BPH, modern treatment methods and the significance of ethnobotanically relevant medicinal plants as alternative therapeutics for managing BPH. MATERIAL AND METHODS: A thorough and systematic literature search was performed using electronic databases and search engines such as PubMed, Web of Science, NCBI and SciFinder till October 2023. Specific keywords such as "benign prostatic hyperplasia", "medicinal plants", "phytochemicals", "pharmacology", "synergy", "ethnobotany", "5-alpha reductase", "alpha blocker" and "toxicology". By include these keywords, a thorough investigation of pertinent papers was assured, and important data about the many facets of BPH could be retrieved. RESULTS: After conducting the above investigation, 104 herbal remedies were found to inhibit Phosphodiesterase-5 (PDE-5) inhibition, alpha-blockers, or 5α -reductase inhibition effects which are supported by in vitro, in vivo and clinical trial studies evidence. Of these, 89 plants have ethnobotanical significance as alpha-blockers, alpha-reductase inhibition, or PDE-5 inhibition, and the other fifteen plants were chosen based on their ability to reduce BPH risk factors. Several phytocompounds, including, rutaecarpine, vaccarin, rutin, kaempferol, ß-sitosterol, quercetin, dicaffeoylquinic acid, rutaevin, and phytosterol-F have been reported to be useful for the management of BPH. The use of combination therapy offers a strong approach to treating long-term conditions compare to single plant extract drugs. Furthermore, several botanical combinations such as lycopene and curcumin, pumpkin seed oil and saw palmetto oil, combinations of extracts from Funtumia africana (Benth.) Stapf and Abutilon mauritianum (Jacq.) Medik., and Hypselodelphys poggeana (K.Schum.) Milne-Redh. and Spermacoce radiata (DC.) Sieber ex Hiern are also supported through in vitro and in vivo studies for managing BPH through recuperation in patients with chronic long-term illnesses, as measured by the International Prostate Symptom Score. CONCLUSION: The review proposes and endorses careful utilization of conventional medications that may be investigated further to discover possible PDE-5, 5 alpha-reductase, an alpha-blocker inhibitor for managing BPH. Even though most conventional formulations, such as 5 alpha-reductase, are readily available, systemic assessment of the effectiveness and mechanism of action of the herbal constituents is still necessary to identify novel chemical moieties that can be further developed for maximum efficacy. However, there exist abundant botanicals and medicinal plants across several regions of Africa, Asia, and the Americas, which can be further studied and developed for utilization as a potential phytotherapeutic for the management of BPH.


Assuntos
Compostos Fitoquímicos , Plantas Medicinais , Hiperplasia Prostática , Hiperplasia Prostática/tratamento farmacológico , Humanos , Masculino , Compostos Fitoquímicos/uso terapêutico , Compostos Fitoquímicos/farmacologia , Plantas Medicinais/química , Animais , Fitoterapia/métodos , Extratos Vegetais/uso terapêutico , Extratos Vegetais/farmacologia , Inibidores de 5-alfa Redutase/uso terapêutico , Inibidores de 5-alfa Redutase/farmacologia
8.
J Ethnopharmacol ; 327: 118002, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38437890

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Polygonati Rhizome (PR) is a plant that is extensively widespread in the temperate zones of the Northern Hemisphere. It is a member of the Polygonatum family of Asparagaceae. PR exhibits diverse pharmacological effects and finds applications in ethnopharmacology, serving as a potent tonic for more than two millennia. PR's compounds endow it with various pharmacological properties, including anti-aging, antioxidant, anti-fatigue, anti-inflammatory, and sleep-enhancing effects, as well as therapeutic potential for osteoporosis and age-related diseases. AIM OF THE STUDY: This review seeks to offer a thorough overview of the processing, purification, extraction, structural characterization, and biosynthesis pathways of PR. Furthermore, it delves into the anti-aging mechanism of PR, using organ protection as an entry point. MATERIALS AND METHODS: Information on PR was obtained from scientific databases (Google Scholar, Web of Science, ScienceDirect, SciFinder, PubMed, CNKI) and books, doctoral theses, and master's dissertations. RESULTS: In this investigation, 49 polysaccharides were extracted from PR, and the impact of various processing, extraction, and purification techniques on the structure and activity of these polysaccharides was evaluated. Additionally, 163 saponins and 46 flavonoids were identified, and three key biosynthesis pathways of secondary metabolites were outlined. Notably, PR and Polygonat Rhizomai polysaccharides (PRP) exhibit remarkable protective effects against age-induced injuries to the brain, liver, kidney, intestine, heart, and vessels, thereby promoting longevity and ameliorating the aging process. CONCLUSIONS: PR, a culinary and therapeutic herb, is rich in active components and pharmacological activities. Based on this review, PR plays a meaningful role in lifespan extension and anti-aging, which can be attributed to PRP. Future research should delve deeper into the structural aspects of PRP that underlie its anti-aging effects and explore potential synergistic interactions with other compounds. Moreover, exploring the potential applications of PR in functional foods and pharmaceutical formulations is recommended to advance the development of industries and resources focused on healthy aging.


Assuntos
Fitoterapia , Extratos Vegetais , Fitoterapia/métodos , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Extratos Vegetais/química , Rizoma , Etnofarmacologia , Polissacarídeos , Compostos Fitoquímicos/farmacologia , Compostos Fitoquímicos/uso terapêutico
9.
J Ethnobiol Ethnomed ; 20(1): 32, 2024 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-38461267

RESUMO

BACKGROUND: Ethnoveterinary medicinal plants have been used by the people of Dugda District in the primary health care system to treat various livestock ailments for generations, particularly, in underserved rural areas. However, these ethnoveterinary practices and medicinal plants are dwindling without proper documentation, due to undergoing socio-cultural and environmental changes. Hence, this study aimed at inventory and analysis of ethnoveterinary medicinal plants and the associated indigenous and local knowledge used in the treatment of livestock health problems in Dugda District. METHODS: Data were collected from 378 local inhabitants through semi-structured interviews, 18 focus group discussions with 6 to 8 participants in each couple with participant field observations. Informant consensus factor (ICF), fidelity-level (FL) and relative importance value (RI) were used to evaluate the agreement of informants on ethnoveterinary practices, healing potential of medicinal plants and the most multipurpose species. Using standard taxonomic procedures, voucher specimens were collected, identified and deposited at the National Herbarium of Addis Ababa University. RESULTS: In total, 64 medicinal plants of ethnoveterinary uses, belonging to 33 families were reported to treat 37 livestock health problems. Anthrax, inappetence and diarrhoea were said to be the most prevalent veterinary health problems treated by traditional medicinal plants. Family Fabaceae was the most widely reported (7 spp.), followed by Apocynaceae, Cucurbitaceae and Solanaceae (5 spp. each). Herbs were the dominant life forms (21spp.), followed by shrubs (20 spp.). The most commonly sought plant parts were leaves (55.25%), followed by roots (23.44%). The principal method of preparation was pounding remedial parts (46.85%) and mixing with cold water. The main route of administration was via oral application (72.67%), drenching diseased livestock. Withania somnifera and Kedrostis foetidissima were the most cited medicinal plants with 53 and 43 use reports (URs), respectively. ICF showed that respiratory diseases scored the highest value (0.94), while most of the reported medicinal plants were gastrointestinal agents. RI value analysis revealed that Croton macrostachyus had highest diversity of uses, followed by K. foetidissima and W. somnifera. Ethnoveterinary uses of some medicinal plants such as Phytolacca dodecandra, Calpurnia aurea, Cyphostemma cyphopetalum and Verbascum sinaiticum as prophylaxis against rabies were a new input for ethnoveterinary database. CONCLUSION: The study revealed that the people of the Dugda District are endowed with rich ethnoveterinary knowledge and medicinal plants. However, ethnoveterinary knowledge associated with medicinal plant species significantly differ (P < 0.05) between general and key informants, young and matured age groups and informants' educational level. This infers the impact of mode of ethnoveterinary knowledge transfer, literacy, modern education and globalization on ethnoveterinary uses of medicinal plant species. And also most of the medicinal plants are found in wild habitats with nearly no conservation attention. Therefore, it is imperative to implement participatory conservation actions for medicinal plants in collaboration with traditional institutions (Gada system). The disparity of ethnoveterinary knowledge could be also minimized through awareness creation among local communities about the knowledge and its revitalization. Furthermore, medicinal plants, which are widely utilized and multipurpose, should be screened for their phytochemicals, pharmacological and toxicological activities to confirm ethnoveterinary uses and for future development of veterinary pharmaceuticals.


Assuntos
Plantas Medicinais , Drogas Veterinárias , Animais , Humanos , Etnobotânica/métodos , Fitoterapia/métodos , Etiópia , Gado
10.
Altern Ther Health Med ; 30(3): 16-23, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38518171

RESUMO

Introduction: Ageing is a natural process of life. With increasing age, the skin suffers progressive morphological and physiological decrement. Hyperpigmentation, Wrinkles, and roughness of skin are some of the symptoms of aged skin. Exposure to sunlight, pollution, stress, nicotine, etc aggravates Skin aging. This study aimed to determine the efficacy and safety of polyherbal formulation and compare its efficacy with the standard drug tretinoin in subjects of moderate to advanced Photoaged facial skin. Ingredients of polyherbal formulation are Aarade baqla (Vicia faba), Jau (Hordeum vulgare), Nakhud (Cicer arietinum),Masoor (Lens esculenta), Tukhm e turb (Raphanus sativus), Khardal (Brassica nigra), Haldi (Curcuma longa), Kateera (Cochlospermum religiosum). Methods: This was a randomized open-label standard controlled study. 82 eligible subjects were allocated equally into test and control groups by computer-generated random numbers. In the test group, a paste of 15 gm polyherbal formulation in milk, and the control group, 0.025% Tretinoin 1 gram was used topically on the face once a day for two months. The response was assessed by theclinician using following different scales for different parameters. Assessment of Skin hyperpigmentation: It was assessed by the Skin Hyperpigmentation Index online calculator (SHI). It describes the ratio of two scores, namely the hyperpigmented skin of the affected area and normal sun-protected skin from the same patient. The image was recorded with a Digital microscope-Win7 from a hyperpigmented area and normal sun-protected area. Both the images were uploaded on https://shi.skinimageanalysis.com/ and calculated the mean value of hyperpigmentation. SHI ranges from 1 (no hyperpigmentation) to 4 (maximum hyperpigmentation) where scores between 1 and 2 showed as light hyperpigmentation, 2-3 as medium hyperpigmentation, and scores between 3 and 4 as severe hyperpigmentation. Assessment of Fine wrinkles: Fine wrinkles number was determined by digital photography. The photographs were taken through Canon EOS 1500D DSLR Camera with an 18-55 mm Lens. Three images were taken of each subject's face (right, left, and center full face) on Baseline and Day 15th, 30th, 45th, and 60th to assess visible changes/improvement in their fine wrinkles score. Assessment of Nasolabial Fold: Modified Fitzpatrick Wrinkle Scale (MFWS) was used to assess Nasolabial folds. The scale comprised four main classes of Nasolabial wrinkling: 0, 1, 2, and 3 representing absent, fine, moderate, and deep wrinkles, respectively, and three inter classes i.e., 0.5, 1.5, and 2.5 to estimate wrinkle depth. The definitions of the entire classes of the scale are as follows: Class 0 = No wrinkle. No visible wrinkle; continuous skin line; Class 0.5 = Very shallow yet visible wrinkle; Class 1= Fine wrinkle. Visible wrinkle and slight indentation; Class 1.5= Visible wrinkle and clear indentation. <1-mm wrinkle depth; Class 2= Moderate wrinkle. Visible wrinkle, 1- to 2-mm wrinkle depth; Class 2.5= Prominent and visible wrinkle. More than 2-mm and less than 3-mm wrinkle depth; Class 3=Deep wrinkle. Deep and furrow wrinkle; more than 3-mm wrinkle depth. Assessment of Forehead lines score: Forehead lines were assessed (number and depth) by a Validated Grading Scale for Forehead Lines. The Forehead Lines Grading Scale is a 5- point photonumeric rating scale that was developed to objectively quantify resting (static) and hyperkinetic (dynamic) forehead lines. The scale ratings are 0 for no wrinkles, 1 for no wrinkles present at rest but fine lines with facial expression, 2 for fine wrinkles present at rest and deep lines with facial expression, 3 for fine wrinkles present at rest and deeper lines with facial expression, and 4 for deeper wrinkles at rest and deeper furrows with facial expression. Assessment of lateral canthal lines: The number of lateral canthal lines was determined by a Validated Grading Scale for Crow's Feet. The Crow's Feet Grading Scale is a 5- point photonumeric rating scale developed to objectively quantify the severity of crow's feet. This scale was applied to two separate evaluations of crow's feet: at rest (static) and with expression (dynamic). The scale ratings are 0 for no wrinkles, 1 for very fine wrinkles, 2 for fine wrinkles, 3 for moderate wrinkles, and 4 for severe wrinkles. Assessment of Facial Skin Roughness: The Allergan Skin Roughness Scale was used for facial skin roughness assessment. The area of assessment for the Allergan Skin roughness Scale is the area between the nasolabial fold to the preauricular cheek and from the inferior orbital rim to the mandible. The Allergan Skin Roughness Scale assigns a grade from none (0) to extreme (4) that describes the severity of skin coarseness, crosshatching, and elastosis in the midface area. The scale grading are 0 (None) Smooth visual skin texture, 1 (Minimal) Slightly coarse and uneven visual skin texture, 2 (Moderate) Moderately coarse and uneven visual skin texture; may have early elastosis, 3 (Severe) Severely coarse visual skin texture, cross-hatched fine lines; may have some elastosis, and 4 (Extreme) Extremely coarse visual skin texture, cross Hatched deep creases; extreme elastosis. Assessment of Facial Dullness: Dullness was assessed on a clinical basis with an arbitrary scoring ranging from 0 to 9 where 0-3=mild, 3.5-6=moderate, and 6.5-9=severe facial skin dullness. Assessment of quality of life: Subjects' life quality was assessed by the Dermatology Life Quality Index questionnaire. It consists of 10 questions. Each question is scored on a four-point Likert scale: Very much = 3, A lot = 2, A little = 1, Not at all = 0, Not relevant = 0 and Question unanswered = 0. The DLQI is calculated by adding the score of each question, resulting in a maximum of 30 and a minimum of 0. Where, 0-1= no effect at all on patient's life, 2-5 = small effect on patient's life, 6-10 = moderate effect on patient's life, 11-20 = very large effect on patient's life, 21-30 = extremely large effect on patient's life. Results: Both groups showed a significant improvement in Fine Wrinkles, Forehead Lines, Crow's Feet, Roughness, Dullness, Nasolabial Fold, Hyperpigmentation, and Quality of Life parameters. (P < .001) A large number of subjects in the control group reported mild to moderate redness, itching, dryness, and blackening of the skin, while in the test group, absolutely no side effects were reported during treatment. Conclusion: The effects in both groups were substantial, but the polyherbal formulation is safe and effective for use in photoaged facial skin. It may be a more feasible easily accessible cheap and safe formulation to prevent skin aging and restore skin elasticity and make skin brighter. Further studies to evaluate the efficacy of formulation on objective parameters using standard instruments should be done for appropriate measurements of parameters.


Assuntos
Envelhecimento da Pele , Humanos , Pessoa de Meia-Idade , Feminino , Masculino , Adulto , Envelhecimento da Pele/efeitos dos fármacos , Medicina Unani/métodos , Idoso , Face , Administração Tópica , Fitoterapia/métodos , Extratos Vegetais/uso terapêutico , Extratos Vegetais/farmacologia
11.
J Ethnobiol Ethnomed ; 20(1): 22, 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38395900

RESUMO

BACKGROUND: The Yi people are a sociolinguistic group living in Mile City, which is their typical settlement in southeastern Yunnan, China. Over the long history of using medicinal plants, the Yi people have accumulated and developed a wealth of traditional medicinal knowledge, which has played a vital role in their health care. However, only a few studies have been performed to systematically document the medicinal plants commonly used by the Yi people. This study provides fundamental data for the development and application of ethnomedicine as well as supports the conservation of the traditional medical knowledge of the Yi people. METHODS: This study was conducted from May 2020 to August 2022 and involved five townships in Mile. Information regarding medicinal plants was obtained through semistructured interviews, key informant interviews, and participatory observation. The collected voucher specimens were identified using the botanical taxonomy method and deposited in the herbarium. Ethnobotanical data were analyzed using informant consensus factor, relative frequency of citation, and fidelity level. RESULTS: In total, 114 informants distributed in five townships of Mile were interviewed. The Yi people used 267 medicinal plant species belonging to 232 genera and 104 families to treat various diseases. Asteraceae, Lamiaceae, and Fabaceae were the most commonly used plant families by the Yi people. In addition, herbs were most commonly used by the Yi people. Whole plants and roots were the preferred medicinal parts. Decoctions were the most common method of herbal medicine preparation. There are 49 different recorded diseases treated by Yi medicinal plants, and among them, respiratory diseases, rheumatism, traumatic injury, fractures, and digestive system diseases have the largest number of species used. A quantitative analysis demonstrated that plants such as Zingiber officinale, Lycopodium japonicum, Aconitum carmichaelii, Panax notoginseng, Cyathula officinalis, and Leonurus japonicus played crucial roles in disease prevention and treatment. CONCLUSION: Traditional knowledge of medicinal plants is closely associated with the social culture of the local Yi people. The medicinal plants used for health care in the study area were diverse. Local healers were skilled at using medicinal plants to treat various diseases. Their treatment methods were convenient and unique, exhibiting distinctive regional characteristics. However, the inheritance of their traditional medicinal knowledge and protection of wild medicinal plant resources are facing serious challenges, including the decreasing number of local healers, aging of healers, lack of successors, and excessive harvesting of medicinal plant resources. This ethnobotanical survey provides a useful reference for the sustainable utilization and protection of medicinal plant resources in Mile and the inheritance of traditional medicinal knowledge of the Yi people.


Assuntos
Plantas Medicinais , População do Sudeste Asiático , Humanos , China , Etnobotânica/métodos , Medicina Tradicional/métodos , Fitoterapia/métodos , Preparações de Plantas
12.
J Ethnobiol Ethnomed ; 20(1): 21, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38389077

RESUMO

BACKGROUND: Ethnoveterinary studies are important to maintain the sustainability of livestock health and support people's livelihoods through the provision of food, maintaining livestock health, and other biological resources. This study was carried out in Soro District, southern Ethiopia, to identify, document and analyse plant species with ethnoveterinary uses along with the associated indigenous and local knowledge. MATERIALS AND METHODS: Informants were selected using purposive (key informants) and systematic random sampling (general informants) methods. Data on ethnoveterinary plants and their uses were collected through semi-structured interviews, guided field walks, 13 focus group discussions with five to seven members in each and participant observation. Informant consensus factor and fidelity level were computed to identify the most common livestock ailment categories and the best plant species with ethnoveterinary use, respectively. Preference ranking methods were used to identify the potentially effective ethnoveterinary medicinal plants for the most frequently reported livestock ailments. The use diversity of multipurpose plants with ethnoveterinary importance was analysed using the analytical methods of ethnobotany including priority ranking, comparisons and important indices. The T-test statistic was used to compare knowledge differences among different social groups. RESULTS: A total of 132 plant species in 120 genera and 61 families were reported by informants as having ethnoveterinary uses. The plants are said to be used by the local communities in various ways to treat 50 livestock health problems. Higher number of informants (23.77%) cited Momordica foetida for the treatment of 16 livestock ailments. The highest informant consensus value for this species is associated with its use for treating blackleg in cattle; Nicotiana tabacum was cited for the treatment of 15 livestock ailments mainly recommended for the Lumpy Skin Disease/Ailment of bovines; Croton macrostachyus for treatment of 13 livestock ailments including wooden tongue, FMD in bovines; and Gymnanthemum amygdalinum for nine ailments mainly diarrhoea of all livestock types. Achyranthes aspera is claimed to provide the most effective treatment for Aspiration pneumonia (severe coughing in bovines, sheep and goats) alone, while Croton macrostachyus, Ximenia americana, Allium sativum and Juniperus procera were indicated as potential plant species to treat Lumpy Skin Disease in bovines in the order given. The fidelity level analysis showed that Datura stramonium, Dodonaea viscosa subsp. angustifolia and Asparagus africanus were potential medicinal plant species to treat the respective ailments of rabies, Peste des petits ruminants (PPR) and evil eye/spirit. Multipurpose plant species including Prunus africanus, Combretum molle and Afrocarpus falcatus have been highly threatened as indicated by direct matrix ranking mainly due to collection of fuel wood, construction materials and making household utensils, and farm implements rather than for other uses. CONCLUSION: Soro District has rich and diversified livestock herbal medicinal resources, and indigenous knowledge of remedy preparations and applications is transmitted through generation lines. This resource faces anthropogenic threats with deforestation being the leading factor. Consequently, ethnoveterinary medicinal plants continue to decline before adequate and proper scientific documentation and testing are made. There is a dire need for planning and implementation of appropriate in situ and ex situ conservation strategies and to strive towards ensuring the survival and sustainable utilization of such important plant resources of Soro District. This must be supported by further documentation of the associated indigenous knowledge and pharmacological testing of the key promising species including Balanites aegyptiaca (novel species/NS to treat specific ailment), Brugmansia suaveolens (novel species/NS reported first to treat Livestock ailments/LsAs), Euclea divinorum (NS to treat specific ailments), Grevillea robusta (NS), Hagenia abyssinica (NS for the reported specific ailment), Pentanema confertiflorum (NS), Juniperus procera (NS), Maesa lanceolata (NS), Millettia ferruginea (NS for reported specific ailments), Schrebera alata/NS, Securidaca longepedunculata, Spiniluma oxyacantha/NS, Vepris nobilis (novel species reported first to treat LsAs), Zanthoxylum asiaticum /NS and Ximenia americana (NS for specific ailments). This ethnoveterinary study attempted to fill part of the gaps concerning the prevalent livestock health problems and the associated indigenous and local knowledge in the area.


Assuntos
Porcelana Dentária , Doença Nodular Cutânea , Ligas Metalo-Cerâmicas , Plantas Medicinais , Titânio , Humanos , Animais , Bovinos , Ovinos , Fitoterapia/métodos , Etiópia , Etnobotânica/métodos , Gado , Cabras
13.
J Ethnopharmacol ; 325: 117837, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38310985

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Infection and inflammation are critical to global human health status and the goal of current pharmacological interventions intends formulating medications/preventives as a measure to deal with this situation. Chemokines and their cognate receptors are major regulatory molecules in many of these ailments. Natural products have been a keen source to the drug development industry, every year contributing significantly to the growing list of FDA approved drugs. A multiverse of natural resource is employed as a part of curative regimen in folk/traditional/ethnomedicine which can be employed to discover, repurpose, and design potent medications for the diseases of clinical concern. AIM OF THE STUDY: This review aims to systematically document the ethnopharmacologically active agents targeting the infectious-inflammatory diseases through the chemokine-receptor nexus. MATERIALS AND METHODS: Articles related to chemokine/receptor modulating ethnopharmacological anti-inflammatory, anti-infectious natural sources, bioactive compounds, and formulations have been examined with special emphasis on women related diseases. The available literature has been thoroughly scrutinized for the application of traditional medicines in chemokine associated experimental methods, their regulatory outcomes, and pertinence to women's health wherever applicable. Moreover, the potential traditional regimens under clinical trials have been critically assessed. RESULTS: A systematic and comprehensive review on the chemokine-receptor targeting ethnopharmaceutics from the available literature has been provided. The article discusses the implication of traditional medicine in the chemokine system dynamics in diverse infectious-inflammatory disorders such as cardiovascular diseases, allergic diseases, inflammatory diseases, neuroinflammation, and cancer. On this note, critical evaluation of the available data surfaced multiple diseases prevalent in women such as osteoporosis, rheumatoid arthritis, breast cancer, cervical cancer and urinary tract infection. Currently there is no available literature highlighting chemokine-receptor targeting using traditional medicinal approach from women's health perspective. Moreover, despite being potent in vitro and in vivo setups there remains a gap in clinical translation of these formulations, which needs to be strategically and scientifically addressed to pave the way for their successful industrial translation. CONCLUSIONS: The review provides an optimistic global perspective towards the applicability of ethnopharmacology in chemokine-receptor regulated infectious and inflammatory diseases with special emphasis on ailments prevalent in women, consecutively addressing their current status of clinical translation and future directions.


Assuntos
Neoplasias , Plantas Medicinais , Feminino , Humanos , Etnofarmacologia , Fitoterapia/métodos , Receptores de Quimiocinas , Extratos Vegetais/farmacologia , Neoplasias/tratamento farmacológico , Quimiocinas , Compostos Fitoquímicos/farmacologia
14.
J Ethnobiol Ethnomed ; 20(1): 28, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38419092

RESUMO

BACKGROUND: Medicinal plants have been used for centuries and are still relied upon by over 80% of the Ethiopian population. The people of Gamo, southern Ethiopia, have a rich cultural and traditional lifestyle with a long history of using plant resources for various uses including traditional herbal medicine. However, their traditional knowledge of traditional medicinal plants in Boreda Abaya District has not been explored Ethnobotanically yet, despite preserving diverse indigenous traditional medicinal plants. Hence, the study aimed to document and analyze traditional medicinal plants and associated traditional knowledge and practices used by local people. MATERIALS AND METHODS: Quantitative ethnobotanical data were collected via semi-structured interviews, face-to-face conversations, group discussions, and guided field trips between September 2022 and February 2023. In total, 92 informants participated, of which 25 were key informants. Quantitative data indices (informant consensus factor-ICF-and use report-Ur) were computed by MS Excel spreadsheet software. Scientific names of medicinal plants were checked via World Flora Online. RESULTS: In the present study, we recorded 188 traditional medicinal plant species belonging to 163 genera and 73 plant families. Lamiaceae (16 species), Asteraceae (16 species), Fabaceae (11 species), and Euphorbiaceae (8 species) contributed highest number of species and were found to be predominant family in the area. Leaves and seeds were most frequently used plant parts, and pounding (46%) was the main method to prepare remedies. The sudden sickness disease category scored the highest consensus (ICF: 0.35), followed by blood and circulatory-related disease categories (ICF: 0.33). The highest number of plant taxa (61 species) used to treat dermal disease has a 71-use report score, while fewer plant taxa (21 species) were utilized to treat genitourinary system-related disease category, having 25 use reports. Ocimum lamiifolium (Ur:56) and Moringa stenopetala (Ur:51) are widely used species and received highest use report value. CONCLUSION: Gamo people possess extensive traditional knowledge of ethnomedicine. The region's vegetation hosts diverse medicinal species, but deforestation, agriculture, and droughts threaten them. Local conservation practices require scientific support, prioritizing species having higher use reports (Ur), and in-depth investigations of promising species for drug development are essential.


Assuntos
População da África Oriental , Plantas Medicinais , Humanos , Fitoterapia/métodos , Etiópia , Etnobotânica/métodos
15.
Eur Neuropsychopharmacol ; 82: 6-28, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38359657

RESUMO

Valerian is one of the most used herbal agents (phytotherapeutics) to manage sleep disturbances, in particular, sleep-onset difficulties in young adults. However, the evidence based on primary studies and systematic reviews that supports its use in this domain is weak or inconclusive. In the current study, an umbrella review was performed on the efficacy of valerian for sleep disturbances with a focus on insomnia. As such, only systematic reviews (with or without meta-analysis) were considered for this study. Systematic searches in PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews, PROSPERO and CNKI databases retrieved 70 records. Only 8 articles were considered eligible for qualitative analysis. Overall, data suggested that valerian has a good safety profile, however, the results showed no evidence of efficacy for the treatment of insomnia. Moreover, valerian appears to be effective concerning subjective improvement of sleep quality, although its effectiveness has not been demonstrated with quantitative or objective measurements. Despite its widespread use and prescription by general practitioners, psychiatrists and other professionals, valerian does not have empirical support for insomnia. Further studies, in particular high quality randomized controlled trials, are highly recommended since there are scarce studies and the existing ones are quite heterogeneous and with low methodological quality. The implications of our findings for clinical practice are critically discussed.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Valeriana , Humanos , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Fitoterapia/métodos
16.
J Ethnobiol Ethnomed ; 20(1): 1, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38169414

RESUMO

BACKGROUND: Herbal tea usually refers to "beverage plants that do not belong to the genus Camellia", and it holds a significant historical legacy as a traditional beverage among specific regions and ethnic groups. In light of this, our research aims to investigate and analyze the traditional knowledge pertaining to herbal tea plants used by local people in the Qianxinan Buyi and Miao Autonomous Prefecture, Guizhou Province. We also initiated preliminary efforts to create tea products from herbal tea leaves using various processing techniques. Additionally, we attempted to test hypotheses to elucidate how local people select herbal tea plants. METHODS: Data related to the use of herbal tea plants in this study were collected through semi-structured interviews and participatory observations in four villages in Qianxinan. Quantitative indicators, including the relative frequency of citation (RFC) and the relative importance (RI) value, were calculated, and the availability of plants was also evaluated. General linear model was performed to examine the relationship between the frequency of citation and resource availability, as well as the correlation between the relative frequency of citation and the relative importance, to test both the resource availability hypothesis and the versatility hypothesis. Centella asiatica tea was processed using techniques from green tea, black tea and white tea, with a preliminary sensory evaluation conducted. RESULTS: A total of 114 plant species were documented as being used for herbal teas by local residents, representing 60 families and 104 genera. Of these, 61% of herbal tea plants were found growing in the wild, and 11 species were exotic plants. The family with the highest number of species was Asteraceae (20 species). The study identified 33 major medicinal functions of herbal tea, with clearing heat-toxin and diuresis being the most common functions. General linear model revealed a strong correlation (correlation coefficient of 0.72, p < 0.001) between the frequency of citation and plant availability, as well as a significant correlation (correlation coefficient of 0.63, p < 0.001) between RFC and RI. Under different processing conditions, the characteristics of Centella asiatica tea exhibited variations and were found to be suitable for consumption. CONCLUSION: The consumption of herbal tea serves as a preventive measure against common ailments for local residents. The resource availability hypothesis, diversification hypothesis and the versatility hypothesis were shown to provide some insight into "how and why local communities select plants for use." Exotic herbal tea plants in the study area also possess valuable therapeutic properties. The processing and production of Centella asiatica herbal tea products hold promising prospects.


Assuntos
Plantas Medicinais , Chás de Ervas , Humanos , Etnobotânica , Fitoterapia/métodos , Chá , China
17.
J Ethnobiol Ethnomed ; 20(1): 3, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-38172804

RESUMO

BACKGROUND: The documentation of ethnobotanical knowledge in Sudan is restricted to specific regions, and there is a far-reaching lack of written information on the traditional use of medicinal plants in other places like Darfur State, in western Sudan. The present study was designed to document the medicinal plants used in traditional medicine of Melit area in North Darfur State. METHOD: Ethnomedicinal information was collected from 135 local informants through semi-structured questionnaires. Data were analysed for use value (UV), informant consensus factor (ICF) and fidelity level. RESULTS: A total of 59 medicinal plants, belonging to 32 families and 55 genera, were recorded for their traditional uses in Melit area. Fabaceae were represented by highest number of species (13) followed by Asteraceae and Malvaceae (4 each) and Poaceae (3). Herbs comprise the main sources (50.8%) of traditional remedies. Fruits and stem bark (17.9% each) were the major plant parts used. Decoction (36.5%) is the most mode of preparation used. Geigeria alata was most commonly used species with UV of 2.37. The highest ICF values were recorded for swellings (ICF = 1.00) and respiratory system (ICF = 0.95) categories. Ten plants, namely Carica papaya, Corchorus trilocularis, Eragrostis cilianensis, Heliotropium sudanicum, Mollugo cerviana, Psiadia punctulate, Rhynchosia minima, Solanum coagulans, Solanum forskalii and Tephrosia purpurea, were cited for the first time as medicinal plants used in Sudan traditional medicine. Resins of Boswellia papyrifera, seeds of Nigella sativa, pods of Vachellia nilotica (syn. Acacia nilotica) and clove of Syzygium aromticum were used to make different preparations for the treatment of the corona virus. CONCLUSION: This is the first ethnobotanical survey conducted in this region which is always suffering from security issues, and results indicated that Melit area harbours high diversity of plants used traditionally to cure different health conditions. The present study aids in conserving such rich heritage, and it is recommended that the newly reported species worth further studying over their phytochemical and biological properties.


Assuntos
Acacia , Plantas Medicinais , Humanos , Fitoterapia/métodos , Etnobotânica/métodos , Medicina Tradicional/métodos , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde
18.
J Ethnobiol Ethnomed ; 20(1): 9, 2024 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-38218888

RESUMO

BACKGROUND: The Bai people in Yunlong County, northwest Yunnan, China, have used medicinal plants and traditional remedies for ethnoveterinary practices. The Bai have mastered ethnoveterinary therapeutic methods in livestock breeding since ancient times. The Bai's traditional ethnoveterinary knowledge is now facing extinction, and their unique ethnoveterinary practices have rarely been recorded. This study documented animal diseases, EMPs, and related traditional knowledge in Yunlong County, China. METHODS: Ethnobotanical fieldwork was conducted in six villages and townships of Yunlong County between 2021 and 2022. Data were obtained through semi-structured interviews, participatory observations, and keyperson interviews. A total of 68 informants were interviewed, and the informant consensus factor and use reports (URs) were used to evaluate the current ethnoveterinary practices among the local communities. Information on livestock diseases, medicinal plants, and traditional ethnoveterinary medicine knowledge were also obtained. RESULTS: A total of 90 plant species belong to 51 families, 84 genera were recorded as being used as EMPs by the Bai people, and Asteraceae plants are most frequently used. A total of 68 informants were interviewed, including 58 men (85.3%) and 10 women (14.7%). The most commonly used EMPs parts included the roots, whole plants, leaves, and stems, and the common livestock diseases identified in this field investigation included trauma and fracture, gastrointestinal disorders, respiratory disorders, parasitic diseases, miscellaneous, venomous snake bites, reproductive diseases, infectious diseases, skin disease, and urinary diseases. Most of the EMPs are herbs (77.78%). Courtyard is one of the habitats of medicinal plants in Yunlong County. CONCLUSION: Traditional knowledge of ethnoveterinary medicine is related to the local sociocultural characteristics of the Bai. Plants are used in cultural traditions, which, in turn, nourish the plant culture. Cultural diversity and biodiversity are interdependent. This traditional knowledge is at risk of disappearance because of the increasing extension of Western veterinary medicine, lifestyle changes, and mainstream cultural influences. Therefore, it is important to continue research on ethnoveterinary practices.


Assuntos
Plantas Medicinais , População do Sudeste Asiático , Masculino , Animais , Humanos , Feminino , Fitoterapia/métodos , China , Melhoramento Vegetal , Etnobotânica/métodos , Gado
19.
Explore (NY) ; 20(2): 168-180, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37643948

RESUMO

OBJECTIVE: This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of Chinese herbal medicines (CHMs) on hematologic manifestations in patients with systemic lupus erythematosus (SLE). DATA SOURCES: PubMed, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Airiti Library were searched for the period January 2000 to February 2022. STUDY SELECTION: RCTs involving CHMs in patients with SLE with available hematologic data. DATA EXTRACTION: The primary outcomes included white blood cell (WBC) count, hemoglobin level, and platelet count. The Cochrane risk of bias tool was used to assess the quality of the included RCTs. Sensitivity analysis of RCTs with abnormal hematologic data before intervention was performed to verify the robustness of the results. Subgroup analysis was also applied for results with high heterogenicity. Core patterns of used herbal drug pairs had also been analyzed and visualized. DATA SYNTHESIS: Fifteen RCTs involving 1183 participants were included. The effects of elevating WBC count (weighted mean difference [WMD]: 0.69; 95% confidence interval [CI]: 0.33-1.06; p <0.001), hemoglobin levels (WMD: 0.64; 95% CI: 0.31-0.97; p <0.001), and platelet count (WMD: 0.61; 95% CI: 0.48-0.74; p <0.001) in the CHM group were significantly greater than those in the control group. In total, 23 single herbs and 152 herbal drug pairs were identified for core patterns network analysis. CONCLUSIONS: We demonstrated significantly superior therapeutic effects achieved with CHMs and conventional therapy regarding leukopenia, anemia, and thrombocytopenia compared to that of conventional therapy alone in patients with SLE.


Assuntos
Medicamentos de Ervas Chinesas , Lúpus Eritematoso Sistêmico , Humanos , Medicamentos de Ervas Chinesas/uso terapêutico , Fitoterapia/métodos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Contagem de Leucócitos , Hemoglobinas
20.
Cochrane Database Syst Rev ; 11: CD001321, 2023 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-37947276

RESUMO

BACKGROUND: Cranberries contain proanthocyanidins (PACs), which inhibit the adherence of p-fimbriated Escherichia coli to the urothelial cells lining the bladder. Cranberry products have been used widely for several decades to prevent urinary tract infections (UTIs). This is the fifth update of a review first published in 1998 and updated in 2003, 2004, 2008, and 2012. OBJECTIVES: To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations. SEARCH METHODS: We searched the Cochrane Kidney and Transplant Specialised Register up to 13 March 2023 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA: All randomised controlled trials (RCTs) or quasi-RCTs of cranberry products compared with placebo, no specific treatment or other intervention (antibiotics, probiotics) for the prevention of UTIs were included. DATA COLLECTION AND ANALYSIS: At least two authors independently assessed and extracted data. Information was collected on methods, participants, interventions and outcomes (incidence of symptomatic UTIs, positive culture results, side effects, adherence to therapy). Risk ratios (RR) with 95% confidence intervals (CI) were calculated where appropriate. Study quality was assessed using the Cochrane risk of bias assessment tool. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. MAIN RESULTS: For this update, 26 new studies were added, bringing the total number of included studies to 50 (8857 randomised participants). The risk of bias for sequence generation and allocation concealment was low for 29 and 28 studies, respectively. Thirty-six studies were at low risk of performance bias, and 23 studies were at low risk of detection bias. Twenty-seven, 41, and 17 studies were at low risk of attrition bias, reporting bias and other bias, respectively. Forty-five studies compared cranberry products with placebo, water or no specific treatment in six different groups of participants. Twenty-six of these 45 studies could be meta-analysed for the outcome of symptomatic, culture-verified UTIs. In moderate certainty evidence, cranberry products reduced the risk of UTIs (6211 participants: RR 0.70, 95% CI 0.58 to 0.84; I² = 69%). When studies were divided into groups according to the treatment indication, cranberry products probably reduced the risk of symptomatic, culture-verified UTIs in women with recurrent UTIs (8 studies, 1555 participants: RR 0.74, 95% CI 0.55 to 0.99; I² = 54%), in children (5 studies, 504 participants: RR 0.46, 95% CI 0.32 to 0.68; I² = 21%) and in people with a susceptibility to UTIs due to an intervention (6 studies, 1434 participants: RR 0.47, 95% CI 0.37 to 0.61; I² = 0%). However, there may be little or no benefit in elderly institutionalised men and women (3 studies, 1489 participants: RR 0.93, 95% CI 0.67 to 1.30; I² = 9%; moderate certainty evidence), pregnant women (3 studies, 765 participants: RR 1.06, 95% CI 0.75 to 1.50; I² = 3%; moderate certainty evidence), or adults with neuromuscular bladder dysfunction with incomplete bladder emptying (3 studies, 464 participants: RR 0.97, 95% CI 0.78 to 1.19; I² = 0%; low certainty evidence). Other comparisons were cranberry products with probiotics (three studies) or antibiotics (six studies), cranberry tablets with cranberry liquid (one study), and different doses of PACs (two studies). Compared to antibiotics, cranberry products may make little or no difference to the risk of symptomatic, culture-verified UTIs (2 studies, 385 participants: RR 1.03, 95% CI 0.80 to 1.33; I² = 0%) or the risk of clinical symptoms without culture (2 studies, 336 participants: RR 1.30, 95% CI 0.79 to 2.14; I² = 68%). Compared to probiotics, cranberry products may reduce the risk of symptomatic, culture-verified UTIs (3 studies, 215 participants: RR 0.39, 95% CI 0.27 to 0.56; I = 0%). It is unclear whether efficacy differs between cranberry juice and tablets or between different doses of PACs, as the certainty of the evidence was very low. The number of participants with gastrointestinal side effects probably does not differ between those taking cranberry products and those receiving a placebo or no specific treatment (10 studies, 2166 participants: RR 1.33, 95% CI 1.00 to 1.77; I² = 0%; moderate certainty evidence). There was no clear relationship between compliance with therapy and the risk for repeat UTIs. No difference in the risk for UTIs could be demonstrated between low, moderate and high doses of PACs. AUTHORS' CONCLUSIONS: This update adds a further 26 studies, taking the total number of studies to 50 with 8857 participants. These data support the use of cranberry products to reduce the risk of symptomatic, culture-verified UTIs in women with recurrent UTIs, in children, and in people susceptible to UTIs following interventions. The evidence currently available does not support its use in the elderly, patients with bladder emptying problems, or pregnant women.


Assuntos
Infecções Urinárias , Vaccinium macrocarpon , Masculino , Feminino , Criança , Adulto , Humanos , Idoso , Infecções Urinárias/prevenção & controle , Rim , Antibacterianos , Fitoterapia/métodos , Extratos Vegetais/uso terapêutico
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