Table Of ContentPhytotherapy
AQuickReferenceto HerbalMedicine
Springer-Verlag Berlin Heidelberg GmbH
FRANCESCO CAPASSO
TIMOTHY S. GAGINELLA
GIULIANO GRANDOLINI
Izzo
ANGELO A.
Phytotherapy
A Quick Reference to Herbal Medicine
With77Plates,65Figuresand57Tables
, Springer
Professor Dr PRANCESCO CAPASSO Professor Dr GIULIANO GRANDOLINI
Department of Experimental Department of Pharmaceutical
Pharmacology Chemistry and Technology
University of Naples "Pederico II" University of Perugia
Via D. Montesano 49 Via del Liceo 1
80131 Naples, ltaly 06123 Perugia, ltaly
Professor Dr TIMOTHY S. GAGINELLA Professor Dr ANGELO A. Izzo
School of Pharmacy Department of Experimental
University of Wisconsin Pharmacology
Madison, WI 53706, USA University of Naples "Pederico II"
Via D. Montesano 49
80131 Naples, Italy
ISBN 978-3-540-00052-5
Library of Congress Cataloging-in-Publication Data
Phytotherapy: a quick reference to herbal medicine / Prancesco Capasso ... [et al.].
p.cm.
Includes bibliographical references.
ISBN 978-3-540-00052-5 ISBN 978-3-642-55528-2 (eBook)
DOI 10.1007/978-3-642-55528-2
1. Herbs-Therapeutic use-Handbooks, manuals, etc. 2. Materia medica, Vegetable
Handbooks, manuals, etc. I. Capasso, Francesco.
RM666.H33P497 2003
615'.321-dc21
2003041548
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Foreword
It is evidentthat phytotherapyduring the last 20 years has gained sig
nificanceindrugtherapy;inspiteofthis concernshavebeenvoicedby
practitionersofconventionalmedicinewithrespecttotheuseofplant
derived,"herbal"medicines. On balance,most properly cultivated and
prepared herbal medicines are usually free of side effects, while syn
thetic drugs frequently produce undesirable adverse effects. If plant
derived drugs with a low therapeutic index (e.g.foxglove, belladonna)
are excluded, most herbs indeed have a low incidence ofside effects.
Herbal medicines with a high therapeutic index can therefore be con
sideredsafewhen usedforhealthdisturbancesandchronicdiseases.In
thisrespectphytotherapymustbeseenasanintegrationofpharmacog
nosy, pharmacology and pathology that enables students, physicians
and practitioners to understand why,when and how herbal medicines
canbeusedtotreatdiseases.Itisthereforelogicalthatitwouldbemore
efficient to learn pharmacognosy by first reviewing the medicinal
plants, then pharmacology and pathophysiology to understand how
botanicalsmaynormaliseanalteredfunction.Itisimportantto under
stand how to appropriately use herbal medicines to treat diseases.
However, medical practitioners are often confused by the frequently
conflictinginformationavailableonthe safetyandefficacyofherbs. In
addition, herbal medicines very sometimes co-prescribed without
properattentiontoadjustmentofdosages.
Thistextbook,unlike manyphytotherapy texts,treatsthesubjectof
herbal medicines in an integrated fashion relative to pharmacognosy,
pharmacologyandtoxicology. Manytablesandfigures are includedto
clarifycomplexmechanismsandotherinformation.Itishopedthatstu
dents, physicians and other healthcare practitioners will find this
approachnotmuchonerousanduseful.
LUDOVICOSORRENTINOMD
ProfessorofPharmacology
UniversityofNaples FedericoII
v
Preface
In the last centurythe sources ofnatural medicines have expanded to
include higher and lower plants, microorganisms, marine organisms,
arthropods as well as animals. Nevertheless plants continue to be the
majorsourceofbiologicallyactivenaturalproductssuchasteasextracts
and tinctures, which may be utilized. The importance of medicinal
plants can be realized from their prominence in the market place.
Severalanalysis carriedoutin recent years have revealed thatabout30
% ofall prescriptionsissuedin Europe,USA and Canadacontainedan
herb, a purified extract or an active component (or fraction) derived
fromherb.Inothercountriesoftheworldherbscanbepresentin70-90
% ofthe prescriptions. Therefore in spite ofthe substantial advances
that have been made in synthetic chemistry, herbs and their con
stituents still remain an integral part ofmodern therapeutics in some
countries,whileplayaroleofprimaryimportanceinothers.
The most frequently documented uses claimed for herbs include
constipation and othergastrointestinal disturbances. In the therapy of
constipation, especially,herbal laxatives have aleading position. Sleep
disturbancesandanxietyareotherdisordersinwhichherbsareusedin
the clinicalpractice.Acuteand chronic diseases ofthe airways and the
common cold, but also other disturbances referred to in the present
book,are then a domain for herbs in the general medical practice. It's
evidentthattherearecontroversialopinionswithregardtophytothera
pyanditsefficacyandsafety.Thosewhoopposeherbaltherapyconsid
er these medicines as placebo while the extreme proponents of phy
totherapyconsiderherbalmedicineswithoutsideeffects,healthfuland
absolutelysafe.Phytotherapyisalso an importantadjunct to the useof
syntheticdrugs.However,there isalso apoliticalaspectthat influences
therapy with herbal medicines. For example in some industrialized
countries the authorization ofherbal medicines occurs on the basis of
experimentaland clinical studies,while inothers the traditional use of
herbal medicines is also considered as proof for efficacy and safety.
VII
Preface
There are also data ofquestionable assurance,found in medical jour
nals,booksandfrom internetsources,whichfrequentlydo notprovide
objectiveinformation.
This book of phytotherapy is designed to provide phytotherapists
with an objective review ofthe available information on the pharma
cognosyand pharmacologyofcommonlyusedherbs and approved by
Commission E.Clinicalandtoxicologicalfindings ofherbs treatedand
theirdosagesaredescribed.Agooddeal ofpathologyandtherapeutics
information is included. Alarge iconography section can be of some
helpwhentheidentityofanherbaldrugisindoubt.Thefirstpartofthe
book deals with general aspects ofherbs,Le. history,their complexity,
efficacyandsafety,theirpreservation,activeprinciples,galenicprepara
tionsandspecificsituationsfortheuseofherbs.Anoverviewofthereg
ulation ofherbal medicines concludes the general section.The special
section is organized in systems and for each ofthem there is an intro
duction of physiopathology, then are treated herbal medicines as fol
lows: botany/keyconstituents,mode ofaction,clinical studies,adverse
events/contraindications,preparation/dosage.
AttheendofthebookanAppendixdealswithnutraceuticals,herbal
medicinesandcancer,orientalmedicinesandasummaryoftheclinical
efficacyofherbalmedicines.Finallythereisaniconographyofthemain
plantsandcrudedrugstreatedinthebook.Wehopethatthisbookcan
be usefulfor awidevarietyofstudents andprofessionalswith various
interests.
As documentation throughout the text,we have given preference to
review articles, well known book and new original research contribu
tions. We are greatly indebted to colleagues at the Department of
ExperimentalPharmacologyfor theirhelpandsuggestions.Wearealso
deeply grateful to Dr Emilia Nocerino and Dr Francesca Borrelli for
selectingreferencesandplatesandforpreparing tables.
NaplesApril18,2002 FRANCESCOCAPASSO
TYMOTYS.GAGINELLA
GIULIANOGRANDOLINI
ANGELOA.Izzo
VIII
Contents
PartI .
1 Introduction........................................... 3
2 Definitions............................................ 7
3 History............................................... 9
4 TheComplexityofHerbalMedicines ...................... 11
5 AretheHerbalMedicinesSafe? ........................... 13
6 TheHerbalMedicinesandtheImportanceof
theScientificResearch. ................................. 21
7 Partsofthe Planttobe used,Nomenclature,Drug
AcquisitionandPreservation. ............................ 25
8 ActivePrinciples ....................................... 31
9 TherapeuticOverviewofGalenicalPreparations. ............ 45
10 UsesofHerbalMedicinesinSpecificSituations.............. 61
11 SourcesofHerbalMedicineInformation ................... 71
12 Herbal ProductRegulations. ............................. 73
PartII 87
13 Plantsandthe NervousSystem ........................... 89
14 Plantsandthe CardiovascularSystem 109
15 PlantsandMetabolicDiseases 135
16 PlantsandtheRenalSystem 159
17 Anti-inflammatoryPlants 173
18 Plantsandthe RespiratorySystem 193
19 Adaptogenic Plants 217
20 PlantsandtheReproductiveSystem 231
21 PlantsandtheDigestiveSystem 251
22 Plants,LiverandBiliarySystem 295
23 Plantsandthe CutaneousSystem 309
IX
Contents
IdentificationGuide 333
Plants 337
CrudeDrugs 347
Appendix. ................................................363
A:NutraceuticalandHerbalSupplements 365
B:HerbalMedicinesand CancerPrevention 371
C:HerbsinTraditionalChineseand IndianMedicine 377
D:SummaryoftheClinicalEfficacyofHerbalMedicines 385
GlossaryofBotanicalTerms 399
SubjectIndex 403
x
Abbrev·ations
ll-OHSD ll-hydroxysteroiddehydrogenase
5-HT 5-hydroxytryptamine(serotonin)
AC Adenylatecyclase
ACE Angiotensinconvertingenzyme
ACTH Adrenocorticotrophichormone
AESGP AssociationEuropeennesdesSpecialitesGrand Publique
AIDS Acquiredimmunodeficientsyndrome
ALA Alpha-linolenicacid
AMG Arzneimittelgesetz
AMM Authorisationdemisesurmarche
AMP Adenosinemonophosphate
ATP Adenosinetriphosphate
ATPase Adenosinetriphosphatase
BHC British HerbalCompendium
BHP BritishHerbalPharmacopoeia
BPH Benignprostatichyperplasia
cAMP Cyclicadenosine monophosphate
CAPE Caffeicacidmethylester
CE Cholesterolester
CHF Congestiveheartfailure
CM Chylomicrons
CRH Corticotropin-releasinghormone
CNS Centralnervoussystem
Core-SPCS Core-SummaryofProductCharacteristics
COX Cyclooxygenase
CPMP Committeefor ProprietaryMedicinalProducts
CRH Corticotrophinreleasinghormone
CSP CodedelaSantePublique
DGL Deglycyrrhinizedliquorice
DGLA Dihomoi-gamma-linolenicacid
DHT Dihydrotestosterone
DNA Deoxyribonucleicacid
DSHEA DietarySupplementHealthand EducationAct
XI
