GŁÓWNE METODY TERAPII CHORÓB UKŁADU SERCOWO-
-NACZYNIOWEGO Z WYKORZYSTANIEM ROŚLIN LECZNICZYCH

Kostyantyn L. Kosyachenko, Іvanna V. Sakhanda

Bogomolets National Medical University, Kyiv, Ukraine

 

ABSTRACT

Introduction: In recent years, a fundamentally new approach to the treatment of cardiopathology is actively developing, so it consists of the combined use of traditional drugs and medicinal products of plant origin (MP PO), because herbal remedies are mostly compatible with each other and with synthetic medicines, which leads to synergy of their action.

The aim of this work is to briefly consider, on specific examples, the main methods of treating cardiovascular diseases with medicinal plants.

Materials and methods: Situational analysis of the target segment of finished medicinal products (MP) of plant origin for 2012-2017 was held and it indicates a significant potential for using them as a drug therapy or as a preventive measure in many diseases.

Review and Conclusions: Some plants, used to treat cardiovascular diseases, have been considered. The list of plants, that were given, reflects the main approaches to phytotherapy of diseases of the cardiovascular system: this is the use of cardiac glycosides – the first highly effective drugs for the treatment of heart failure, P-active compounds, strengthen the blood vessels and regulate metabolism in the body, a variety of alkaloids, including stimulating the activity of the body, which is important, for example, in hypotension. A number of medicinal plants are representatives of the ruderal flora (motherwort). It causes widespread use of plants in folk medicine. Individual plants are introduced into the culture to produce medicinal products based on them (Valerian, Digitalis, Periwinkle, Astragalus).

Wiad Lek 2018, 71, 5, -1283

 

Introduction

For the treatment of cardiovascular diseases, various drugs are being developed and used. Their high therapeutic effect is due to a powerful specific effect on a certain process in the body.

Diseases of the cardiovascular system firmly occupy a leading position in the list of diseases that affect the population, regardless of the age and physiological characteristics of its representatives. Various kinds of disorders of the cardiovascular system are the main cause of development of dangerous diseases, worsening of general health, risk of severe pathology. To prevent the emergence of serious ailments, the general strengthening of the circulatory system, traditional medicine offers the use of medicinal and prophylactic purposes of plants whose medicinal properties are checked by time [1, 2].

Violations of the cardiovascular system and the appearance of characteristic diseases are caused by such factors as slagging of the body due to malnutrition, the formation of cholesterol plaques in the cavity of the vessels, decrease in their density and elasticity.

To eliminate the negative phenomena, it is recommended to use various herbs that will help cure existing diseases or prevent the occurrence of such diseases [3].

The composition of most medicinal plants is enriched with a large number of antioxidant substances, flavonoids, essential oils, vitamin complexes and other important microelements.

The aim

The aim of this work is to briefly consider, on specific examples, the main methods of treating cardiovascular diseases with medicinal plants.

Materials and methods

Situational analysis of the target segment of finished medicinal products (MP) of plant origin for 2012-2017 was held and it indicates a significant potential for using them as a drug therapy or as a preventive measure in many diseases.

Review and discussion

Substances that normalize blood circulation are often used in practical medicine in violation of heart activity and pathological changes in vascular tone. Based on the clinical application of these drugs, the following groups can be distinguished.

I. Remedies for heart disorders:

a) with heart failure;

b) for violations of the rhythm of heartbeats;

c) with insufficient blood supply to the myocardium.

II. Remedies used in pathological conditions accompanied by changes in blood pressure:

a) with arterial hypertension;

b) with hypotensive states.

Regular consumption of decoctions and infusions, prepared on the basis of medicinal herbs as a medicinal product, makes it possible to obtain the following positive results:

1. Systematically occurring stress, nervous overstrain, depressive conditions often become the causes of vascular disease. Any phytotea for vessels and myocardium, the composition of which is enriched with valerian or melissa, will help to have a soothing effect and bring the psychoemotional state of the patient into relative norm.

2. The beneficial effect of medicinal fees promotes stimulation of circulatory processes, which in turn increases the number of incoming nutrients and oxygen to organs and tissues at times.

3. Some types of plants help significantly reduce pressure and bring the patient into a relatively normal state.

4. But it should be remembered that permanent effect with the help of such remedies can only be provided by long-term use.

5. Penetrating into the tissues of vessels and veins, the active components contribute to their strengthening, increasing elasticity and preventing the fragility of the vascular walls.

The spectrum of medicinal plants, used in the treatment of vascular pathologies and diseases, is incredibly extensive. To achieve the desired result, you should choose a certain plant that has properties which help to eliminate existing pathologies.

For more than 200 years, cardiac glycosides have been the main drugs for the treatment of patients with heart decompensation. However, a more detailed study of the genesis of chronic heart failure and a broad comparative study of cardiac glycosides and other cardiotonics regarding their efficacy and safety over the past two-three decades has led to a revision of their significance in the treatment of chronic heart failure. It turned out that cardiotonics for some time improve the quality of life of patients, but life expectancy not only does not extend, but when using many «non-glycoside» drugs can even be shortened (partly as a result of their arrhythmogenic effect). Although cardiotonics are still being used, they are only one of the components in the complex treatment of chronic heart failure.

The main principle of pharmacotherapy of this pathology is to create the most optimal conditions for the work of the heart. It is advisable to increase the effectiveness of its work not so much through direct cardiostimulating action, as by reducing the excessive burden on the contractile myocardium and creating the most sparing mode of its operation. In a broad sense, this refers to the cardioprotective action of drugs. This can be achieved by improving the blood supply and metabolism of the myocardium, reducing preload and afterload on the heart, normalizing the rhythm of heartbeats, reducing the volume of circulating blood, normalizing the function of the blood coagulation system, etc. [4].

Rational pharmacotherapy of chronic heart failure includes a large complex of medicines of different directionality of action. Next we will consider cardiotonic agents (cardiac glycosides).

Cardiac glycosides are substances of plant origin that have a pronounced cardiotonic effect. They increase the efficiency of the myocardium, providing the most economical and, at the same time, effective heart activity. Cardiac glycosides are used in the treatment of heart failure, which most often develops against the background of coronary heart disease, myocardial lesions of different etiology and heart rhythm disturbances.

In medical practice, cardiac glycosides preparations are used, so they are obtained from the following plants [5]:

Digitalis purple (Digitalis purpurea) – digitoxin;

Woolly foxglove (Digitalis lanata) – digoxin, ceelanid (lanatoside C, isolanide);

Strophete Kombyo (Strophanthus Kombé) – strofantin K;

Lily of the valley (Convallaria) – korglikon;

Adonis (Adonis vernalis) – infusion of herbs of Adonis.

Sources for the production of cardiac glycosides, the drugs used and their active principles are given in Table I. The most interesting are individual glycosides. The main property of cardiac glycosides is their selective effect on the heart. Strengthening of the systole (cardiotonic action, positive inotropic action), associated with the direct effect of drugs on the myocardium, plays a major role in the pharmacotherapeutic effect of cardiac glycosides.

Cardiac glycosides markedly increase the stroke and minute volume of the heart with heart failure. It is important that the work of the heart is increased without increasing oxygen consumption (per unit of work).

It is important that the work of the heart rises against the background of a decrease in the heart rate (negative chronotropic action) and diastole lengthening. It creates the most economical mode of the heart: strong systolic contractions are replaced by sufficient periods of “rest” (diastole), favorable for the restoration of energy resources in the myocardium. The decrease in the rhythm of the heartbeats is largely due to the cardio-cardiac reflex. Under the influence of cardiac glycosides, the endings of the sensitive nerves of the heart are excited and, reflexively, a bradycardia arises through the system of vagus nerves. It is not excluded that a certain role is played by the intensification of heart reflexes from the mechanoreceptors of the sinoaortic zone during systole as a result of an increase in blood pressure. In addition, cardiac glycosides, having a direct inhibitory effect on the conduction system of the heart and toning the vagus nerve, reduce the rate of excitation (negative dromotropic action).

With heart failure, an increase under the influence of cardiac glycosides of its minute volume has a positive effect on blood circulation as a whole (Table II).

The main effect of cardiac glycosides on blood circulation in decompensating the heart is to reduce venous stasis. At the same time, venous pressure decreases and edema gradually disappears. The reflex increase in the heart rate (Bainbridge reflex from the mouth of the upper hollow veins) does not occur with the elimination of venous stasis. The arterial pressure does not change or rises (if it was lowered). Total peripheral resistance of blood vessels decreases, blood supply and oxygenation of tissues improve. Disrupted functions of internal organs (liver, gastrointestinal tract, etc.) are restored. due to the normalization of the general hemodynamics, cardiac glycosides can improve the blood supply of the heart (a slight direct coronary-exerting effect is noted in the preparations of digitalis, when these drugs are administered at high doses).

Preparations of cardiac glycosides are absorbed from the gastrointestinal tract unequally. More lipophilic digitoxin (90-95%) and digoxin (50-80%) are absorbed very well, – celanide (20-40%) is absorbed well. Strophanthin is very poorly absorbed (2-5%) and partially destroyed. Glycosides of the lily of the valley are largely destroyed in the digestive tract. Therefore enterally expediently to enter mainly preparations of digitalis (digoxin). Inside take also drugs of Adonis (infusion of herbs of Adonis).

Сardiac glycosides and the products of their transformation are mainly excreted by the kidneys, and also with bile (they are partially absorbed from the intestine). The duration of action of cardiac glycosides increases with renal pathology.

Digitoxin is excreted mainly in the form of metabolites and conjugates. Digoxin is only in a small part subjected to chemical transformations. Strophanthin is excreted unchanged.

Іncomplete atrioventricular block, pronounced bradycardia, acute infectious myocarditis are contraindications to the use of cardiac glycosides. Gently use cardiac glycosides with calcium preparations and with hypokalemia. This is due to the fact that with an increased content of calcium ions in the blood serum, the sensitivity of the myocardium to cardiac glycosides increases and, accordingly, the possibility of toxic effects of these drugs increases. Similarly, the effect of cardiac glycosides varies with a decrease in the potassium ion content (which can occur with the use of diuretics, diarrhea, postoperative diuretics) [6].

Infusion of clover and hawthorn.

For the prevention of diseases of the cardiovascular system, as well as for the complex treatment of such diseases, a universal collection is recommended, where the main components are the inflorescences of meadow clover and hawthorn berries.

To prepare such herb collection, the following types of medicinal plants should be joined in equal parts:

pre-milled willow bark;

inflorescence of red clover;

dried or fresh hawthorn berries;

ziziphora;

cranberry leaves;

leaves of ginkgo biloba.

A couple of large tablespoons of the prepared mixture should be filled with half a liter of pre-heated water, and boiled for ten minutes. Use this remedy for half a glass twice a day.

Infusion of lemon balm and yarrow.

Effective herbal collection for the cardiovascular system, which includes yarrow and lemon balm, improves the processes of metabolism and circulation, strengthens the vascular walls, and also increases their elasticity several times.

In order to prepare such remedy, it is necessary to prepare a mixture comprising the following kinds of medicinal plants:

2 tbsp. chopped anise seeds;

1 tbsp. dried lemon grass;

1 tbsp. preliminarily ground valerian roots;

1 tbsp. umbrellas of the yarrow.

The resulting mixture in the amount of a dessert spoon should be steamed with a glass of boiling water, then wrap the container with the received infusion with a warm towel and let stand for several hours. Divide the finished medicine into two equal parts, then drink in two meals during the day.

Effective treatment of the circulatory system with herbs can be done by taking a collection of hawthorn and motherwort. This variant of the drug mix helps to strengthen and improve the functioning of the heart muscle, cleans the vessels of cholesterol, increases the elasticity of tissues and has a calming effect [7].

Infusion of mint and valerian.

The next version of the herbal collection has a mild sedative effect, promotes the stimulation of metabolic processes and improves blood flow.

In order to prepare such a decoction, the following medicinal herbs should be prepared:

two parts of the three-sheeted watch;

two parts of dried leaves of peppermint;

three parts of the grass of Angelica;

three parts of the previously crushed rhizome of valerian.

To prepare a healing mixture, you should brew a small handful of herbal mixture of 500 ml of boiling water, and then boil the resulting infusion for a minimum of half an hour. The finished product should be consumed in the amount of one third of the glass at least three times a day.

Regardless of which herbal preparations are used for the treatment and prevention of diseases, you should always consult with your doctor before using them. Otherwise, there is a risk of side effects and a significant deterioration in the patient’s condition.

Hypertensive disease is a very common disease now [8]. Experts note that the disease is getting younger. This disease is characterized by an increase in blood pressure, as well as a violation of the kidneys, heart, nervous system. Deeper organ changes are observed in the marked stages.

These factors contribute to the development of hypertension:

heredity,

functional disorders of the nervous and endocrine systems,

malnutrition and excess weight,

bad habits (smoking and drinking alcohol),

decreased motor activity,

atherosclerosis in old age,

bad ecology,

kidney disease.

Hypertensive disease develops due to the following reasons:

acute and chronic psychoemotional stresses;

permanent mental overstrain,

brain injury and its hypoxia (oxygen starvation),

age-related hormonal changes (climacteric period),

salt abuse.

Hypertension can be accompanied by the following symptoms:

pain and discomfort in the heart,

headaches, dizziness, hearing loss, noise in the head,

decreased visual acuity,

flies, spots, circles before the eyes,

shortness of breath.

Arterial pressure in hypertensive disease goes beyond the boundary of 140/90 mm Hg.Art. At the beginning of the disease, the pulse is normal, at later stages, its increase and arrhythmia are observed.

It is important to note that the disease may not manifest itself at an early stage and can be detected accidentally during routine clinical examination.

It is necessary to establish the cause of the disease to treat of hypertension, including medicinal plants.

High-risk patients should increase their physical activity, pick up classes that provide a safe level of load. Showing physical exercises for half an hour several times a week.

Healthy people are encouraged to visit the pool, group sports (volleyball, basketball, tennis). At any age yoga classes are shown. Concerning specific loads, you should consult your doctor.

Doctors are especially advised to engage in fresh air or at least in a well-ventilated room. Aeration increases the supply of tissues with oxygen, burns up fat, brings pleasure, improves mood.

Conclusions

Some plants, used to treat cardiovascular diseases, have been discussed above. The list of plants, that were given, reflects the main approaches to phytotherapy of diseases of the cardiovascular system: this is the use of cardiac glycosides – the first highly effective drugs for the treatment of heart failure, P-active compounds, strengthening blood vessels and regulating metabolism in the body, various alkaloids, stimulating the activity of the body, which is important, for example, in hypotension. A number of medicinal plants are representatives of the ruderal flora (Motherwort). It causes widespread use of plants in folk medicine. Individual plants are introduced into the culture to produce medicinal products based on them (Valerian, Digitalis, Periwinkle, Astragalus).

A special stage of treatment is the rehabilitation of persons who have suffered acute cardiovascular disease in a sanatorium. Here, the balneological procedures (baths, showers), physiotherapy techniques are used to the full, you can learn autogenous training. Specialists trained in curative physical education, conduct group sessions with patients, depending on the type of pathology. Sanatoria use the benefits of the climate zone, recommended terencuri (measured routes) in the woods or the seaside. At the same time, a person breathes with phytoncides of needles, charged by electrodes of water spray. Local sanatoria use mineral water, herbal treatment, massage.

We learned that plants are widely used in medicine. A significant part of modern pharmaceuticals, used for the treatment of cardiovascular diseases, is the continuation of those approaches that were started by the use of herbal preparations.

References

1. Barnaulov OD. Phytotherapy of patients with cardiovascular diseases. Petersburg: 2010, р. 42-78.

2. Korsun VF, Korsun EV, Malyshko MA. History of phytotherapy in Belarus. Minsk: 2012, р. 13-32.

3. Korsun VF, Roizman SA, Chuyko TV. Phytotherapy of cardiovascular diseases. Minsk: 2003, р. 112-134.

4. Kryvtsk AA, Kuntcevich LP. Vegetable world: thematic vocabulary. Minsk: 2001, р. 66-82.

5. Ogrenich NA. Methodology of phytotherapy. 2014;12(5):175-198.

6. Sakhanda IV, Nehoda TS, Syatynya ML. Expert estimation of therapeutic effectiveness of medicinal herbs used in cardiovascular diseases. Odessa: 2015, p. 12-13.

7. Syatynya ML, Nehoda TS, Sakhanda IV. The role of herbal medicines in the prevention and treatment of cardiovascular diseases. Bulgaria: 2015, p. 12-14.

8. Syatynya ML, Nehoda TS, Sakhanda IV. Structure and dynamics of the development of cardiovascular morbidity in the population. Poland: 2015, p. 17-19.

9. Syatynya ML, Nehoda TS, Sakhanda IV. The use of medicinal plants the treatment of cardiovascular diseases. Nauka i studia. 2015;8:38–42.

 

This work was carried out in the framework of the research work «Organizational and technological research of medicinal and cosmetic products» (registration number № 0114U001826).

Authors’ contributions:

According to the order of the Authorship

Conflict of interest:

The Authors declare no conflict of interest

CORRESPONDING AUTHOR

Ivanna V. Sakhanda

Bogomolets National Medical University, Kyiv, Ukraine

tel: +380991943687

e-mail: sahanda.ivanna@ukr.net

Received: 25.05.2018

Accepted: 10.08.2018

Table I. Plants and preparations containing cardiac glycosides

Plant

Parts of the plant, used for the manufacture of drugs

Preparations

Cardiac glycosides contained in

new-galenic preparations and preparations of individual glycosides

Simple, galenic and infusions

New-galenic and individual glycosides

Digitalis (Digitalis) purple (purpurea)

rusty (ferruginea)

woolly (lanata)

Leaves

Powder

Еxtract

Digitoxin

Gitoxin

Cordigit

Digalen-neo

Lantozide

Digoxin

Celanide

Digitoxin

Gitoxin

Digitoxin and Gitoxin

Digitoxin, Gitoxin

Digoxin

Lantozide –C

(Dihylanide-C)

Smooth strophant (Strophanthus gratus)

Strophant

Kombyo (Strophantus Kombe)

Seeds

 

Strophanthine G (ouabain)

Strophanthine К

Strophanthine-G

К– Strophanthine

K- Strobathoside

Lily of the valley (Convallaria)

Grass (leaves and inflorescences)

Tincture

Korglikon

Covallаsid

Convallatoxin

Adonis (Adonis vernalis)

Grass

Infusion

Extract

Adonisid

Adonitoxin

Tsimarin

Onions Marine (Scilla maritima)

Bulbs

Tincture

Szilaren

Szilaren

Table II. Effects of cardiac glycosides in heart failure

Parameters, function

Changes in the cardiovascular system with heart failure

Effects of cardiac glycosides in heart failure

Changes in the activity of the heart

Systole

Diastole

Shock volume

Minute volume (cardiac output)

Heart rate

Carrying out pulses through the cardiac conduction system

Weakened

Shortened

Increased

Increased

Shortened

Strengthens and shortens

Extends

Approach the norm (decrease)

Increases

Decreased

Slows down

Changes in blood circulation

Venous pressure

Arterial pressure

Blood supply to the heart

Volume of circulating blood

Increased

Sometimes reduced

Insufficient

Increased

Approaching the norm (decreasing)

Approaching the norm (rising)

Approaching the norm (improves)

Approaching the norm (decreasing)

Changes in the functions of organs and tissues, associated with the state of the circulation

Extracellular fluid in tissues

Diuresis

Functions of a number

of other internal organs

(liver, digestive tract, etc.)

Edema

Reduced (oliguria)

Disrupted (due to venous congestion)

Disappearance of edema

Approaching the norm (rising)

Approaching the norm