Most Common Herbal Medicines in the Treatment of Iranian Children: A Systematic Review

Authors

1 Student Research Committee, Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Mashhad University of Medical Science, Mashhad, Iran

2 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Department of Microbiology, Islamic Azad University of Varamin-pishva, Varamin, Iran.

5 Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
To assess the efficacy of foeniculum Vulgar, menthe longifolia and Garlic
in Iranian children.
Methods and Matherials:
Nine databases such as MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials as well as domestic  database (Persian) such as SID, Iranmedex, Magiran, Medlib, Irandoc, and Google Scholar were searched using keywords such as
 “child” and “complementary treatments or alternative treatments or herbal treatments or Anthum Foeniculum or Capillaceum or Foeniculum Officinale or Foeniculum vulgare or menthe longifolia or Garlic in June 2014
Result:
Five studies were included in the systematic review. Our systematic review showed beneficial effect of Foeniculum Vulgare on redacting of infant colic and also led to significant increase on prolactin levels in lactating mothers.  Base on only study, comparison between two groups (Shirafza and placebo Drops) did not show any significant difference in regarding infant weight gain. Menthe longifolia combined with ORS improved frequency of defecation, Volume and consistency of stool. Also Review Systematic showed that Garlic significantly decreased fever, frequency and duration of diarrhea, leukocyte in stool.
 
Conclusion:
herbals medicine (foeniculum Vulgar, menthe longifolia and Garlic) had beneficial effect on Women's serum prolactin levels, infantile colic, frequency of defecation, Volume, consistency of stool. However, this result should be interpreted with caution which low number of sample and methodological quality.

Keywords


Introduction

 

Fear of side effect has been driving user away from chemical medicine and consequently, many people have been interested in the use of herbal remedies (1-3). In Iran, both many people and health care professional have been seeking natural therapies due to the efficiency, safety tolerability, and lower toxicity and adverse events in comparison with to chemical medicines (3, 4).  Many herbal medicines have been used in Iranian traditional system. Plants such as Punica granatum, Foeniculum Vulgar, menthe longifolia, Garlic, Plantago, Glycyrrhiza glabra Rosa damascene are the most popular among them (5-8). Foeniculum Vulgar is also known as fennels It has a long background in relief infant colic, wind, irritable bowel and increase of breast feeding(8). The main types of identified compounds are contain 18.5% fibre, 6.3% of moisture10% fat, 13.4% minerals, 9.5% protein and 42.3% carbohydrates (5, 9). Menthe longifolia is widely used as antispasmodic, digestive and carminative and in relieving stomach pain. Mentha species also showed fungicidal, anti-inflammatory, antimicrobial and antioxidant activities. It is containing dihydrocarvone (23.64%), Piperitone (17.33%) and Cis-dihydrocarvone (15.68%),Ciscarveol (53 to 78%) (10). To our knowledge, the efficacy of herbal medicine has not been systematically assessed in Iran. This Systematic Review assessed the efficacy of Foeniculum Vulgar, menthe longifolia and Garlic in Iranian children

 

Search Strategy

English databases such as  MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials as well as  domestic(Persian) database such as  SID, Iranmedex, Magiran, Medlib, Irandoc, Google Scholar using keywords such as Iran, colic, weight gain, Prolactin, complementary treatments or alternative treatments  or herbal treatments or Anthum Foeniculum Capillaceum, Foeniculum Officinale , Foeniculum vulgare ) was searched in June 2014. The data collected independently by two authors.

 

Results

The process of searching and selecting studies has been described in Fig 1. In total, fives studies were included in the systematic review

The effect of Foeniculum Vulgare on Serum Prolactin Levels

Honarvar et al assessed the Effect of Foeniculum Vulgare on Serum Prolactin Level in Lactating women. 45 women met criteria inclusion. Subject received 3gr of Foeniculum Vulgare daily for 15 days.  The mean of serum prolactin  levels significantly increased from 64.55±32.06 ng/ml to 95.55±65.90 ng/ml in Foeniculum Vulgare groups (11)

The Effect of "Shirafza Drops" on the weight gain of Infants

Shariati et al assessed the Effect of "Shirafza Drops" on the weight gain of Infants.158 breast feeding mothers had complain of lack of weight gain of infant attended primary health care center in mashhad city. Subject was randomized two groups: The placebo Drop (solution of chlorophy in alcohol) including 103 patients and Shirafza Drop group including 83 patients. Shirafza Drop contained Foeniculum Volgare, Pimpinella Anisum, Cuminum Cyminum, Nigella Sativa, Anetom Gravolen and Petroselinum Crispum. Comparison between two groups showed any significant difference at 1 ,2 ,3 and 4 weeks and feeding mothers did not report any increases in Brest feeding rate(12).

Comparison of the effect of Foeniculum vulgare extrac and Gripe water syrup on colic infant

Attarha et al compared two groups Foeniculum vulgare extract and Gripe water syrup. Foeniculum vulgare extract group received one teaspoonful for less than one month old infant and a dessertspoonful for 1-6 month old infant three times a day for one week and Gripe water syrup received same instruction as Foeniculum vulgar group. Demographic characteristics were comparable between groups. Main outcome was length of crying on three point time(less than 60 minutes, 60-120 minutes and more than minutes) and during of crying after 24 hours.  Diagnoses of colic were made by pediatrics. Infant was re-examined by same pediatrics in 3rd and 7rd after treatment. Both groups showed a statistical significant improvement compared with baseline regarding during of crying 24 hours at 3rd and 7rd respectively (Foeniculum vulgare p=0.004 and p=0.005) and (Grip water group p=0.037 and p=0.002). However, there were not any significant difference between two group on none of three point time (less than 60, 60-120 and more than 120 minutes)(13)

The effect of Menthe longifolia on acute nonbacterial diarrheas in children

Rezaei et al assessed the effect of Menthe longifolia on acute nonbacterial diarrheas in children. subject divided into two groups. 35 subjects were treated with oral rehydration solution (ORS) alone for four time/day and other 35 patient received ORS in addition to the leaf powder of Mentha Longifolia for controlling of diarrhea. Main outcome measure was frequency of defecation, the volume and consistency of stool. Stool had a normal frequency of defecation (less than three per day) on 48 hours in 26(81%) of 32 intervention group compared to 50(78%) of 32 in control group (p<0.05) but, this was not significant the case after 24hours.Volume and consistency of stool showed a statistically significant improvement in menthe longifolia in addition to ORS groups as compared to the ORS only(14).

 

Effect of aqueous garlic extract on inflammatory Gastroenteritis in children

Rafati et al. included 50 children 2-10 years who suffer from inflammatory Gastroenteritis. Patient randomized into two groups (control group, n=20) and (aqueous garlic extract, n=20) for 5 days. Aqueous garlic extracts significantly decreased frequency of diarrhea after 2 days.  Comparison of two groups showed significant difference to respect with fever at 2 days and leukocyte in stool in 4 days. However; there were no significant difference between group about vomiting and nausea (15)

 

Discussion

 

This systamatic rewivw highlight the fact that very few studis have been done in regarding the  the of  the efficacy ofherbal medicin.

The effect of Foeniculum Vulgare on Serum Prolactin Level

Only study assessed the effect of of Foeniculum Vulgare on Serum Prolactin Level and showed  Foeniculum Vulgare intake significantly increased serum prolactin levels.  This resulth should be interpreted with caution  because there were no control group. Again Further studies is still need which design as clinical trial (11) .

The effect of Foeniculum Vulgare on infant weight gain

Infant weight gain showed a increased in Foeniculum Vulgare compred controle group, which wasnot significant. further trials is still need to confim this finding(12)

Comparison of the effect of Foeniculum vulgare extrac and Gripe water syrup on colic infant

To sum up, both Foeniculum vulgare extract and Gripe water syrup showed beneficial effect on colic infant. However difference was not significant between two groups. Again further trials is still need to confirm this finding

The effect of menthe longifolia on acute nonbacterial diarrheas in children

a statistically significant improvement was observed in menthe longifolia in addition to ORS groups as compared to the ORS only. Again further trial is need to confirm this result

 

Effect of Aqueous Garlic on inflammatory Gastroenteritis in children

Base on only one trial, Garlic significantly decreased fever, frequency and duration of diarrhea, leukocyte in stool and increase appetite. Again further trials is need to confirm this result

 

Limition

Low methodological quality and the small sample size of include studies are potential limitation of this review systematic there is still need to further studies which design base on Consort checklist to improve methodological. Another  limitations of the current systematic review all of studies only addressed to the efficacy of intervention but neglected assessing side effect , further studies should be taken into report both efficacy and side effect

Conclusion

Herbals medicine (foeniculum Vulgar, menthe longifolia and Garlic) had beneficial effect on Women's serum prolactin levels, infantile colic, frequency of defecation, Volume, consistency of stool. Herbals medicine can be taken into consideration an appropriate alterative due to several reason a cost-effective, safety tolerability, and lower toxicity and adverse events in comparison with to chemical medicines. Also high acceptance both Iranian people and health care provider is another factors.   However, this result should be interpreted with caution which low number of sample and methodological quality.

 

 

 

 

 

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