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Comprehensive review on medicinal plants used as analgesic

M. Akram

Department of Eastern Medicine and Surgery, Faculty of Medical and Health Sciences, The University of Poonch, Rawalakot, Azad Jammu and Kashmir, Pakistan

Correspondence Address

Muhammad Akram

Author of Correspondence makram_0451@yahoo, makram_0451@hotmail.com Address: Department of Eastern Medicine and Surgery, Faculty of Medical and Health Sciences, The University of Poonch, Azad Jammu and Kashmir, Pakistan

Cell No: 923343367632

Abstract

Context: Conventional medicine has discovered some important agents, their popularity and utility among people of developed countries is restricted due to some unwanted and troublesome effects. Researchers are in search of safe and active agents of synthetic or herbal origin. Thorough literature review of ancient and modern herbal pharmacology reveals that there are many plants having scientifically proven activities. These plants may be valuable sources of herbal agents. Objective: The present work constitutes a review of the medicinal plants in literature that have been tested for activity. Methods:

We performed PUBMED, EMBASE, and CENTRAL searches for research papers of medicinal plants used as analgesic Results: Medicinal plants having activity include such as Acorus calamus L., Linum usitatissimum, Marrubium vulgare, Verbena officinalis and

Commiphora myrrha. Conclusion: The plant species listed have potential activity and may aid researchers in their study of natural products which may be used as analgesics

Keywords: Analgesic, medicinal plants, efficacy, literature review

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Introduction

Analgesics are drugs that control pain and inflammations. Ongoing research is being done throughout the world to seek out effective treatments for pain and inflammation, including the use of plants to relieve and treat this condition. This treatment makes use of the compounds naturally present in plants that are known to treat pain and inflammation. An alternative to allopathic treatment, which is the most common means by which doctors and specialists treat pain and inflammation, organically based treatments may not have the severe side effects that radial treatments has (Table 2). The harsh side effects of pain and inflammation treatment are one motivating factor to finding alternative methods. The use of botanical when treating patients is considered a natural alternative, because some plants may contain properties that naturally have the ability to treat pain and inflammation. As in all medical testing, careful precautions and considerations are taken when studying the different plants that are known to treat pain and inflammation. Some examples of plants that may be used for pain and inflammation treatment are discussed. Some side effects are still expected, and it is important that any patient interested in exploring botanical treatment seek the advice of a licensed medical professional. Herbal medicine is an integral part of the development of modern civilization. In herbal medicine simple (Table 1) and compound drugs (plant based formulation) are prescribed to treat diseases. Preethi et al has reported the anti-inflammatory activity of flower extract of Calendula officinalis Linn. and its possible mechanism of action(Preethi et al, 2009). Raval et al has reported the analgesic effect of Lepidium sativum Linn. (Chandrashura) in experimental animals(Raval et al, 2010).

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Causes of chronic pain

Peripheral neuropathy e.g. diabetes mellitus

Neuroma, e.g. Morton metatarsalgia

Peripheral nerve entrapment, e.g. carpal and ulnar nerve tunnel syndrome Amputation stump syndrome

Causalgia

Nerve root trauma, e.g. by avulsion or stretching

Post herpetic neuralgia

Trigeminal neuralgia

Thalamic nucleus pain

Metastatic malignant deposits, e.g. from prostate or breast

Irremovable malignant infiltration, e.g. from advanced carcinoma of cervix Chronic visceral pain, e.g. chronic pancreatitis

Methods

A review of the literature published in scientific journals, books, thesiss and reports.

Acorus calamus L.

Family: Acoraceae

Parts used: Leaves and roots

Its local name is Bachh. Ahad et al has reported the analgesic and cytotoxic activity of Acorus calamus (Ahad et al, 2012).

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Linum usitatissimum

Family: Linaceae

Part used: Seeds

Flax seed has mucilaginous qualities which makes it good for all intestinal inflammations. A teaspoon of the powdered seed mixed in a cup of hot water or juice and taken three times a day will ease all ulcers and inflammations. The tea is good for coughs, asthma and pleurisy. Mixed in poultices it is one of the best remedies for sores, boils, carbuncles, inflammations and tumors. Combine with slippery elm bark for a very effective poultice for boils, pimples, oozing sores and burns. It is excellent added to diets which are low in fiber. Kaithwas et al reported the analgesic aactivity of Linum usitatissimum L (Kaithwas et al, 2011).

Marrubium vulgare

Family: Lamiaceae

Parts used: Leaves

It increases the perspiration after taking the hot infusion. The infusion or tincture given cold is a bitter digestive tonic. In syrup it is a tonic and expectorant. It is effective for breaking up colds, bronchitis, bronchial catarrh, and it will expectorate mucus. It is very useful in chronic sore throats and pulmonary problems; use as a syrup for children. Meyre et al reported the analgesic activity of this plant (Meyre et al, 2005).

Verbena officinalis

Family: Verbenaceae

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Parts used: Leaves

Vervain is one of the palliatives for the onset of colds, flu, coughs and upper respiratory inflammations. It will promote sweating to allay fevers. Combine with boneset for fevers take ½ to 1 hot cup every hour. The tea will settle a nervous stomach and is good for insomnia. It is good for pneumonia, asthma and all other congestive chest diseases. The tea can also be applied to sores to increase healing. Drink the warm tea for pain or cramps in the stomach and bowels. Large amounts of it will act as an emetic. It is bitter and can be made more palatable if combined with lemon grass or peppermint and honey. Start with one teaspoonful when treating children and increase if needed; one tablespoon to 1 cup with adults. Calvo reported the analgesic activity of the topical preparation of Verbena officinalis (Calvo, 2006).

Commiphora myrrha

Family: Burseraceae

Part used: Gum resin

Myrrh gum is a powerful antiseptic. Goldenseal and myrrh in equal parts used in capsules or tea is a specific for intestinal ulcers, bad breath, catarrh of the intestines and all other mucus membrane conditions. The tincture added to water is an excellent mouth wash for spongy gums, pyorrhea and all throat diseases. Myrrh destroys putrification in the intestines and prevents blood absorption of toxins. It has been successful in treating chronic diarrhea, lung diseases and general body weaknesses. It is a good wash for wounds and skin diseases. Inject the tincture of myrrh in the sinuses for all sinus infections and inflammations. If the sinuses are too sensitive for the straight tincture,

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dilute it with water. The powder of myrrh can be applied to dry up moist skin conditions. Myrrh is best suited for all pus conditions both internally and externally as well as for mucus membrane problems. Su et al reported the analgesic activity of different extracts of this plant (Su et al, 2011).

Piper longum Linn.

Family: Piperaceae

Local name: Taboppi.

Part used: Leaves and roots

It is a climber with orbicular-ovate or ovate oblong leaves. Analgesic activities of Piper longum Linn have been reported (Vedhanayaki et al, 2003).

Sida rhombifolia Linn

Family: Malvanceae.

Local name: Uhaan.

Part used: Leaves

It is a wild, small under shrub. Decoction of the leaves promotes the flow of urine. Analgesic alkaloid from Sida cordifolia linn has been reported (Sutradhar et al, 2007).

Enhydra fluctuans

Family: Asteraceae

Local name: Komprek tujombi

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Decoction of the whole plant is used to treat various ailments. Fresh juice extract of the plant can also be used. Analgesic activity of Enhydra fluctuans has been reported (Rahman et al, 2002).

Abutilon indicum (L.)

Family: Malvaceae

Parts used: Seed and Leaves

It is used to treat diarrhea and vomiting. It is laxative, demulcent and diuretic. Analgesic principle from Abutilon indicum have been reported (Ahmed et al., 2000).

Clerodendrum viscosum

Family: Verbenaceae

Parts used: Leaf

It is used to treat dysentery, chest pain and tumor. Analgesic effects of saponin isolated from the leaves of Clerodendrum infortunatum Linn have been reported (Pal et al., 2009).

Holoptelea integrifolia

Family: Ulmaceae

Parts used: Bark

It is used to treat hydrocele. Analgesic activity of various extracts of Holoptelea integrifolia (Roxb.) Planch leaves has been reported (Rizwani et al., 2012).

Lawsonia inermis L.

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Family: Lythraceae

Parts used: Root and leaves

It is used to treat jaundice and leucorrhoea. Analgesic activities of Lawsonia inermis L. (henna) in rats have been reported (Ali et al., 1995).

Achyranthes bidentata

Family: Amaranthaceae

Parts used: Root.

Achyranthes species contain triterpenoid saponins. In traditional Chinese medicine, it is believed to invigorate blood flow. It is used to stimulate menstruation when a period is delayed or scanty. The herb is also prescribed to ease period pain. It is used to relieve pain in the lower back, especially when the discomfort is attributable to kidney stones. The herb is also taken as a treatment for mouth ulcers, tooth ache, bleeding gums and nose bleeds (Vetrichelvan et al., 2002).

Cannabis sativa

Family: Cannabaceae

It is a tall annual plant that attains an ultimate height of 5 m. The leaves are long narrow, margins toothed, with several leaflets, and arranged on the stem alternately. The plant is native to Central Asia and Himalaya. It is grown throughout India. Ordinary rich soil and sunny situation are suitable for these species. Plants are propagated by seeds. Mature leaves and flowing top of the female plants are used medically. The tincture of this plant and hemp extract is used for pharmaceutical preparation. This is used to treat depression,

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bladder inflammation, gonorrhea and nervous disorder. Analgesic activity of Cannabis sativa has been reported (Formukong et al., 1988).

Acorus calamus L.

Family: Acoraceae

It is an aromatic marshy herb with creeping root stocks. Leaves are distichous and ensiform. The species is found throughout India. In nature, it is seen in moist places between 1700-2500 m elevation at Arakot of Utter Kashi. In Kwashiorkor diseases of children, small pieces of roots are tied around the neck. The rhizomes are used as a carminative, stimulant and tonic. An essential oil is extracted from the rhizomes which is utilized in perfumery. Analgesic activity of Acorus calamus has been reported (Mohammad et al., 2012).

Table 1: Medicinal plants having analgesic activity

S. No. Plant name

Family

Reference

 

 

 

 

1.

Cussonia paniculata

Araliaceae

Adedapo et al, 2008

2.

Erigeron floribundus

Asteraceae

Asongalem et al, 2004

3.

Vitex Negundo

Lamiaceae

Dharmasiri et al, 2003

4.

Maytenus rigida

Celasteraceae

Dias et al, 2007

5.

Bauhinia racemosa

Fabaceae

Gupta et al, 2005

6.

Tragia involucrata Linn

Euphorbiaceae

Dhara et al, 2000

7.

Sida cardiafolia.

Malvaceae

Franzotti et al, 2002

8.

Elephantorrhiza elephantine

Mimosaceae

Maphosa et al, 2010

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9. Aloe ferox

Xanthorrhoeceae

Mwale et al, 2010

10.

Abutilon indicum

Malvaceae

Khan et al, 2000

11.

Cannabis indica

Cannabaceae

Khan et al, 2000

12.

Cissus quadrangularis

Vitaceae

Khan et al, 2000

13.

Desmodium gangeticum

Fabaceae

Khan et al, 2000

14.

Embelia ribes

Myrsinaceae

Khan et al, 2000

15.

Hedychium spicatum

Zingiberaceae

Khan et al, 2000

16.

Randia dumetorum

Rubiaceae

Khan et al, 2000

17.

Salvia haematodes

Lamiaceae

Khan et al, 2000

18.

Sisymbrium irio

Brassicaceae

Khan et al, 2000

19.

Solanum melongena

Solanaceae

Khan et al, 2000

20.

Stephania wightii

Menispermaceae

Khan et al, 2000

21.

Taxus baccata

Taxaceae

Khan et al, 2000

22.

Trianthema portulacastrum Aizocaea

Khan et al, 2000

Table 2: Side effects of commonly used analgesic drugs

Drug name

Side effects

Reference

 

 

 

Aspirin

Heartburn, indigestion,

Gumpel, 1978

 

stomach irritation, and mild

 

 

nausea or vomiting

 

 

 

 

Acetaminophen

Chronic use or higher

Issioui et al, 2002

 

dosages may damage the

 

 

liver and the kidneys

 

 

 

 

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Naproxen, and ketoprofen

Continuous use may irritate

Wollheim et al, 1978

 

stomach lining, long-term

 

 

high-dose use may damage

 

 

the liver and the kidneys

 

 

 

 

Conclusion

The present review demonstrates the analgesic of commonly used medicinal plants in Unani system of medicine. Efforts will be undertaken to continue the biologically guided fractions in order to isolate and identify the active ingredient as well as to understand the mechanism of inhibition. Since herbal products are globally used and the bio-active compounds isolated from these plants may work as bio-marker in variety of herbal formulations. These formulations may meet out the need of time against pain and inflammation

References

Adedapo AA, Sofidiya MO, Maphosa V, Moyo B, Masika PJ, Afolayan AJ (2008). Anti- inflammatory and analgesic activities of the aqueous extract of Cussonia paniculata stem Bark. Rec. Nat. Prod. 2(2): 46-53.

Ahad M, Torequl M (2012). Analgesic and cytotoxic activity of Acorus calamus L., Kigelia pinnata L., Mangifera indica L. and Tabernaemontana divaricata L, J Pharm Bioallied Sci;4(2): 149–154.

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Ahmed M, Amin S, Islam M, Takahashi M, Okuyama E, Hossain CF (2000). Analgesic principle from Abutilon indicum, Pharmazie; 55(4):314-316.

Ali BH, Bashir AK, Tanira MO (1995). Anti-inflammatory, antipyretic, and analgesic effects of Lawsonia inermis L. (henna) in rats, Pharmacology;51(6):356-363.

Asongalem EA, Foyet HS, Ngogang J, Folefoc GN, Dimo T, Kamtchouing P (2004). Analgesic and antiiflammatory activites of Erigeron floribundus J. Ethnopharmacol. 91: 301-308.

Calvo MI (2006). Anti-inflammatory and analgesic activity of the topical preparation of Verbena officinalis L, J Ethnopharmacol;107(3):380-382

Dhara AK, Suba V, Sen T, Pal S, Chaudhuri AKN (2000). Preliminary studies on the anti-inflammatory and analgesic activity of the methanol fraction of the root extract of Tragia involucrata Linn. J. Ethnopharmacol. 72: 265-268.

Dharmasiri JR, Jayakody AC, Galhena G, Liyanage SSP, Ratnasooriya WD (2003). Anti- inflammatory and analgesic activities of mature fresh leaves of Vitex negundo. J. Ethnopharmacol. 87: 199-206.

Dias KS, Marques MS, Menezes IAC, Santos TC, Silva ABL, Estevam CS, Sant'Ana AEG, Pizza C, Antoniolli ÂR, Marçal RM (2007). Antinociceptive activity of Maytenus rigida stem bark. Fitoterapia 78: 460-464.

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Formukong EA, Evans AT, Evans FJ (1988). Analgesic and antiinflammatory activity of constituents of Cannabis sativa L, Inflammation; 12(4):361-371.

Franzotti EM, Santos CVF, Rodriques HMSL, Mourao RHV, Andrade MR, Antoniolli AR (2002). Anti-inflammatory, analgesic, and acute toxicity study of Sida cardiafolia. J. Ethnopharmacol. 72: 273-278.

Gupta M, Mazunder UK, Sambath S, Kumbar R, Gomath P, Rajeshwar Y, Kakoti Y, Tamil BB, Selven V (2005). Anti-inflammatory, analgesic and antipyretic effects of methanol extract from Bauhina racemosa stem bark in animal models. J. Ethnopharmacol. 98: 267-273.

Gumpel J (1978). Incidence of gastric side effects in controlled trials with unbranded aspirin and with various long-acting aspirin preparations. Ann Rheum Dis; 37(4):389

Issioui T, Klein KW, White PF, Watcha MF, Coloma M, Skrivanek GD, Jones SB, Thornton KC, Marple BF (2002). The efficacy of premedication with celecoxib and acetaminophen in preventing pain after otolaryngologic surgery, Anesth Analg. ;94(5):1188-1193.

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Kaithwas G, Mukherjee A, Chaurasia AK, Majumdar DK (2011). Anti-inflammatory, analgesic and antipyretic activities of Linum usitatissimum L. (flaxseed/linseed) fixed oil, Indian J Exp Biol;49(12):932-938.

Khan Usmanghani (2000). Pharmacological activity present in different plants, Herbal Medicine Industry in Pakistan, 1st edi. Research Institute of Indusyunic Medicine, Pakistan, Karachi University Press, pp. 196-200.

Maphosa V, Masika PJ, Moyo B (2010). Investigation of the anti-inflammatory and antinociceptive activities of Elephantorrhiza elephantina (Burch.) Skeels root extract in male rats. Afr. J. Biotechnol. 8(24): 7068-7072.

Meyre C, Yunes RA, Schlemper V, Campos-Buzzi F, Cechinel-Filho V (2005). Analgesic potential of marrubiin derivatives, a bioactive diterpene present in Marrubium vulgare (Lamiaceae), Farmaco;60(4):321-326.

Mohammad A, Mohammad T (2012). Analgesic and cytotoxic activity of Acorus calamus L., Kigelia pinnata L., Mangifera indica L. and Tabernaemontana divaricata L, J Pharm Bioallied Sci; 4(2): 149–154.

Mwale M, Masika PJ (2010). Analgesic and anti-inflammatory activities of Aloe ferox Mill. aqueous extract. Afr. J. Pharmacy Pharmacol. 4(6): 291-297.

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Pal D, Sannigrahi S, Mazumder UK (2009). Analgesic and anticonvulsant effects of saponin isolated from the leaves of Clerodendrum infortunatum Linn. in mice, Indian J Exp Biol;47(9):743-747.

Preethi KC, Kuttan G, Kuttan R (2009). Anti-inflammatory activity of flower extract of Calendula officinalis Linn. and its possible mechanism of action, Indian J Exp Biol;47(2):113-120.

Rahman MT, Begum N, Alimuzzaman M, Khan MO (2002). Analgesic activity of Enhydra fluctuans, Fitoterapia;73(7-8):707-709.

Raval ND, Ravishankar B (2010). Analgesic effect of Lepidium sativum Linn. (Chandrashura) in experimental animals, Ayu;;31(3):371-373.

Rizwani GH, Mahmud S, Shareef H, Perveen R, Ahmed M (2012). Analgesic activity of various extracts of Holoptelea integrifolia (Roxb.) Planch leaves, Pak J Pharm Sci; 25(3):629-632.

Su S, Wang T, Duan JA, Zhou W, Hua YQ, Tang YP, Yu L, Qian DW (2011). Anti- inflammatory and analgesic activity of different extracts of Commiphora myrrha, J Ethnopharmacol;134(2):251-258

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Sutradhar RK, Rahman AM, Ahmad M, Bachar SC, Saha A, Roy TG (2007). Anti- inflammatory and analgesic alkaloid from Sida cordifolia linn, Pak J Pharm Sci;20(3):185-188.

Vedhanayaki G, Shastri GV, Kuruvilla A (2003). Analgesic activity of Piper longum Linn. root, Indian J Exp Biol;41(6):649-651.

Vetrichelvan T, Jegadeesan M (2002). Evaluation of analgesic, anticonvulsant locomotor activities of alcoholic extract achyranthes bidentata blume in mice, Anc Sci Life;22(1): 17–27.

Wollheim FA, Lindroth Y, Sjöblom KG (1978). A comparison of ketoprofen and naproxen in rheumatoid arthritis. Rheumatol Rehabil, 78-83.

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