Monthly Archives: August 2012

PANAX GINSENG

PANAX GINSENG

Panax ginseng is used for improving thinking, concentration, memory and work efficiency, physical stamina, and athletic endurance.Some people use Panax ginseng to help them cope with stress and as a general tonic for improving well-being. They sometimes call Panax ginseng an “adaptogen” when it’s used in this way.

Panax ginseng is also used for depression, anxiety, chronic fatigue syndrome (CFS), for boosting the immune system, and for fighting particular infections in a lung disease called cystic fibrosis. These infections are caused by a bacterium named Pseudomonas.

Some people use Panax ginseng to treat breast cancer and prevent ovarian cancer, liver cancer, lung cancer, and skin cancer.

Other uses include treatment of anemia, diabetes, inflammation of the stomach lining (gastritis), fever, hangover, and asthma.

Panax ginseng is also used for bleeding disorders, loss of appetite, vomiting, intestinal problems, fibromyalgia, sleeping problems (insomnia), nerve pain, joint pain, dizziness, headache, convulsions, disorders of pregnancy and childbirth, hot flashes due to menopause, and to slow the aging process.

Some men use Panax ginseng on the skin of the penis as part of a multi-ingredient product for treating early orgasm (premature ejaculation). Men also use it for erectile dysfunction (ED). There is some evidence that Panax ginseng is effective for these uses.

In manufacturing, Panax ginseng is used to make soaps, cosmetics, and as a flavoring in beverages.

Ginseng has been used as a medicine for over two thousand years. Today, approximately 6 million Americans use it regularly.

In Western medicine, Panax ginseng is used as a stimulant to make people more active. But, in contrast, in Traditional Chinese Medicine (TCM), Panax ginseng is used to make people feel calmer. It is also widely used in China for the heart and blood vessels. Higher doses are generally used in TCM than in Western medicine.

Be aware that Panax ginseng products are not always what they claim. The contents of products labeled as containing Panax ginseng can vary greatly. Many contain little or no Panax ginseng.

Panax ginseng interacts with many prescription drugs. See the section below titled “Are there any interactions with medications?” If you take medications, talk to your healthcare provider before taking Panax ginseng.

Etymology

The English word ginseng derives from the Chinese term rénshēn (simplified: 人参; traditional: 人蔘). Rén means “man” and shēn means a kind of herb; this refers to the root’s characteristic forked shape, which resembles the legs of a man. The English pronunciation derives from a southern Chinese reading, similar to Cantonese yun sum (Jyutping: jan4sam1) and the Hokkien pronunciation “jîn-sim”.
The botanical/genus name Panax means “all-heal” in Greek, sharing the same origin as “panacea”, and was applied to this genus because Linnaeus was aware of its wide use in Chinese medicine as a muscle relaxant.
Besides Panax ginseng, there are many other plants which are also known as or mistaken for the ginseng root. The most commonly known examples are Xiyangshen, also known as American Ginseng 西洋参 (Panax quinquefolius), Japanese ginseng 东洋参 (Panax japonicus), crown prince ginseng 太子參 (Pseudostellaria heterophylla), and Siberian ginseng 刺五加 (Eleutherococcus senticosus). Although all have the name ginseng, each plant has distinctively different functions. However, true ginseng plants belong to the Panax genus.

How effective is it?

Natural Medicines Comprehensive Databaserates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.The effectiveness ratings for GINSENG, PANAX are as follows:

Possibly effective for…

  • Thinking and memory. Taking Panax ginseng by mouth might improve abstract thinking, mental arithmetic skills, and reaction times in healthy, middle-aged people. Panax ginseng alone does not seem to improve memory, but there is some evidence that a combination of Panax ginseng and ginkgo leaf extract can improve memory in otherwise healthy people between the ages of 38 and 66.
  • Diabetes. There is some evidence that Panax ginseng might lower fasting blood sugar in people with type 2 diabetes.
  • Male impotence (erectile dysfunction, ED). Taking Panax ginseng by mouth seems to improve sexual function in men with ED.
  • Premature ejaculation (reaching orgasm too early) when a cream containing ginseng and other ingredients is applied directly to the skin of the penis.

Possibly ineffective for…

  • Improving athletic performance.
  • Improving mood and sense of well-being.
  • Hot flashes associated with menopause. Taking Panax ginseng by mouth doesn’t seem to help hot flashes but it might improve other menopausal symptoms such as fatigue, insomnia, and depression.

Insufficient evidence to rate effectiveness for…

  • Breast cancer. Some studies conducted in China suggest that some people with breast cancer treated with any form of ginseng (American or Panax) do better and feel better. But this may not be a result of taking the ginseng, because the people in the study were also more likely to be treated with the prescription cancer drug tamoxifen. It is difficult to know how much of the benefit to attribute to ginseng.
  • Infection of the airways in the lung (bronchitis). Panax ginseng, combined with treatment with antibiotics, might be more effective in killing bacteria that antibiotic treatment alone.
  • Common cold. There is some evidence that taking a specific Panax ginseng extract (G115) by mouth can decrease the chance of catching a cold.
  • Influenza. There is some evidence that taking a specific Panax ginseng extract (G115) by mouth four weeks before a flu shot and continued for eight more weeks can decrease the risk of getting the flu.
  • Cancer (stomach, lung, liver, ovarian, skin). Population studies suggest that taking ginseng by mouth might decrease the occurrence of cancer, specifically stomach cancer, lung cancer, liver cancer, ovarian cancer, and skin cancer.
  • Depression.
  • Anemia.
  • Fluid retention.
  • Stomach inflammation and other digestive problems.
  • Chronic fatigue syndrome (CFS).
  • Fibromyalgia.
  • Fever.
  • Other conditions.

More evidence is needed to rate Panax ginseng for these uses.

How does it work?

 

Panax ginseng contains many active substances. The substances thought to be most important are called ginsenosides or panaxosides. Ginsenosides is the term coined by Asian researchers, and the term panaxosides was chosen by early Russian researchers.

Panax ginseng is often referred to as a general well-being medication, because it affects many different systems of the body.

Are there safety concerns?

 

Panax ginseng is POSSIBLY SAFE when taken by mouth for most adults when used for less than 3 months. It is POSSIBLY UNSAFEwhen taken long-term. Researchers think it may have some hormone-like effects that could be harmful with prolonged use.

Side effects

A common side effect of P. ginseng’s may be insomnia, but this effect is disputed. Other side effects can include nausea, diarrhea, headaches, nose bleeds, high blood pressure, low blood pressure, and breast pain. Ginseng may also lead to induction of mania in depressed patients who mix it with antidepressants.
Ginseng has been shown to have adverse drug reactions with phenelzine and warfarin, but has been shown to decrease blood alcohol levels.

A cream (SS-Cream) containing Panax ginseng and other ingredients for reaching orgasm too quickly in men (premature ejaculation) seems to be safe when applied to the penis and removed after one hour. It might cause mild pain and irritation or a burning sensation. It is not known if this cream is safe with repeated, long-term use.

Special precautions & warnings:

Pregnancy and breast-feeding: Do not use Panax ginseng if you are pregnant. It is POSSIBLY UNSAFE. One of the chemicals in Panax ginseng has been found to cause birth defects in animals.

Not enough is known about the safety of Panax ginseng during breast-feeding. Stay on the safe side and don’t use it.

Infants and children: Panax ginseng is LIKELY UNSAFE in infants and children. Using Panax ginseng in babies has been linked to poisoning that can be fatal. The safety of Panax ginseng in older children is not known. Until more is known, don’t use Panax ginseng even in older children.

“Auto-immune diseases” such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Panax ginseng seems to increase the activity of the immune system. It might make auto-immune diseases worse. Don’t use Panax ginseng if you have any auto-immune condition.

Bleeding conditions: Ginseng seems to interfere with blood clotting. Don’t use Panax ginseng if you have a bleeding condition.

Heart conditions: Panax ginseng can affect heart rhythm and blood pressure slightly on the first day it is used. However, there are usually no changes with continued use. Nevertheless, Panax ginseng has not been studied in people with cardiovascular disease. Use Panax ginseng with caution if you have heart disease.

Diabetes: Panax ginseng might lower blood sugar. In people with diabetes who are taking medications to lower blood sugar, adding Panax ginseng might lower it too much. Monitor your blood sugar closely if you have diabetes and use Panax ginseng.

Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Panax ginseng contains chemicals (ginsenosides) that can act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don’t use Panax ginseng.

Trouble sleeping (insomnia): High doses of Panax ginseng have been linked with insomnia. If you have trouble sleeping, use Panax ginseng with caution.

Schizophrenia (a mental disorder): High doses of Panax ginseng have been linked with sleep problems and agitation in people with schizophrenia. Be careful when using Panax ginseng if you have schizophrenia.

Organ transplant: Panax ginseng might make the immune system more active. This could interfere with the effectiveness of medications that are given after an organ transplant to reduce the chance that the organ will be rejected. If you have received an organ transplant, don’t use Panax ginseng.

Are there interactions with medications?

 

Moderate

Be cautious with this combination.
Alcohol
The body breaks down alcohol to get rid of it. Taking Panax ginseng might increase how fast your body gets rid of alcohol.
Caffeine
Caffeine can speed up the nervous system. By speeding up the nervous system, caffeine can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with caffeine might cause serious problems, including increased heart rate and high blood pressure. Avoid taking caffeine along with Panax ginseng.
Furosemide (Lasix)
Some scientists think that Panax ginseng might decrease how well furosemide (Lasix) works. But there isn’t enough information to know if this is a big concern.
Insulin
Panax ginseng might decrease blood sugar. Insulin is also used to decrease blood sugar. Taking Panax ginseng along with insulin might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your insulin might need to be changed.
Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Some medications are changed and broken down by the liver. Panax ginseng might decrease how quickly the liver breaks down some medications. Taking Panax ginseng along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking Panax ginseng, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

Medications for depression (MAOIs)
Panax ginseng might stimulate the body. Some medications used for depression can also stimulate the body. Taking Panax ginseng with these medications used for depression might cause too much stimulation. This might cause side effects such as anxiousness, headache, restlessness, and insomnia.

Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

Medications for diabetes (Antidiabetes drugs)
Panax ginseng might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking Panax ginseng along with diabetes medications could add to the effects of diabetic medications and lower blood sugar too much. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

Medications that decrease the immune system (Immunosuppressants)
Panax ginseng increases the immune system. By increasing the immune system, Panax ginseng might decrease the effectiveness of medications that decrease the immune system.

Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Panax ginseng might slow blood clotting. Taking Panax ginseng along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, cilostazol (Pletal), clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Stimulant drugs
Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with Panax ginseng.

Some stimulant drugs include diethylpropion (Tenuate), epinephrine, phentermine (Ionamin), pseudoephedrine (Sudafed), and many others.

Warfarin (Coumadin)
Warfarin (Coumadin) is used to slow blood clotting. There is some concern that Panax ginseng might decrease the effectiveness of warfarin (Coumadin). But it’s not clear if this interaction is a big problem. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Are there interactions with herbs and supplements?

 

Bitter orange
Taking Panax ginseng along with bitter orange might increase the risk of the type of irregular heart rhythm that can be life-threatening.
Country mallow
Country mallow contains ephedra. Ephedra can make the heart beat irregularly. Taking Panax ginseng along with country mallow might increase the risk of irregular heartbeats that can be life-threatening.
Ephedra
Ephedra can make the heart beat irregularly. Taking Panax ginseng along with ephedra might increase the risk of irregular heart beats that can be life-threatening.
Herbs and supplements that lower blood sugar
Panax ginseng might lower blood sugar. Taking Panax ginseng along with other herbs and supplements that lower blood sugar might make the blood sugar too low. Some of these products include bitter melon, ginger, goat’s rue, fenugreek, kudzu, willow bark, and others.

Are there interactions with foods?

 

Alcohol
The body breaks down alcohol to get rid of it. Taking Panax ginseng might increase how fast your body gets rid of alcohol.
Coffee, tea
Coffee and tea contain caffeine. Caffeine can speed up the nervous system. By speeding up the nervous system, caffeine can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with caffeine might cause serious problems including increased heart rate and high blood pressure. Avoid taking caffeine along with Panax ginseng.

What’s about dose?

BY MOUTH:

  • For treating type 2 diabetes: 200 mg daily.
  • For erectile dysfunction: Panax ginseng 900 mg three times daily.

APPLIED TO THE SKIN:

  • For premature ejaculation: a cream (SS-Cream) containing Panax ginseng and other ingredients has been applied to the glans penis one hour before intercourse and washed off before intercourse.

Other names

 

Asian Ginseng, Asiatic Ginseng, Chinese Ginseng, Chinese Red Ginseng, Ginseng, Ginseng Asiatique, Ginseng Blanc, Ginseng Blanc de Corée, Ginseng Chinois, Ginseng Coréen, Ginseng Coréen Rouge, Ginseng de Corée, Ginseng Japonais, Ginseng Oriental, Ginseng Panax, Ginseng Radix Alba, Ginseng Root, Ginseng Rouge, Ginseng Sino-coréen, Ginseng Tibétain, Guigai, Hong Shen, Japanese Ginseng, Jen-Shen, Jinsao, Jintsam, Insam, Korean Ginseng, Korean Panax, Korean Panax Ginseng, Korean Red Ginseng, Korean White Ginseng, Mandragore de Chine, Ninjin, Ninzin, Oriental Ginseng, Panax Coréen, Panax Ginseng Blanc, Panax schinseng, Racine de Vie, Radix Ginseng Rubra, Red Chinese Ginseng, Red Ginseng, Red Kirin Ginseng, Red Korean Ginseng, Red Panax Ginseng, Ren Shen, Renshen, Renxian, Sang, Seng, Sheng Shai Shen, Tibetan Ginseng, White Ginseng, White Panax Ginseng.

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Ashwagandha (Withania somnifera)

Ashwagandha (Withania Somnifera) :

Latin Name
Withania somnifera (Physalis flexuosa L., Physalis somnifera L.)
Sanskrit Name
Hayagandha, Vajigandha
English Name
Winter Cherry and Indian Ginseng
Common Name
Asgandh, Angarberu, Hiremaddina-gida, Amukkuram, Amukkaramkizangu, Pennerugadda
Ayurvedic Properties and Action:
Rasa
Tikta, Kasaya
Guna
Laghu
Virya
Usna
Vipaka
Madhura
Karma
Rasayana, Vatakaphapaha, Balya, Vajikarana

Phytochemistry:
It contains various alkaloids such as withanine, somniferine, somnine, somniferinine, withananine, pseudo-withanine, tropine, pseudo-tropine, Tropanol, 3-a-gloyloxytropane, choline, cuscohygrine, isopelletierine, anaferine and anahydrine. It also contains glycoside such as acyl steryl glucoside viz. Sitoindoside VII and sitoindoside VIII Majority of the constituents are withanolides (Steroidal lactones with ergostane skeleton) and alkaloids. These include Withanone, Withaferin A, Withanolide I, II, III, A, D, E, F, G, H, I, J, K, L, M, WS-I, P and S, withasomidienone, withanolide C.

The free amino acids include aspartic acid, glycine, tyrosine, alanine, valine, proline, hydroxyproline, tryptophan, glutamic acid, cysteine and cystine and Iron.

Withania somnifera (L.) Dunal important components


Pharmacological Actions:
Adaptogenic, nervine sedative, CNS depressant, hepatoprotective, antistress and GABA mimetic, anti-stress, immune system stimulants, antioxidant, antibacterial, antibiotic, astringent, deobstruent, tonic, stimulates the central nervous system, antihepatotoxic, antiinflammatory and antimicrobial.

Medicinal Use:
It acts mainly on the nervous systems, having a rejunative effect on the body and is used to improve vitality and aid recovery after chronic illness .

It is an aphrodisiac and stimulant, and used for impotence, in general debility, nervous exhaustion, loss of muscular energy and spermatorrhoea.

It is used to tone the uterus after a miscarriage, in treating post-partum difficulties, infertility, strengthening the female reproductive system, renowned as a blood tonic, is especially beneficial in gynecology for deficient blood conditions, anemia and irregular menstruation.

It is used as an antiinflammatory drug for swellings, tumours, scrofula arthritis and rheumatism; and as a sedative and hypnotic in anxiety neurosis.

It is used to treat anorexia, nervous exhaustion, senile debility, aging, insomnia, epilepsy, rheumatism, wasting diseases, memory loss, and multiple sclerosis, improvement of mental functions.


Clinical / experimental study:
Studies indicate WS may be useful as a growth promoter and Haematinic and as a general health tonic in growing children, in younger as well as in older populations.

Isolated constituents of Withania somnifera (Sitoindosides VII-X and withaferin-A) increased cortical muscarinic acetylcholine receptor capacity, partly explaining the cognition-enhancing and memory-improving effects traditionally attributed to Ashvagandha.

Withanolide-A is significantly regenerate both axons and dendrites, in addition it reconstruct pre and post synapses in the neurons so useful for therapeutic treatment of neurodegenerative disease as it is able to reconstruct neural networks.

Root extract of WS was tested for immunomodulatory effects in three myelosuppression models in mice: cyclophosphamide, azathioprin, or prednisolone. Significant increases (p<0.05) in hemoglobin concentration, red blood cell count, white blood cell count, platelet count, and body weight were observed in WS-treated mice compared to untreated control mice. The authors also reported significant increases in hemolytic antibody responses toward human erythrocytes which indicated immunostimulatory activity.

Ashwagandha is also useful for strengthening the female reproductive system for which it is commonly combined with another Ayurvedic herb called shatavari (Asparagus racemosa), renowned as a blood tonic, is especially beneficial in gynecology for deficient blood conditions, anemia and irregular menstruation. The uniqueness of Ashwagandha is that it achieves its results through strengthening the nervous system and potentiates reproductive hormones.

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Adusi (Adhatoda Vasika)

Adusi (Adhatoda Vasika) 
Latin Name
Adhatoda vasica, A. zeylanica, Justicia adhatoda
Sanskrit Name
Vrsa, Atarusa, Vasaka
English Name
Vasaka
Common Name
Titabahak, Bahak, Vachaka, Baksa, Ardusi, Aduss, Atarusha, Vasa, Atalotakam
Ayurvedic Properties and Action:
Rasa
Tikta, Kasaya
Guna
Laghu
Virya
Sita
Vipaka
Katu
Karma
Hrdya, Kaphapittahara, Raktasangrahika, Kasaghna.

Phytochemistry:
The chief quinazoline alkaloid vasicine is reported in all parts of the plant.
It also contains vasicinine and arachidic, behenic, cerotic, lignoceric, linoleic and oleic acids, ether alkaloids vasicol, adhatodine, vasicinone, vasicinol and vasicinolone.

Pharmacological Actions:
It is expectorant, bronchodilator, antiasthmatic, antispasmodic and febrifuge.
Vasicine is a bitter bronchodilator, respiratory stimulant and hypotensive.

Medicinal Use:
It is used in bronchial, asthmatic and pulmonary affections.
Have mucolytic, mucokinetics and is extensively used for treating cold, cough, whooping cough and chronic bronchitis, asthma and as mild expectorant.

Vasaka (Vasicine) has mucokinetics (Expectorant) and mucolytic properties.
It is used externally in inflammatory swelling, neuralgias, scabies and other skin complaints.

Clinical / experimental study:

Skin
An extract of the leaves showed significant antifungal activity against ringworm.

Bronchodilatory activity
An aqueous solution of vasicinone hydrochloride was found to potentiate the bronchodilatory activity of aminophylline, also that of soprenaline.
Vasicinone exhibited smoothmuscle-relaxant properties of airways.

Alkaloids present in the plant showed significant protection against allergin-induced bronchial obstruction. Adhatoda vasica reduced ovalbumin and PAF-induced allergic reaction. A fraction containing the minor alkaloid Vasicinol and about 20% Vasicine inhibited ovalbumin-induced allergic reaction by about 37% at a concentration of 5 gm.

Antitussive effect
The antitussive activity of Adhatoda vasica (AV) extract was evaluated in anaesthetized guinea pigs and rabbits and in unanaesthetized guinea pigs. AV was shown to have a good antitussive activity.

Intravenously, it was 1/20-1/40 as active as codeine on mechanically and electrically induced coughing in rabbits and guinea-pigs. After oral administration to the guinea-pig the antitussive activity of AV was similar to codeine against coughing induced by irritant aerosols.

Results from animal studies show that Adhatoda vasica extract considerable antitussive activity when administered orally and is comparable to codeine when cough is due to irritant stimuli. The antitussive activity may be due to the action of vasicinone and vasicinol, which have activity in the cerebral medulla.

Bronchodilator and Anti-Asthmatic activity
Clinical trials of drugs containing vasicine and vasicinone have not revealed any side effects while treating bronchial asthma.

According to a 2002 review, both Vasicine and vasicinone possess in vitro and in vivo bronchodilatory activity and inhibit allergen-induced bronchial obstruction in a manner comparable to that of sodium cromoglycate.

Antispasmodic
The essential oil from the leaves has been shown to exert antispasmodic action on guinea pig tracheal chain.

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Arjuna : Terminalia arjuna

Ayurvedic Properties and Action:
Rasa
Kasaya
Guna
Ruksa
Virya
Sita
Vipaka
Katu
Karma
Bhagnasandhanakara, Hrdya, Kaphahara, Pittahara, Vrananasana, Vyanga Hara

Phytochemistry:
The bark extract contains acids (arjunolic acid, terminic acid), glycosides (arjunetin, arjunosides I–IV), and strong antioxidants—flavones, tannins, oligomeric proanthocyanidins2. It also contains alicyclic, amino acids and polyols, Triterpenoid saponins (arjunic acid, arjunolic acid, arjungenin, arjunglycosides), Flavonoids (arjunone, arjunolone, luteolin), Gallic acid, ellagic acid, Oligomeric proanthocyanidins (OPCs), Phytosterols (b-sitosterol), calcium, magnesium, zinc, and copper.

Pharmacological Actions:
It is cardio protective, anti-anginal, spasmogenic, antifungal, antibacterial, hepatoprotective, astringent, tonic, deobstruent, and cardiotonic.

Medicinal Use:
It is useful in cardiac disorder, excessive perspiration, fatigue, inflammation, cirrhosis of liver and hypertension.

It is used as a cardioprotective and cardiotonic in angina and poor coronary circulation; as a diuretic in cirrhosis of liver and for symptomatic relief in hypertension.

The Ayurvedic Pharmacopoeia of India recommends the powder of the stembark in emaciation, chest diseases, cardiac disorders, lipid imbalances and polyuria.


Clinical / experimental study:
Several studies have been made to assess the efficacy of Terminalia Arjuna bark in cardiac disorders. Decoction of bark powered was found more useful in hypertensive heart disease as compared to congestive heart failure. Alcoholic decoction of bark was found to be beneficial in stable cases of ischemic heart disease. Prolonged use of this drug brought sense of well being in patients and increased euglobulin lysis time and prothrombin time. The drug also showed electrocardiographic improvement.A particular patient, an adult male who developed Stokes-Adams attacks following acute chest pain, became well after three months use of crude powder of Terminalia Arjuna. In another study 500 mg crude drug powder of Terminalia Arjuna was administered in 30 stable angina pectoris patients. The drug was found to be effective in alleviating angina pain. It was also noted to be useful in cases of ischemic heart diseases associated with rhythm disturbances, particularly premature beats. The drug was found to be beneficial in modifying various known coronary risk factors like obesity, hypertension, hyperglycemia and circulating catecholamine in these patients. No significant side effects were observed in these patients.A clinical trial was taken on 51 patient of coronary heart disease to assess the effect of Terminalia Arjuna. The studies revealed statistically significant positive results. Reduction in systolic and diastolic blood pressure, pulse rate, erum cholesterol and HDL and LDL cholesterol was noticed.The bark given to (58 male) patients with stable angina with provocable ischemia on treadmill exercise, led to improvement in clinical and treadmill exercise parameters as compared to placebo therapy. These benefits were similar to those observed with isosorbide mononitrate.Arjunolic acid exhibited significant cardiac protection in isoproterenol induced myocardial necrosis in rats.
A study demonstrated that the alcoholic extract of Terminalia arjuna bark augmented endogenous antioxidant compounds of the rat heart and prevented from isoproterenol-induced myocardial ischemic reperfusion injury.

Cardiac lipid peroxidation in male Wistar rats was reduced by 38.8% in a study based on aqueous freeze-dried extract of the bark.

Oral administration of bark powder for 10 days produced significant increase in circulating histamine, a little increase in 5-HT, catecholamines and HDL cholesterol, and decrease in total lipid, triglycerides and total cholesterol in normal rats.


Cardiovascular
Experiments in rats with T. arjuna and extracted arjunolic acid have demonstrated an antiplatelet and anticoagulant action similar to that of acetylsalicylic acid.
In dogs, T. arjuna bark extract caused dose-dependent hypotension, suggesting adrenergic beta-2 receptor agonist activity.

Clinical studies have been conducted in coronary heart disease using T. arjuna bark extract at doses of 500 mg every 8 hours. Statistically significant reduction in angina and improved diastolic function was shown in patients with ischemic mitral regurgitation at 1 and 3 months with T. arjuna11. Effects similar to treatment with isosorbide mononitrate 40 mg daily were demonstrated in patients with chronic stable angina given T. arjuna bark extract. Reduction in the frequency of angina and improved treadmill exercise test parameters were shown.

Brachial artery endothelial dysfunction was improved after 2 weeks of T. arjuna bark extract versus placebo in young male smokers.
A reduction in cholesterol in humans has also been reported with T. arjuna bark extract at a dosage of 500 mg daily.

In clinical trials and animal experiments, T. arjuna exhibited hepatoprotective effects.

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