Yazbek P B, Tezoto J, Cassas F, Rodrigues E
Center for Ethnobotanical and Ethnopharmacological Studies-Institute of Environmental Sciences, Chemical and Pharmaceutical, Universidade Federal de São Paulo, Brazil.
Center for Ethnobotanical and Ethnopharmacological Studies-Institute of Environmental Sciences, Chemical and Pharmaceutical, Universidade Federal de São Paulo, Brazil.
J Ethnopharmacol. 2016 Feb 17;179:310-31. doi: 10.1016/j.jep.2015.12.054. Epub 2015 Dec 28.
For innumerous clinical cases related to women's health and precarious medical care in developing countries, a large repertoire of plants have been used as popular medicines in order to fill this gap, which in a certain way creates health risks to users, since pharmacological and toxicological tests are still insufficient to guarantee their efficacy and safety. Besides therapeutic use, abortive plants are broadly used in countries where abortion is prohibited, increasing that risk even more. In this way, ethnopharmacological studies that register plants used for women's health can contribute not only to the selection of potential bioactives, enriching the repertoire of drugs available to females, above all in public health systems, but also questioning the safety of products that are used without prescription.
This review aims at determining plants applied by Brazilian cultures in the treatment of conditions related to maternity, menstrual cycle and other women's health particularities, and to supplement the lack of epidemiological data available to assess the health of indigenous, rural and other populations of Brazilian women.
A literature review was conducted of the collection at the Ethnobotanical and Ethnopharmacological Center of the Federal University of São Paulo (period covered: 1965 to 2012). All of the 343 articles were consulted and 31 articles mentioning therapeutic uses of interest were selected. Relevant information was extracted to compose Table 1 - Maternity, Table 2 - Menstrual Cycle and Table 3 - Other Conditions. Data was statistically analyzed in order to generate the discussion about plants used in healing contexts by different Brazilian ethnicities. A bibliographic review was performed using the Scopus database to collect the following information about the most cited plants: ethnobotany/ethnopharmacology of non-Brazilian cultures for women's health conditions, pharmacology, toxicology, and adverse reactions.
A total of 319 species were cited for 22 indications related to women's health. Ninety-seven species were indicated for conditions related to maternity, 94 to the menstrual cycle and 232 to others. The same species could be present in more than one of these three categories. The most cited family was Fabaceae (13.5%), and the species were Ruta graveolens L. (1.76%) and Strychnos pseudoquina A. St.-Hil (1.76%). The most frequent part utilized, mode of preparation and route of administration were leaves (2.0%), tea (73.38%) and oral (87. 2%), respectively. The indications that showed the highest number of species were: to treat venereal diseases (69 species), abortive (54) and anti-inflammatory for the ovaries and/or uterus (54). According to our bibliographic survey, among the 19 most indicated species in this review, only four are also used by non-Brazilian cultures for conditions related to women's health; 25% of them were pharmacologically investigated and it was possible to validate their ethnopharmacological/ethnobotanical use, 10.5% have presented well-described adverse reactions and for 42.1% of these species toxicological studies were performed.
The survey raised important data about plants implemented in healing related to women's health conditions by Brazilian cultures and their practices. The compilation presented in this study enables the realization of further investigation regarding the development of herbal medicines and contributes to the incrementation of policies focused on these cultures. Further phytochemical, pharmacological and toxicological studies should be conducted, which will allow the discovery of pharmacological properties, bioactive constituents, and moreover, adequate posology, manner of use and adverse events.
在发展中国家,与女性健康和医疗条件不稳定相关的无数临床病例中,大量植物被用作民间药物以填补这一空白,这在一定程度上给使用者带来了健康风险,因为药理学和毒理学测试仍不足以保证其有效性和安全性。除治疗用途外,堕胎植物在禁止堕胎的国家也被广泛使用,这进一步增加了风险。这样,记录用于女性健康的植物的民族药理学研究不仅有助于选择潜在的生物活性成分,丰富女性可用药物的种类,尤其是在公共卫生系统中,还能对无处方使用产品的安全性提出质疑。
本综述旨在确定巴西文化中用于治疗与孕产妇、月经周期及其他女性健康特殊性相关病症的植物,并补充评估巴西土著、农村及其他女性群体健康状况的流行病学数据的不足。
对圣保罗联邦大学民族植物学和民族药理学中心的馆藏进行了文献综述(涵盖时间段:1965年至2012年)。查阅了所有343篇文章,挑选出31篇提及感兴趣治疗用途的文章。提取相关信息以编制表1 - 孕产妇、表2 - 月经周期和表3 - 其他病症。对数据进行统计分析,以便就不同巴西民族在治疗中使用的植物展开讨论。使用Scopus数据库进行文献综述,以收集以下关于引用最多的植物的信息:非巴西文化用于女性健康状况的民族植物学/民族药理学、药理学、毒理学及不良反应。
共引用了319种植物用于22种与女性健康相关的适应症。97种植物用于与孕产妇相关的病症,94种用于月经周期相关病症,232种用于其他病症。同一植物可能出现在这三个类别中的多个类别中。引用最多的科是豆科(13.5%),植物物种是芸香(1.76%)和假奎宁马钱子(1.76%)。最常使用的部位、制备方式和给药途径分别是叶子(2.0%)、茶剂(73.38%)和口服(87.2%)。显示植物种类最多的适应症是:治疗性病(69种)、堕胎(54种)以及卵巢和/或子宫抗炎(54种)。根据我们的文献调查,在本综述中最常提及的19种植物中,只有4种也被非巴西文化用于与女性健康相关的病症;其中25%进行了药理学研究,并且有可能验证其民族药理学/民族植物学用途,10.5%有详细描述的不良反应,42.1%的这些植物进行了毒理学研究。
该调查收集了关于巴西文化在治疗与女性健康状况相关病症中使用的植物及其应用的重要数据。本研究中的汇编有助于进一步开展关于草药开发的调查,并有助于增加针对这些文化的政策。应进一步开展植物化学、药理学和毒理学研究,这将有助于发现药理特性、生物活性成分,此外,还有助于确定合适的剂量、使用方式和不良事件。