Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
CNS Drugs. 2017 Oct;31(10):867-889. doi: 10.1007/s40263-017-0466-4.
Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disorder of the central nervous system (CNS) that can cause cognition, mobility, and sensory impairments. It is considered one of the most common non-traumatic causes of disability in the world. The aim of the present article was to review the clinical evidence related to medicinal plants in the management of MS symptoms. Electronic databases, including the Cochrane Library, Pubmed, and Scopus, were searched for entries from 1966 to February 2017. Only clinical studies were included in this review. Different medicinal plants have positive effects on MS, including Andrographis paniculata, Boswellia papyrifera, Ruta graveolens, Vaccinium spp., Camellia sinensis, Panax ginseng, Aloysia citrodora, Ginkgo biloba, Oenothera biennis, and Cannabis sativa. C. sativa had the highest level of clinical evidence, supporting its efficacy in MS symptoms. Proanthocyanidins, ginkgo flavone glycosides, ginsenosides, epigallocatechin-3-gallate, cannabinoids (including delta-9-tetrahydrocannabinol and cannabidiol), boswellic acid, and andrographolide were presented as the main bioactive components of medicinal plants with therapeutic benefits in MS. The main complications of MS in which natural drugs were effective include spasticity, fatigue, scotoma, incontinence, urinary urgency, nocturia, memory performance, functional performance, and tremor. Herbal medicines were mostly well tolerated, and the adverse effects were limited to mild to moderate. Further well-designed human studies with a large sample size and longer follow-up period are recommended to confirm the role of medicinal plants and their metabolites in the management of MS.
多发性硬化症（MS）是一种中枢神经系统（CNS）的慢性炎症性脱髓鞘疾病，可导致认知、运动和感觉功能障碍。它被认为是世界上最常见的非外伤性残疾原因之一。本文旨在综述与药用植物治疗多发性硬化症相关的临床证据。电子数据库，包括 Cochrane 图书馆、Pubmed 和 Scopus，对 1966 年至 2017 年 2 月的文献进行了检索。本综述仅纳入了临床研究。不同的药用植物对多发性硬化症有积极的影响，包括穿心莲、乳香、芸香、越橘属、茶树、人参、香桃木、银杏、月见草和大麻。大麻的临床证据水平最高，支持其在多发性硬化症症状治疗中的疗效。原花青素、银杏黄酮糖苷、人参皂苷、表没食子儿茶素-3-没食子酸酯、大麻素（包括Δ9-四氢大麻酚和大麻二酚）、乳香酸和穿心莲内酯被认为是具有治疗多发性硬化症益处的药用植物的主要生物活性成分。天然药物对多发性硬化症的主要并发症有效，包括痉挛、疲劳、弱视、失禁、尿急、夜尿、记忆表现、功能表现和震颤。草药大多耐受性良好，不良反应仅限于轻度至中度。建议进行更多设计良好的、具有较大样本量和更长随访期的人类研究，以确认药用植物及其代谢物在多发性硬化症管理中的作用。
