Volume 203, 5 May 2017, Pages 55–68
Abstract
Ethanopharmacological relevance
The
process of formation or appearance of a urinary stone anywhere in the
renal tract is known as urolithiasis. It is a longstanding health
problem, known to exist since early age of civilization. Records about
symptoms, signs and treatment strategies of urinary stones diseases are
found in the several ancient texts of traditional medicines such as
Ayurveda, Traditional Chinese Medicine (TCM), Siddha and Unani. In
Ayurveda, urolithiasis has been considered as one of the eight most
troublesome diseases. Ayurvedic management and cure of urinary stone
involves herbal formulas, alkaline liquids and surgical procedures.
Whereas, TCM recommends polyherbal drugs, acupuncture and mexibustion
for treatment of the urinary stones. Among these therapies, herbal
remedies are in practice till today for the treatment and cure urinary
stone diseases.
Materials and methods
A
comprehensive review of the scientific literature about pathophysiology
of urinary stones and antiurolithiatic plants was undertaken using the
following bibliographic databases: MEDLINE/PubMed, Scopus, Web of
Knowledge and Google Scholar. The search was conducted from publications
from all years until Dec., 2015 by combination of the search terms and
Boolean operators; ‘urinary stone’ OR ‘kidney stone’ AND ‘plant’ OR
‘medicine’ OR ‘antiurolithiatic plants’. Outputs were restricted to
those completed studies only published in English. In this review,
literatures about plants which are used as diuretic and/or in treatment
urinary tract infections have not also been considered. The Plant List
and Royal Botanical Garden, Kew databases were used to authenticate
botanical names of plants. Books and monographs published in English
were used to collect information about historical records of
antiurolithiatic plants.
Results
Recent
pharmacological interventions accredited ancient antiurolithiatic
claims to several plants and their formulations. The majority of
antiurolithiatic plants were found to either dissolve the stones or
inhibit the process of urinary stone formation. Plants such as Phyllanthus niruri L. and Elymus repens
(L.) Gould, as well as herbal products including ‘Wu-Ling-San’ formula,
‘Cystone’ and ‘Herbmed’ have been proved their utility as promising
antiurolithiatic medicines in the different phases of clinical trials.
In addition, some of the isolated phytochemicals such as berberine,
lupeol, khelin, visnagin, 7-hydroxy-2′,4′,5′-trimethoxyisoflavone and
7-hydroxy-4′-methoxyisoflavone were reported to have potent
antiurolithiatic activity.
Conclusion
In
ancient medicinal texts, antiurolithiatic potential has been ascribed
to several plants and their formulations. Present scientific studies
provide scientific evidences for few of these claims however, they are
insufficient to establish many of these plants and herbal formulations
as therapeutic remedies for the treatment and management of urinary
stones. Conversely, findings of pre-clinical and clinical studies about
some plants and herbal formulations are promising, which underlines the
utility of herbal remedies as alternative medicines for the treatment
and management of urinary stones in the future.
Graphical abstract
Abbreviations
- b.w., body weight;
- CT, computerized tomography;
- ESWL, extracorporeal shock wave lithotripsy;
- GAG, glycosaminoglycans;
- i.p., intraperitoneal;
- PCNL, percutaneous nephrolithotomy;
- TCM, traditional Chinese medicine;
- URS, ureteroscopy
Keywords
- Alternative medicine;
- Ayurveda;
- Chinese medicine;
- Homeopathy;
- Plant remedies;
- Shiddha;
- Urinary stone;
- Urolithiasis;
- Unani
