J Ethnopharmacol. 2017 Apr 18;202:38-53. doi: 10.1016/j.jep.2017.03.002. Epub 2017 Mar 9.
- 1
- UMR 152 Pharmadev, Université de Toulouse, IRD, UPS, France. Electronic address: francois.chassagne@ird.fr.
- 2
- UMR 152 Pharmadev, Université de Toulouse, IRD, UPS, France. Electronic address: eric.deharo@ird.fr.
- 3
- Faculty of Medicine, University of Health Sciences, Phnom Penh, Cambodia. Electronic address: hieng_punley@yahoo.com.
- 4
- UMR 152 Pharmadev, Université de Toulouse, IRD, UPS, France. Electronic address: genevieve.bourdy@ird.fr.
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE:
Liver
disorders are a major health problem in Cambodia, where some patients
prefer to seek treatment from traditional healers. The aim of the study
was to document the knowledge and practices of these healers in four
Southern Cambodian provinces.
MATERIALS AND METHODS:
An
ethnopharmacological survey was carried out from September 2015 to
January 2016 in Cambodian urban and rural areas. Thirty-three Khmer
traditional healers (KTH) were interviewed using a semi-structured
questionnaire including socio-demographic data, healer's formation and
their professional practice conditions, perception of liver diseases
(types and causes of liver disorders, diagnostic methods and symptoms of
liver problems), dietary recommendations given to patients, and herbal
remedies used to treat them. For each medicinal plant mentioned in
herbal remedies, the local name, part of the plant, mode of preparation
and administration, and their properties, according to the healers, were
recorded. The plants mentioned by the traditional therapists were
collected and later identified by specialists.
RESULTS:
Different
types of liver disease are identified by the healers, and diagnosis was
mostly based on reading medical records, and by observing the yellow
discoloration of the skin and eyes. A total of 42 herbal remedies
including 83 medicinal plants
belonging to 40 families were mentioned for treating liver disorders.
The most predominant families were Leguminosae and Poaceae. Among the
plants reported, Cananga latifolia, Andrographis paniculata, Smilax aff.
glabra, Gomphrena celosioides, Passiflora foetida and Physalis minima
were the most cited species. A large part of the herbal remedies used
were multi-ingredient recipes, and were prepared mainly by a decoction
administered orally. Plants are combined in multi-ingredient recipes,
and selected on the basis of their properties (trocheak, psah, somrap mé
rok, ktchol) which originate from Khmer medical concepts. Most of the
plants used by healers have a wide ethnobotanical use for liver
disorders, and have been studied for their hepatoprotective activity and
related activities on the liver.
CONCLUSION:
In
the diagnosis and treatment of liver diseases, KTH have incorporated
biomedical concepts and new practices, which suggest that they could be
defined as neotraditional healers. Medicinal plants
constitute the core of traditional medicine practice by these healers,
and these plants play a very important role in the health care of people
with liver problems in Cambodia. Therefore, more attention should be
paid to the integration of healers in national health care programs for
the development of combined therapies. Furthermore, two plant species
(i.e. Cananga latifolia and Willughbeia edulis) were found to be widely
used for treating liver disorders in our survey, and should be studied
for their pharmacological potential for liver problems.
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