Abstract
Background: The aim of this study was to investigate and evaluate the efficacy of Rheum emodi in the management of primary dysmenorrhoea.
Methods: A randomized, single-blind, standard controlled trial compared efficacy of R. emodi against mefenamic acid on diagnosed subjects of primary dysmenorrhoea for three consecutive cycles. Experimental group (n=30) received capsules of R. emodi powder two times a day, two days before the expected date of menstruation, and continued first three days of menstruation, while control group (n=15) participants received mefenamic acid capsules three times a day on the same protocol. The primary outcome measures were reduced in severity and duration of pain, assessed by visual analogue scale (VAS) and verbal multidimensional scoring system (VMSS), and secondary outcome measures were overall improvement of dysmenorrhoea and improved in quality of life (QOL). Statistical analysis was done by repeated measures analysis of variance and Chi-square/Fisher Exact test.
Results: The menstrual pain was significantly decreased in both groups after three-cycle intervention. Significant changes were observed in VAS (p<0.001) and VMSS (p<0.001) in the experimental group. There is a significant (p<0.001) reduction in duration of pain in both the groups. Associated symptoms and QOL were markedly improved after treatment (p<0.001).
Conclusions: It has been clear from the above result that R. emodi is an effective herb in alleviating symptoms of primary dysmenorrhoea. It can serve as an alternative treatment without any apparent side effects. These results deserve further investigations.
Acknowledgments
The authors are grateful to institutes’ Director Prof. Mansoor Ahmed Siddiqui for providing the facilities to carry out research.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report or in the decision to submit the report for publication.
References
1. DawoodYM. Primary dysmenorrhea advances in pathogenesis and management. Obstet Gynecol2006;108:428–41.10.1097/01.AOG.0000230214.26638.0cSuche in Google Scholar PubMed
2. DawoodYM. Dysmenorrhea. Glob. libr. Women’s med June 2008. Available at: http://www.glowm.com/section_view/heading/Dysmenorrhea/item/910.3843/GLOWM.10009Suche in Google Scholar
3. SchorgeJO, SchafferJI, HalvorsonLM, HoffmanBL, BradshawKD, CunninghamFG. Williams gynaecology. New York: McGraw Hill, 2008:257.Suche in Google Scholar
4. MontoyaJS, CabezzaAH, RojasOM, NavarreteandRC, KeeveMA. Menstrual disorders in adolescents. Bol Med Hosp Infant Mex2012;69:60–72.Suche in Google Scholar
5. HarelZ. Dysmenorrhea in adolescents and young adults: an update on pharmacological treatments and management strategies review. Expert Opin Pharmacother2012;13:2157–70.10.1517/14656566.2012.725045Suche in Google Scholar PubMed
6. OrtizMI. Primary dysmenorrhea among Mexican university students: prevalence, impact and treatment. EJOG2010;152:73–7.10.1016/j.ejogrb.2010.04.015Suche in Google Scholar PubMed
7. GaugaT, TkeshelashviliB, GaguaD. Primary dysmenorrhea leading problem of adolescent gynecology (review). Georgian Med News2012;207:7–13.Suche in Google Scholar
8. SinghA, KiranD, SinghH, NelB, SinghP, TiwarP. Prevalence and severity of dysmenorrhea: a problem related to menstruation, among first and second year female medical students. Indian J Physiol Pharmacol2008;52:389–97.Suche in Google Scholar
9. LakshmiA, SaraswathiI, SaravananA, RamamchandranC. Prevalence of premenstrual syndrome and dysmenorrhea among female medical students and its association with college absenteeism. Int J Biol Med Res2011;2:1011–16.Suche in Google Scholar
10. MarjoribanksJ, ProctorM, FarquharC, DerksRS. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev2010;1:CD001751.10.1002/14651858.CD001751.pub2Suche in Google Scholar PubMed
11. KumarP, Jeffcoate’sMN. Principles of gynecology. New Delhi: Jaypee Brothers Medical Publishers, 2008:617–24.Suche in Google Scholar
12. ZahradnikHP, Hanjalic-BeckA, GrothK. Non-steroidal anti-inflammatory drugs and hormonal contraceptives for pain relief from dysmenorrhea: a review. Contraception2010;8:185–96.10.1016/j.contraception.2009.09.014Suche in Google Scholar PubMed
13. KhanSK, ChampaneriaR, LatthePM. How effective are non-drug, non-surgical treatments for primary dysmenorrhoea?BMJ2012;344:e3011 [cited on 5/11/2012].10.1136/bmj.e3011Suche in Google Scholar PubMed
14. ProctorM, MurphyPA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Rev2009;2:CD002124.Suche in Google Scholar
15. RajkumarV, GuhaG, KumarRA. Antioxidant and anti-cancer potentials of Rheum emodi rhizome extract. Evid Based Complement Alternat Med2011;1–9.10.1093/ecam/neq048Suche in Google Scholar PubMed PubMed Central
16. RokayaMB, MunzbergovaZ, TimsinaB, BhattaraiKR. Rheum australe D. Don: a review of its botany, ethnobotany, phytochemistry and pharmacology. J Ethnopharmacol2012;141:761–74.10.1016/j.jep.2012.03.048Suche in Google Scholar PubMed
17. KaurA, KumarS, SharmaR. Assessment of anti-ulcer activity of Rheum emodi rhizomes extract. IGJPAI2012;2:333–41.10.35652/IGJPS.2012.38Suche in Google Scholar
18. AkhtarMS, AminM, AhmadM, AlamgeerA. Hepatoprotective effect of rheum emodi roots (revand chini) and akseer-e-jigar against paracetamol-induced hepatotoxicity in rats. Ethnobot Leaflets2009;13:310–15.Suche in Google Scholar
19. KausarF, RatherMA, GhaniBA, ZargarMA. Immune-enhancing effects of the herbal extract from Himalayan Rhubarb Rheum emodi Wall. Ex. Meissn. Food Chem2011;126:967–71.10.1016/j.foodchem.2010.11.103Suche in Google Scholar
20. DymockW, WardenCJ, HooperD. Pharmacographica indica. A history of the principal drugs of vegetable origin, Vol. III. New Delhi: Shrishti Book Distributors, 2005:153–7.Suche in Google Scholar
21. QinaY, WangaJ, KongaW, ZhaoaY, YangaH, DaiC, et al. the diarrhoeogenic and antidiarrhoeal bidirectional effects of rhubarb and its potential mechanism. J Ethnopharmacol2011;133:1096–102.10.1016/j.jep.2010.11.041Suche in Google Scholar
22. SinaI. Al Qanoon Fil Tib (Urdu trans. by Kantoori GH). New Delhi: Ejaz Publication House, 2010:447–8.Suche in Google Scholar
23. BaitarI. Jami al Mufradat al Advia wal Aghzia (Urdu translation), Vol. II. New Delhi: CCRUM, 2000:275–82.Suche in Google Scholar
24. KhanA. Al Akseer (Urdu trans. by Kabeeruddin), Vol. II. New Delhi: Ejaz Publishing House, 2003:1356–64.Suche in Google Scholar
25. AnderschB, MilsomI. An epidemiologic study of young women with dysmenorrhea. Am J Obstet Gynecol1982;144:655–60.10.1016/0002-9378(82)90433-1Suche in Google Scholar
26. LindhI, EllstromAA, MilsomI. The effect of combined oral contraceptives and age on dysmenorrhoea: an epidemiological study. Hum Reprod2012;27(3):676–82.10.1093/humrep/der417Suche in Google Scholar
27. KarunagodaK, ShuklaK (Upadhyaya), DongaS, TannaC, DeiLP. A comparative study of dashamoola taila matra basti and tila taila matra basti in kashtartava (dysmenorrhea). AYU2010;31:305–10.10.4103/0974-8520.77154Suche in Google Scholar
28. CowanP, KellyN. Quality of life scale: A measure for functioning of people with pain. American Chronic Pain Association 2003. Available at: http://www.theacpa.org/uploads/documents/Quality_of_Life_Scale.pdf Accessed:12 Jan 2013.Suche in Google Scholar
29. CharuS, AmitaR, SujoyR, ThomasGA. Menstrual characteristics’ and ‘prevalence and effects of dysmenorrhea’ on quality of life of medical students. IJCRIMPH2012;4:276–94.Suche in Google Scholar
30. RushdI. Kitabul kulliyat, 2nd ed. New Delhi: CCRUM, 1987:56, 114, 116, 226, 299.Suche in Google Scholar
31. KirmaniBN. Kulliyate Nafisi (Urdu trans. by Kabeeruddin). New Delhi: Aijaz Publication, 1934:118–20.Suche in Google Scholar
32. YeM, HanJ, ChenH, ZhengJ, GuoD. Analysis of phenolic compounds in rhubarbs using liquid chromatography coupled with electrospray ionization mass spectrometry. J Am Soc Mass Spectrom2007;18:82–91.10.1016/j.jasms.2006.08.009Suche in Google Scholar
33. MartinezJ, MorenoJJ. Effect of resveratrol, a natural polyphenolic compound, on reactive oxygen species and prostaglandin production. Biochem Pharmacol2000;59:865–70.10.1016/S0006-2952(99)00380-9Suche in Google Scholar
34. KimSJ, KimMC, LeeBJ, ParkDH, HongSH, UmJY. Anti-inflammatory activity of chrysophanol through the suppression of NF-κb/caspase-1 activation in vitro and in vivo. Molecules2010;15:6436–51.10.3390/molecules15096436Suche in Google Scholar
35. LiuC-H, JiangZ-Z, HuangX, WangC-F, DuanW-G, YaoJ-C. Cellular absorption of emodin influenced by anthraquinones in human intestinal caco-2cells. Chin J Nat Med2008;6:298–301.10.3724/SP.J.1009.2008.00298Suche in Google Scholar
36. GaoY, LiuH, DengL, ZhuG, XuC, LiG, et al. Effect of emodin on neuropathic pain transmission mediated by P2X2/3 receptor of primary sensory neurons. Brain Res Bull2011;84:406–13.10.1016/j.brainresbull.2011.01.017Suche in Google Scholar
37. HuangHC, LeeCR, ChaoPD, ChenCC, ChuSH. Vasorelaxant effect of emodin, an anthraquinone from a Chinese herb. Eur J Pharmacol1991;205:289–94.10.1016/0014-2999(91)90912-ASuche in Google Scholar
38. KounsarF, AfzalZM. Rheum emodi induces nitric oxide synthase activity in murine macrophages. Am J Biomed Sci2010;2:155–63.10.5099/aj100200155Suche in Google Scholar
39. WangaJ, KongaW, WangbH, ZhaoaH, XiaobH, DaiaC, et al. Toxic effects caused by rhubarb (Rheum palmatum L.) are reversed on immature and aged rats. J Ethnopharmacol2011;134:216–20.10.1016/j.jep.2010.12.008Suche in Google Scholar PubMed
40. FangaF, WangaJ, ZhaoaY, JinC, KongaW, ZhaocH, et al. A comparative study on the tissue distributions of rhubarb anthraquinones in normal and CCl4-injured rats orally administered rhubarb extract. J Ethnopharmacol2011;137:1492–7.10.1016/j.jep.2011.08.028Suche in Google Scholar PubMed
41. AlamMM, JavedK, JafriMA. Effect of Rheum emodi (Revand Hindi) on renal functions in rats. J Ethnopharmacol2005;96:121–5.10.1016/j.jep.2004.08.028Suche in Google Scholar PubMed
©2015 by De Gruyter
Artikel in diesem Heft
- Frontmatter
- Review
- An emphasis on molecular mechanisms of anti-inflammatory effects and glucocorticoid resistance
- Preclinical Studies
- Endothelium nitric oxide-independent vasorelaxant effects of the aqueous extract from Stephania abyssinica on the isolated rat thoracic aorta
- Evidence of attenuation of intestinal ischemia–reperfusion injury following pre-treatment with methanolic extracts from Chromolena odorata in rats
- Comparative effects of Orchis anatolica vs. the red Korean Panax ginseng treatments on testicular structure and function of adult male mice
- The Miaoyao Fanggan Sachets regulate humoral immunity and cellular immunity in mice
- Toxicological evaluation of the aqueous extract of Acalypha wilkesiana in Wistar albino rats
- Clinical Studies
- Tolerability of the combination of ginger (Zingiber officinalis), gentian (Gentiana lutea) and turmeric (Curcuma longa) in patients with cancer-associated anorexia
- Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial
- Integrating traditional medical practice with primary healthcare system in Eritrea
- Factors affecting the use of complementary and alternative medicine among Japanese university students
- Short Communication
- Complementary and alternative medicine in diabetes (CALMIND) – a prospective study
- Online Only: Congress Abstracts
- 2014 IN-CAM Research Symposium: The Next Wave of Complementary and Integrative Medicine and Health Care Research
Artikel in diesem Heft
- Frontmatter
- Review
- An emphasis on molecular mechanisms of anti-inflammatory effects and glucocorticoid resistance
- Preclinical Studies
- Endothelium nitric oxide-independent vasorelaxant effects of the aqueous extract from Stephania abyssinica on the isolated rat thoracic aorta
- Evidence of attenuation of intestinal ischemia–reperfusion injury following pre-treatment with methanolic extracts from Chromolena odorata in rats
- Comparative effects of Orchis anatolica vs. the red Korean Panax ginseng treatments on testicular structure and function of adult male mice
- The Miaoyao Fanggan Sachets regulate humoral immunity and cellular immunity in mice
- Toxicological evaluation of the aqueous extract of Acalypha wilkesiana in Wistar albino rats
- Clinical Studies
- Tolerability of the combination of ginger (Zingiber officinalis), gentian (Gentiana lutea) and turmeric (Curcuma longa) in patients with cancer-associated anorexia
- Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial
- Integrating traditional medical practice with primary healthcare system in Eritrea
- Factors affecting the use of complementary and alternative medicine among Japanese university students
- Short Communication
- Complementary and alternative medicine in diabetes (CALMIND) – a prospective study
- Online Only: Congress Abstracts
- 2014 IN-CAM Research Symposium: The Next Wave of Complementary and Integrative Medicine and Health Care Research