Research - Salix Alba / White Willow Bark
Clinical efficacy of an herbal mouth wash composed of Salix alba, Malva sylvestrais and Althaea officinalis in chronic periodontitis patients
- Mehrdad Radvara, 1, ,
- Amir Moeintaghavia, 1,
- Mohsen Tafaghodib,
- Habibollah Ghanbaria,
- Kazem Fatemic,
- Majid Reza Mokhtaric, ,
- Fahime Najafid,
- Zahra Hoseinipourd,
- Parisa Dastmalchid,
- Fateme Farazie
Abstract
BackgroundThe aim of this pilot study was to evaluate the adjunctive use of a herbal mouthwash consisting of Salix alba, Malva sylvestris and Althaea officinalis with scaling and root planing, compared with chlorhexidine (CHX) as a standard chemical mouthwash in the treatment of chronic periodontitis and gingivitis.
Materials and methodsIn the first part of this trial (study No 1) the clinical efficacy of a prepared herbal mouthwash was assessed in chronic periodontitis patients; in study No 2, the same mouthwash was assessed in gingivitis patients. In study No 1, 30 periodontitis patients were randomly selected and divided into three groups. Along with their scaling and root planing, group A received CHX as their mouthwash, group B received a herbal mouthwash and group C received a placebo mouthwash. Each of the groups were assessed for bleeding on probing, probing depth and clinical attachment level at baseline and 6 weeks after scaling and root planing plus 4 weeks usage of their bottle of mouthwash. In study No 2, 34 gingivitis patients were divided into the same three groups. For 2 weeks patients rinsed with their mouthwash twice daily. Each of the groups were assessed for bleeding on probing, gingival index and plaque index at baseline and 2 weeks after using mouthwashes.
ResultsIn study No 1 the results showed greater reduction in indices in the CHX group than the herbal mouthwash group and the herbal mouthwash compared to the placebo group. However, the differences in indices between the three groups were not statistically significant. No adverse reaction was seen in the herbal mouthwash group. In study No 2, the CHX and herbal mouthwash groups produced greater reduction in bleeding on probing and gingival indices than the placebo group, but the difference between groups A and B was not statistically significant. Furthermore, the reduction in plaque index in all three groups was statistically significant, but differences between the groups were not significant.
ConclusionWithin the limitation of this small pilot investigation, an herbal mouthwash consisting ofSalix alba, Malva sylvestris and Althaea officinalis, provided a clinical benefit comparable to that of CHX if used as an adjunct to scaling and root planing, especially in gingivitis patients, however, further large-scale studies are warranted.
Source : Journal of Herbal Medicine
Link to Full Article
Herbal medicine for low-back pain
- Hanna Oltean1,
- Chris Robbins1,
- Maurits W van Tulder2,
- Brian M Berman3,
- Claire Bombardier4,
- Joel J Gagnier5,*
Abstract
Low-back pain (LBP) is a common condition and imposes a substantial economic burden upon people living in industrialized societies. A large proportion of people with chronic LBP use complementary and alternative medicine (CAM), visit CAM practitioners, or both. Several herbal medicines have been purported for use in treating people with LBP. This is an update of a Cochrane Review first published in 2006.
Objectives
To determine the effectiveness of herbal medicine for non-specific LBP.
Search methods
We searched the following electronic databases up to September 2014: MEDLINE, EMBASE, CENTRAL, CINAHL, Clinical Trials.gov, World Health Organization International Clinical Trials Registry Portal and PubMed; checked reference lists in review articles, guidelines and retrieved trials; and personally contacted individuals with expertise in this area.
Selection criteria
We included randomized controlled trials (RCTs) examining adults (over 18 years of age) suffering from acute, sub-acute, or chronic non-specific LBP. The interventions were herbal medicines which we defined as plants used for medicinal purposes in any form. Primary outcome measures were pain and function.
Data collection and analysis
A library scientist with the Cochrane Back Review Group conducted the database searches. One review author contacted content experts and acquired relevant citations. We downloaded full references and abstracts of the identified studies and retrieved a hard copy of each study for final inclusion decisions. Two review authors assessed risk of bias, GRADE criteria (GRADE 2004), and CONSORT compliance and a random subset were compared to assessments by a third individual. Two review authors assessed clinical relevance and resolved any disagreements by consensus.
Main results
We included 14 RCTs (2050 participants) in this review. One trial on Solidago chilensis M. (Brazilian arnica) (20 participants) found very low quality evidence of reduction in perception of pain and improved flexibility with application of Brazilian arnica-containing gel twice daily as compared to placebo gel. Capsicum frutescens cream or plaster probably produces more favourable results than placebo in people with chronic LBP (three trials, 755 participants, moderate quality evidence). Based on current evidence, it is not clear whether topical capsicum cream is more beneficial for treating people with acute LBP compared to placebo (one trial, 40 participants, low quality evidence). Another trial found equivalence of C. frutescens cream to a homeopathic ointment (one trial, 161 participants, very low quality evidence). Daily doses of Harpagophytum procumbens (devil's claw), standardized to 50 mg or 100 mg harpagoside, may be better than placebo for short-term improvements in pain and may reduce use of rescue medication (two trials, 315 participants, low quality evidence). Another H. procumbens trial demonstrated relative equivalence to 12.5 mg per day of rofecoxib (Vioxx®) but was of very low quality (one trial, 88 participants, very low quality). Daily doses of Salix alba (white willow bark), standardized to 120 mg or 240 mg salicin, are probably better than placebo for short-term improvements in pain and rescue medication (two trials, 261 participants, moderate quality evidence). An additional trial demonstrated relative equivalence to 12.5 mg per day of rofecoxib (one trial, 228 participants) but was graded as very low quality evidence. S. alba minimally affected platelet thrombosis versus a cardioprotective dose of acetylsalicylate (one trial, 51 participants). One trial (120 participants) examining Symphytum officinale L. (comfrey root extract) found low quality evidence that a Kytta-Salbe comfrey extract ointment is better than placebo ointment for short-term improvements in pain as assessed by VAS. Aromatic lavender essential oil applied by acupressure may reduce subjective pain intensity and improve lateral spine flexion and walking time compared to untreated participants (one trial, 61 participants,very low quality evidence). No significant adverse events were noted within the included trials.
Authors' conclusions
C. frutescens (Cayenne) reduces pain more than placebo. Although H. procumbens, S. alba, S. officinale L., S. chilensis, and lavender essential oil also seem to reduce pain more than placebo, evidence for these substances was of moderate quality at best. Additional well-designed large trials are needed to test these herbal medicines against standard treatments. In general, the completeness of reporting in these trials was poor.
Source : Cochrane Library
Link to Abstract