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THE ROLE OF FOLK MEDICINE IN THE TREATMENT OF GASTRIC
AND DUODENAL ULCER
(literature review)
Kadirov Bekhruzbek Saidovich
Bukhara State Medical Institute, Department
of Faculty and Hospital Therapy,
Uzbekistan, Bukhara, Gijduvan 23
e-mail: kadirov.bexruzbek@bsmi.uz
ORCID ID 0009-0009-1552-6367
Resume.
It is well known that gastric ulcer and duodenal ulcer rank first among
diseases of the gastrointestinal tract. This disease has been scientifically proven
through a number of scientific studies aimed at its treatment. However, more than 90%
of treatments aimed at curing the disease are medicinal. The article discusses the role
of natural plants in the treatment of peptic ulcer disease, while limiting
pharmacotherapy.
Keywords:
medicinal plants, helicobacter pylori, gastric ulcer and duodenal
ulcer, Allium sativum, Zingiber officinalis, Cistus Laurifolius, Curcuma Longa,
Artemisia Asiatica.
Various medicinal plants and their anti-H. pylori activities have been reported in
many studies. In recent years, inhibition of enzymatic (dihydrofolate reductase,
DNAse, myeloperoxidase N-acetyltransferase and urease) and adhesion activities, high
redox potential and hydrophilic/hydrophobic nature of the components play an
important role in their anti-H. pylori activity. Gastric inflammation induced by H.
pylori can lead to superficial gastritis and atrophic gastritis, and possibly gastric cancer.
Various natural products have been found to have anti-inflammatory activities and the
main mechanisms include inhibition of nuclear factor-B and activation of the mitogen-
activated protein kinase pathway and suppression of oxidative stress [4,7].
The role of H. pylori infection in carcinogenesis is to promote carcinogenesis
rather than directly playing a major role as a carcinogen, and its eradication alone
cannot eliminate H. pylori-associated gastric cancer [10].
Medicinal plants such as Allium sativum, Zingiber officinalis, Korean red
ginseng, and Cistus laurifolius have been shown to inhibit precancerous changes by
binding to nuclear factor-kappa B DNA, inhibiting chemokine production, cytokine
inhibition, and mutagenesis, and inducing multiple levels of apoptosis. Other
unresolved issues need to be addressed before they can be accepted as standard therapy
for H. pylori infection [13].
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Allium sativum. Throughout history, the health benefits of garlic have been
documented, and the primary use of Allium sativum has been for its medicinal
properties. Organosulfur compounds of Allium sativum, including S-allyl-L-cysteine
(SAC) sulfoxides and -glutamyl S-allyl-L-cysteine, have been identified as the main
compounds. Raw Allium sativum is easily converted to a biologically inactive form.
Accordingly, many types of its extracts with different compositions of biologically
active components have been developed and their efficacy has been observed and
evaluated in many studies. The main role of Allium sativum extract is to exert
antioxidant effects by scavenging reactive oxygen species, inhibiting lipoprotein
oxidation, and reducing plasma glucose levels by reducing the induction of antioxidant
enzymes. It has also shown in vivo inhibitory effects on gastric inflammation caused
by H. pylori and has antitumor effects by promoting apoptosis and inducing cell cycle
arrest. Allicin and allyl-methyl plus methyl-allyl thiosulfinate from acetone Allium
sativum extract inhibited the growth of H. pylori in vitro [15].
Cistus Laurifolius. Flavonoids are one of the most important components of the
human diet, responsible for many biological activities, in particular antioxidant
activity. Due to their limited availability and high cost, rapid synthesis of
polyoxygenated flavones has been developed starting from convenient and inexpensive
flavanones. The limited flavone 30-demethoxysudaxitin has been shown to be active
against H. pylori through a methoxylation and bromination protocol. Many studies on
flavonoids have been carried out with Cistus laurifolius extract [2,3]. This has been
proven by testing the antimicrobial activity of the most active compounds against H.
pylori, such as 3-demethoxysudaxitin and sudaxitin. A similar study has shown that the
chloroform extract of Cistus laurifolius has a very high anti-H. pylori activity.
According to these studies, the isolated flavonoids can be used as an additional
component in the standard treatment of H. pylori infection [11,14].
Li HQ et al. observed various degrees of anti-H.pylori activity of many
isoflavones. Several metronidazole-flavonoid extracts were used for the experiment to
determine the antimicrobial activity against H.pylori. Only one compound was shown
to significantly increase the level of IL-8 in gastric cancer cells stimulated with
H.pylori aqueous extract. On the other hand, the experiments of Nakagawa et al.
revealed that new flavonoid compounds such as 6, 7 and (2C)-40,7-dihydroxy-8-
methylflavan were most effective against H.pylori [8].
Similarly, Ustun et al. found that the chloroform extract of Cistus laurifolius has
significant anti-H. pylori activity [5,9]. Therefore, the isolated flavonoids may be used
as alternative or complementary compounds to the current treatment of H. pylori
infection.
Zingiber Officinalis and Zingiber Zerumbet. Zingiber officinalis is known as
ginger, which is consumed as a flavoring agent. The plant extract has shown antitumor
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effects on colon cancer cells by inhibiting their growth, increasing DNA synthesis; and
inducing apoptosis. In addition, the main potent phenolic compound of Zingiber
officinalis is 6-gingerol, which has many pharmacological activities. Zingiber
officinalis extracts containing gingerols play a major role in the inhibition of
prostaglandin E2 (PGE2). On the other hand, active phenolic compounds such as
gingerol and zingerone have a significant effect on inhibiting parietal cell H+, K+-
ATPase. Therefore, the activities of gingerol and zingerone play a very important role
in inhibiting the proton pump and reducing gastric acid secretion. In addition, it has a
protective effect against ulcers caused by H. pylori [1,15].
Furthermore, Sidahmed et al. demonstrated that zerumbone from Zingiber
zerumbet plays a significant role in gastroprotective activity against ethanol-induced
gastric ulcer in rats. Pretreatment of gastric ulcer-bearing rats with zerumbone or
omeprazole significantly reduced ulcer formation compared with the control group.
Furthermore, pretreatment with omeprazole at 20 mg/kg div weight (p < 0.05)
inhibited ulcer formation by 76.77%, while zerumboneate at 5 and 10 mg/kg div
weight inhibited ulcer formation by 75.59% and 88.75%, respectively. On the other
hand, zerumbone and its gastroprotective mechanisms have not been tested against
other ulcer models; therefore, other mechanisms may exist and their effects need to be
investigated and elucidated [9].
Camellia Sinensis is one of the most widely consumed beverages today. The
chemopreventive effects of Camellia Sinensis are not only due to its antioxidant
activity, but also to its molecular regulation of cell growth, development, and apoptosis,
and are associated with the selective improvement of the function of the intestinal
bacterial flora. Among the numerous components of green tea, polyphenols and
epigallocatechin gallate suppress the expression of the tumor necrosis factor-alpha
(TNF-α) gene. On the other hand, H. pylori urease is very important for its colonization
and has been proven in studies. Camellia sinensis extract has shown inhibitory activity
of this enzyme. As a result, bacterial colonization is inhibited. Many similar studies
have shown that Camellia sinensis extract enhances cell vacuolation and has an
inhibitory effect on cytotoxin A vacuolation and urea transport in H. pylori infection.
Consequently, it can pursue anti-H.pylori activity in vivo [7].
Conclusion.
The combination of herbal products and standard antiulcer drugs
has a synergistic effect against H. pylori and peptic ulcer disease and may clearly
improve outcomes for peptic ulcer patients. Only a few studies have been conducted,
suggesting that further clinical trials with larger sample sizes are warranted on the
efficacy and safety of medicinal plants with antiulcer activity. In addition, it would be
beneficial to design studies to investigate and further elucidate the mechanisms of
action of medicinal plants used to treat or prevent peptic ulcers.
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