The interest in the study and implementation of herbal medicines in medical practice is not accidental. It is explained by an increasing flow of pharmacological drugs, an increase in the number of their side effects (from allergic reactions to severe drug reactions up to fatal outcomes), an increase in chronic comorbid pathology, especially in pediatric and gerontological practice, due to incorrect aggressive pharmacotherapy.
The revival of herbal medicine is currently based on the following factors.
- With long-term use in the treatment of chronic diseases, for the purpose of preventive therapy and medical rehabilitation, this method is effective and safe both in pediatric and gerontological practice.
- There are pathological conditions in which phytotherapeutic drugs are the first choice, that is, there is no alternative in the form of pharmaceuticals (chemically synthesized).
- For a number of diseases and conditions (functional disorders), phytotherapeutic agents can be an alternative to synthetic ones.
- Phytotherapeutic agents can complement standard therapies, increasing the effectiveness and quality of the treatment.
- The varied content of biologically active substances in herbal medicines determines their multifunctional pharmacotherapeutic action.
- According to the mechanism of action, phytotherapeutic agents are more physiological and economically available.
At the same time, the doctor should prescribe the specified treatment after the diagnosis is established, using standardized, registered phytotherapeutic agents. In doing so, he should be guided by the following principles:
- individualization of therapy – “to treat not a disease, but a patient”;
- the adequacy of therapy – to take into account the etiology, pathogenesis, degree and stage of development of the process, starting treatment from simple to complex, from monopropes to complex recipes, fees;
- continuity, consistency, complexity, consistency of therapy, taking into account comorbid conditions.
Today, the arsenal of recommended herbal medicines is quite extensive and has a large scientifically grounded evidence base for prescribing in the daily practice of a doctor. Commission E (1989, Berlin, Germany) regulated the following criteria for the action and effectiveness of herbal medicines:
- proven in scientific articles, described in textbooks and reference books;
- there are results of studies that have been compared with controls or placebo;
- there are published clinical trials supported by experimental data;
- popular cognitive material has a scientific and practical interpretation, justification;
- bibliographic rationale, confirmation of evidentiary and informative effectiveness, the presence of experimental studies.
The purpose of this article is to substantiate the basic principles of herbal medicine in the complex preventive therapy of neuroses, depression, as well as in the period of medical rehabilitation.
In the heading “neuroses” we consider a group of diseases that arise under the influence of various psycho-traumatic factors. They are based on temporary reversible disorders of the nervous system. This diagnosis is characterized by emotional-affective and somatovegetative disorders without psychotic manifestations, but there is a temporary decrease in physical and mental performance.
The etiology of neurosis is associated with various acute and chronic stress factors, as well as physical and mental fatigue. In the pathogenesis of neuroses, there is a dysfunction of the limbic structure of the brain, including hypoxia, which causes disturbances in energy metabolism in the neurons of the limbic system, which leads to the depletion of the body’s defense mechanisms.
The clinical picture of neuroses is characterized by symptoms such as increased fatigue, weakness, headache, mood lability – from depression (depression) to an explosive reaction; violation of memory, attention, appetite; as well as somatovegetative manifestations (excessive sweating, tachycardia, functional disorders of the intestines, dysuria, stuttering, tremors).
The generally accepted standards of treatment include psycho-, pharmaco-, hypno-, physiotherapy, a complete and balanced diet, physical activity, swimming, walking.
In the management of a patient with neurosis, herbal medicine can be both the main and auxiliary method. Herbal preparations, accumulating various biologically active substances, provide a multifunctional effect: sedative, adaptogenic, immune-correcting, antihypoxic, membrane-, cardio- and neuroprotective, anti-inflammatory. These pharmacotherapeutic properties can be listed for a long time, since today there is a solid evidence base, confirmed by domestic and international specialized publications.
In the treatment of neuroses, an internist should take into account the patient’s condition and begin its management with monotherapy, gradually moving on to drawing up fees. So, with the predominance of arousal processes, sedative-hypnotics with a moderately pronounced effect are prescribed. If the symptoms include irritability, hysterical manifestations, herbal stimulants, adaptogens are not recommended.
With obsessive-compulsive disorder and depression, the appointment of adaptogens is indicated in the first half of the day, and herbal sedatives should be taken in the afternoon and at night.
When compiling fees, it is necessary to include plants that normalize the function of the cardiovascular, excretory, and digestive systems.
Adaptogens (alcoholic tinctures, extracts) are recommended to be prescribed in the autumn-winter period at a dose not exceeding 15-20 drops in the first half of the day (no later than 14: 00-15: 00).
Thus, plants with a sedative effect are most often used for diseases of the nervous system. And these include medicinal valerian, motherwort, lemon balm, peppermint, oregano, lavender, ordinary hops, etc. They are used for neuroses, headaches, excessive nervous overload, acute and chronic stress both in monotherapy and in complex treatment.
When the nervous system is suppressed, agents with a tonic effect based on medicinal plants with adaptogenic pharmacotherapeutic activity are recommended. They help the body adapt to various unfavorable environmental factors, tone up the nervous system. This group includes ginseng, Eleutherococcus prickly, Manchurian aralia, Zamaniha high, Chinese magnolia vine, Rhodiola rosea, etc. Adaptogens are widely used in neurocirculatory dystonia.
In monotherapy for nervous diseases, valerian medicinal is most often used, the pharmacotherapeutic properties of which are diverse. Valerian relieves the state of nervous excitement against the background of overwork, insomnia and palpitations. The coefficient of sedative action of drugs based on valerian is equal to one. To enhance the effect, it is combined with other medicinal plants: with nervous excitability and fatigue – with lemon balm; with insomnia – with hops; with nervous palpitations, with calendula. In addition to the sedative, valerian demonstrates a tranquilizing effect on the central nervous system, regulates cardiac activity, exerting a positive effect on the basic mechanisms of the heart’s automatism, its conduction system, thus realizing a positive neuroregulatory effect on the heart muscle. In experimental studies, it was found that valerian preparations reduce reflex excitability in the central parts of the nervous system and enhance inhibition processes at the level of neurons in the cortical and subcortical structures of the brain.
Valerian prolongs sleep, has an anticonvulsant effect.
Common hops is a mild sedative with more pronounced hypnotic and sedative effects than valerian. The plant contains various biologically active substances (flavonoids, alkaloids, essential oil, coumarins, bitter acids humulon and lupunol). At the same time, hops are known to inhibit sexual activity due to the presence of isoflavonoids, which have estrogenic activity. The use of drugs based on hops is relevant for neuroses, insomnia, gastropathy, sexual neurosis.
Motherwort contains flavonoids, essential oil, alkaloids, bitterness, organic acids, mineral salts. According to a number of authors, motherwort preparations inhibit certain functions of the central nervous system 3-5 times stronger than valerian preparations, and also have a more pronounced sedative effect, hypotensive and cardiotonic effects. This allows the internist to use motherwort-based remedies in combination with other herbal remedies for neuroses.
Lemon balm contains up to 1% essential oil, flavonoids, phenolic acids, coumarins; it is used in case of falling asleep disturbance, which is accompanied by unpleasant sensations in the region of the heart, a feeling of fear. There are literary data that confirm the antiviral effect of lemon balm preparations.
Passiflora incarnate is a tropical perennial plant containing saponins, flavonoids, alkaloids, which provide a pronounced sedative and mild hypnotic effect in various functional diseases of the nervous system, insomnia, climacteric disorders.
Evasive peony (Maryin root) is a medicinal plant that contains essential oil (1.6%), organic acids, monoterpene glycosides, phenologlycosides, flavonoids, saponins. Medicines based on this plant have a sedative effect. They are prescribed for neurasthenic conditions, insomnia, vegetative-vascular disorders of various etiologies.
Blue cyanosis is a perennial herb that accumulates triterpene saponins, which provide a pronounced sedative effect.
St. John’s wort is one of the most famous medicinal plants, which exhibits a certain sedative activity, and also works well for depression. The first effect from its use is found after 3 weeks, it must be taken within 2-3 months.
In case of depressive conditions, you can prescribe a collection, which includes: St. John’s wort herb – 20.0 g; linden inflorescences – 10.0 g; mint leaves, dill fruits – 5.0 g each. Put 1 tablespoon of the mixture in 200.0 ml of boiling water, boil in a water bath for 15 minutes, cool for 30 minutes, drain. Take 4-6 times a day, 50 ml 15 minutes before meals or 30 minutes after meals. The course of treatment is 2-3 weeks.
With neuroses and neurosis-like states, depression, one of the most common symptoms is headache. Today, the painful symptom complex is recognized as a vital protective phenomenon that reflects the pathogenetic, psychophysiological state of a person, arising under the influence of various factors, and includes such components as a state of consciousness, sensation, memory, motivation, autonomic, somatic and behavioral reactions.
The etiological factor of both acute and chronic pain can be traumatic, infectious, metabolic or other damage to various organs and tissues, including the nervous system. Headache occurs as a result of irritation of the nerve endings of the vessels of the head or meninges and, depending on the cause, has its own characteristics: in vascular diseases it is pulsating, aggravated by overwork, alcohol consumption, smoking, exposure to sharp irritating factors (noise, smell, bright light). Severe headache with vomiting and loss of consciousness occurs against a background of high temperature with inflammation of the brain and its membranes. For headaches, plants with sedative, analgesic and antispasmodic effects are used.
The next symptom, dizziness, occurs with dysfunction of the vestibular, visual and somatosensory systems; accompanied by vegetative disorders: sweating, changes in pulse and blood pressure with nausea, vomiting, diarrhea and dysuric manifestations.
In severe experiences, various neuroses, mental illnesses, organic pathology of the brain (encephalitis, arachnoiditis), as well as in some diseases of the cardiovascular system, respiratory tract, dysfunction of the endocrine glands, sleep disorders are observed. Insomnia should be understood as sleep disorders of various pathogenesis and clinical characteristics, which are manifested by impaired sleep, intermittent, superficial sleep or awakening. With insomnia, not only falling asleep, depth of sleep, duration, but also its structure are disturbed. Treatment for insomnia depends on the underlying cause. The medicinal fees include various plants that exhibit a hypnotic, sedative effect: valerian, lemon balm, hops, mint, lavender, etc.
Neurocirculatory, or vegetative-vascular, dystonia (NCD) is a term that combines various disorders of the autonomic functions of the body caused by disorders of their regulation. NDC develops as a result of neurosis or as a manifestation of neurosis-like states in various mental and somatic diseases, intoxication, withdrawal symptoms, allergies, endocrine diseases, in the climacteric period, with fatigue, exhaustion, physical inactivity.
Most patients have signs of asthenia (fatigue, sleep disturbance, headache), a burning sensation in various parts of the body, increased sweating, and dizziness. Disorders from the gastrointestinal tract, sexual function, and the cardiovascular system are observed.
When NCD is hypotonic, the following herbal preparations can be recommended: rhizomes with roots of leuzea, rhizomes of calamus, leaves of willow-herb, raspberries; fruits of mountain ash, wild rose; flowers of hawthorn, calendula, meadowsweet; lingonberry, nettle, currant leaves; watch grass, St. John’s wort, string. These plants, rich in a variety of biologically active substances, are prescribed in the form of monopropes or fees, which provide a multifunctional pharmacotherapeutic effect.
With NCD for the hypertensive type, herbal preparations are prescribed that provide a sedative, antispasmodic, cardiotropic effect, as well as normalize metabolic processes: fruits and inflorescences of hawthorn, valerian rhizome, grass yarrow, motherwort, calendula flowers, linden inflorescences, sweet clover herb.
Migraine is a disease caused by hereditary dysfunction of vasomotor regulation and manifests itself mainly in the form of recurrent headache attacks in one half of the head. A migraine attack is characterized by the following phases: pre-pain, vascular local headache, diffuse pain, post-pain period.
Before the attack, depression of mood, apathy, reduced performance, drowsiness are observed. Then a migraine aura arises: sparks in the eyes, a feeling of numbness in the limbs, etc.
Herbal medicine consists in the use of plants with analgesic, sedative and antispasmodic pharmacotherapeutic multifunctional action (lemon balm leaves, mint, coriander fruits, oregano herb, willow herb, meadow clover, sunflower flowers) both as monopreparations and in the form of collections.
Neurasthenia is a neurosis that is caused by overwork or prolonged exposure to traumatic factors, manifested by a state of increased excitability, sleep disorders, and autonomic disorders. Phytotherapy of neurasthenia consists in the use of plants with sedative and tranquilizing effects (hops, rhizomes with valerian roots, watch grass, lavender flowers, raspberries, mint grass).
With the hypersthenic form of neurasthenia, phytopreparations with sedative, antispasmodic, metabolic pharmacotherapeutic effects are used: rhizome with valerian roots, motherwort herb, hawthorn fruits and inflorescences, calendula flowers, chamomile, linden inflorescences, sweet clover herb.
With the hyposthenic form of neurasthenia, the roots of radiola, zamanihi are used; rose hips, hawthorn fruits and flowers, stinging nettle leaves, St. John’s wort, calamus rhizomes, rhizomes and roots of elecampane.