Impact of Capsella bursa-pastoris (Shepherd’s Purse) Herbal Tea Preparations on Symptoms and Severity of Hemorrhoidal Disease: A Prospective Randomized Study

Year 2022, Volume: 3 Issue: 3, 138 - 144, 15.12.2022

Tuba Mert Ece Yiğit

https://doi.org/10.53811/ijtcmr.1173400

Abstract

Objectives: Medicinal herbs have been used to treat hemorrhoidal disease for centuries. Given its anti-oxidant and anti-inflammatory mechanisms, Capsella bursa-pastoris (Shepherd’s purse) may potentially lead to regression of the hemorrhoidal plexuses. In this context, the objective of this study is to investigate the effect of Capsella bursa-pastoris, an affordable and easy-to-use herbal medicine, on the severity and physical examination findings of hemorrhoidal disease in patients, who receive conventional treatment for hemorrhoids.
Material-Method: This study was designed as a prospective, randomized study. The population of the study comprised symptomatic patients who presented with second and third-degree hemorrhoids to the Internal Medicine and General Surgery departments of Istanbul Medipol University Hospital, İstanbul, Turkey, between October 2021 and February 2022. The patients were randomized into two groups: the control group, that is, the group of patients, who were to receive conservative treatment only for three months, and the study group, that is, the group of patients who were to receive conservative treatment and use herbal tea preparations of Capsella bursa-pastoris for three months. Demographic (age and gender) and baseline and 3-month clinical characteristics were recorded. The study's primary outcome was the changes observed in the symptoms and physical examination findings of hemorrhoidal disease in the study group relative to those in the control group.
Results: The study sample consisted of a total of 218 patients, who were randomized into the study and control groups, with 109 patients in each group. Significantly older patients were seen in Group CT (39.5 ± 14.6 and 35.5 ± 11.7 years, p=0.030). There was no significant difference between the groups in terms of other characteristics (p>0.05). At the 3rd-month follow-up examination, it was determined that there were significantly fewer patients with bleeding and difficulty during defecation in the study group compared to the control group (p=0.001 for both cases). Patients in the study group had significantly lower VAS scores for pain and the number of affected quadrants compared to those in the control group (p<0.001 for both cases). The proportion of patients with Grade II and III hemorrhoidal disease was significantly lower in the study group.
Conclusion: The findings of this study, which revealed significant improvements in the symptoms and physical examination findings of hemorrhoidal disease, suggest that the use of Capsella bursa-pastoris herbal tea may benefit patients with symptomatic hemorrhoids.

Keywords

Hemorrhoids, Phytotherapy, Medicinal Herbs, Capsella Bursa-Pastoris

Project Number

Yok

References

• Ahmet Sargin S. Ethnobotanical Survey of Medicinal Plants in Bozyazi District of Mersin, Turkey. J Ethnopharmacol 2015;173:105–126.
• Al-Snafi AE. The Chemical Constituents and Pharmacological Effects of Capsella Bursa-Pastoris-A Review. Int J Pharmacol Toxicol 2015;5(2):76–81.
• Apaydin Yildirim B, Aydin T, Kordali S, et al. Antihemorrhoidal Activity of Organic Acids of Capsella Bursa-Pastoris on Croton Oil-Induced Hemorrhoid in Rats. J Food Biochem 2020;44(9):e13343.
• Choi HK, Shin EJ, Park SJ, et al. Ethanol Extract of Capsella Bursa-Pastoris Improves Hepatic Steatosis Through Inhibition of Histone Acetyltransferase Activity. J Med Food 2017;20(3):251–257.
• Durić K, Hadžiabdić SK, Durić M, et al. Efficacy and Safety of Three Plant Extracts Based Formulations of Vagitories in the Treatment of Vaginitis: A Randomized Controlled Trial. Med Glas 2021;18(1):47–54.
• Ghalandari S, Kariman N, Sheikhan Z, et al. Effect of Hydroalcoholic Extract of Capsella Bursa Pastoris on Early Postpartum Hemorrhage: A Clinical Trial Study. J Altern Complement Med 2017;23(10):794–799.
• Gravina AG, Pellegrino R, Facchiano A, et al. Evaluation of the Efficacy and Safety of a Compound of Micronized Flavonoids in Combination With Vitamin C and Extracts of Centella Asiatica, Vaccinium Myrtillus, and Vitis Vinifera for the Reduction of Hemorrhoidal Symptoms in Patients With Grade II And . Front Pharmacol 2021;12:1–9.
• Gulec M, Ogur R, Gul H, et al. Investigation of Vasoactive Ion Content of Herbs Used in Hemorrhoid Treatment in Turkey. Pak J Pharm Sci 2009;22(2):187–192.
• Gupta PJ. The Efficacy of Euphorbia Prostrata in Early Grades of Symptomatic Hemorrhoids - A Pilot Study. Eur Rev Med Pharmacol Sci 2011;15(2):199–203.
• Gurel E, Ustunova S, Ergin B, et al. Herbal Haemorrhoidal Cream for Haemorrhoids. Chin J Physiol 2013;56(5):253–262.
• Hashempur MH, Khademi F, Rahmanifard M, et al. An Evidence-Based Study on Medicinal Plants for Hemorrhoids in Medieval Persia. J Evidence-Based Complement Altern Med 2017;22(4):969–981.
• Hwang JT, Choi E, Choi HK, et al. The Cholesterol-Lowering Effect of Capsella Bursa-Pastoris Is Mediated via SREBP2 and HNF-1α-Regulated PCSK9 Inhibition in Obese Mice and HEPG2 Cells. Foods 2021;10(2):1–14.
• Jaradat NA, Zaid AN, Al-Ramahi R, et al. Ethnopharmacological Survey of Medicinal Plants Practiced by Traditional Healers and Herbalists for Treatment of Some Urological Diseases in the West Bank/Palestine. BMC Complement Altern Med 2017;17(1):255.
• Joksimovic N, Spasovski G, Joksimovic V, et al. Efficacy and Tolerability of Hyaluronic Acid, Tea Tree Oil and Methyl-Sulfonyl-Methane in a New Gel Medical Device for Treatment of Haemorrhoids in a Double-Blind, Placebo-Controlled Clinical Trial. Updates Surg 2012;64(3):195–201.
• Kurt BZ, Gazioğlu I, Sevgi E, et al. Anticholinesterase, Antioxidant, Antiaflatoxigenic Activities of Ten Edible Wild Plants from Ordu Area, Turkey. Iran J Pharm Res 2018;17(3):1047–1056.
• Malekuti J, Mirghafourvand M, Samadi K, et al. Comparison of the Effect of Myrtus Communis Herbal and Anti-Hemorrhoid Ointments on the Hemorrhoid Symptoms and Quality of Life in Postpartum Women with Grade i and II Internal Hemorrhoid: A Triple-Blinded Randomized Controlled Clinical Trial. J Complement Integr Med 2019;16(4):20180147.
• Man KM, Chen WC, Wang HM, et al. A Randomized, Double-Blind, Placebo-Controlled Trial of a Chinese Herbal Sophora Flower Formula in Patients with Symptomatic Haemorrhoids: A Preliminary Study. Afr J Tradit Complement Altern Med 2013;10(2):343–351.
• Memariani Z, Moeini R, Hamedi SS, et al. Medicinal Plants with Antithrombotic Property in Persian Medicine: A Mechanistic Review. J Thromb Thrombolysis 2018;45(1):158–179.
• Mosavat SH, Ghahramani L, Sobhani Z, et al. Topical Allium Ampeloprasum Subsp Iranicum (Leek) Extract Cream in Patients With Symptomatic Hemorrhoids: A Pilot Randomized and Controlled Clinical Trial. J Evidence-Based Complement Altern Med 2015;20(2):132–136.
• Naafe M, Kariman N, Keshavarz Z, et al. Effect of Hydroalcoholic Extracts of Capsella Bursa-Pastoris on Heavy Menstrual Bleeding: A Randomized Clinical Trial. J Altern Complement Med 2018;24(7):694–700.
• Peng J, Hu T, Li J, et al. Shepherd’s Purse Polyphenols Exert Its Anti-Inflammatory and Antioxidative Effects Associated with Suppressing MAPK and NF-ΚB Pathways and Heme Oxygenase-1 Activation. Oxid Med Cell Longev 2019;2019:1–14.
• Ray-Offor E and Amadi S. Hemorrhoidal Disease: Predilection Sites, Pattern of Presentation, and Treatment. Ann Afr Med 2019;18(1):12–16.
• Srivastava JK, Shankar E and Gupta S. Chamomile: A Herbal Medicine of the Past with a Bright Future (Review). Mol Med Rep 2010;3(6):895–901.
• Tariq A, Mussarat S and Adnan M. Review on Ethnomedicinal, Phytochemical and Pharmacological Evidence of Himalayan Anticancer Plants. J Ethnopharmacol 2015;164:96–119.
• Tetik F, Civelek S and Cakilcioglu U. Traditional Uses of Some Medicinal Plants in Malatya (Turkey). J Ethnopharmacol 2013;146(1):331–346.
• Xie L kun, Xu X jing, Wu X, et al. Capsella Bursa-Pastoris (L.) Medic. Extract Alleviate Cataract Development by Regulating the Mitochondrial Apoptotic Pathway of the Lens Epithelial Cells. J Ethnopharmacol 2022;284:114783.
• Yildirim AB, Karakas FP and Turker AU. In Vitro Antibacterial and Antitumor Activities of Some Medicinal Plant Extracts, Growing in Turkey. Asian Pac J Trop Med 2013;6(8):616–624.