Plants in this group include:

Great celandine

Tansy

Sandy immortelle

Corn silk

Common barberry

Classification:

1. Drugs that stimulate the formation of bile (choleretics or cholesecretics): immortelle flowers (Flamin drug), tansy flowers (Tanacehol drug), corn columns and silks (liquid extract), rose hips (Holosas drug).

2. Preparations that promote the excretion of bile (cholekinetics): roots and leaves of barberry (the drug “Berberine bisulfate” and tincture of leaves). Celandine herb.

Mechanism of action

They enhance the formation of bile and promote its discharge.

Application

Chronic hepatitis, cholecystitis, biliary dyskinesia, cholangitis, cholelithiasis, in complex therapy to improve digestion.

Features of application:

Use 30 minutes before meals.

Contraindications for use are the individual characteristics of herbal medicines.

Characteristics of plants using a pharmacognostic algorithm.

MP Herb Celandine - Herba Chelidonii

Production plant Greater celandine - Chelidonium majus

Poppy family - Papaveraceae

JFR (brief botanical description): MTP The stem is branched, sparsely pubescent, 30-80 cm high. The leaves are odd-pinnate, arranged alternately. The basal and lower stem leaves are larger, on long petioles, the upper ones are sessile, with fewer lobes. Leaf lobes with large, unevenly shaped edges. The leaves are green above, bluish below. The flowers are bright yellow, collected in groups of 3-8 at the ends of the stems in inflorescences - simple umbrellas. The fruit is a pod-shaped capsule. The whole plant is poisonous, contains an orange milky sap,

Everywhere .

Harvesting, drying The grass is collected in the flowering phase, according to the rules for harvesting toxic raw materials. Air-shade drying or 50-60 degrees.

Chem. Compound: alkaloids gr. Isoquinoline, flavonoids.

herbs with flowers and fruits varying degrees development, leafy stems up to 30-50 cm long, crushed, less often whole leaves, flowers, fruits. The stems are slightly ribbed, branched at the top, and slightly pubescent. The leaves are often broken. The terminal lobe is larger than the lateral ones. The smell of raw materials is peculiar.

Side effect : nausea, allergic reaction.

Contraindications:

Action and application:choleretic, antispasmodic, hypotensive, bactericidal, antiviral, cytostatic.

LF: herb, infusion 1:400, Holagogum capsules, Holaflux tea for diseases of the liver and gall bladder, external juice for cauterizing warts, skin tuberculosis.

Storage:. In dry, well-ventilated areas, with caution. Order 706 n

MPF Tansy flowers – Flores Tanaceti

Production plant Tansy - Tanacetum vulgare

Aster family Ast eraceae (Compositae)

ZhFR (brief botanical description): MTP 50-150cm high, with a strong characteristic odor, with numerous erect stems, branched in the inflorescence. The leaves are dark green above, grayish-green below, arranged alternately, pinnately dissected, basal leaves long-petiolate, stem leaves sessile. Flower baskets are in dense corymbose inflorescences. All flowers are tubular and golden yellow. The fruit is an achene without a tuft

Geographical distribution, habitat Everywhere . It grows as a weed in meadows, near roads, in gardens and parks.

Harvesting, drying The grass is collected at the beginning of flowering, cutting off baskets and parts of inflorescences with peduncles up to 4 cm. Air-shade drying or up to 40 degrees.

Chem. Compound: flavonoids, essential oil, bitters.

DPS ( diagnostic signs raw materials), External signs LRS according to GF XI: separate blossoming flower baskets without peduncles and parts of a corymbose inflorescence with a peduncle no more than 4 cm from the upper baskets. The baskets are hemispherical, 6-8 mm in diameter. The bed is bare, flat, surrounded by a wrapper; it bears small yellow tubular flowers. The smell of raw materials is specific. The taste is spicy and bitter.

Side effect: allergic reaction.

Contraindications:.Individual intolerance to drugs.

Action and application: choleretic antispasmodic, normalizing the biochemical composition of bile, anthelmintic, insecticidal.

LF: Flowers,, infusion 1:10, tab. “Tanacehol” (cholecystitis, biliary dyskinesia), “Sibektan” (hepatitis), choleretic preparations..

Storage:.

MRS Flowers of immortelle -- Flores Helichrysi

Production plant Helichrysum arenarium

Aster family – Asteraceae

:A P (brief botanical description): MTP height 15-30cm. The basal leaves are oblong-obovate with a rounded apex and a short petiole, collected in rosettes. One or several ascending, branched stems emerge from the rhizome only in the inflorescence. Stem leaves are middle and upper, sessile, lanceolate. The flowers are tubular, golden-orange, in small baskets, from which a complex inflorescence is formed - a thick corymbose panicle. The fruit is an achene with a tuft.

Geographical distribution, Grows in the middle and southern zones of the European part of Russia, Western Siberia, sandy soils.

Harvesting, drying The grass is collected at the beginning of flowering, cutting off baskets and parts of inflorescences with peduncles up to 1 cm. Air-shade drying or up to 40 degrees.

Chem. Compound: flavonoids, essential oil, tannins.

DPS (diagnostic signs of raw materials), External signs of pharmaceutical products according to the State Fund XI: spherical baskets, single or several together, on short, up to 1 cm, felt peduncles, about 7 mm in diameter. The baskets have numerous flowers located on a bare bed, surrounded by a three-four-row involucre; its leaves are lemon-yellow, dry, filmy, shiny. The flowers are bisexual, tubular, five-toothed, with a tuft, lemon yellow or orange. The smell is weak, aromatic. The taste is spicy and bitter.

Action and application: choleretic, antispasmodic, increases the secretion of the glands of the stomach and pancreas, anti-inflammatory, antibacterial..

LF: Flowers,, infusion 1:10, tab. “flamin” (cholecystitis, biliary dyskinesia), choleretic preparations..

Side effect: allergic reaction.

Contraindications:.Individual intolerance to drugs.

Storage:. In dry, well-ventilated areas, Order 706 n

LRS Columns with corn silks - - StylicumstigmatisMaydis

Producing plant Common corn - Zea mays

Poaceae family - Poaceae

ZhFR (brief botanical description An annual plant 1-3 m high. Stems are solitary, knotty, bamboo-like. The leaves are linear, pointed. The flowers are unisexual: the staminate flowers are collected in apical panicles, the pistillate flowers are in cobs hidden in the axils of the stem leaves. The fruit is a yellow-orange grain. Collected into a cylindrical cob in vertical rows.

Geographical distribution The homeland of corn is Southern Mexico and Guatemala. It is cultivated everywhere in Russia, especially in forest-steppe and steppe regions. Grows mainly on fertile, moderately moist soils.

Harvesting, drying Pistil columns with stigmas (corn hair) are harvested in the summer in the stage of milky ripeness of the cobs, when harvesting corn for silage.

Chem. Compound: fatty oil, essential oil, bitterness, flavonoids, saponins, vitamins.

DPS (diagnostic signs of raw materials), External signs of pharmaceutical products according to the State Fund XI: has the form of bundles or lumps of densely tangled silky threads with a diameter of 0.1 mm and a length of up to 20 cm. At the end of the thread there are sometimes forked stigmas. Color yellow-brown. The smell is characteristic. The taste is sweetish-slimy.

Action and application: choleretic, antispasmodic, blood clotting agent, diuretic, mild laxative.

LF: Fasov. Raw materials,, infusion 1:10, Liquid extract, choleretic preparations..

Side effect: decreased appetite.

Contraindications:.Individual intolerance to drugs.

Storage:. In dry, well-ventilated areas, hygroscopic. Order 706 n

II. Questions for consolidation:

1. The mechanism of action of choleretic drugs.

2. Indications for the use of choleretic action.

3. List medicinal plants that have a choleretic effect

4. List herbal medicines that have a choleretic effect.

III.Homework:

Work with educational literature on the topic “Pharmaceutical medicines and herbal medicines that regulate the digestive system. Medicines with ulcer-healing action.” Presentations.

IV.References :

1.I.N. Sokolsky, I.A. Samylina, N.V. Bespalova. Pharmacognosy: Textbook. - M.: Medicine, 2003 pp. 192-204.

^State Pharmacopoeia of the USSR, XI ed. Part 11. - M.: Medicine, 1990.

3. Muravyova D.A. Samylina I.A., Yakovlev G.P. Pharmacognosy: Textbook, 4th ed. M.: Medicine, 2002.-

4. Kuznetsova M.A., Rybachuk I. 3. Pharmacognosy.-M.: Medicine, 1993.

5. Kurkin V.A. Pharmacognosy. - Samara: "SamSMU" - 2007

6. “Pharmacognosy” textbook for pharmaceutical colleges and technical schools Zhokhova E.V., Goncharov M.Yu., Povydysh M.N., Derenchuk S.V -M.: GEOTAR-Media, 2012 pp. 193,197-202,207

Federal Agency for Health and Social Development of the Russian Federation

State educational institution

Higher vocational education

Samara State Medical University

Roszdrav

Faculty of Pharmacy

Department pharmacognosy with botany and basics of herbal medicine

course work

on the topic: “Medicinal plants used for diseases of the liver and biliary tract”

Executor Lazareva Svetlana Nikolaevna

correspondence student

3 courses 31 groups

Scientific supervisor: Associate Professor of the Department of Pharmacognosy with Botany and Basics of Herbal Medicine

Avdeeva E.V.

Relevance of the chosen topic. In the last decade, the importance of herbal medicine in the treatment of diseases of the liver and biliary tract has increased significantly. This is due to the fact that many biologically active substances of plant origin are successfully used in combination with other drugs.

Currently, choleretic drugs in the form of galenic and novogalenic drugs are actively used in clinical practice. The method of combined pharmacotherapy is widely used in the treatment of many diseases of the liver, gallbladder and biliary tract (chronic hepatitis, cholangitis, cholecystitis, cholangiohepatitis, etc.).

The therapeutic effect of most herbal preparations used for liver pathology is aimed at reducing liver damage and fibrosis and correcting biliary dyskinesia. These violations act as universal disorders inherent in most liver diseases.

And the main place in the treatment of these diseases is deservedly given to herbal medicines. Choleretic drugs - choleretics, cholekinetics and cholespasmolytics - deserve special attention. A strict division of these drugs into the above groups is not always possible, since many of them have mixed effects.

Scientific and folk medicine More than 100 medicinal plants are known, classified as choleretic agents.

Purpose course work began to study the principles of treatment of diseases of the liver and biliary tract with medicinal plants.

When completing the course work, the following questions were set: tasks :

1) characterize the most common diseases of the liver and biliary tract;

2) consider the principles drug therapy these diseases;

3) study the composition and effect of medicinal plants used for the treatment of these diseases;

4) draw conclusions on the use of official medicinal plants in the treatment of liver diseases.

Chronic hepatitis- polyetiological chronic (lasting more than 6 months) liver lesions of an inflammatory-dystrophic nature with moderate fibrosis and predominantly preserved lobular structure of the liver. Among chronic liver diseases, chronic hepatitis is the most common.

The greatest importance is viral, toxic and toxicoallergic liver damage due to viral hepatitis, industrial, household, medicinal chronic intoxications (alcohol, chloroform, lead compounds, trinitrotoluene, atophan, aminazine, isoniazid, methyldopa, etc.), less often - viruses of infectious mononucleosis, herpes , cytomegaly. Chronic hepatitis is often observed with prolonged septic endocarditis, visceral leishmaniasis, and malaria. Chronic cholestatic hepatitis can be caused by prolonged subhepatic cholestasis (due to stone blockage or cicatricial compression of the common bile duct, cancer of the head of the pancreas, etc.) in combination with a usually associated inflammatory process in the bile ducts and passages, predominantly primary toxic or toxic allergic damage to cholangioles. It can also be caused by certain medications (phenothiazine derivatives, methyltestosterone and its analogues, etc.) or occur after viral hepatitis.

In addition to chronic hepatitis, which is an independent disease ( primary hepatitis), there are also chronic nonspecific hepatitis that occurs against the background of chronic infections (tuberculosis, brucellosis, etc.), various chronic diseases of the digestive tract, systemic diseases connective tissue, etc. (secondary, or reactive, hepatitis). Finally, in many cases the etiology of chronic hepatitis remains unclear.

Cholelithiasis- a common disease that affects more often women and older people. The etiological factors of this disease are very diverse: hereditary, constitutional, nutritional, sedentary lifestyle, various infections, etc. There are many theories regarding the development of this disease, the main ones are the following: infectious theory (epithelium of the mucous membrane of the gallbladder, microbes and others elements can serve as the “core” for the formation of stone); metabolic theory, according to which it is believed that the stone is formed due to a violation of the composition of bile, its consistency, and the ratio between bile acids and cholesterol; the main importance is given to the liver, with the active participation of which there is a violation of general metabolic processes in the body, hypercholesterolemia, stagnation of bile in the gallbladder and its thickening, which may be a consequence of biliary dyskinesia, neuropsychic disorders, reflex influences and etc.

At cholelithiasis characteristic acute attacks pain in the right hypochondrium - hepatic colic, pain in the epigastric region and throughout the abdomen, accompanied by nausea, sometimes vomiting, a feeling of heaviness in the liver, constipation, bloating, fever, sometimes urinary retention, bradycardia and pain in the heart of a reflex nature.

Urine becomes dark in color, feces are discolored, and icterus is sometimes noted skin and sclera.

Attacks can be frequent or very rare. Attacks of hepatic colic end either with the release of stones into the intestines, and then they can be found in the feces, or biliary colic is complicated by blockage of the neck of the gallbladder or cystic duct, followed by hydrops of the gallbladder, or blockage of the common bile duct, followed by obstructive jaundice, enlarged liver and angiocholitis with undulating fever and severe general condition. In such cases, the stone can pass into the duodenum or move into the intestine through the resulting fistula, which leads to infection of the biliary apparatus and makes possible the formation of a purulent process in the liver and the occurrence of sepsis.

Prevention of cholelithiasis includes measures aimed at preventing stagnation of bile, combating metabolic disorders, gastrointestinal diseases, especially constipation and infectious foci. All this is carried out by regulating the lifestyle of patients, using therapeutic exercises, sufficient movements on fresh air, because physical work affects the process of bile secretion, and increasing oxygen delivery improves blood supply to the liver. It is necessary to regulate the diet ( frequent meals small portions), since food intake affects the process of bile secretion, food irritants act on the mechanism that emptys the gallbladder and on the liver cells, mobilizing bile and stimulating its formation.

The mechanism of action of essential oils. The therapeutic effect of most herbal preparations used for liver pathology is aimed at reducing liver damage and fibrosis and correcting biliary dyskinesia. Essential oil plants are widely used in the treatment of diseases of the liver and biliary tract. Essential oils have a mild irritant effect, and, therefore, stimulate the evacuation of bile, and also relieve spasm of the biliary tract. Essential oils are active metabolites of metabolic processes, have antimicrobial, anti-inflammatory and antispasmodic effects, which is especially important for spasms of the biliary tract.

The mechanism of action of herbal preparations consists, in particular, in direct stimulation of the secretory function of hepatocytes (for example, essential oils of juniper, coriander, oregano, cumin), increasing the osmotic gradient between bile and blood and increasing the flow of water and electrolytes into the bile ducts, stimulating mucosal receptors small intestine, which promotes activation of the autocrine regulatory system and increased bile formation.

Mechanism of action of iridoids. When treating the liver and biliary tract, plants containing bitterness (iridoids) are used. Iridoids (for example, obtained from dandelion and yarrow) cause a reflex increase in the release of cholecystokinin, and therefore increase bile secretion.

In chronic cholestatic hepatitis, the main focus should be on identifying and eliminating the cause of cholestasis, in which case success can be expected from treatment measures.

The mechanism of action of flavonoids on the liver. The mechanism of choleretic action consistently includes irritation of the mucous membrane of the duodenum, the release of cholecystokinin, the latter causes contraction of the gallbladder and at the same time relaxes the sphincter of the hepatic-pancreatic ampulla. The antispasmodic effect of flavonoids is myotropic in nature.

Choleretic herbs improve bile excretory function liver, enhance the excretory function of the gallbladder and bile ducts. This entire complex, in addition to the liquid form of the medicinal drug, eliminates bile stagnation in the gallbladder. Thus, in this disease, herbal medicine serves as a pathogenetic method.

The mechanism of action of ions contained in plants. Magnesium ions included in herbal medicinal preparations can stimulate the secretion of cholecystokinin by epithelial cells of the duodenum, which is probably associated with the cholekinetic effect of arnica, birch, immortelle, rose hips and fennel. When combining plants with different mechanisms of cholekinetic action, the effect is enhanced. In addition to choleretic activity, many plants have antimicrobial, anti-inflammatory and antihypoxic effects, some have hepatoprotective properties.

Despite the emergence of powerful drugs in the arsenal of modern hepatology that make it possible to combat the causes of liver diseases and intervene in key stages of pathogenesis, doctors continue to turn to old, “time-tested” recipes. And in our time, herbal medicines are widely used in the treatment of hepatopathy.

Currently, hepatoprotectors are used in the complex therapy of liver diseases. Hepatoprotectors also include various herbal preparations that have a therapeutic effect on liver diseases. Among them, the most famous are various medicinal forms of milk thistle, celandine, fume, artichoke, chicory, yarrow, cassia, etc.

Herbal medicine for gallstone disease aims to reduce inflammation in the bile ducts and bladder, improve the outflow of bile, eliminate metabolic disorders, destruction of small stones and impact on accompanying illnesses.

For treatment, the following are used: chamomile flowers, sage leaves, birch leaves, calendula flowers, barberry leaves, plantain leaves, wormwood grass, calamus rhizomes, rose hips, knotweed grass, caraway fruits, corn silk, tansy flowers, thyme, etc.

The dissolution of stones is facilitated by knotweed, wild strawberry leaves, rosehip roots, etc.

Common yarrow - Achillea millefolium .

The Astrov family - Asteraceae .

Yarrow grass - Herba Millefolii .

Herbaceous perennial. Stems up to 20-60 cm high are erect, branched, rounded, finely grooved, with shortened leafy branches in the axils of the upper and middle stem leaves. The leaves are alternate, linear-lanceolate, doubly pinnately dissected, with two- and three-incised segments and almost linear terminal lobes.

The root leaves are petiolate, 35-50 cm long, the stems are sessile. The rhizome is thin, creeping, rooting in the nodes. Inflorescences are small (up to 5 mm long), numerous baskets, collected at the top of the stems into complex shields. The marginal reed flowers are white (less often pink), the inner ones are jagged and yellow.

Found in the European part of the USSR, the Caucasus, Western and Eastern Siberia, less often on Far East And Central Asia. The main thickets of yarrow are located in the southern part of the forest zone, as well as in the forest-steppe and steppe regions of the European part of the USSR. The main commercial harvesting areas are Bashkiria, the Volga region, Ukraine, Belarus, Rostov and Voronezh regions. It grows in dry meadows, elevated parts of floodplain meadows, forest edges, clearings, young fallow lands, roadsides, shelter belts, parks, young forest plantations and populated areas. Often forms thickets over an area of ​​several hectares.

Grass is harvested as a raw material. The grass is harvested in the flowering phase (June - the first half of August), cutting off the leafy tops of shoots up to 15 cm long with sickles, knives or pruners, without the rough, leafless stem bases. Areas where yarrow grows abundantly can be mowed with scythes, and then grass can be selected from the mowed mass. When collecting inflorescences, cut off the corymbs with peduncles no longer than 2 cm and individual flower baskets. The raw materials are collected in dry weather, folded loosely and immediately sent for drying. Plants should not be uprooted, as this will destroy the bushes. When carrying out rational harvesting, the same areas can be used for several years in a row. Then giving the bushes a rest for 1-2 years. Dry the raw materials in the open air in attics, as well as under sheds, spreading them in a layer 5-7 cm thick on paper or fabric with periodic stirring. The yield of raw materials is 20-25% by weight of freshly harvested.

Grass. External signs. Scutellums with stem remains no longer than 15 cm; there are individual baskets and groups of them. The baskets are small, ovoid, 3-4 mm long, collected in dense scutes. Marginal flowers are ligulate, whitish, less often pink, pistillate, usually in number 5. The stems are pubescent, grayish-green, often with alternate stem leaves. The leaves are lanceolate, doubly pinnately dissected. The leaf blade lobes are cut into 3-5 lanceolate or linear lobes. The leaves are drooping in erect hairs. Color grey-green; the smell is aromatic, peculiar; the taste is bitter.

Numerical indicators. Moisture no more than 13%; total ash no more than 15%; ash, insoluble in a 10% solution of hydrochloric acid, no more than 3%; crushed parts passing through a sieve with a hole diameter of 1 mm, no more than 3%; stems thicker than 3 mm no more than 3%; foreign impurities: organic no more than 0.5%, mineral no more than 1%.

Chemical composition . The aerial part of yarrow contains 0.8% essential oil, which includes millefolide, chamazulene, etc. The essential oil also contains monocyclic monoterpenes (cineole), bicyclic monoterpenes (thujone, thujol, camphor-borneol), and the sesquiterpene caryophyllene. The accompanying components of the essential oil are formic, acetic and isovaleric acids. The second group of BAS should include flavonoids - glycosides of apigenin (cosmosiin), luteolin (cinaroside), cacticin, artemetin, rutin, which determine the choleretic properties of yarrow preparations. In addition, it contains phenylpropanoids - derivatives of chlorogenic acid. Yarrow herb contains nitrogenous substances - the alkaloid betonicine, which also determines the bitter properties of the drugs betaine, stachydrine, and choline.

The herb contains vitamin K in an amount sufficient to exhibit an active hemostatic effect.

Related substances also include sterols - β - sitosterol, stigmasterol, campestrin.

Application. The herb and flowers of yarrow are used in the form of infusion, liquid extract as an aromatic bitterness to improve appetite for gastritis and as a remedy against inflammation of the mucous membranes of the gastrointestinal tract. intestinal tract And oral cavity. Yarrow herb is included in different fees and drugs (choleretic collection No. 1, Liv - 52). The liquid extract is prescribed as a hemostatic agent for hemorrhoidal, uterine and other bleeding. The liquid extract is part of the drug "Rotokan".

Common tansy – Tanacetum vulgare .

The Astrov family - Asteraceae .

Tansy flowers - Flores Tanaceti .

Tansy is a perennial herbaceous plant with a strong, distinctive odor. The rhizome is horizontal, multi-headed. Stems 50-150 cm high, numerous, erect, grooved, branched in inflorescence, glabrous or slightly pubescent. The leaves are alternate, elliptical in outline, up to 20 cm long, pinnately dissected or pinnately divided, short pubescent or almost glabrous. The lowermost leaves are petiolate, the rest are sessile; their lobes are oblong-lanceolate, pinnately incised or jagged, serrate along the edge. The midrib of the leaf between the main lobes also carries small adventitious lobes. Flower baskets are hemispherical, almost flat on top, 5-8 mm in diameter, collected in dense apical scutes; The outer leaves of the involucre are ovate-lanceolate, pointed, the inner ones are oblong-ovate, obtuse, at the apex and along the edges with a narrow light or brownish border. All flowers are yellow or orange-yellow, tubular. The fruits are oblong achenes with or without a short, finely serrated margin.

Blooms in July-August. The fruits ripen in August - September.

Area, cultivation. Tansy is distributed throughout almost the entire European part of Russia and the CIS countries, except for Transcaucasia, the lower reaches of the Volga and Ural, and the eastern regions of the Ciscaucasia. It also grows in the southern forest, forest-steppe and steppe zones of Western Siberia and northern Kazakhstan. In Eastern Siberia, the Far East, Eastern Kazakhstan and Kyrgyzstan, it is found only as an alien plant.

Common tansy is a plant of forest and forest-steppe zones, rising into the mountains to the mid-mountain zone. Through meadows and weedy habitats it enters steppe and semi-desert zones. It often forms thickets near dwellings, on weedy places, pebbles, railway rashes, coastal sands, clearings and among bushes. The main procurement of tansy is carried out in the Central regions of the Russian Federation, Rostov region, Volga region, Bashkortostan, Belarus, and Ukraine. Mass procurement possible in Western Siberia(Tomsk region. Altai region).

Preparation, drying. Tansy inflorescences are prepared as raw materials, which are collected at the beginning of flowering by cutting off the baskets and parts of complex corymbose inflorescences with a common peduncle no more than 4 cm long (counting from the upper baskets). You cannot collect tansy raw materials in heavily polluted places - along railway embankments, along highways, etc. The collected raw materials are placed in paper or fabric bags and delivered to the drying site. Before drying, you should inspect the raw materials and remove impurities and flower stalks longer than 4 cm from them. Dry the raw materials under sheds, in attics, in air or heat dryers at a temperature not exceeding 40 ° C.

Medicinal raw materials. The raw materials are collected at the beginning of flowering and dried inflorescences (flowers) of a perennial wild plant. herbaceous plant - common tansy.

External signs. Whole raw materials. Parts of a complex corymbose inflorescence and individual flower baskets. The baskets are hemispherical in shape with a depressed middle, 6-8 mm in diameter, and consist of small tubular flowers: marginal - pistillate, middle - bisexual. The receptacle is bare, inhollow, slightly convex, surrounded by an involucre of imbricated lanceolate leaves with a membranous edge. Peduncles are furrowed, bare, less often slightly pubescent. The color of the flowers is yellow, the involucre leaves are brownish-green, and the peduncles are light green. The smell of the raw materials is peculiar, the taste is spicy, bitter.

Chemical composition. Flower baskets contain essential oil (about 1.5-2%), which is the leading group of BAS of this raw material. The dominant components of the essential oil are bicyclic monoterpene ketones - α-thujone and β-thujone (up to 47-70%). Among other terpenes in significant quantities contains thujol, camphor, borneol, camphene, pinene, 1,8-cineole, n-cymene, limonene, etc.

Associated substances are represented by organic (citric, tartaric), phenolcarbopic and hydroxycinnamic acids (caffeic acid), bitterness and tannins.

Pharmachologic effect. An anthelmintic and choleretic agent, which also has antispasmodic and anti-inflammatory properties. Total tansy preparations (infusions) can cause allergization. The above-ground part of the plant has insecticidal properties.

Application. Tansy inflorescences are used in the form infusion as a choleretic and anthelmintic agent (for ascariasis and pinworms). The raw material is also included in choleretic preparations used for various liver diseases, including cholecystitis. Flowers are included choleretic collection № 3 , as well as in the composition of choleretic, antispasmodic and anti-inflammatory drugs "Polyphytohol".

A choleretic drug is produced based on the amount of flavonoids "Tanacehol" (0.05 g tablets) (developer - VILAR), recommended for chronic cholecystitis, biliary dyskinesia. Tansy preparations are not recommended for use during pregnancy.

Three-leaf watch – Menyanthes trifoliata .

The Vakhtov family - Menyanthaceae .

Leaves of the watch trifoliate - Folia Menyanthidis .

Trefoil trefoil (water trefoil) is a perennial herbaceous aquatic plant with a long, creeping, jointed, thick rhizome. The apex of the rhizome rises slightly and bears several trifoliate, long-petiolate, simple, alternate leaves. The petioles of the leaves are up to 20 cm long, at the base they are expanded into long membranous sheaths. Leaves are short-petiolate, entire, glabrous, obovate or elliptic.

In spring, the trefoil develops a flower arrow up to 30 cm long. The flowers are pale pink, about 1 cm in diameter, collected in a thick raceme 3-7 cm long. The corolla is 10 - 14 mm long, with 5 sharp lobes, funnel-shaped, densely white-pubescent on the inside; 5 stamens attached to the corolla tube. The ovary is superior, unilocular. The fruit is an almost spherical multi-seeded capsule that opens with two doors.

The plant blooms in May–June. The fruits ripen in June – July.

Collected after flowering and dried leaves of a wild perennial herbaceous plant, used as a medicine and medicinal raw material.

Area, cultivation. Vahta trifolia grows in almost the entire European part of Russia (except for the southernmost regions), in Western and Eastern Siberia and in the Far East. The plant is very rarely found in Crimea, the Caucasus and Central Asia. Water trefoil grows in grassy and mossy swamps, marshy and marshy banks of lakes, rivers and reservoirs, in marshy meadows and swampy forests. The plant forms pure thickets or is found in a community with cinquefoil, horsetails, whitewing and sedges. Prefers the outskirts of overgrown lakes, the banks of stagnant and weakly flowing reservoirs, and swampy meadows. The main procurement is carried out in the northern regions of Russia (Karelia, Tomsk region, Krasnoyarsk Territory, Yakutia), in Belarus, Lithuania and Ukraine.

Preparation, drying. The growth of trefoil leaves is most intense in June, after the plant has flowered, so they should be collected after flowering, that is, in July-August. It is best to collect shamrock leaves in warm weather, as the collectors usually have to go into the water. Shamrocks are often collected from boats. Only fully developed leaves are harvested, cutting them off with a short (no longer than 3 cm) remaining petiole. Young and apical leaves cannot be harvested, as they turn black when dried. You should not pull out the trefoil with its rhizome, as this leads to the destruction of its thickets. Repeated harvesting on the same arrays is possible no more than after 2-3 years. The collected leaves are laid out in the wind for several hours, and then placed in a loose layer in an open container (boxes, wicker baskets, etc.) and quickly delivered to the drying site. The raw materials are dried in dryers at a temperature not exceeding 45-5СГС (or in attics under an iron, tiled or slate roof, in barns and other well-ventilated rooms, with trefoil leaves spread out thin layer on racks).

Medicinal raw materials. The raw material is the collected and dried leaves of a wild perennial herbaceous plant - the three-leaved plant.

External signs. Whole or partially crushed, thin, bare trifoliate leaves with a petiole remnant up to 3 cm long. Individual leaves are elliptical or oblong-obovate, entire or with a slightly uneven edge, 4-10 cm long, 2.5-7 cm wide. The color of the raw material is green. , the smell is weak, the taste is very bitter.

Chemical composition. The leaves of Trefolia contain iridoids or bitters (the leading group of ALS), including the secoiridoids loganin, sweroside, foliamentin and menthiafolin.

The flavonoid compounds rutin, hyperoside, and trifolin can be interpreted as the second group of BAS that determine the choleretic properties of this plant. The raw material also contains phenylpropanoids (ferulic acid), tannins (up to 3-7%), carotenoids, ascorbic acid, traces of monoterpene alkaloids (gentianine, heptcyanidin), iodine.

Pharmachologic effect. Bitterness (appetite stimulant and choleretic), which has sedative properties.

Application. Trefoil leaves are used as infusion V as a bitterness to improve digestion, as well as for diseases of the liver and biliary tract. Trefoil leaves are part of the preparations - appetizing, choleretic and sedative. In addition, they produce thick extract, used for cooking complex bitter tincture.

Common centaury – Centaurium erythraea .

Gentchavkov family - Gentianaceae .

Centaury grass - Herba Centauria .

Biennial herbaceous plant 35-40 cm high. The roots are small, poorly developed; stems are erect, single or several, tetrahedral, often forked at the top with branches directed upward. Stem leaves are opposite, sessile, longitudinally lanceolate, up to 3 cm long with clearly visible veins, basal leaves are collected in a rosette. The flowers are up to 1.5 cm long, dark pink, with a nail-shaped 5-petalled corolla, collected in dense umbellate-paniculate inflorescences. It is found throughout almost the entire northern, middle and southern zones of the European part of the USSR, and in the Caucasus. It grows mainly in dry meadows, watersheds and ravines. In more southern areas it is found in floodplains, along the edges of lakes, swamps, ponds, streams and canals. Sometimes it grows in scattered thickets whose area reaches 1 hectare, more often found in smaller groups. It reproduces only by seed, usually blooming in the 2-3rd year of life. One of the main areas of industrial procurement of centaury is the Ukrainian Carpathians.

Grass harvesting is carried out during flowering, while the basal leaves are preserved (usually in July - August). Cut the grass with a knife or sickle above the basal leaves; It is forbidden to pull out centaury with its roots. The cut grass is placed in baskets with inflorescences in one direction. Dry in dryers at a temperature of 40-50 ° C or in attics under iron, tiled or slate roofs, less often under a canopy) by spreading the grass in a thin layer on paper or fabric so that the inflorescences are located in one direction. When dried in a thick layer or prolonged rainy weather, especially in mixed areas with poor ventilation, the grass turns yellow and the flowers become discolored or turn black. Drying in bundles is not allowed, as this leads to discoloration of the raw material or rotting inside the bundle. The yield of dry raw materials is about 25% of the mass of freshly collected raw materials.

Chemical composition. The herb contains monoterpene glycosides (sveroside, gentiopicrin, erythrocentaurine). The second group of BAS contains xanthones, among which primverosides and rutinosides superirin predominate. Also contains alkaloids, flavonoids, phenolcarboxylic acids, nicotinamide, oleanolic acid.

External signs. Stems are leafy with flowers, straight, single or branched, green or yellowish-green, glabrous, hollow, ribbed, 10-30 cm long, 2 mm thick. The basal leaves are collected in a rosette, oblong-obovate, obtuse, narrowed at the base, from 4 cm long, 2 cm wide; stem leaves sessile, opposite
oblong-lanceolate, pointed, entire, glabrous, inflorescence corymbose-paniculate; flowers pink-violet. The smell is weak; the taste is bitter.

Application. The herb (whole, cut) is used as an appetite stimulant in the form of an infusion; is part of choleretic preparations and bitter tinctures.

Dandelion officinalis – Taraxacum officinale .

The Astrov family - Asteraceae .

Dandelion roots - Radices Taraxaci .

A perennial herbaceous plant with short rhizomes and a fleshy, slightly branched taproot. The leaves in the basal rosette are glabrous or sparsely hairy, 10-25 cm long, deeply pinnately cut, gradually tapering into a long winged petiole. Peduncles up to 30 cm long, cylindrical, hollow, bare below, cobwebby-fluffy above. The flowers are collected in large baskets with a diameter of up to 5 cm. All flowers are bisexual, the reeds are bright yellow.

It is found almost throughout the entire territory of the USSR, with the exception of the Arctic. More rare in Eastern Siberia and the Far East. The main thickets are located in forest, forest-steppe and northern steppe regions of the European part of the USSR. The main commercial harvesting areas are Ukraine, Belarus, Bashkiria, Voronezh, Kursk and Kuibyshev regions. It grows in meadows (especially near villages), pastures, roadsides, streets, courtyards, vegetable gardens, parks, sometimes as a weed in crops.

The roots are harvested in the spring, at the beginning of the plant's regrowth (April - early May) or in the fall (September - October). They are dug out with a shovel or plowed with a plow to a depth of 15-25 cm. On dense soils, the roots are much thinner than on loose soils. Repeated harvesting in one place should be carried out at intervals of 2-3 years. The dug roots are shaken off the ground, the aerial parts, rhizome (“neck”) and thin lateral roots are cut off and immediately washed in cold water. Lay out to dry in the open air for several days (until the milky juice stops secreting when cut); dry in attics under an iron roof or under a canopy with good ventilation, spread out in a thin layer (3-5 cm) with periodic stirring. Can be dried in ovens or drying cabinets at a temperature of 40-50 °C. The yield of dry raw materials is 33-35% by weight of freshly harvested.

Dried roots of wild perennial plant Dandelion officinalis, used as a medicine and medicinal raw material.

External signs. The roots are whole or in pieces from 2 to 15 cm long, 0.3 to 3 cm thick, simple or slightly branched, longitudinally wrinkled, sometimes spirally twisted, dense, heavy. In the center of the root there is small yellow or yellowish-brown wood, surrounded by wide grayish-white bark, in which brownish concentric thin belts of laticifers are visible (under a magnifying glass). The outside color is light brown and dark brown; no smell; the taste is bitter with a sweet aftertaste.

Chemical composition. The roots contain bitter substances of sesquiterpene nature (lactucopicrin, tetrahydroridentin B, taraxolide, taraxic acid), bitter glycosides (taraxacin and taraxacerin). Also contains polysaccharides (inulin), sugars, fatty oil. Triterpene compounds (arnidiol, faradiol) and sterols were isolated from the roots. The milky juice contains resinous substances of rubber nature.

Dried roots of the wild perennial plant Dandelion officinalis, used as a medicine and medicinal raw material.

Application. The roots (whole, cut, crushed) are prescribed as a bitterness as a means of stimulating appetite and improving digestion; are used as a choleretic agent. It is used in the form of a decoction, it is part of the preparations, and thick dandelion extract is used to make pills.

Peppermint - Mentha piperita .

Family Lamiaceae - Lamiaceae .

Peppermint leaves - Folia Menthae piperitae .

Etymology of the name, historical background. Generic Latin name Mentha comes from the name of the beloved Hades - the god of the underworld and the kingdom of the dead: Hades turned her into a mint plant. According to myth, the generic name Mentha (Greek minthe ) comes from the name of the nymph Minta, who was transformed by Proserpina into a plant dedicated to Aphrodite.

Species name from Lat. piper - pepper, plperitus - burning. The generic name passed into Slavic languages, changing into the modern Russian word “mint”. Peppermint is also called “English mint”, as this species was developed in England in the 17th century, and also “cold mint” due to the long-lasting cold sensation in the mouth and tongue. According to other researchers, peppermint is a more ancient cultivated species.

In the wild, water mint, green mint, and also M. pulegia (flea beetle) are widespread. IN Ancient Rome rooms were sprinkled with mint water, and tables were rubbed with mint leaves to create a cheerful mood among guests. It was believed that the smell of mint stimulates the brain (the Roman historian Pliny the Elder constantly wore a wreath of fresh herbs and mint on his head, recommending that his students do the same, so students in the Middle Ages were advised to wear wreaths of mint on their heads during classes).

In Russia, peppermint was introduced into cultivation in early XVIII V. (in pharmaceutical gardens). Currently, it is one of the most important industrial essential oil crops.

Peppermint is a perennial herbaceous plant up to 60-100 cm high. The stems are branched, tetrahedral, bare or with sparse hairs, densely leafy. The leaves are opposite, short-petiolate, oblong-ovate, with a pointed apex and a heart-shaped base. The edge of the leaf is unevenly serrated, with the leaves being dark green on the upper side and light green on the lower side. There are numerous essential oil glands on both sides of the leaves. The flowers are small, red-violet, with a slightly irregular four-lobed corolla, collected at the tops of stems and branches in inflorescences - spike-shaped thyrsos. The rhizome is horizontal, branched, with fibrous thin roots extending from the nodes of the rhizomes. Many young underground shoots develop from the rhizome, located close to the soil surface, some of them penetrate deep into the soil and take on the character of rhizomes, and some emerge to the surface of the soil and spread from above in the form of lashes. The whole plant has a characteristic strong aroma. Blooms from late June to September.

Area, cultivation. Peppermint is unknown in the wild. It is assumed that peppermint is a triple hybrid (see diagram), from which the corresponding varieties and two main forms are obtained - black and pale (white).

Origin of peppermint. The black form of peppermint has stems and leaves that are dark, reddish purple (anthocyanin). The pale (white) form of peppermint lacks anthocyanin coloring and has light green leaves and stems. In this case, the term “pale” emphasizes not the color, but the degree of coloring. White mint essential oil has a more delicate odor than anthocyanin mint oil, but the latter is more productive (in terms of oil yield and menthol content).

Both forms of peppermint are cultivated in Russia. The black form of mint is an industrial source of menthol. There are a number of valuable high-menthol industrial varieties of this form, the leaves of which contain up to 5-6% essential oil containing 65-70% menthol (varieties “Prilukskaya-6”, “Krasnodarskaya-2”, “Kubanskaya-5.41” and etc.). The pale form of mint is more valuable for the needs of the perfume and food industries, where the aroma of the oil is important.

Mint propagates vegetatively, by segments of rhizomes (6-10 cm in length) and young shoots from rhizomes that have overwintered in the soil.

The main cultivation areas in Russia are the North Caucasus (Krasnodar Territory), Voronezh region, and within the former USSR - Ukraine, Moldova, Belarus. Breeding work is aimed at developing mint varieties with high yields, rich in menthol in oil and characterized by resistance to fungal diseases and pests.

Harvesting, primary processing and drying. Peppermint leaves are harvested at the beginning of flowering, that is, when flowering occurs in approximately half of the plants. The grass is mowed, withered in windrows and dried in dryers at a temperature not exceeding 40 ° C or in the shade under canopies. The dried grass is threshed, the stems are separated and discarded.

Freshly harvested peppermint herb is used to obtain essential oil.

Medicinal raw materials. Mechanically collected and threshed, dried leaves of a perennial cultivated herbaceous plant - peppermint - are collected during the flowering phase.

External signs. Pieces of leaves of various shapes, up to 10 mm in size or more, with an admixture of flowers and buds. The edge of the leaf is serrated with unequal sharp teeth; the surface is bare, only from below along the veins under a magnifying glass are sparse, pressed hairs visible, and throughout the entire leaf blade are shiny golden-yellow or darker glands. Leaf color ranges from light green to dark green. The smell is strong, aromatic. The taste is slightly hot and cooling.

Chemical composition. Peppermint leaves contain essential oil (leading group of BAS) (about 3-5%). The inflorescences are the richest in essential oil (4-6%). A low content of essential oil (about 0.3%) was noted in the stems. The main components of mint oil are monocyclic monoterpene - menthol (50-80%), as well as other terpenoids - menthone (10-20%), mentofuran (up to 5-10%), pulegone, menthol esters with acetic (menthylaceate) and isovaleric acids (5-20%).

Peppermint oil also contains associated terpenes: limonene, α-phellandrene, ospine and β-pinene, as well as free acetic and isovaleric acids.

The second group of BAS should include flavonoids, represented by derivatives of apigenin (mentoside), luteolin, hesperidin, etc., which determine the choleretic properties of the infusion and other total preparations of peppermint (tincture, collections).

Among the accompanying substances of peppermint leaves, triterpene saponins (ursolic and oleanolic acids) (up to 0.5%), tannins (5-10%), carotenoids (up to 40 mg%), betaine, etc. should be noted.

Peppermint oil is an easily mobile, almost colorless oily liquid with a refreshing odor and a cooling, long-lasting, pungent taste. In accordance with the Global Fund of the X edition, free menthol in the oil must be at least 46%. When the oil is cooled to -10 °C, menthol begins to crystallize.

Pharmachologic effect.

Antispasmodic, anti-inflammatory, choleretic agent, which also has sedative, antiseptic, analgesic properties.

Application. Peppermint leaves in shape infusion used as an antispasmodic, choleretic, and digestive improver.

Peppermint leaves are included in choleretic fees No. 1 And № 2.

From the leaves of peppermint it is obtained tincture, which is a mixture of equal parts of extract in 90% alcohol (1:20) and peppermint oil and is used as a remedy against nausea and vomiting, as an analgesic, and also as a corrigens to improve the taste of mixtures.

Peppermint essential oil is widely used in medicine as a refresher and antiseptic, and in perfumery in the form of aromatic waters, toothpastes and powders. Peppermint oil is an integral part of numerous drugs (“Corvalol”, “Valocordin”, “Mint tablets”, etc.) that have a calming, antispasmodic, and anti-nausea effect.

Menthol part of complex cardiovascular drugs (validol, Zelenin drops, etc.), and is also used to produce painkillers (“Menovazin”), antiseptics (“Pektusin”, etc.), anti-migraine pencils, ointments ("Efkamon") all kinds of drops, including for a runny nose ("Eucatol"), inhalation mixtures (“In gakamf") etc.

Natural menthol is obtained by freezing at a temperature of -10 ° C or by converting it into an ester boric acid followed by steam distillation.

The most significant effect of mint and the essential oil it contains is their choleretic and choleretic effect. It has been established experimentally that an extract from mint leaves increases bile secretion 9 times. Under the influence of an infusion of mint leaves, a gradual increase in bile secretion occurs.

Peppermint oil, like chamomile essential oil, has a pronounced antispasmodic effect.

Based on these properties, a decoction of mint leaves is used for cholecystopathy, gastritis, as well as gastrointestinal and biliary colic pain of any etiology.

Barberry ordinary – Berberis vulgaris.

Barberry family - Berberidaceae .

Common barberry leaves - Folia Berberidis vulgaris .

Common barberry is a branched thorny shrub up to 3 m high with a powerful root system. Branches with tripartite spines up to 2 cm long, in the axils of which there are shortened shoots with bunches of leaves. The bark of old stems is gray, cracking; on young stems it is furrowed, yellow-brown or yellowish-gray. The leaves are elliptical, obovate, sharply serrated along the edge, narrowed into a short petiole, leaves 3-6 cm long, 2-3 cm wide. Flowers in drooping racemes 3-6 cm long, three-membered with a double perianth, yellow corolla. The fruit is a juicy oblong single leaflet, 9-10 mm long, purple to dark red in color, usually with a slight waxy coating, the taste is very sour. The seeds are oblong, dark brown, somewhat flattened.

The rhizome is horizontal, a large main root with lateral branches emerges from it, with bright yellow wood. The bulk of the lateral roots are located at a depth of 10-30 cm. The rhizomes have numerous buds, due to which the plant has a pronounced ability for vegetative propagation. IN natural conditions after removing above-ground shoots or after they have been frozen, common barberry produces abundant growth. Sometimes cases of vegetative propagation through rooting of above-ground shoots are observed. It blooms in May-June (depending on habitat conditions), the fruits ripen from late July to September.

Area, cultivation. Common barberry grows in the European part Russian Federation, and the main reserves of this plant are concentrated in the North Caucasus. Significant thickets of common barberry are noted in the upper reaches of the Kuban and its tributaries. Procurement of raw materials is carried out in the Krasnodar and Stavropol territories, in Dagestan.

Within the CIS, common barberry is widespread in Transcaucasia (Azerbaijan, Georgia), Ukraine (mainly in Crimea) and is widely cultivated.

Common barberry is found from the sandy coasts of the Black Sea to the subalpine zone (1700 m above sea level). It grows on rocky slopes in the mountains, as well as in floodplains of rivers and streams. The plant is found mainly in disturbed plant communities, sparse oak forests, bleached pine forests, and thickets of dry-loving shrubs.

Leaves are harvested during the budding and flowering phase. The raw materials are dried in a well-ventilated area under a canopy or in dryers at 40 - 50°C.

External signs. Barberry roots are cylindrical, straight or curved pieces of woody roots from 2 to 20 cm long, up to 6 cm thick, with a coarse fibrous fracture. The color of the roots on the outside is grayish-brown or brown, at the break they are lemon-yellow. The smell is weak, peculiar, the taste is bitter. The shelf life of raw materials is 3 years.

The leaves of barberry are dark green and matte on the upper side, and much lighter on the lower side. Both sides are covered with a waxy coating (they are not wetted with water). The smell is peculiar, the taste is sour.

Chemical composition. Barberry roots contain isoquinoline alkaloids of the protoberberine group, the main one of which is berberine (0.47-2.38%), which is responsible for the yellow color of this raw material. Berberine is found in plants in two forms: ammonium, that is, in the form of the corresponding salt of berberine (the OH group is replaced by an acidic residue) and carbinol, corresponding to the structure of a free alkaloid (base).

The roots also contain palmatine, iatrorizine, columbanine, berberrubine, magnoflorine and other alkaloids. Along with protoberberine derivatives, the roots contain alkaloids of the bisbenzylisoquinoline group - oxyacanthin and berbamine. The largest amount of alkaloids accumulates in the root bark (up to 15%), and berberine - up to 9.4%. Chelidonic acid (a derivative of γ-pyrone) was found in the roots.

The main raw materials are bark, roots and fruits. Barberry contains a huge amount of biologically active substances, various alkaloids (berberine, palmatine, etc.), organic acids (malic, tartaric, citric), vitamin C, and carotenoids.

Pharmachologic effect. Choleretic agent.

Application. It has been established that a decoction and alcohol infusion from the roots, as well as a total extract from the alkaloid mixture of barberry, actively stimulate the secretion of bile. Berberine alkaloids stimulate the production of bilirubin and the effect of bile acids, increase bile flow and cause contraction of the gallbladder.

Barberry raw materials, as well as herbal preparations obtained from it (berberine bisulfate - Berberini bisulfas, alcohol tincture), are used as agents that provide choleretic, tonic, antimicrobial, gastrointestinal effect. Recommended for cholecystitis, including calculous, chronic hepatitis, hepatocholecystitis, atony of the gallbladder and insufficient bile secretion during the recovery period after infectious diseases, and other cases.

Currently in medical practice Over 17 thousand medicines are used in the Russian Federation, of which about 40% are made from plant materials. The share of herbal preparations used for the treatment of diseases of the liver and biliary tract is 70%. In addition, there is currently a trend towards an increasingly widespread use of herbal medicines both for the treatment and prevention of diseases of the biliary system.

Although most herbal medicines have not undergone randomized controlled clinical trials, they continue to occupy a worthy place in the treatment of various diseases of the liver and biliary tract. Similar drugs cannot be classified as essential medicines with proven and predictable effectiveness and powerful potential. However, as practice shows, their use is justified as additional, auxiliary, or even alternative means of treatment.

High choleretic and choleretic effect The above herbal preparations are often associated with a number of other effects inherent in these plants, such as: antispasmodic, anti-inflammatory, gas absorption, hepatoprotective, laxative, etc., which in their totality can determine greater effectiveness in the treatment of liver and gallbladder diseases. This can be achieved by the combined use of several types of medicinal plants, the main actions of which complement each other.

It should be borne in mind that in herbal medicine for chronic diseases of the liver and gallbladder, treatment with selected plants should usually last for several months. In this case, it is advisable, several weeks after treatment with one type of plant, to switch to the use of another species that has similar action. Rationally composed combinations of medicinal plants are also useful.

In the last decade, herbal medicine and traditional medicine have received well-deserved recognition. The success of this approach to treatment is undeniable, scientifically substantiated and confirmed by centuries of experience in herbal medicine.

Consequently, today it is very important to search for rational ways to use medicinal plants and medicinal plants in accordance with the principles of modern therapy.

In my opinion, herbal medicine for diseases of the liver and biliary tract, as a scientifically based method of treatment and prevention, should not only remain in our lives, but also develop creatively, taking into account modern trends in medicine.

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Abstract: “Medicinal plants used for diseases of the liver and biliary tract. The use of choleretic drugs for certain diseases Thank you Currently choleretic drugs with complex treatment and prevention various diseases liver and gallbladder are used quite widely in the clinical practice of a gastroenterologist. This is due to the effects choleretic drugs, which relieve painful attacks, alleviate the course of the disease, and also prevent the deterioration of the condition or the emergence of a new pathology provoked by decompensation of an existing disorder. To understand why choleretic drugs are needed, you should know what bile is, what its physiological functions are and how it moves in the digestive system. Bile is a biological fluid produced by liver cells and accumulates in the gallbladder. The liquid has a bitter taste, a specific odor and, depending on how long it was produced, can be yellow, brown or greenish in color. Bile performs the following physiological functions in the human body: Emulsification and digestion of fats received from food; Activation of enzymes of the small intestine and pancreas necessary for complete digestion of food; Ensures complete absorption of fat-soluble vitamins, calcium and cholesterol. Activation of enzymes of the small intestine and pancreas is carried out due to the fact that bile neutralizes the effect of pepsin, which came from the stomach with the food bolus. After neutralization of pepsin, the necessary conditions for enzyme work small intestine and pancreas. Emulsification of fats is carried out by bile acids contained in bile, which in addition improve intestinal motility, stimulate the formation of protective mucus and prevent the attachment of bacteria and proteins to the mucous membrane. Thanks to these effects, bile prevents constipation and intestinal infections. In addition, bile is necessary for the excretion of substances such as cholesterol, bilirubin, glutathione and steroid hormones from the human body along with feces. Bile is synthesized by liver cells and enters the gallbladder through special ducts. Then from the gallbladder, also through the duct system, it enters the duodenum, where it performs its physiological functions. That is, the gallbladder is a kind of reservoir for the temporary storage of bile from the moment of its production until the food bolus enters the duodenum. Classification of choleretic drugs Currently, an anatomical-therapeutic-chemical classification of choleretic drugs is used, which takes into account chemical structure the medicinal substance used, and its therapeutic effects, and anatomical structures affected by the drug. This integrated approach allows us to create the most complete classification, reflecting various aspects of application, therapeutic effects and characteristics of absorption, distribution and excretion of drugs from the human body. So, today choleretic drugs are classified into the following groups and subgroups: 1. Choleretics(drugs that increase bile production by liver cells): True choleretics, increasing bile production due to the active synthesis of bile acids: Choleretics containing bile acids and made from plant or animal raw materials (for example, animal bile, plant extracts, etc.); Synthetic choleretics, which are chemical substances obtained by organic synthesis and have the property of increasing bile production; Medicinal herbs that have a choleretic effect (used in the form of infusions, decoctions, etc.). Hydrocholeretics, which are substances that increase the volume of bile by diluting it and increasing the percentage of water in it. 2. Cholekinetics(drugs that improve the flow of bile by increasing the tone of the gallbladder and simultaneous relaxation of the bile ducts). 3. Cholespasmolytics (drugs that improve the flow of bile by relaxing the muscles of the gallbladder and biliary tract): Anticholinergics; Synthetic antispasmodics; Antispasmodics made from plant materials. 4. Drugs to reduce the bile lithogenicity index (the products prevent the formation of gallstones and promote the dissolution of existing ones): Preparations containing bile acids – ursodeoxycholic or chenodeoxycholic; Preparations containing highly active solvents organic compounds lipid nature, for example, methyl tert-butyl ether. True choleretics, containing bile acids as active components, are medicinal preparations, mainly made from animal raw materials. The most commonly used raw materials are natural bile, extracts of the liver or pancreas, as well as tissue from the mucous membrane of the small intestine of healthy animals. That is why choleretic drugs of this group are often called drugs of animal origin. In addition to animal raw materials, many complex preparations may include extracts of medicinal herbs that have the necessary choleretic effect. Synthetic choleretics are drugs that contain only compounds obtained through organic synthesis as active substances. In addition to the choleretic effect, drugs in this group also have the following therapeutic effects: antispasmodic (reduce pain in diseases of the biliary tract and gallbladder), hypolipidemic (reduce the concentration of cholesterol in the blood), antibacterial (destroy pathogenic bacteria that provoke inflammatory diseases of the biliary tract) and anti-inflammatory (reduce inflammation present in the biliary tract). In addition, synthetic choleretics suppress the processes of putrefaction and fermentation in the intestines, thereby eliminating bloating, stool instability and other symptoms of dyspepsia. Medicinal herbs with choleretic effects improve liver function, increase bile secretion, while simultaneously reducing its viscosity. Herbs also increase the concentration of cholates in bile. Along with the choleretic effect, medicinal herbs also have a cholekinetic effect, that is, on the one hand, they increase the secretion of bile, and on the other, they improve its excretion, thereby achieving a complex therapeutic effect on the human body. Herbal preparations can also have anti-inflammatory, antimicrobial and diuretic effects. Due to the content of only various herbs as active substances, drugs in this group are often called herbal choleretic agents. Hydrocholeretics increase the volume of bile due to its dilution and reduction of viscosity, achieved by increasing the content of the water fraction in it. In this situation, the excretion of bile is facilitated and the formation of stones is prevented. Cholekinetics are agents that enhance the tone of the gallbladder and at the same time relax the muscles of the bile duct. To understand the significance of the effect of cholekinetics, you need to know that the gallbladder is connected to the duodenum by the bile duct, through which bile flows from one organ to another. Accordingly, with increased tone of the bile duct, it narrows, which interferes with the movement of bile. And with low tone of the gallbladder, it simply does not “push” bile into the duct. Thus, an increase in the tone of the gallbladder and relaxation of the duct creates ideal conditions for the outflow of bile, since the first contracts intensively, pushing out the contents and preventing it from stagnating, and the second has a lumen wide enough to allow the entire volume to pass through within a short period of time. The resulting effect of cholekinetics is the release of the gallbladder and the flow of bile into the duodenum, resulting in improved digestion and elimination of congestion. Cholespasmolytics are divided into several groups depending on the characteristics of their pharmacological action, but the resulting effects are the same in all. Cholespasmolytics eliminate spasms and expand the bile ducts, facilitating the excretion of bile into the intestine. These drugs are usually used in short courses to relieve pain in various diseases of the gallbladder and biliary tract. Drugs to reduce bile lithogenicity, strictly speaking, are intended to dissolve existing gallstones and prevent the formation of new ones. Since these drugs have a choleretic effect, they are, with some degree of convention, classified in the group of choleretic drugs. Each group and subgroup includes certain drugs that have a number of properties and clinical effects used for various types of pathology of the biliary tract and liver. In the next section we provide a list of choleretic drugs belonging to each group and subgroup. Choleretic drugs - lists Below, for ease of orientation and selection, we provide a list of choleretic drugs by classification group. In this case, we will first indicate international name active substance, and next to or in brackets a number of commercial names under which the drug can be produced. True choleretics True choleretics containing bile components include the following drugs: Preparations containing components of natural animal bile - Allohol, Cholenzym, Vigeratin, Lyobil; Dehydrocholic acid – Hologon; Sodium salt of dehydrocholic acid - Decholin, Biliton, Suprakol, Kholamine, Kholomin. Synthetic choleretics The following drugs are synthetic choleretics: Hydroxymethylnicotinamide (Nicodin, Bilamid, Bilizarin, Bilocid, Cholamid, Coloton, Felosan, Isochol, Niciform); Gimecromon (Odeston, Holonerton, Holestil); Osalmid (Oxafenamide, Osalmid, Auxobil, Drenamid, Driol, Enidran, Salmidochol); Cyclovalon (Cyclovalon, Benevo, Cyclovalone, Divanil, Divanone, Flavugal, Vanilone). Choleretics based on medicinal herbs Choleretics based on medicinal herbs are as follows: Immortelle flower extract (Flamin); Corn silk extract (Peridol, Insadol); Tansy extract (Tanacehol, Tanaflon, Sibektan, Solaren); Turmeric extract (Convaflavin, Febichol); Mackerel leaf extract (Flacumin); Extract of leaves and roots of barberry (Berberine sulfate, Berberis-Homaccord, Berberis plus); Rose hip extract (Holosas, Holemaks, Holos); Datiscanna hemp extract (Datiscan); Voludushka extract (Pequocrine); Artichoke extract (Hofitol, Holebil); Preparations containing a complex of herbs that have a choleretic effect (Cholagol, Holagogum, Travochol, choleretic preparations No. 2 and 3, Urolesan, Phytohepatol No. 2 and 3). Hydrocholeretics The following drugs are hydrocholeretics: Alkaline mineral waters (Naftusya, Borjomi, Narzan, Essentuki 17, Essentuki 4, Arzni, Smirnovskaya, Slavyanovskaya, Izhevskaya, Jermuk, etc.); Salicylates (sodium salicylate); Valerian preparations (alcoholic infusion of valerian, valerian tablets, Valerianahel, etc.). Cholekinetics The following drugs are cholekinetics: Magnesium sulfate (Magnesia, Cormagnesin); Sorbitol (Sorbitol); Mannitol (Mannitol, Mannitol); Xylitol; Extract of leaves and roots of barberry (Berberine sulfate, Berberis-Homaccord, Berberis plus); Immortelle flower extract (Flamin); Rose hip extract (Holosas, Holemaks, Holos). Cholespasmolytics The following choleretic drugs are cholespasmolytics: 1. Anticholinergics: Bellalgin; Belloid; Besalol; Metacin; Platyfillin; Spasmolitin; Fubromegan. 2. Synthetic cholespasmolytics: Papaverine (Papaverine, Papaverine bufus, Papazole); Drotaverine (Bioshpa, Nora-Drotaverine, Droverin, No-Shpa, Nosh-Bra, Ple-Spa, Spazmol, Spazmonet, Spazoverin, Spakovin); Aminophylline (Aminophylline-Eskom, Eufillin); Mebeverine (Duspatalin). 3. Herbal cholespasmolytics: Arnica tincture; Valerian tincture; Tincture of elecampane; St. John's wort tincture; Mint tincture; Melissa tincture; Tincture of calendula flowers; Convaflavin (turmeric root); Cholagol (extracts of various herbs). Choleretic with litholytic action Choleretic drugs with litholytic action are as follows: 1. Ursodeoxycholic or chenodeoxycholic acids - Livodexa, Urdoxa, Urso 100, Ursodez, Ursodex, Uroliv, Ursolit, Ursorom S, Ursosan, Ursofalk, Choludexan, Exchol; 2. Methyl tert-butyl ether. Choleretic herbal preparations Choleretic herbal preparations are presented in ready-made dosage forms (tablets, tinctures or powders for preparing a solution for oral administration) or dried crushed parts of plants that have the necessary properties. Currently on the domestic pharmaceutical market The following choleretic herbal preparations are available in ready-made forms: Berberis-Homaccord; Berberis plus; Berberine sulfate; Datiscan; Insadol; Peridol; Convaflavin; Pequocrine; Sibektan; Solaren; Tanaflon; Tanacehol; Travochol; Urolesan; Febichol; Phytohepatol No. 2 and 3; Flacumin; Flamin; Holagogum; Holagol; Holebil; Holemaks; Holos; Holosas; Hofitol. In addition, the following medicinal herbs have a choleretic effect: Birch buds; Turmeric root; Calamus rhizome; Barberry roots and leaves; Burdock roots; Dandelion roots; Chicory root; Corn silk; Artichoke leaves; Volodushka leaves; Nettle leaves; Peppermint leaves and oil; Orthosiphon leaves; Parsley leaves; Mackerel leaves; Tansy leaves and flowers; Fir oil; Terpene oil Rose hips; Coriander fruit; Rowan fruits; Carrot seeds; Horseradish root juice; Knotweed herb; Danish grass; Oregano herb; Centaury grass; Lily of the valley herb; Artemisia grass; Immortelle flowers; Cornflower flowers; Tatar flowers. Have a cholekinetic effect following products and medicinal herbs: Calamus rhizomes; Dandelion roots; Rhubarb roots; Barberry leaves; Lingonberry leaves; Watch leaves; Coriander oil; Juniper oil; Cumin oil; Olive oil; Coriander fruit; Juniper fruits; Cumin fruits; Fennel fruit; Dog-rose fruit; Sunflower oil; Lingonberry juice; Knotweed herb; Oregano herb; Shepherd's purse grass; Thyme herb; Yarrow herb; Immortelle flowers; Cornflower flowers; Calendula flowers; Chamomile flowers. Modern choleretic drugs Modern choleretic drugs are represented by a group of synthetic choleretics and combined herbal and animal agents. Synthetic choleretics include drugs containing nicodine, hymecromone, osalmide or cyclone as active substances. Synthetic choleretics compared to natural ones (for example, Allochol, Cholenzym, Lyobil, etc.) are better tolerated and do not cause unstable stool, and also have a number of additional positive therapeutic effects, such as antispasmodic, hypolipidemic, antibacterial and anti-inflammatory. In addition, modern choleretic drugs include dehydrocholic acid (Hologon, Decholin) and ursodeoxycholic acid (Livodexa, Urdoxa, Urso 100, Ursodez, Ursodex, Uroliv, Ursorom, Ursorom S, Ursosan, Ursofalk, Choludexan, Exchol). Also a modern drug is the cholespasmolytic Duspatalin. Among the modern choleretic plant and animal preparations are the following: Berberis-Homaccord; Vigeratin; Insadol; Convaflavin; Pequocrine; Peridol; Sibektan; Solaren; Tanacehol; Tanaflon; Urolesan N; Febichol; Holagogum; Holagol; Holaflux; Holosas. Choleretic drugs - indications for use A general indication for the use of choleretic drugs is pathology of the gallbladder, biliary tract or liver. However, to select the optimal drug, it is necessary to know the indications for use of each group of choleretic drugs. Within the groups there are slight differences between the drugs, which, however, do not affect their indications for use, which remain the same. Thus, for clinical orientation in choleretic drugs, it is necessary to know the indications for use of each classification group, which we will consider below. Choleretics Indications for the use of choleretics are the same for all three subgroups of this group of choleretic drugs. This means that synthetic choleretics (for example, Tsikvalon, Nicodin, Oksafenamide, etc.), and drugs containing components of natural bile (for example, Allohol, Lyobil, Decholin, Cholenzym, Hologon, etc.), and herbal products (for example, Convaflavin, Holosas, Flacumin, etc.) have the same indications for use. So, choleretics are indicated for use in the following conditions or diseases: Chronic inflammatory liver diseases (for example, hepatitis, steatosis, etc.); Chronic inflammatory diseases of the biliary tract (cholangitis, cholecystitis, etc.); Habitual constipation caused by impaired bile flow. Choleretics, depending on the characteristics of the disease, can be used in combination with antibiotics, painkillers, antispasmodics and laxatives. In addition, in case of insufficient bile secretion, choleretics containing components of natural animal bile can be used as replacement therapy drugs. Among choleretics, the most “harsh” are drugs containing bile components, so they are the worst tolerated and often provoke stool disorders. Synthetic choleretics have a milder effect, but in terms of the range of positive therapeutic effects they are significantly inferior to drugs containing bile components. In addition, synthetic choleretics do not improve the properties of bile, like natural preparations and products containing medicinal herbs. But synthetic choleretics, in addition to choleretic, have the following therapeutic effects: Antispasmodic effect (eliminate spasm and pain in the biliary tract) is expressed in osalmide and hymecromone; Lipid-lowering effect (reduce the concentration of cholesterol in the blood due to its removal from the body) expressed in osalmide; Antibacterial effect expressed in nicodine; Anti-inflammatory effect expressed in cyclone; Suppression of rotting and fermentation in the intestines - the effect is pronounced in nicodine. These therapeutic effects must be taken into account when choosing the optimal drug. For example, if a person has a pronounced pain component, then he needs a choleretic drug with an antispasmodic effect. That is, he needs to choose a drug containing osalmide or hymecromone. If diseases of the biliary tract and gallbladder are combined with atherosclerosis, hypertension and high levels of cholesterol in the blood, then you should choose a drug containing osalmide. In case of pronounced inflammatory changes in the wall of the gallbladder or biliary tract, it is necessary to choose drugs with cyclophen. Plant choleretics have a milder effect compared to synthetic and natural preparations containing bile components. In addition, they have a complex positive effect on the organs gall bladder, ducts and liver, due to which their very high efficiency. That is why at present, in the absence of allergies or intolerance to herbal components, it is recommended to use preparations containing herbal components as choleretics. Hydrocholeretics Indications for the use of hydrocholeretics, in principle, do not differ from those for choleretics. However, drugs in this group are almost never used independently. They are usually used in combination with other choleretic agents, mainly choleretics and cholekinetics, to enhance the therapeutic effect. Cholekinetics Indications for the use of cholekinetics are as follows: Hypotonic biliary dyskinesia; Atony of the gallbladder with stagnation of bile in combination with dyskinesia; Chronic cholecystitis; Chronic hepatitis; Gastritis with low or zero acidity (hypoacid or anacid) gastric juice; Preparation for duodenal intubation. Cholekinetics cause an increase in the tone of the gallbladder and relaxation of the sphincter of Oddi, so they are prescribed mainly for the hypotonic form of biliary dyskinesia. Indications for their use are atony of the gallbladder with stagnation of bile with dyskinesia, chronic cholecystitis, chronic hepatitis, in anacid and strong hypoacid conditions. They are also used during duodenal intubation. Cholespasmolytics Indications for the use of cholespasmolytics are as follows: Hyperkinetic biliary dyskinesia; Moderate pain syndrome accompanying diseases of the biliary tract and gallbladder. Cholespasmolytics are mainly used to relieve moderate pain in an outpatient or home setting. Indications for the use of choleretic drugs with litholytic action Indications for the use of choleretic drugs with litholytic action are as follows: Dissolving small stones in the gall bladder and preventing the formation of new ones; Dissolution of stone fragments formed after the ultrasonic crushing procedure; Complex treatment of cholelithiasis; Reflux gastritis or reflux esophagitis, provoked by the reflux of bile acids into the stomach or esophagus; Acute hepatitis; Toxic damage to the liver from poisons, alcohol, drugs, etc.; Compensated biliary cirrhosis of the liver; Primary cholangitis; Atresia of the intrahepatic biliary tract; Stagnation of bile due to parenteral nutrition; Biliary dyskinesia; Complex treatment of chronic opisthorchiasis; Prevention of liver damage during the use of cytostatics or oral contraceptives. Taking choleretic drugs - brief instructions All choleretic drugs, regardless of the form of release, must be taken 20 - 30 minutes before meals. Moreover, the general daily dosage divided equally into 3 to 5 doses, depending on how many times a day a person eats. It is recommended to take choleretic drugs before each meal. The medications must be taken with a sufficient amount of water and be sure to eat something half an hour after taking it. If a person does not eat something after taking a choleretic drug, he will experience nausea, diarrhea and general health will worsen. Typically, choleretic drugs are taken in long-term (up to 3-8 weeks) courses 2-4 times a year, with intervals of at least 1-2 months between them. Such courses of use of choleretic drugs are preventive and should be carried out for the entire period of time while the disease persists. In case of exacerbation of diseases of the biliary tract, liver and gallbladder, choleretic drugs are used in the composition complex therapy in large dosages. Ursodeoxycholic acid preparations for the treatment of reflux gastritis and reflux esophagitis, as well as the dissolution of gallstones, must be taken continuously for 6 to 8 months. Choleretic drugs for children The following choleretic drugs can be used in children: Choleretics containing components of natural bile - Allochol; Synthetic choleretics - Nicodin, Oksafenamide, Osalmid; Choleretics containing medicinal herbs - Flamin, Febichol, Holosas, Holemaks, Holos, Chofitol; Cholekinetics - Valerian, Valerianahel, Magnesia, Cormagnesin, magnesium sulfate; Anticholinergics (cholespasmolytics) - Atropine, Metacin, Platiphylline, Papaverine, Papazol, Drotaverine, No-Shpa, Bioshpa, Nora-Drotaverine, Nosh-Bra, Ple-Spa, Spasmol, Spasmonet, Spazoverine, Spakovin Eufillin. The dosage of the above choleretic drugs is calculated individually by body weight, based on the ratio specified in the instructions for each specific drug. In addition, children can drink alkaline mineral waters (Borjomi, Essentuki 17, Essentuki 4, Jermuk, Slavyanovskaya, etc.) as natural hydrocholeretics. It is recommended not to use medicinal herbs with a choleretic effect in children under 12 years of age, since the prepared infusions and decoctions contain a wide range of active substances and it is simply impossible to predict the child’s body’s reaction to all of them. Choleretic drugs during pregnancy Pregnant women can take only those choleretic drugs that do not provoke contractile activity of the uterus and do not penetrate through the placenta to the fetus, and also do not cause a significant deterioration in the condition. The following choleretic drugs are completely safe during pregnancy: Holenzyme; Holosas; Holemaks; Holos; Valerian; Magnesia (magnesium sulfate); Cormagnesin; Atropine; Metacin; Papaverine (Papazole); Drotaverine (No-Shpa, Bioshpa, Nora-Drotaverine, Nosh-Bra, Ple-Spa, Spazmol, Spazmonet, Spazoverin, Spakovin). In addition, there is a group of choleretic drugs that can be taken during pregnancy under the supervision of a doctor and only as directed. These drugs are theoretically safe for pregnant women, but experimental clinical trials For obvious ethical reasons, this was not carried out. Therefore, the instructions usually state that the drugs can be used during pregnancy, but only under the supervision of a doctor. These choleretic drugs include the following: Odeston; Holonerton; Cholestil; Flamin; Febichol; Berberis-Gommacord; Chophytol; Eufillin. It is better not to use medicinal herbs with a choleretic effect during pregnancy, since their infusions and decoctions contain a large number of active substances, the effects of each of which are in advance and with high accuracy impossible to estimate. If necessary, you can choose ready-made dosage forms, made on the basis of herbs, for example, Holosas, Holemaks, Cholenzym, etc. Dosages, rules of administration and duration of therapy with choleretic drugs in pregnant women are exactly the same as usual. The use of choleretic drugs for certain diseases Biliary dyskinesia (BID) The selection of drugs depends on the form of biliary dyskinesia. Yes, when hypertensive type of biliary dyskinesia (ZhVP) the following choleretic drugs are indicated: Cholespasmolytics of any type (for example, No-Shpa, Papaverine, Platyfillin, Metacin, Duspatalin, Odeston, etc.), which reduce pain; Cholekinetics (for example, Magnesia, Cormagnesin, Berberine-Gommacord, Holosas, Holemaks, Holos, Sorbitol, Mannitol, Flamin, etc.). The general treatment regimen is usually as follows: cholespasmolytics are used in short courses to eliminate pain, after which long-term use of cholekinetics begins. Cholespasmolytics can also be used occasionally as needed. In case of hypertensive type of dyskinesia of the gallbladder, choleretic drugs from the group of choleretics and hydrocholeretics, for example, Allochol, mineral waters, etc., cannot be used. With dyskinesia of the gallbladder of the hypotonic type The following choleretic drugs are indicated: Any choleretics (for example, Allohol, Lyobil, Nikodin, Tsikvalon, Holagogum, Holagol, Flacumin, Convaflavin, Febichol, Sibektan, Tanacechol, etc.); Hydrocholeretics (alkaline mineral waters, etc.); Antispasmodics of myotropic action (Duspatalin, Odeston). Choleretics are used in long courses of 4–10 weeks, and antispasmodics short cycles– 7 – 14 days. Alkaline mineral waters can be drunk constantly. Cholekinetics are usually not used for the hypotonic form of gastric dyskinesia. Choleretic drugs for bile stagnation In this case, to eliminate congestion, the most effective and optimal are the choleretic group of cholekinetics, for example, Cormagnesin, Berberine-Gommacord, Holosas, Mannitol, Flamin, etc. Cholecystitis Choleretic drugs for cholecystitis are used at any stage of the disease. In the presence of gallstones in cholecystitis, only products containing ursodeoxycholic acid as an active substance can be used as choleretic drugs (for example, Livodex, Urdox, Urso 100, Ursodez, Ursodex, Uroliv, Ursolite, Ursorom S, Ursosan, Ursofalk, Choludexan , Exhol). For non-stone cholecystitis, it is necessary to take choleretics from any group. Among synthetic choleretics, the optimal ones are choleretic ones containing oxafenamide and hymecromone or cyclovalone as active substances. When using oxafenamide or hymecromone, there is no need to additionally take cholespasmolytics (No-Shpa, Papaverine, etc.), since these synthetic choleretics have an antispasmodic effect. And while using cyclovalone, there is no need to take additional antibacterial drugs, since this choleretic has a pronounced antimicrobial effect. When using choleretics containing bile components or medicinal herbs (for example, Allochol, Liobil, Sibektan, Tanacechol, etc.), it is necessary to additionally take cholespasmolytics or antibacterial drugs. In addition to any choleretics for non-stone cholecystitis, it is necessary to take cholekinetics (Magnesia, Cormagnesin, Berberine-Gommacord, Holosas, Holemaks, Holos, Sorbitol, Mannitol, Flamin, etc.), which will facilitate the release of bile into the duodenum from the gallbladder. There are very few negative reviews about choleretic drugs and they are usually due to the ineffectiveness of a particular drug in this particular case. Absence clinical effect causes disappointment in a person, from which he concludes that the drug is ineffective and leaves a negative review about it. However, choleretic drugs are very effective if taken correctly and as directed, taking into account the properties of each drug. Therefore, a negative review of a drug is not a reflection of its ineffectiveness, but of the wrong choice of drug. Choleretic drugs - prices Prices for choleretic drugs are very variable and range from 50 to 500 rubles per package. The cost of the drug depends on the manufacturer (imported drugs are more expensive than domestic ones) and its composition. The cheapest are preparations containing components of natural bile and medicinal herbs. The most expensive are synthetic choleretics, cholespasmolytics and ursodeoxycholic acid preparations. That is, there are groups of drugs with relatively expensive and cheap prices. However, since in each specific case choleretic drugs from a certain group are indicated, it is impossible to replace them with drugs from another, cheaper classification subgroup. You can only choose the most cheap drug from the same group. This principle of replaceability should always be used when choosing a choleretic drug. Preparation of choleretic Marco Polo salad - video Before use, you should consult a specialist. Important! Choleretic folk remedies for bile stagnation should not completely replace traditional drug treatment. Biliary herb can be used exclusively as part of complementary therapy. Existing contraindications Choleretic herbs for bile stagnation can be used only after a comprehensive examination of the patient, under the supervision of the attending physician, since cholestasis often provokes the development of cirrhosis and liver failure. Treatment with folk remedies is contraindicated in the presence of the following conditions: The appearance of stones big size in the gallbladder or biliary tract. Choleretic drugs for stagnation of bile will provoke the movement of stones, which will lead to blockage of the ducts and the development of intense pain syndrome (hepatic colic). Often, while taking herbs, inflammation develops, which requires emergency surgical treatment; Exacerbation of gastric or duodenal ulcer; Child's age is under 3 years; The presence of individual intolerance to medicinal plants; Development of acute pancreatitis. What herbs have a choleretic effect? Herbal preparations for the treatment of bile stagnation may have the following mechanisms of action: Liquefies bile, which normalizes the excretion of digestive secretions. This helps to improve the patient’s well-being and the functioning of the organs of the biliary system. The herb celandine, cap letter, has such properties; An increase in the tone of the gallbladder muscles causes accelerated evacuation of the organ's contents. The following choleretic herbs have a similar effect: tansy, corn silk; Increased pressure in the digestive tract, which leads to large quantity fluids into the gallbladder, diluting bile; Reduced muscle tone of the ducts, which increases their throughput. Common dandelion has a similar effect. The list includes herbal raw materials that effectively expel bile from the gallbladder: Milk thistle; Arnica montana; Corn silk; Common dandelion; Tansy; Calamus root; Sandy immortelle; Stinging nettle; Potentilla gossamer; Elecampane is tall; Great celandine. Features of therapy for children Cholestasis can occur in patients of any age group. In pediatric practice, medications that have a choleretic effect and minimal side effects. Therefore, the safest drugs based on herbal ingredients. Such means include: Holosas; Flamin; Allohol; Chophytol; Valerian. The dosage of the listed medications can only be determined by a doctor, according to the instructions, age, and body weight of the child. To eliminate cholestasis, freshly squeezed fruit and vegetable juices, alkaline drinking. Important! Folk recipes for children under 12 years of age, it can be used under the constant supervision of a specialist, because choleretic herbs often provoke the development of side effects. The use of choleretic fees Stagnation of bile can be treated with choleretic preparations No. 1, 2 and 3, which are sold in the pharmacy chain. These drugs have different composition, pharmacological action. Therefore, before taking them, you should choose the most suitable remedy. Choleretic collection No. 1 contains the following medicinal raw materials: Cotton grass trifoliate. The plant has a pronounced anti-inflammatory effect; Mint leaves. Raw materials improve the functioning of the biliary system organs, have a sedative and antispasmodic effect; Coriander seeds. The plant has a pronounced choleretic effect; Immortelle flowers. The raw material stimulates bladder motility, reduces the level of bilirubin and cholesterol in the blood, and normalizes the rheological properties of bile. Choleretic collection No. 2 additionally contains yarrow, which helps cure many pathologies of the biliary system. The plant has an antispasmodic, analgesic, anti-inflammatory effect, and quickly eliminates bile stagnation in the gallbladder. Choleretic collection No. 3 is characterized by the following composition: Tansy flowers, which have an anti-inflammatory effect, stimulate peristalsis of the digestive organs; Chamomile and calendula flowers, mint leaves effectively eliminate signs of inflammation and promote the excretion of bile; Yarrow. The plant is used as a pain reliever and choleretic agent. How to drink choleretic preparations? To prepare a medicine based on choleretic collection No. 1 and 2, you should brew 1 tablespoon of dry raw materials in 250 ml of boiling water. The resulting composition must be boiled in a water bath for 15 minutes. The prepared broth is infused for 1 hour, filtered, diluted boiled water to the original volume. The drug is drunk 100 ml before meals no more than 3 times a day. The course of therapy is usually 2–4 weeks. During treatment medicinal herbs It is necessary to strictly follow medical recommendations for the preparation of drugs and dosage. To prepare collection No. 3, which has choleretic properties, it is enough to brew 2 tablespoons of 200 ml of boiling water, heat the composition in a water bath in an enamel bowl for 20 minutes. The product is infused for 40 minutes, squeezed out, and brought to the original volume. Before each appointment medicinal composition should be shaken. The medicine can be taken 100 ml 30 minutes before meals. Choleretic mixtures No. 2 and 3 are also produced in filter bags. In this case, to prepare the medicine, just pour 1 sachet of 100 ml of boiling water and leave the product for 20 minutes. The resulting composition is consumed before meals (30 minutes before meals) 100 ml. Important! During treatment of children, it is recommended to reduce the daily dosage to 150 ml, dividing it into 3 doses. Choleretic juices Along with medicinal decoctions, juices that remove bile from the body are widely used for the treatment of cholestasis. To eliminate congestion, the following is prescribed: Dandelion juice. To make the medicine you will need freshly harvested, washed plants. It is recommended to drink 20 ml 1-2 times a day for 1 month; Turnip juice. The drug allows you to normalize the functioning of the bile ducts when they are narrowed. You can drink 25 ml of juice three times a day until you feel normal. Refuse this recipe necessary if you have a stomach ulcer; Pear juice. The product improves bile production. It is enough to drink 100 ml of juice in the morning and evening, the duration of therapy is not limited; Radish juice. The composition increases the intensity of bile production and normalizes its excretion. Drink 25 ml of juice no more than 3 times a day. However, in case of ulcers, enteritis, gastritis, this recipe should be abandoned. To preserve the beneficial substances in juices, it is necessary to prepare the products before consumption. To do this, medicinal raw materials are thoroughly washed and dried with a paper towel. There are the following methods for obtaining juice: grind the plant in a meat grinder, squeeze with a juicer or gauze.	Choleretic List of herbal preparations presented in the pharmacy: Syrups: 1. Travisil 100 ml 2. Rosehip 100 ml 3. Bronchicum 4. Licorice root 5. Linkas 6. Stoptusin phyto 7. Codelac 8. Doctor Mom 8. Althea syrup 9 "Doctor Theiss" with plantain Pills: 1. "Liv 52" 2. "Karsil" 3. "Hofitol" 4. "Senade" 5. "Senadexin" 6. Glaxenna 7. "Mukaltin" 8. “Cough tablets” 9. "Relaxozan" 10. “Motherwort forte” 11. Dragee “Evening” Tinctures: Toning: 1. Ginseng 50 ml 2. Eleutherococcus 100 ml 3. Rhodiola 50 ml 4. Aralia 50 ml 5. Schisandra Sedatives: 1. Mint 25 ml 2. Valerian 25ml 3. Motherwort 25ml 4. Hawthorn 25ml 5. Peony 25ml Oil: 1. sea buckthorn 50.0 and 100.0 2. peach 3. apricot Ointment 1. Capsicum 50.0 2. Arnigel Essential oils: 1. tea tree oil 2. eucalyptus oil 3. orange oil 4. lemon oil 5. bergamot oil Complex preparations containing medicinal plant materials Trade name, company, manufacturer country pharmachologic effect Indications for use Release form Storage conditions and periods Valocordin Krewel Meuselbach, Germany, Peppermint oil + Phenobarbital + Hops cones oil + Ethyl bromizovalerianate. Phenobarbital 18.4; Ethyl bromizovalerate 18.4; mint oil 1.29; hop oil 0.18; ethanol, water Antispasmodic, vasodilator, sedative, hypnotic Functional disorders of cardio-vascular system(including cardialgia, sinus tachycardia); neuroses accompanied by irritability, anxiety, fear; insomnia (difficulty falling asleep); states of excitement, accompanied by pronounced vegetative reactions. 15-20 drops 3 times a day orally. Orange glass bottle of 20 and 50 ml in a cardboard box List B. In a dark place at a temperature not exceeding +15 ° C. Shelf life 5 years Carsil Sopharma, Bulgaria Milk thistle fruit extract, Silybi mariani fructuum extract Contains silymarin - a mixture of various flavonoids, the most active of which is silibinin from the plant Milk thistle Silybum marianum fam. Asterceae Silymarin has a stabilizing effect on the cell membrane, preventing harmful effects on the liver, and promotes the restoration of damaged liver cells. Hepatoprotector Indications: toxic liver damage, chronic hepatitis of non-viral etiology, liver cirrhosis (as part of complex therapy) condition after acute hepatitis, for the purpose of prevention long-term use medications, alcohol, chronic intoxication (including occupational). Brown dragee, 35 mg No. 80 in a cardboard box. Store in a place protected from light at a temperature not exceeding 25° Rutin (Rutinum) Akrikhin (Russia) Flavonol glycoside contained in the buds and leaves of Sophora japonica. Japanese Sophora bud (Sophorae japonicae alabastrum), Japanese Sophora fruit (Sophorae japonicae fructus). Angioprotective agent Venous insufficiency of the lower extremities, accompanied by swelling, pain, trophic ulcers of the lower leg (against the background of varicose veins); haemorrhoids; as an auxiliary treatment after sclerotherapy of veins and removal of varicose veins; diabetic retinopathy (as part of complex therapy) Contraindications: Hypersensitivity, pregnancy (1st trimester). Tablets 0.02 g No. 30 List B.: In a dry place, protected from light. Novo-Passit IVAX-CR, Czech Republic Dry extract (valerian officinalis, lemon balm, St. John's wort, common hawthorn, passionflower incarnata (passionflower), common hop, black elderberry) 0.1575 g; guaifenesin 0.2 g Sedative and HYPERLINK "http://www.webapteka.ru/drugbase/search.php?filt_ftgid=31" anxiolytic HYPERLINK "http://www.webapteka.ru/drugbase/search.php?filt_ftgid=31" agent Neurasthenia and neurotic reactions, accompanied by irritability, anxiety, fear, fatigue, absent-mindedness; “manager” syndrome, insomnia (mild forms); headaches caused by nervous tension, migraines, itchy dermatoses Film-coated tablets 0.2; There are 30 pcs in a blister; 1 blister in a cardboard pack. In a place protected from light, at a temperature of 10-25 °C. Plantaglucidum (Plantaglucidum), Vifitech PKP LLP Plantain leaves extract (Plantaginis majoris foliorum extract) A total preparation obtained from the leaves of plantain and containing a mixture of polysaccharides, reducing sugars and galacturic acid. Antispasmodic agent of plant origin. Reduces the tone of smooth muscles of the stomach and intestines, has a moderate anti-inflammatory effect. Strengthens the secretion of gastric juice, increasing its acidity. Hypoacid gastritis. Contraindications: Hypersensitivity, hyperacid gastritis, peptic ulcer of the stomach and duodenum in the acute stage. Release form: granules for the preparation of a suspension for oral administration (laminated paper bags) 2 g No. 25 Storage: in a dry place at a temperature of 18-20°C. Digoxin (Digoxinum) Digoxin (Digoxinum) The sum of native digilanides A, B, C of Foxglove - Digitalis lanata, fam. Norichnikov - Scrophulariaceae Cardiovascular drugs, cardiac glycosides Used for chronic circulatory failure, tachyoarrhythmias, atrial fibrillation; Tablets of 0.25 mg No. 50, 0.025% solution in ampoules of 1 ml No. 10. Storage according to list A. Collections of medicinal herbal raw materials presented in a pharmacy Trade name country of origin International generic name(INN) pharmachologic effect Indications for use Release form Terms and conditions storage Arfazetine Arfazetine Russia, JSC Krasnogorsk lek means Blueberry shoots 20% Common bean fruit leaves 20% Eleutherococcus senticosus roots and rhizomes 15% Rosehip fruits 15% Horsetail grass 10% St. John's wort herb 10% Daisies pharmacy flowers 10% The infusion of the collection has a hypoglycemic effect, helps reduce blood glucose levels, increases tolerance to carbohydrates and enhances the glycogen-forming function of the liver. Diabetes mellitus type 2 (mild to moderate severity, both alone and in combination with sulfa drugs and insulin). in filter bags of 2 grams, 20 pieces in cardboard packs, Store in dry protected from light no more place 2 days. Store in inaccessible to children place Brusniver Lingonberry leaves 50% Rosehip fruits 20% St. John's wort herb 20% Sequences grass 10% The infusion of the collection has antimicrobial (staphylococci, Escherichia coli, Pseudomonas aeruginosa, some other microorganisms), anti-inflammatory, and diuretic effects. Indications: antimicrobial, anti-inflammatory and diuretic agent in the complex therapy of acute and chronic diseases in urology (cystitis, urethritis, prostatitis), gynecologists (vaginitis, vulvitis), proctology (proctitis, inflammation of hemorrhoids, anal fissures, colitis) Powder in filter bags of 4 grams, 20 pieces in cardboard packs Collection cut and pressed in KYAU 8.0 No. 6 Store in dry protected from light place, prepared infusion - in a cool place for no more than 2 days. Keep out of reach place for children. Chest collection No. 2 Russia, LLC Apex Coltsfoot leaves 40% Plantain leaves 30% Licorice roots 30% The infusion of the collection has an expectorant and anti-inflammatory effect. Used for infectious and inflammatory diseases of the respiratory tract (tracheitis, bronchitis, tracheobronchitis, pneumonia), ARVI ( symptomatic therapy), bronchial asthma Collection crushed 70 grams in cardboard packs with an inner bag Store in dry protected from light place, prepared infusion - in a cool place for no more than 2 days. Keep out of reach place for children Chest collection No. 3 Russia, ZAO Zdorovye Licorice roots 28% Althea roots 28.8% sage leaves 14.4% Anise fruit 14.4% Pine buds 14.4% Sora infusion has an expectorant and anti-inflammatory effect. Used as an expectorant for inflammatory diseases of the upper respiratory tract Store in dry protected from light place, cooked infusion - cool no more place 2 days. Keep out of reach place for children Calming collection No. 2 Russia, JSC Krasnogorskleksredstva Motherwort grass 40% Hops cones 20% Mint pepper leaves 15% Valerian roots with rhizomes 15% Licorice roots 10% The infusion of the collection has a calming, moderate antispasmodic effect. Indications: increased nervous excitability, sleep disorders, early stage arterial hypertension(as part of complex therapy) Collection crushed 50 grams in cardboard packs with an inner bag Proctophytol antihemorrhoidal collection Russia, JSC Krasnogorskleksredstva Hay leaves 20% Yarrow grass 20% Buckthorn bark 20% Coriander fruits 20% Licorice roots 20% The infusion of the collection has a laxative, antispasmodic, and hemostatic effect. Indications: hemorrhoids, chronic constipation Powder in filter bags of 2 g, 20 pieces in cardboard packs Collection crushed 50 grams in cardboard packs with an inner bag Store the prepared infusion in a dry place, protected from light, in a cool place for no more than 2 days. Keep out of the reach of children Elekasol Russia, JSC Krasnogorskleksredstva Licorice roots 20% Sage leaves 20% Eucalyptus rodent leaves 20% Marigold flowers 20% Sequences grass 10% Chamomile flowers 10% The infusion has antimicrobial activity against staphylococci, E. coli, Protea and some other microorganisms, has an anti-inflammatory effect and stimulates reparative processes. Indications: as part of complex therapy: - diseases of the respiratory tract and ENT organs (chronic tonsillitis, acute laryngopharyngitis, tracheitis, bronchitis) - in dentistry (acute and recurrent aphthous stomatitis, red lichen planus oral mucosa, periodontitis) -gastroenterology ( chronic gastroduodenitis, enteritis, colitis, enteroclitus) - in dermatology (microbial eczema, neurodermatitis, rosacea, acne vulgaris) - in gynecology (nonspecific inflammation of the vagina and cervix) -in urology (chronic pyelonephritis, cystitis, urethritis, chronic prostatitis). Powder in filter bags of 2 g, 20 pieces in cardboard packs Collection crushed 50 grams in cardboard packs with an inner bag Store in a dry place, protected from light, use the infusion freshly prepared. Keep out of the reach of children Storage of drugs, herbal medicines and essential oils in a pharmacy medicinal raw material herbal preparation Storage of drugs and drugs of plant origin is carried out in accordance with the order dated November 13, 1996. No. 377 “On approval of instructions for organizing storage in pharmacies various groups medicines and medical products." Pharmaceutical products are stored in a dry, well-ventilated area, in well-closed containers, the quality of which is checked upon acceptance of the goods. Pharmaceutical products containing essential oil are stored separately and well packaged. Liquid dosage forms, such as tinctures, extracts, syrups, are stored in hermetically sealed containers, protected from light. Storage of FPP must also comply with the Global Fund X edition. And all the general requirements of the instructions of Order No. 377. All FPPs are placed on shelves with the label facing outwards and a rack card attached. Tablets from medicinal products are stored separately from other dosage forms in original packaging that protects against external influence. As already mentioned, medicinal products are supplied pre-packaged, in original packaging. She is usually primary, those. individual, it has direct contact of the medicinal product with the packaging material. Secondary- combines several primary packages and maintains their integrity. STORING essential oils. · Essential oils should be stored tightly closed in a dark glass container in a dry (relative humidity no higher than 70%), dark, cool place at a temperature of 5 to 25°C, in an upright position. The bottles should be placed in a dark cabinet at a temperature not exceeding 15 °C. After storage for a year, oils must be tested for suitability using the methods adopted for each of them. · Oils that are not stored correctly quickly deteriorate, oxidize, and some oxidation products have an allergic and irritating effect. Citrus, lemongrass, litsea, citronella and pine oils require mandatory storage in the refrigerator. · If an expiration date is indicated on an essential oil, it must be observed, since individual components of the essential oil may enter into chemical reaction with each other, which will eventually affect the quality and deterioration of the smell. Only certain essential oils: rose, sandalwood, patchouli, when properly stored, improve their aroma. · Oils should be out of reach of children. · Oils should be kept away from open flames. Sometimes the expiration of the shelf life can be judged even visually, for example, bottle caps for camphor, lime, marjoram, tea tree and some others oils swell, i.e. oil vapors enter into a chemical reaction with the plastic cap. And for a number of oils (for example, orange, bigaradia, lemon, tangerine, cajeput) in a closed bottle, the liquid level decreases over time, this, in particular, may indicate incomplete tightness of the bottle, resulting in the process of evaporation of the oil, as well as its resinization, the oil becomes more dense and its volume decreases. These processes are accelerated if the bottle is stored in a warm room. As a rule, standards establish guaranteed shelf life for oils from 6 months (for citrus fruits) to 12 (for most others). However, if the oil is stored in a full, hermetically sealed bottle, in a cool, dry place out of direct sunlight, the shelf life of this oil can be significantly increased. Main types of packaging of drugs of herbal origin: For medicines use: 1. cardboard packs 2. paper bags 3. contour - cell packaging 4. cans made of polymer material 5. dark glass bottles 6. cellless paper packaging There are basic packaging requirements: 1. gas and vapor tightness 2. chemical indifference 3. strength 4. resistance to thermal influences 5. lightproof 6. impermeability to microorganisms All these requirements should ensure the maximum shelf life of the drug. In addition to these requirements, there are also consumer requirements to packaging: 1. must contain information about the storage and acceptance of drugs, 2. have an attractive appearance, 3. must be comfortable to wear, 4. there must be control of the first opening, 5. ease of destruction of used packaging. Requirements for the external design of packaging (in accordance with the Federal Law “On Medicines”) On the inner and outer packaging, in clearly readable font in Russian, 1. name of the drug and international nonproprietary name 2. manufacturer 3. series number and date of manufacture 4. Method of application 5. dose and number of doses per package 6. expiration date 7. vacation conditions 8. storage conditions 9. Precautions when using medications 10. registration number