Plants in this group include:

Large celandine

Common tansy

Sandy immortelle

Corn silk

Barberry common

Classification:

1. Preparations stimulating the formation of bile (choleretics or cholesecretics): immortelle flowers (Flamin preparation), tansy flowers (Tanacehol preparation), corn columns and stigmas (liquid extract), rose hips (Holosas preparation).

2. Drugs that promote the excretion of bile (cholekinetics): roots and leaves of barberry (drug "Berberine bisulfate" and tincture of leaves). Celandine grass.

Mechanism of action

Enhance the formation of bile and promote its discharge.

Application

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

Application Features:

Apply 30 minutes before meals.

Contraindications for use are the individual characteristics of herbal remedies.

Characteristics of plants according to the pharmacognostic algorithm.

MPC Celandine Grass - Herba Chelidonii

Producing plant Great celandine - Chelidonium majus

Poppy family - Papaveraceae

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

Everywhere .

Harvesting, drying Grass is harvested in the flowering phase, according to the rules for harvesting poisonous raw materials. Drying air-shadow or 50-60 degrees.

Chem. Compound: alkaloids gr. isoquinoline, flavonoids.

herbs with flowers and fruits of varying degrees of development, leafy stems up to 30-50 cm long, crushed, less often whole leaves, flowers, fruits. Stems slightly ribbed, branched above, slightly pubescent. Leaves are often broken. The terminal lobule 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, capsules "Holagogum", tea "Holaflux" for diseases of the liver and gallbladder, external juice for cauterization of warts, skin tuberculosis.

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

MPS Tansy flowers – Flores Tanaceti

Producing plant Common tansy - Tanacetum vulgare

Aster family Ast eraceae (Compositae)

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

Geographic distribution, habitat Everywhere . It grows like a weed in meadows, along roadsides, in gardens, parks.

Harvesting, drying Grass is harvested in the phase of the beginning of flowering, cutting off the baskets and parts of inflorescences with peduncles up to 4 cm. Drying is air-shadow or up to 40 degrees.

Chem. Compound: flavonoids, essential oil, bitterness.

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

Side effect: allergic reaction.

Contraindications:.Individual intolerance to drugs.

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

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

Storage:.

MVP Flower immortelle -- Flores Helichrysi

Producing plant Sand immortelle - Helichrysum arenarium

Aster family - Asteraceae

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

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

Harvesting, drying Grass is harvested in the phase of the beginning of flowering, cutting off the baskets and parts of inflorescences with peduncles up to 1 cm. Drying is air-shadow or up to 40 degrees.

Chem. Compound: flavonoids, essential oil, tannins.

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

Action and application: choleretic antispasmodic, increasing 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

MRS Columns with stigmas of corn - - Stylicum stigmatis Maydis

Producing plant Common corn - Zea mays

Family Bluegrass - Poaceae

ZFR (brief botanical description Annual plant 1-3 m high. Stems solitary, knotty, bamboo-like. Leaves linear, pointed. The flowers are unisexual: stamens are collected in apical panicles, pistillate - on the cob, hidden in the axils of the stem leaves. The fruit is a grain of yellow-orange color. Collected in a cylindrical ear in vertical rows.

Geographic distribution Corn is native to southern Mexico and Guatemala. It is cultivated everywhere in Russia, especially in the forest-steppe and steppe regions. It grows mainly on fertile, medium-moistened soils.

Harvesting, drying Harvest pistillate columns with stigmas (corn hair) in the summer in the phase of milky 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 FMCG according to GF XI: has the appearance of bundles or lumps of densely tangled silky threads with a diameter of 0.1 mm and a length of up to 20 cm. Sometimes there are forked stigmas at the end of the thread. Color yellow-brown. The smell is characteristic. The taste is sweet and slimy.

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

LF: Fasov. raw material,, 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 remedies with choleretic action.

III. Homework:

Work with educational literature on the topic “LR and herbal remedies that regulate the digestive system. LRS of ulcer-healing action.” Presentations.

IV. References :

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

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

3. D. A. Murav’eva, I. A. Samylina and G. P. Yakovlev, Russ. Pharmacognosy: Textbook, 4th ed. M.: Medicine, 2002.-

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

5. Kurkin V.A. Pharmacognosy. - Samara: Samara State Medical University - 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 p.

Federal Agency for Health and Social Development of the Russian Federation

State educational institution

Higher professional education

Samara State Medical University

Roszdrav

Faculty of Pharmacy

department pharmacognosy with botany and the basics of herbal medicine

course work

on the topic: "Medicinal plants used in diseases of the liver and biliary tract"

Executor Lazareva Svetlana Nikolaevna

correspondence student

3 courses 31 groups

Supervisor: Associate Professor of the Department of Pharmacognosy with Botany and Fundamentals of Phytotherapy

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 markedly. 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 preparations 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 in liver pathology is aimed at reducing damage and fibrosis of the liver, correcting biliary dyskinesia. These disorders act as universal disorders inherent in most liver diseases.

And the main place in the treatment of these diseases is deservedly assigned 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 a mixed effect.

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

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

During the course work, the following tasks :

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

2) consider the principles of drug therapy for these diseases;

3) to study the composition and action 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 most important is viral, toxic and toxic-allergic liver damage in viral hepatitis, industrial, household, drug chronic intoxications (alcohol, chloroform, lead compounds, trinitrotoluene, atofan, chlorpromazine, 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 blockage by a stone or cicatricial compression of the common bile duct, cancer of the pancreatic head, etc.) in combination with the usually associated inflammatory process in the bile ducts and ducts, predominantly primary toxic or toxic allergic lesion of cholangiol. 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 non-specific hepatitis occurring against the background of chronic infections (tuberculosis, brucellosis, etc.), various chronic diseases of the digestive tract, systemic connective tissue diseases, 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, alimentary, sedentary lifestyle, various infections, etc. There are many theories about the development of this disease, the main ones are: elements can serve as a "core" for the formation of a 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, 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 the general metabolic processes in the body, hypercholesterolemia, stagnation of bile in the gallbladder and its thickening, which may be the result of biliary dyskinesia, neuropsychiatric disorders, reflex influences, etc.

In cholelithiasis, acute attacks of pain in the right hypochondrium are characteristic - 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 region of the heart of a reflex character.

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

Seizures can be frequent or very rare. Attacks of hepatic colic end or the passage of a stone into the intestine, and then they can be detected in fecal masses, or biliary colic is complicated by blockage of the neck of the gallbladder or cystic duct, followed by dropsy of the gallbladder or blockage of the common bile duct, followed by obstructive jaundice, enlargement of the 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, to combat 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 in the fresh air, because physical work affects the process of bile secretion, and an increase in oxygen delivery improves the blood supply to the liver. It is necessary to regulate the diet (frequent meals in small portions), since food intake affects the process of bile secretion, food irritants act on the mechanism that empties 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 in liver pathology is aimed at reducing damage and fibrosis of the liver, correcting biliary dyskinesia. Essential oil plants are widely used in the treatment of diseases of the liver and biliary tract. Essential oils have a weak irritating 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 spasm of the biliary tract.

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

Mechanism of action of iridoids. In the treatment of 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 focus should be on identifying and eliminating the cause of cholestasis, in which case success can be expected from therapeutic measures.

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

Plants of choleretic action improve the biliary function of the liver, enhance the excretory function of the gallbladder and bile ducts. This whole complex, in addition to the liquid form of the medicinal product, eliminates the stagnation of bile in the gallbladder. Thus, in this disease, phytotherapy serves as a pathogenetic method.

The mechanism of action of ions contained in plants. Magnesium ions, which are part of herbal medicines, can stimulate the secretion of cholecystokinin by duodenal epithelial cells, which is probably the reason for the cholekinetic effect of arnica, birch, helichrysum, rosehip and fennel preparations. When combined with 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, which allow fighting the causes of liver diseases and interfering with key links in 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 in liver diseases. Among them, the most famous are various dosage forms of milk thistle, celandine, fumes, artichoke, chicory, yarrow, cassia, etc.

Phytotherapy of cholelithiasis aims to reduce inflammation in the bile ducts and bladder, improve the outflow of bile, eliminate metabolic disorders, destroy small stones and affect concomitant diseases.

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

The dissolution of stones is facilitated by the mountaineer, the leaves of wild strawberries, the roots of the wild rose, etc.

Yarrow ordinary - Achillea millefoliym .

Astrov family - Asteraceae .

Yarrow herb - Herba Millefolii .

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

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

It occurs in the European part of the USSR, in the Caucasus, Western and Eastern Siberia, less often in the Far East and Central Asia. The main yarrow thickets 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 areas of commercial harvesting are Bashkiria, the Volga region, Ukraine, Belarus, Rostov and Voronezh regions. Grows in upland meadows, elevated parts of floodplain meadows, forest edges, clearings, young fallows, roadsides, forest belts, parks, young forest plantations and settlements. 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 secateurs, without coarse, 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, scutes with peduncles no longer than 2 cm and individual flower baskets are cut. Raw materials are collected in dry weather, folded loosely and immediately sent for drying. You can not uproot plants, as this leads to the destruction of thickets. When carrying out rational harvesting, you can use the same areas for several years in a row. Giving then rest to thickets for 1-2 years. The raw materials are dried in the open air in attics, as well as under sheds, spread out in a layer 5-7 cm thick on paper or cloth with occasional stirring. The yield of raw materials is 20-25% by weight of freshly harvested.

Grass. External signs. The corymbs with the remnants of the stem are no longer than 15 cm; there are individual baskets and groups of them. Baskets are small, ovoid, 3-4 mm long, collected in dense corymbs. Marginal flowers reed, whitish, less often pink, pistillate, usually among 5. Stems pubescent, greyish-green, often with alternate stem leaves. Leaves lanceolate, double-pinnate. The lobes of the leaf blade are incised into 3-5 lanceolate or linear lobes. The leaves are drooping with erect hairs. Color grey-green; the smell is fragrant, peculiar; bitter taste.

Numerical indicators. Moisture not more than 13%; total ash no more than 15%; ash, insoluble in 10% hydrochloric acid solution, not more than 3%; crushed parts passing through a sieve with a hole diameter of 1 mm, not 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 millefolid, chamazulene, etc. The essential oil also contains monocyclic monoterpenes (cineol), bicyclic monoterpenes (thujone, thujol, camphor borneol), sesquiterpene caryophyllene. The accompanying components of the essential oil are represented by formic, acetic and isovaleric acids. The second group of BAS should include flavonoids - glycosides of apigenin (cosmosiin), luteolin (cynaroside), cacticin, artemetin, rutin, which determine the choleretic properties of yarrow preparations. In addition, it contains phenylpropanoids - derivatives of chlorogenic acid. The yarrow herb contains nitrogenous substances - the alkaloid beniticin, which also determines the bitter properties of drugs betaine, stachidrine, choline.

The grass contains vitamin K in an amount sufficient for the manifestation of an active hemostatic effect.

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

Application. Yarrow grass and flowers are used in the form of an infusion, a liquid extract as an aromatic bitterness to improve appetite in gastritis and as a remedy for inflammation of the mucous membranes of the gastrointestinal tract and oral cavity. Yarrow herb is a part of various fees and preparations (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 preparation "Rotokan".

Common tansy - Tanacetum vulgare .

Astrov family - Asteraceae .

Tansy flowers - Flores Tanaceti .

Common tansy is a perennial herbaceous plant with a strong peculiar smell. Rhizome horizontal, many-headed. Stems 50-150 cm high, numerous, erect, furrowed, branched in inflorescence, glabrous or slightly pubescent. The leaves are alternate, elliptical in outline, up to 20 cm long, pinnately dissected or pinnatipartite, shortly pubescent or almost glabrous. The lowermost leaves are petiolate, the rest are sessile; their lobes are oblong-lanceolate, pinnately incised or serrated, serrated along the edge. The middle vein of the leaf between the main lobes bears, in addition, also small adnexal lobules. Flower baskets are hemispherical, almost flat from above, 5-8 mm in diameter, collected in dense apical corymbs; the outer leaflets 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 a short, finely serrated margin or without it.

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

Range, cultivation. Common 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 the Urals, and the eastern regions of Ciscaucasia. It also grows in the south of the forest, in the forest-steppe and steppe zones of Western Siberia and in the north of Kazakhstan. In Eastern Siberia, the Far East, Eastern Kazakhstan and Kyrgyzstan, it occurs only as an invasive plant.

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

Preparation, drying. Tansy inflorescences are harvested as raw materials, which are harvested at the beginning of flowering, 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). It is impossible to collect tansy raw materials in heavily polluted places - along railway embankments, along highways, etc. The collected raw materials are put into paper or fabric bags and delivered to the drying place. Before drying, the raw materials should be examined and impurities and peduncles longer than 4 cm should be removed from it. The raw materials are dried under sheds, in attics, in air or heat dryers at a temperature not exceeding 40 ° C.

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

External signs. Whole raw material. Parts of a complex corymbose inflorescence and individual flower baskets. Baskets of hemispherical shape with a depressed middle, 6-8 mm in diameter, consist of small tubular flowers: marginal - pistillate, median - bisexual. Receptacle bare, non-hollow, slightly convex, surrounded by an involucre of imbricate lanceolate leaflets with membranous margin. Peduncles furrowed, glabrous, rarely slightly pubescent. The color of the flowers is yellow, the leaves of the involucre are brownish-green, the peduncles are light green. The smell of raw materials is peculiar, the taste is spicy, bitter.

Chemical composition. Flower baskets contain essential oil (about 1.5-2%), which is the leading BAS group 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, thujol, camphor, borneol, camphene, pinene, 1,8-cineol, n-cymene, limonene, etc., are found in significant amounts.

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

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

Application. Tansy inflorescences are used in the form infusion as a choleretic and antihelminthic agent (for ascariasis and pinworms). Raw materials are also part of the choleretic collections used for various liver diseases, including cholecystitis. Flowers are included choleretic collection № 3 , as well as in the composition of the choleretic, antispasmodic and anti-inflammatory agent "Polyphytochol".

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

Three-leaf watch - Menyanthes trifoliata .

The shift family - Menyanthaceae .

Three-leaf watch leaves - Folia Menyanthidis .

Three-leaf watch (water shamrock) is a perennial herbaceous water-marsh plant with a long, creeping, jointed, thick rhizome. The top of the rhizome slightly rises and bears several trifoliate long-petiolate, simple, alternate leaves. Leaf petioles up to 20 cm long, at the base expanded into long membranous sheaths. Leaflets are short-petiolate, entire, glabrous, obovate or elliptical.

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 dense brush 3-7 cm long. Corolla 10-14 mm long, with 5 sharp lobes, funnel-shaped, densely white-pubescent on the inside; 5 stamens attached to the corolla tube. Ovary superior, unilocular. The fruit is an almost spherical multi-seeded pod, opening with two valves.

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.

Range, cultivation. The three-leaf watch grows in almost the entire European part of Russia (except for the southernmost regions), in Western and Eastern Siberia and the Far East. The plant is very rare in the Crimea, the Caucasus and Central Asia. The water trefoil grows in grassy and moss swamps, marshy and swampy shores of lakes, rivers and reservoirs, in swampy meadows and swampy forests. The plant forms pure thickets or occurs in a community with cinquefoil, horsetail, calla and sedges. It prefers the outskirts of overgrown lakes, the banks of stagnant and weakly flowing reservoirs, marshy 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 flowering of the plant, so they should be collected after flowering, that is, in July-August. Shamrock leaves are best harvested in warm weather, as pickers usually have to go into the water. Often the shamrock is harvested from boats. Only fully developed leaves are harvested, cutting them off with a short (not longer than 3 cm) remnant of the petiole. Young and apical leaves are not subject to harvesting, as they turn black when dried. You should not pull out a shamrock with a rhizome, as this leads to the destruction of its thickets. Repeated harvesting on the same massifs is possible no more than in 2-3 years. The collected leaves are laid out in the wind for several hours, and then laid in a loose layer in an open container (boxes, wicker baskets, etc.) and quickly delivered to the place of drying. Raw materials are dried in dryers at a temperature not exceeding 45-5CGS (or in attics under an iron, tiled or slate roof, in sheds and other well-ventilated rooms, spreading the shamrock leaves in a thin layer on the shelves).

Medicinal raw materials. The raw material is collected after flowering and dried leaves of a wild-growing perennial herbaceous plant - three-leaf watch.

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

Chemical composition. The leaves of the three-leafed watch contain iridoids or bitterness (the leading group of ALS), including secoiridoids - loganin, sverozid, foliamentin and mentiafolin.

As the second group of BAS, which determine the choleretic properties of this plant, flavonoid compounds of rutin, hyperoside, trifolin can be interpreted. The raw materials also contain phenylpropanoids (ferulic acid), tannins (up to 3-7%), carotenoids, ascorbic acid, traces of monoterpene alkaloids (gentianin, hepcyanidin), iodine.

Pharmachologic effect. Bitterness (appetizer and cholagogue) with sedative properties.

Application. Shamrock leaves are used as infusion in as bitterness to improve digestion, as well as in diseases of the liver and biliary tract. Shamrock leaves are part of the fees - appetizing, choleretic and sedative. In addition, they produce thick extract, used for cooking difficult bitter tincture.

Ordinary centaury - Centaurium erythraea .

The Gorechavkov family - Gentianaceae .

Centaury herb - Herba Centauri .

Biennial herbaceous plant 35-40 cm high. Roots are small, poorly developed; stems erect, single or several, tetrahedral, often forked-branched at the top with branches directed upwards. Stem leaves are opposite, sessile, longitudinally lanceolate, up to 3 cm long with clearly visible veins, basal leaves are collected in a rosette. Flowers up to 1.5 cm long, dark pink, nail-like 5-petaled corolla are collected in dense umbellate-paniculate inflorescences. It occurs almost throughout the northern, middle and southern zones of the European part of the USSR, in the Caucasus. It grows mainly in upland meadows, on watersheds and in gullies. In more southern regions, it is found in floodplains, along the edges of lakes, swamps, ponds, streams and canals. Sometimes it grows in scattered thickets with an area of ​​up to 1 ha, more often found in smaller groups. Propagated only by seed, usually bloom in the 2nd-3rd years of life. One of the main areas of industrial harvesting of the 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 the centaury with roots. Cut grass is stacked 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 hinge), spreading the grass in a thin layer on paper or cloth so that the inflorescences are located in one direction. When drying in a thick layer or prolonged rainy weather, especially in stirring with poor ventilation, the grass turns yellow, the flowers become discolored or black. Drying in bunches is not allowed, as this leads to discoloration of the raw material or rotting inside the bunch. The yield of dry raw materials is about 25% of the mass of freshly harvested raw materials.

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

External signs. Stems are leafy with flowers, straight, solitary or branched, green or yellowish-green, glabrous, hollow, ribbed, 10-30 cm long, 2 mm thick. 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; pink-purple flowers. The smell is weak; the taste is bitter.

Application. Grass (whole, cut) is used as an appetite stimulant in the form of infusion; is part of the choleretic fees and bitter tincture.

Dandelion officinalis - Taraxacum officinale .

Astrov family - Asteraceae .

Dandelion roots - Radices Taraxaci .

A perennial herbaceous plant with a short rhizome and a fleshy, slightly branched tap root. Leaves in the basal rosette are glabrous or sparsely pilose, 10-25 cm long, deeply pinnatifid, gradually tapering into a long winged petiole. Peduncles up to 30 cm long, cylindrical, hollow, glabrous below, cobweb-fluffy above. The flowers are collected in large baskets up to 5 cm in diameter. All flowers are bisexual, the ligules are bright yellow.

It occurs 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 the forest, forest-steppe and in the north of the steppe regions of the European part of the USSR. The main areas of commercial harvesting are Ukraine, Belarus, Bashkiria, Voronezh, Kursk and Kuibyshev regions. Grows in meadows (especially near villages), pastures, roadsides, streets, yards, gardens, parks, sometimes as a weed in crops.

Roots are harvested in spring, at the beginning of plant growth (April - early May) or in autumn (September - October). They are dug up 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 ones. Repeated preparations in one place should be carried out with interruptions of 2-3 years. The dug roots are shaken off the ground, the aerial parts, the rhizome (“neck”) and thin lateral roots are cut off and immediately washed in cold water. Lay out for drying in the open air for several days (until the secretion of milky juice stops when cut); dry in attics under an iron roof or under a canopy with good ventilation, spreading out in a thin layer (3-5 cm) with occasional stirring. Can be dried in ovens or ovens at 40-50°C. The yield of dry raw materials is 33-35% by weight of freshly harvested.

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

External signs. Roots entire or in pieces 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 is a small yellow or yellowish-brown wood, surrounded by a wide grayish-white bark, in which brownish concentric thin belts of lactifers are visible (under a magnifying glass). The color outside is light brown and dark brown; there is no smell; bitter taste with a sweet aftertaste.

Chemical composition. The roots contain bitter substances of a sesquiterpene nature (lactucopycrin, tetrahydroridentin B, taraxolide, taraxic acid), bitter glycosides (taraxacin and taraxacerin). It also contains polysaccharides (inulin), sugars, and fatty oils. Triterpene compounds (arnidiol, faradiol) and sterols have been isolated from the roots. Milky juice contains resinous substances of a rubber nature.

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

Application. Roots (whole, cut, crushed) are prescribed as bitterness as a means of stimulating appetite and improving digestion; used as a diuretic. It is used in the form of a decoction, is part of the fees, thick dandelion extract is used to make pills.

Peppermint - Mentha piperita .

Lamiaceae family - 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 turned into a plant dedicated to Aphrodite by Proserpina.

Species name from lat. piper - pepper, pperitus - burning. The generic name passed into the Slavic languages, changing into the modern Russian word "mint". Peppermint is also called "English mint" since this species was bred in England in the 17th century, as well as "cold mint" because of the prolonged sensation of cold in the mouth and on the tongue. According to other researchers, peppermint is a more ancient cultivated species.

In the wild, water mint, m. green, and also m. pulegieva (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 for 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 mint wreaths on their heads during classes).

In Russia, peppermint was introduced into culture at the beginning of the 18th century. (in apothecary gardens). At present, 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, glabrous 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 sharp-serrated, and the leaves are dark green on the upper side, and light green on the lower side. On both sides of the leaves there are numerous essential oil glands. The flowers are small, red-violet, with a slightly irregular four-lobed corolla, collected on the tops of the stems and branches in inflorescences - spike-shaped thyrsus. 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, and some of them penetrate deep into the soil and acquire the character of rhizomes, and some come 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.

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

Scheme of the origin of peppermint. The black form of peppermint has dark, reddish purple (anthocyanin) hues on the stems and leaves. The pale (white) form of peppermint is devoid of anthocyanin coloration, and its leaves and stems are light green. In this case, the term "pale" emphasizes not the color, but the degree of coloration. The essential oil of white mint has a more delicate smell than the anthocyanin form of 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 serves as an industrial source of menthol. A number of valuable high-menthol industrial varieties of this form are known, the leaves of which contain up to 5-6% of essential oil with a content of 65-70% menthol in it (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 reproduces vegetatively, by segments of rhizomes (6-10 cm long) and young shoots from rhizomes that overwintered in the soil.

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

Harvesting, primary processing and drying. The preparation of peppermint leaves is carried out in the phase of the beginning of flowering, that is, when flowering occurs in about half of the plants. The grass is mowed, dried in rolls and dried in dryers at a temperature not exceeding 40 ° C or in the shade under awnings. The dried grass is threshed, the stems are separated and discarded.

Freshly harvested peppermint herb is used to obtain the essential oil.

Medicinal raw materials. Collected in the flowering phase by mechanized method and threshed, dried leaves of a perennial cultivated herbaceous plant - peppermint.

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 sheet is serrated with unequal sharp teeth; the surface is bare, only sparse, appressed hairs are visible from below along the veins under a magnifying glass, and shiny golden yellow or darker glands are visible throughout the leaf blade. Leaf color is light green to dark green. The smell is strong, fragrant. The taste is slightly burning, cooling.

Chemical composition. Peppermint leaves contain essential oil (leading ALS group) (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, ospinene and β-pinene, as well as free acetic and isovaleric acids.

As the second group of BAS, flavonoids should be distinguished, represented by derivatives of apigenin (menthoside), luteolin, hesperidin, etc., which determine the choleretic properties of infusion and other total preparations of peppermint (tincture, fees).

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.

Peppermint oil is an easily mobile, almost colorless oily liquid, with a refreshing smell and a cooling, long-lasting, burning taste. In accordance with the GF X edition of free menthol in 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, digestive aid.

Peppermint leaves are included in choleretic charges number 1 and № 2.

Made from peppermint leaves tincture, which is a mixture of equal parts extract of 90% alcohol (1:20) and mint oil and is used as a remedy for nausea and vomiting, as a pain reliever, and also as corrigens to improve the taste of medicines.

Peppermint essential oil is widely used in medicine as a refreshing and antiseptic agent, and in perfumery in the form of fragrant water, toothpastes and powders. Peppermint oil is an integral part of numerous drugs (Corvalol, Valocordin, Peppermint Tablets, etc.), which have a calming, antispasmodic, anti-nausea effect.

Menthol is part of complex cardiovascular drugs (validol, Zelenin drops, etc.), and is also used for the production of painkillers ("Menovazin"), antiseptics ("Pektusin" and others), anti-migraine pencils, ointments ("Efkamon"), all kinds of drops, including from the common cold ("Eucatol"), inhalation mixtures ("In gacamf") etc.

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

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

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

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

Barberry ordinary – Berberis vulgaris.

The Barberry family Berberidaceae .

Leaves of common barberry 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 shortened shoots with tufts of leaves sit. 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, from purple to dark red, usually with a slight wax coating, the taste is very sour. Seeds oblong, dark brown, somewhat flattened.

The rhizome is horizontal, a large main root with lateral branches departs from it, with bright yellow wood. The bulk of the lateral roots is located at a depth of 10-30 cm. There are numerous buds on the rhizomes, due to which the plant has a well-defined ability for vegetative reproduction. Under natural conditions, after the removal of above-ground shoots or after their freezing, the common barberry gives abundant shoots. Sometimes there are cases of vegetative propagation through the rooting of above-ground shoots. Blossoms in May-June (depending on habitat conditions), fruits ripen from late July to September.

Range, cultivation. The common barberry grows in the European part of the 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, the common barberry is distributed in Transcaucasia (Azerbaijan, Georgia), in Ukraine (mainly in the Crimea) and is widely cultivated.

Common barberry is found from the sandy coasts of the Black Sea to the subalpine belt (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, clarified pine forests, thickets of dry-loving shrubs.

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

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

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

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

The roots also contain palmatin, yatrorizin, columbanin, berberrubin, magnoflorin, and other alkaloids. Along with derivatives of protoberberine, the roots contain alkaloids of the bisbenzylisoquinoline nature of the 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, palmatin, etc.), organic acids (malic, tartaric, citric), vitamin C, carotenoids.

Pharmachologic effect. Choleretic agent.

Application. It has been established that a decoction and an alcoholic 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 action of bile acids, increase bile flow and cause gallbladder contraction.

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

Currently, more than 17 thousand medicines are used in the medical practice of the Russian Federation, among which about 40% are produced from plant materials. The share of herbal preparations used for the treatment of diseases of the liver and biliary tract is 70%. In addition, at present there has been a tendency for the increasing use of herbal remedies for both the treatment and prevention of diseases of the biliary system.

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

The high choleretic and choleretic effect of the above herbal preparations is often associated with a number of other effects inherent in these plants, such as: antispasmodic, anti-inflammatory, gas-absorbing, hepatoprotective, laxative, etc., which together can determine greater effectiveness in the treatment of liver diseases and gallbladder . 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, as a rule, last several months. At the same time, it is advisable to switch to the use of another species with a similar effect a few weeks after treatment with one type of plant. Rationally composed combinations of medicinal plants are also useful.

In the last decade, herbal medicine, 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.

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

In my opinion, phytotherapy of 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.

1. Akopov I.E. The most important domestic medicinal plants and their use. - Tashkent, 1986.

2. Asenov I., Nikolov S. Pharmacognosy. – Sofia, 1988.

3. Belousov Yu. B., Moiseev V. S., Lepakhin V. K. Clinical pharmacology and pharmacotherapy.- Moscow: Universum, 1993.- S. 322–328.

4. Gammerman A.f., Kadaev G.N., Yatsenko-Khmelevsky A.A. Medicinal plants. - M .: Higher school, 1983.

5. Georgievsky V.P., Komisarenko N.F., Dmitruk S.E. Biologically active substances of medicinal plants. - Novosibirsk, 1990.

6. Hepatitis: full information - http://www.gepatit-ru.info/

7. Childhood diseases./Under. ed. N. P. Shabalova. - M .: Medicine, 1995.

8. Kurkin V.A. Pharmacognosy. - Samara: LLC "Etching", GOUVPO "SamGMU", 2004.

9. Muravieva D.A. Pharmacognosy. – M.: Medicine, 1991.

10. Muravieva D.A., Samylina I.A., Yakovlev G.P. Pharmacognosy. – M.: Medicine, 2002.

11. Nosal M.A., Nosal I.M. Medicinal plants in folk medicine. - M., 1991.

12. Popov L. P. Medicinal plants in folk medicine.- Kyiv: Health, 1969.

13. Modern herbal medicine / ed. V. Petkova. - Sofia: Medicine and Physical Education, 1988.

14. Sokolov S.Ya. Pharmacotherapy and phytopharmacology. – M.: Medical Information Agency, 2000.

15. Pharmacognosy. Atlas. / ed. N.I.Grinkevich, E.Ya.Ladygina. - M., 1989.

16. http://www.fito.nnov.ru/special/vitamines/sorbus_aucuparia.phtml

Abstract: “Medicinal plants used in diseases of the liver and biliary tract. The use of choleretic drugs for certain diseases Thanks Currently choleretic drugs in the complex treatment and prevention of various diseases of the liver and gallbladder are widely used in the clinical practice of a gastroenterologist. This is due to the effects of choleretic drugs that relieve pain attacks, alleviate the course of the disease, and also prevent the deterioration or the appearance 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 stored in the gallbladder. The liquid has a bitter taste, a specific odor and, depending on the prescription of production, can be colored yellow, brown or greenish. Bile performs the following physiological functions in the human body: Emulsification and digestion of dietary fats; Activation of enzymes of the small intestine and pancreas, necessary for the complete digestion of food; Provides complete absorption of fat - soluble vitamins , calcium and cholesterol . Activation of the enzymes of the small intestine and pancreas is due to the fact that bile neutralizes the effect of pepsin, which came in place with the food bolus from the stomach. After neutralization of pepsin, the necessary conditions are created for the functioning of the enzymes of the 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. Due 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 the 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 it is produced until the food bolus enters the duodenum. Classification of choleretic drugs Currently, an anatomical-therapeutic-chemical classification of choleretic agents is used, which takes into account both the chemical structure of the drug used, its therapeutic effects, and the anatomical structures affected by the drug. Such an integrated approach makes it possible to create the most complete classification that reflects various aspects of the use, therapeutic effects and absorption, distribution and excretion of drugs from the human body. So, today choleretic drugs are classified into the following groups and subgroups: 1. Choleretics(Means that increase the production of bile by liver cells): True choleretics that increase the production of bile due to the active synthesis of bile acids: Choleretics containing bile acids and made on the basis of plant or animal raw materials (for example, animal bile, plant extracts, etc.); Synthetic choleretics, which are chemicals obtained by organic synthesis and have the property of increasing bile production; Medicinal herbs with a choleretic effect (used in the form of infusions, decoctions, etc.). Hydrocholeretics, which are substances that increase the volume of bile by diluting it light and increasing the percentage of water in it. 2. cholekinetics(means that improve the outflow of bile by increasing the tone of the gallbladder and simultaneously relaxing the bile ducts). 3. Cholespasmolytics (means that improve the outflow of bile by relaxing the muscles of the gallbladder and biliary tract): anticholinergics; Synthetic antispasmodics; Antispasmodics made on the basis of vegetable raw materials. 4. Drugs to reduce the bile lithogenicity index (remedies prevent the formation of stones in the gallbladder and contribute to the dissolution of existing ones): Preparations containing bile acids - ursodeoxycholic or chenodeoxycholic; Preparations containing highly active solvents of organic compounds of a lipid nature, for example, methyl tert-butyl ether. True choleretics, containing bile acids as active components, are drugs, mainly made on the basis of animal raw materials. Most often, natural bile, extracts of the liver or pancreas, as well as tissues of the mucous membrane of the small intestine of healthy animals are used as raw materials. That is why choleretic drugs of this group are often called means 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 preparations that contain as active substances only compounds obtained in the course of organic synthesis. The drugs of this group, in addition to the choleretic action, 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 (stop 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 dyspeptic phenomena. Medicinal herbs with choleretic action improve liver function, increase bile secretion, while 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 hand, they improve its excretion, due to which a complex therapeutic effect on the human body is achieved. Herbal preparations are also able to have anti-inflammatory, antimicrobial and diuretic effects. Due to the content of only various herbs as active substances, preparations of this group are often called herbal choleretic agents. Hydrocholeretics increase the volume of bile due to its dilution and decrease in viscosity, achieved by increasing the content of the water fraction in it. In such a situation, the excretion of bile is facilitated and the formation of stones is prevented. cholekinetics are means that increase 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, it is necessary 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 an increased tone of the bile duct, it narrows, which interferes with the progress of bile. And with a 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 create ideal conditions for the outflow of bile, since the first is intensively reduced, pushing the contents out of itself and not allowing it to stagnate, and the second has a wide enough lumen to skip the entire volume 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 stagnation. Cholespasmolytics are divided into several groups depending on the characteristics of their pharmacological action, but the resulting effects are the same for everyone. Cholespasmolytics eliminate spasm and expand the biliary tract, 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 the lithogenicity of bile, strictly speaking, are designed to dissolve existing gallstones and prevent the formation of new ones. Since these drugs have a choleretic effect, they are classified with a certain degree of convention as a choleretic group. Each group and subgroup includes certain drugs that have a number of properties and clinical effects used in various pathologies of the biliary tract and liver. In the next section, we give a list of choleretic drugs belonging to each group and subgroup. Cholagogue drugs - lists Below, for ease of orientation and selection, we present a list of choleretic drugs by classification groups. At the same time, we will first indicate the international name of the 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 bile of animals - Allohol, Cholenzim, Vigeratin, Liobil; Dehydrocholic acid - Hologon; Sodium salt of dehydrocholic acid - Decholin, Biliton, Supracol, Holamine, Holomin. Synthetic choleretics Synthetic choleretics are the following drugs: Hydroxymethylnicotinamide (Nicodin, Bilamid, Bilizarin, Bilocid, Cholamid, Coloton, Felosan, Isochol, Niciform); Hymecromon (Odeston, Holonerton, Holestil); Osalmid (Oxafenamide, Osalmid, Auxobil, Drenamid, Driol, Enidran, Salmidochol); Cyclovalone (Cyclovalone, Benevo, Cyclovalone, Divanil, Divanone, Flavugal, Vanilone). Herbal choleretics Herbal choleretics are as follows: Immortelle flower extract (Flamin); Extract of corn stigmas (Peridol, Insadol); Tansy extract (Tanacehol, Tanaflon, Sibektan, Solaren); Turmeric extract (Konvaflavin, Febihol); Sumpia leaf extract (Flacumin); Barberry leaf and root extract (Berberine sulfate, Berberis-Homaccord, Berberis plus); Rose hip extract (Holosas, Holemaks, Holos); Hemp datiski extract (Datiscan); Volodushka extract (Pekvokrin); Artichoke extract (Hofitol, Holebil); Preparations containing a complex of herbs with a choleretic effect (Cholagol, Cholagogum, Travohol, choleretic preparations No. 2 and 3, Urolesan, Phytogepatol No. 2 and 3). Hydrocholeretics Hydrocholeretics are the following drugs: 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 Cholekinetics are the following drugs: Magnesium sulfate (Magnesia, Cormagnesin); Sorbitol (Sorbitol); Mannitol (Mannitol, Mannitol); Xylitol; Barberry leaf and root extract (Berberine sulfate, Berberis-Homaccord, Berberis plus); Immortelle flower extract (Flamin); Rosehip fruit extract (Holosas, Holemaks, Holos). Cholespasmolytics Cholespasmolytics are the following choleretic drugs: 1. Anticholinergics: Bellalgin; Belloid; Besalol; Metacin; Platifillin; Spasmolitin; Fubromegan. 2. Synthetic cholespasmolytics: Papaverine (Papaverine, Papaverine Bufus, Papazol); Drotaverin (Bioshpa, Nora-Drotaverin, Droverin, No-Shpa, Nosh-Bra, Ple-Spa, Spazmol, Spazmonet, Spazoverin, Spakovin); Aminophylline (Aminophyllin-Eskom, Eufillin); Mebeverin (Duspatalin). 3. Herbal cholespasmolytics: Arnica tincture; Valerian tincture; Elecampane tincture; Hypericum tincture; Mint tincture; Melissa tincture; Tincture of calendula flowers; Convaflavin (turmeric root); Cholagol (extracts of various herbs). Choleretic with litholytic action Choleretic with litholytic action are as follows: 1. Ursodeoxycholic or chenodeoxycholic acids - Livodex, Urdox, Urso 100, Ursodez, Ursodex, Uroliv, Ursolit, Ursor C, Ursosan, Ursofalk, Choludexan, Exhol; 2. Methyl tert-butyl ether. Choleretic herbal preparations Choleretic herbal preparations are presented in finished dosage forms (tablets, tinctures or powders for oral solution) or dried crushed parts of plants with the necessary properties. Currently, the domestic pharmaceutical market has the following choleretic herbal preparations in finished forms: Berberis-Homaccord; Berberis plus; Berberine sulfate; Datiscan; Insadol; Peridol; Convaflavin; Pekvokrin; Sibektan; Solaren; Tanaflon; Tanacehol; Travohol; Urolesan; Febihol; Phytogepatol No. 2 and 3; Flacumin; Flamin; Holagogum; Cholagol; Holebil; Cholemax; Holos; Holosas; Hofitol. In addition, the following medicinal herbs have a choleretic effect (choleretic): Birch buds; Turmeric root; Calamus rhizome; Roots and leaves of barberry; Burdock roots; Dandelion roots; chicory root; Corn silk; Artichoke leaves; Volodya leaves; nettle leaves; Peppermint leaves and oil; Orthosiphon leaves; parsley leaves; Skumpia leaves; Leaves and flowers of tansy; fir oil; Terpene oil Rose hips; coriander fruit; Rowan fruits; Carrot seeds; Horseradish root juice; Grass mountaineer bird; Danish grass; Oregano herb; Herb centaury; Lily of the valley grass; Artemisia grass; Immortelle flowers; Cornflower flowers; Tatar flowers. The following products and medicinal herbs have a cholekinetic effect: Calamus rhizomes; Dandelion roots; Rhubarb roots; leaves of barberry; Cowberry leaves; Watch leaves; coriander oil; Juniper oil; Cumin oil; Olive oil; Coriander fruits; Juniper fruits; Cumin fruits; fennel fruit; Dog-rose fruit; Sunflower oil; Lingonberry juice; Grass mountaineer bird; Oregano herb; Shepherd's purse grass; thyme herb; Yarrow herb; Immortelle flowers; Cornflower flowers; Marigold flowers; Chamomile flowers. Modern choleretic drugs Modern choleretic drugs are represented by a group of synthetic choleretics and combined herbal and animal remedies. Synthetic choleretics include preparations containing nikodin, hymecromone, osalmid or tsikvalon as active substances. Synthetic choleretics compared to natural ones (for example, Allochol, Holenzim, Liobil, etc.) are better tolerated, do not cause unstable stools, and also have a number of additional positive therapeutic effects, such as antispasmodic, lipid-lowering, antibacterial and anti-inflammatory. In addition, modern choleretic drugs include preparations of dehydrocholic acid (Hologon, Decholin) and ursodeoxycholic acid (Livodex, Urdox, Urso 100, Ursodez, Ursodex, Uroliv, Ursor, Ursor C, Ursosan, Ursofalk, Choludexan, Exhol). Also a modern drug is the cholespasmolytic Duspatalin. Among the choleretic herbal and animal preparations, the following are modern: Berberis-Homaccord; Vigeratin; Insadol; Convaflavin; Pekvokrin; Peridol; Sibektan; Solaren; Tanacehol; Tanaflon; Urolesan N; Febihol; Holagogum; Cholagol; Holaflux; Holosas. Choleretic drugs - indications for use A common indication for the use of choleretic drugs is the pathology of the gallbladder, biliary tract or liver. However, in order to select the optimal drug, it is necessary to know the indications for the use of each group of choleretic agents. 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 preparations, it is necessary to know the indications for the 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 agents. This means that both synthetic choleretics (for example, Tsikvalon, Nicodin, Oxafenamide, etc.), and preparations containing natural bile components (for example, Allochol, Liobil, Decholin, Cholenzim, Hologon, etc.), and herbal remedies (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 diseases of the liver (for example, hepatitis, steatosis, etc.); Chronic inflammatory diseases of the biliary tract (cholangitis, cholecystitis, etc.); Habitual constipation, provoked by a violation of the outflow of bile. Choleretics, depending on the characteristics of the course, diseases can be used in combination with antibiotics, painkillers, antispasmodics and laxatives. In addition, with insufficient bile secretion, choleretics containing components of natural bile of animals can be used as replacement therapy drugs. Among choleretics, the most "hard" 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 spectrum of positive therapeutic effects, they are significantly inferior to drugs containing bile components. In addition, synthetic choleretics do not improve the properties of bile, as natural preparations and products containing medicinal herbs. But synthetic choleretics, in addition to choleretic properties, have the following therapeutic effects: Antispasmodic effect (eliminate spasm and pain in the biliary tract) is expressed in osalmid and gimecromon; Lipid-lowering effect (reduce the concentration of cholesterol in the blood due to its excretion from the body) is expressed in osalmid; Antibacterial effect expressed in Nicodin; Anti-inflammatory effect expressed in tsikvalon; Suppression of decay 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 osalmid or gimecromon. If diseases of the biliary tract and gallbladder are combined with atherosclerosis, hypertension and high blood cholesterol, then a drug containing osalmid should be chosen. With pronounced inflammatory changes in the wall of the gallbladder or biliary tract, it is necessary to choose drugs with tsikvalon. Herbal 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 of the gallbladder, ducts and liver, due to which their very high efficiency is achieved. 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 on their own. 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: Biliary dyskinesia of hypotonic form; Atony of the gallbladder with stagnation of bile, combined with dyskinesia; Chronic cholecystitis; chronic hepatitis; Gastritis with low or zero acidity (hypoacid or anacid) of gastric juice; Preparation for duodenal sounding. 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 bile stasis in dyskinesia, chronic cholecystitis, chronic hepatitis, in anacid and severe hypoacid conditions. They are also used during duodenal sounding. Cholespasmolytics Indications for the use of cholespasmolytics are as follows: Biliary dyskinesia of hyperkinetic form; Moderate pain syndrome accompanying diseases of the biliary tract and gallbladder. Basically, cholespasmolytics are used to relieve moderate pain on an outpatient basis or at home. Indications for the use of choleretic drugs with litholytic action Indications for the use of choleretic drugs with litholytic action are as follows: Dissolution of small stones in the gallbladder and prevention of the formation of new ones; Dissolution of fragments of stones formed after the procedure of ultrasonic crushing; 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 by poisons, alcohol, drugs, etc.; Compensated biliary cirrhosis of the liver; Primary cholangitis; Atresia of the intrahepatic biliary tract; Stagnation of bile on the background of parenteral nutrition; Biliary dyskinesia; Complex treatment of chronic opisthorchiasis; Prevention of liver damage against the background of the use of cytostatics or oral contraceptives. Taking choleretic drugs - a brief instruction All choleretic drugs, regardless of the form of release, must be taken 20 to 30 minutes before meals. Moreover, the total daily dosage is divided equally into 3-5 doses, depending on how many times a day a person eats. It is recommended to take choleretic drugs before each meal. The preparations must be washed down with a sufficient amount of water and be sure to eat something half an hour after taking. If a person does not eat anything after taking a choleretic drug, then he will experience nausea, diarrhea and general well-being will worsen. Usually, 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 the use of choleretic drugs are prophylactic and should be carried out during the entire period of time while the disease persists. With exacerbation of diseases of the biliary tract, liver and gallbladder, choleretic drugs are used as part of 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. Cholagogue preparations for children In children, the following choleretic drugs can be used: Choleretics containing components of natural bile - Allochol; Synthetic choleretics - Nicodin, Oxafenamide, Osalmid; Choleretics containing medicinal herbs - Flamin, Febihol, Holosas, Cholemax, Holos, Hofitol; Cholekinetics - Valerian, Valerianahel, Magnesia, Cormagnesin, magnesium sulfate; Cholinolytics (cholespasmolytics) - Atropine, Metacin, Platifillin, Papaverin, Papazol, Drotaverin, No-Shpa, Bioshpa, Nora-Drotaverin, Nosh-Bra, Ple-Spa, Spazmol, Spazmonet, Spazoverin, Spakovin Eufillin. The dosage of the above choleretic drugs is calculated individually by body weight, based on the ratio indicated 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 prepared infusions and decoctions contain a wide range of active substances and it is simply impossible to predict the reaction of a child's body to all of them. Cholagogue drugs during pregnancy Pregnant women can take only those choleretic drugs that do not provoke contractile activity of the uterus and do not penetrate the placenta to the fetus, and also do not cause a pronounced deterioration in the condition. The following choleretic drugs are absolutely safe during pregnancy: Holenzim; Holosas; Cholemax; Holos; Valerian; Magnesia (magnesium sulfate); Cormagnesin; Atropine; Metacin; Papaverine (Papazol); Drotaverin (No-Shpa, Bioshpa, Nora-Drotaverin, 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 studies have not been conducted for obvious ethical reasons. Therefore, the instructions usually write that the drugs can be used during pregnancy, but only under the supervision of a doctor. These choleretics include the following: Odeston; Holonerton; Cholestil; Flamin; Febihol; Berberis-Gommakord; Hofitol; 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 cannot be assessed in advance and with high accuracy. If necessary, you can choose ready-made dosage forms based on herbs, for example, Holosas, Cholemax, Cholenzim, 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 (BDB) The choice of drugs depends on the form of biliary dyskinesia. Yes, at hypertensive type of biliary dyskinesia (ZHVP) shows the following choleretic drugs: Cholespasmolytics of any type (for example, No-Shpa, Papaverine, Platifillin, Metacin, Duspatalin, Odeston, etc.), which reduce pain; Cholekinetics (for example, Magnesia, Cormagnesin, Berberine-Gommakord, Holosas, Cholemax, Holos, Sorbitol, Mannitol, Flamin, etc.). The general scheme of therapy is usually as follows - cholespasmolytics are used in short courses to eliminate pain, after which a long-term intake of cholekinetics begins. Cholespasmolytics can also be used episodically as needed. With a hypertensive type of dyskinesia of the biliary tract, choleretic drugs from the group of choleretics and hydrocholeretics, for example, Allochol, mineral waters, etc., cannot be used. With dyskinesia of the biliary tract by hypotonic type the following choleretic drugs are shown: Any choleretics (for example, Allohol, Liobil, Nicodin, Tsikvalon, Cholagogum, Cholagol, Flacumin, Konvaflavin, Febihol, Sibektan, Tanacehol, etc.); Hydrocholeretics (alkaline mineral waters, etc.); Antispasmodics of myotropic action (Duspatalin, Odeston). Choleretics are used in long courses of 4 to 10 weeks, and antispasmodics in short cycles of 7 to 14 days. Alkaline mineral waters can be drunk constantly. Cholekinetics in the hypotonic form of biliary dyskinesia are usually not used. Cholagogue preparations for stagnation of bile In this case, to eliminate congestion, the most effective and optimal are their choleretic groups of cholekinetics, for example, Cormagnesin, Berberine-Gommakord, Holosas, Mannitol, Flamin, etc. Cholecystitis Choleretic drugs for cholecystitis are used at any stage of the disease. In the presence of stones in the gallbladder with cholecystitis, only products containing ursodeoxycholic acid as an active substance can be used as choleretic drugs (for example, Livodex, Urdox, Urso 100, Ursodex, Ursodex, Uroliv, Ursolit, Ursor C, Ursosan, Ursofalk, Choludexan , Exhol). With non-stone cholecystitis, it is necessary to take choleretics from any group. Among synthetic choleretics, choleretic ones containing oxafenamide and hymecromone or cyclovalone as active substances are optimal. When using oxafenamide or hymecromon, it is not necessary to additionally take cholespasmolytics (No-Shpa, Papaverine, etc.), since these synthetic choleretics have an antispasmodic effect. And against the background of the use of cyclovalon, you do not need to additionally take antibacterial drugs, since this choleretic has a pronounced antimicrobial effect. When using choleretics containing bile components or medicinal herbs (for example, Allochol, Liobil, Sibektan, Tanacehol, 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, Cholemax, 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. The absence of a 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 any drug is not a reflection of its inefficiency, but of the wrong choice of medicine. Cholagogue drugs - prices Prices for choleretic drugs are very variable and range from 50 to 500 rubles per pack. 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 a relatively expensive and cheap cost. However, since in each case choleretic drugs from a certain group are shown, it is impossible to replace them with drugs from another, cheaper classification subgroup. You can only choose the cheapest drug from the same group. This principle of substitution should always be used when choosing a choleretic drug. Cooking choleretic salad Marco Polo - video Before use, you should consult with a specialist. Important! Cholagogue folk remedies for stagnation of bile should not completely replace traditional drug treatment. The biliary herb can only be used as part of complementary therapy. Existing contraindications Cholagogue herbs for stagnation of bile 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 such conditions: The appearance of large stones in the gallbladder or in the biliary tract. Cholagogue drugs during stagnation of bile will provoke the movement of stones, which will lead to blockage of the ducts, the development of an intense pain syndrome (hepatic colic). Often, against the background of taking herbs, inflammation develops, which requires emergency surgical treatment; Exacerbation of peptic ulcer of the stomach or duodenum; The age of the child 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 stasis may have the following mechanisms of action: Liquefaction of bile, which normalizes the excretion of digestive secretions. This helps to improve the patient's well-being, the functioning of the organs of the biliary system. Such properties are possessed by the herb of celandine, the initial letter; An increase in the tone of the muscles of the gallbladder causes an accelerated evacuation of the contents of the organ. Such choleretic herbs have a similar effect: tansy, corn stigmas; Increased pressure in the digestive tract, which leads to the flow of a large amount of fluid into the gallbladder, dilution of bile; Reducing the tone of the muscles of the ducts, which increases their throughput. Common dandelion has a similar effect. The list includes plant materials that effectively expel bile from the gallbladder: milk thistle; mountain arnica; Corn silk; Dandelion common; Common tansy; Calamus root; Immortelle sandy; Stinging nettle; Potentilla goose; Elecampane is high; Large celandine. Features of therapy for children Cholestasis can occur in patients of any age group. In pediatric practice, drugs that have a choleretic effect and a minimum of side effects are widely used. Therefore, for children, the safest preparations based on herbal ingredients are used. These funds include: Holosas; Flamin; Allochol; Hofitol; Valerian. The dosage of the listed drugs can only be determined by a doctor, according to the annotation, age, body weight of the child. To eliminate cholestasis, freshly squeezed fruit and vegetable juices, alkaline drink should be introduced into the children's diet. Important! Folk recipes for children under 12 years of age 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 You can treat stagnation of bile with the help of choleretic fees 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. Cholagogue collection No. 1 contains the following medicinal raw materials: Grass cotton wool trifoliate. The plant has a pronounced anti-inflammatory effect; Mint leaves. The raw material improves the functioning of the organs of the biliary system, has a sedative and antispasmodic effect; Coriander seeds. The plant has a pronounced choleretic effect; Immortelle flowers. The raw material stimulates the motility of the bladder, reduces the level of bilirubin and cholesterol in the blood, and normalizes the rheological properties of bile. As part of the choleretic collection No. 2, there is additionally yarrow, which helps to cure many pathologies of the biliary system. The plant has an antispasmodic, analgesic, anti-inflammatory effect, quickly eliminates the stagnation of bile in the gallbladder. Cholagogue collection No. 3 is characterized by the following composition: Tansy flowers, which have an anti-inflammatory effect, stimulate the peristalsis of the digestive organs; Chamomile and calendula flowers, mint leaves effectively eliminate signs of inflammation, promote the excretion of bile; Yarrow. The plant is used as an analgesic and choleretic agent. How to drink choleretic fees? To prepare a drug based on the 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 with 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 with medicinal herbs, it is necessary to strictly follow the medical recommendations for the manufacture 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 agent is infused for 40 minutes, squeezed out, brought to the original volume. Before each dose, the medicinal composition should be shaken. The medicine can be taken 100 ml 30 minutes before meals. Cholagogue fees No. 2 and 3 are also produced in filter bags. In this case, to prepare the medicine, it is enough to pour 1 sachet of 100 ml of boiling water, leave the remedy for 20 minutes. The resulting composition is consumed before meals (30 minutes before the meal), 100 ml. Important! During the treatment of children, it is recommended to reduce the daily dosage to 150 ml, dividing it into 3 doses. Cholagogue juices Along with medicinal decoctions for the treatment of cholestasis, juices that remove bile from the body are widely used. To eliminate congestion, appoint: Dandelion juice. To make a medicine, you will need freshly picked, washed plants. The remedy is recommended to drink 20 ml 1-2 times a day for 1 month; Turnip juice. The drug allows you to normalize the work of the bile ducts during their narrowing. You can drink juice 25 ml three times a day until you feel better. You need to refuse this recipe if you have a stomach ulcer; Pear juice. The tool allows you to improve the production of bile. It is enough to drink 100 ml of juice in the morning and in the evening, the duration of therapy is not limited; Radish juice. The composition increases the intensity of bile production, normalizes its excretion. Juice drink 25 ml no more than 3 times a day. However, with an ulcer, enteritis, gastritis, this recipe should be abandoned. To preserve nutrients in juices, it is necessary to prepare funds before taking. To do this, the medicinal raw materials are thoroughly washed, dried with a paper towel. There are such ways to obtain juice: grind the plant in a meat grinder, squeeze it with a juicer or gauze.	Cholagogue 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. Altea syrup 9 "Doctor Theiss" with plantain Tablets: 1. "Liv 52" 2. Karsil 3. "Hofitol" 4. "Senade" 5. "Senadexin" 6. Glaxenna 7. "Mukaltin" 8. "Cough pills" 9. Relaxosan 10. "Motherwort Forte" 11. Dragee "Evening" Tinctures: Tonic: 1. Ginseng 50 ml 2. Eleutherococcus 100 ml 3. Rhodiola 50 ml 4. Aralia 50 ml 5. Lemongrass 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. Kapsikam 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 raw materials trade name, company, producing country pharmachologic effect Indications for use Release form Terms and conditions of storage Valocordin Krewel Meuselbach, Germany, Peppermint Oil + Phenobarbital + Hop Cones Oil + Ethyl Bromisovalerianate. Phenobarbital 18.4; Ethyl bromoisovalerianate 18.4; mint oil 1.29; hop oil 0.18; ethanol, water Antispasmodic, vasodilator, sedative, hypnotic Functional disorders of the cardiovascular system (including cardialgia, sinus tachycardia); neurosis, accompanied by irritability, anxiety, fear; insomnia (difficulty falling asleep); states of excitation, accompanied by pronounced vegetative reactions. 15-20 drops 3 times a day inside. Orange glass bottle of 20 and 50 ml in a cardboard box List B. In a place protected from light at a temperature not higher than +15 ° C Shelf life 5 years Karsil (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. Asteraceae Asterceae Silymarin has a stabilizing effect on the cell membrane, preventing harmful effects on the liver, and helps to restore damaged liver cells. Hepatoprotector Indications: toxic damage to the liver, chronic hepatitis of non-viral etiology, cirrhosis of the liver (as part of complex therapy), condition after acute hepatitis, in order to prevent long-term use of drugs, alcohol, chronic intoxication (including professional). 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 pods 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 edema, pain syndrome, 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 (I trimester). Tablets 0.02 g No. 30 List B.: In a dry, dark place. Novo-Passit IVAX-CR, Czech Republic Dry extract (valerian officinalis, lemon balm, St. John's wort, common hawthorn, passionflower incarnate (passion flower), common hop, black elderberry) 0.1575 g; guaifenesin 0.2 g Sedative and HYPERLINK "http://www.webapteka.ru/drugbase/search.php?filt_ftgid=31"anxiolyticHYPERLINK "http://www.webapteka.ru/drugbase/search.php?filt_ftgid=31" remedy Neurasthenia and neurotic reactions, accompanied by irritability, anxiety, fear, fatigue, distraction; "manager" syndrome, insomnia (mild forms); headaches due to nervous tension, migraine, pruritic dermatoses Coated tablets of 0.2; In a blister 30 pcs.; in a pack of cardboard 1 blister. In a place protected from light, at a temperature of 10-25 ° C. Plantaglyucid (Plantagluсidum), Vifitech PKP LLP Plantain leaf extract (Plantaginis majoris foliorum extract) The total preparation obtained from the leaves of a large plantain and containing a mixture of polysaccharides, reducing sugars and galacturic acid. Antispasmodic herbal remedy. Reduces the tone of smooth muscles of the stomach and intestines, has a moderate anti-inflammatory effect. Enhances the secretion of gastric juice, increasing its acidity. hypoacid gastritis. Contraindications: Hypersensitivity, hyperacid gastritis, gastric ulcer and duodenal ulcer 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 Woolly foxglove - Digitalis lanata, fam. Norichnikovye - Scrophulariaceae Cardiovascular agents, cardiac glycosides Used for chronic circulatory failure, tachyarrhythmia, atrial fibrillation; Tablets of 0.25 mg No. 50, 0.025% solution in ampoules of 1 ml No. 10. A list storage. Collections of medicinal plant raw materials presented in the pharmacy Trade name country of origin International non-proprietary name (INN) pharmachologic effect Indications for use Release form Terms and Conditions storage Arfazetin Arfazetin Russia, JSC Krasnogorsk lek means Blueberry shoots 20% Common bean fruit shells 20% Eleutherococcus senticosus roots and rhizomes 15% Rosehip fruits 15% Horsetail herb 10% St. John's wort herb 10% Chamomile flowers 10% The infusion of the collection has a hypoglycemic effect, helps to reduce blood glucose, increases carbohydrate tolerance and enhances the glycogen-forming function of the liver. Diabetes mellitus type 2 (mild and moderate, both alone and in combination with sulfa drugs and insulin). in filter bags of 2 g, 20 pieces in cardboard packs, Stored in dry protected from light place no more 2 days. Store in inaccessible to children place Brusniver Lingonberry leaves 50% Rosehip fruit 20% St. John's wort herb 20% Turf grass 10% The infusion of the collection has an antimicrobial (staphylococcus, E. coli, Pseudomonas aeruginosa, some other microorganisms), anti-inflammatory, diuretic effect. 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 gr, 20 pieces in cardboard packs Stored in dry protected from light place, prepared infusion - in a cool place no more than 2 days. Keep out of reach place for children. Breast collection №2 Russia, OOO Apeks 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), SARS (symptomatic therapy), bronchial asthma Collecting crushed 70 gr in packs of cardboard with an inner package Stored in dry protected from light place, prepared infusion - in a cool place no more than 2 days. Keep out of reach place for children Breast collection #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 in inflammatory diseases of the upper respiratory tract Stored in dry protected from light spot, cooked infusion - cool place no more 2 days. Keep out of reach place for children Calming Collection #2 Russia, OAO Krasnogorskleksredstva Motherwort herb 40% Hop cones 20% Peppermint leaves 15% Valerian roots with rhizomes 15% Licorice roots 10% The infusion of the collection has a calming, moderately antispasmodic effect. Indications: increased nervous excitability, sleep disturbances, early stage of arterial hypertension (as part of complex therapy) Crushed collection of 50 gr in cardboard packs with an inner bag Proctophytol antihemorrhoidal collection Russia, OAO Krasnogorskleksredstva Hay leaves 20% Yarrow herb 20% Buckthorn bark 20% Coriander fruits 20% Licorice roots 20% The infusion of the collection has a laxative, antispasmodic, hemostatic effect. Indications: hemorrhoids, chronic constipation Powder in filter bags of 2 g, 20 pieces in cardboard packs Crushed collection of 50 gr in cardboard packs with an inner bag Store in a dry, dark place, prepared infusion in a cool place for no more than 2 days. Keep out of the reach of children Elekasol Russia, OAO Krasnogorskleksredstva Licorice roots 20% Sage leaves 20% Eucalyptus rod leaves 20% Marigold flowers 20% Turf grass 10% Chamomile flowers 10% The infusion has antimicrobial activity against staphylococci, Escherichia coli, Proteus 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, lichen planus of the oral mucosa, periodontitis) - gastroenterology (chronic gastroduodenitis, enteritis, colitis, enteroclit) - in dermatology (microbial eczema, neurodermatitis, rosacea, acne vulgaris) - in gynecology. (non-specific 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 Crushed collection of 50 gr in cardboard packs with an inner bag Store in a dry, dark place, apply freshly prepared infusion. Keep out of the reach of children Storage of MPC, herbal drugs and essential oils in a pharmacy medicinal raw material herbal preparation Storage of MPS and drugs of plant origin is carried out in accordance with the order dated 11/13/96. No. 377 "On approval of instructions for organizing storage in pharmacies of various groups of medicines and medical devices." MPV is stored in a dry, well-ventilated area, in a well-closed container, the quality of which is checked upon acceptance of the goods. MPV containing essential oil is stored separately and well packaged. Liquid LF, such as tinctures, extracts, syrups, are stored in a hermetically sealed container in a place protected from light. Storage of FPP must also comply with the SP X edition. And all the general requirements of the instructions of order No. 377. All FPPs are stacked on racks labeled outward with a rack card attached. Pills from MPC are stored separately from other dosage forms in their original packaging, protecting them from external influences. As already mentioned, VP comes already packaged, in its 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 preserves their integrity. STORAGE OF ESSENTIAL OILS. · Keep essential oils tightly closed in a dark glass container in a dry (relative humidity not higher than 70%), dark, cool place at a temperature of 5 to 25ºC, in an upright position. The flasks should be placed in a dark cabinet at a temperature not exceeding 15 °C. After storage for a year, the oils must be tested for suitability by the methods accepted for each of them. · Oils that are not properly stored deteriorate quickly, oxidize, and some oxidation products are allergic and irritating. Mandatory storage in the refrigerator requires citrus, lemongrass, litsea, citronella and pine oils · If an essential oil has an expiration date, it must be respected, as the individual components of the essential oil may react chemically 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 must be out of the reach of children. · Keep oils away from open flames. Sometimes the expiration of the shelf life can even be judged visually, for example, the caps of the bottles of camphor, lime, marjoram, tea tree and some other oils swell, i.e., oil vapors enter into a chemical reaction with a plastic cap. And for a number of oils (for example, orange, bigaradium, 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 resinification, oil becomes more dense, its volume decreases. These processes are accelerated if the bottle is stored in a warm room. As a rule, the standards establish the guaranteed shelf life of oils from 6 months (for citrus fruits) to 12 (for most others). However, if the oil is stored in a full, hermetically sealed vial, in a cool, dry place out of direct sunlight, then the shelf life of this oil can be significantly increased. The main types of packaging of drugs of plant origin: For LRS use: 1. carton packs 2. paper bags 3. contour - cellular packaging 4. cans made of polymer material 5. dark glass bottles 6. paper bagless packaging There are basic requirements for packaging: 1. gas and vapor tightness 2. chemical indifference 3. strength 4. thermal resistance 5. opacity 6. impermeability to microorganisms All these requirements should ensure the maximum shelf life of the drug. In addition to these requirements, there are consumer requirements for packaging: 1. must contain information on the storage and acceptance of medicines, 2. have an attractive appearance, 3. should be comfortable to wear, 4. there must be a control of the first opening, 5. ease of destruction of used packaging. Requirements for the external design of the packaging (according to the Federal Law "On Medicines") On the inner and outer packages in a well-readable font in Russian are indicated 1. drug name and international non-proprietary name 2. enterprise - manufacturer 3. serial number and date of manufacture 4. how to use 5. dose and number of doses per package 6. expiration date 7. vacation conditions 8. storage conditions 9. Precautions when using medicines 10. registration number