Uso de fitoterápicos na Doença Hemorroidária

Autores

DOI:

https://doi.org/10.33448/rsd-v12i2.39925

Palavras-chave:

Doenças retais; Fitoterapia; Terapia de ervas; Hemorroidas; Ensino de saúde.

Resumo

O presente estudo trata-se de uma revisão da literatura sobre o uso de fitoterápicos no tratamento da Doença Hemorroidária (DH), um tipo de patologia anorretal, cujo quadro clínico inclui sangramento ao evacuar, desconforto anal, prurido, dor e protrusão anal. Buscou-se reunir dados de ensaios clínicos, guidelines, estudos experimentais e revisões sistemáticas com o objetivo de apresentar os fitoterápicos que demonstraram eficácia no tratamento da DH, haja visto que seu manejo padrão apresenta diversos efeitos colaterais e complicações. Dentre fitoterápicos avaliados (ex.: Terminalia chebula Retz, Allium iranicum e Centella asiatica L.) mostraram melhora significativa, principalmente, nos parâmetros como: sangramento, diminuição da atividade inflamatória, e nos padrões clínicos e endoscópicos da doença. Portanto, há uma grande necessidade de introduzí-los como terapia alternativa ou coadjuvante ao tratamento convencional, e incentivar a realização de mais pesquisas que explorem sua eficácia clínica, assim cooperando para o aperfeiçoamento da qualidade de vida dos indivíduos acometidos.

Referências

Adão, C. R., da Silva, B. P., & Parente, J. P. (2011). A new steroidal saponin with antiinflammatory and antiulcerogenic properties from the bulbs of Allium ampeloprasum var. porrum. Fitoterapia, 82(8), 1175–1180. https://doi.org/10.1016/j.fitote.2011.08.003

Amaturo, A., Meucci, M., & Mari, F. S. (2020). Treatment of haemorrhoidal disease with micronized purified flavonoid fraction and sucralfate ointment. Acta bio-medica: Atenei Parmensis, 91(1), 139–141. https://doi.org/10.23750/abm.v91i1.9361

Andarkhor, P., Sadeghi, A., Khodadoost, M., Kamalinejad, M., Gachkar, L., Abdi, S., Zargaran, A. (2019). Effects of Terminalia chebula Retz. in treatment of hemorrhoids: A double – blind randomized placebo – controlled clinical trial. European Journal of Integrative Medicine, (30), 100935. https://doi.org/10.1016/j.eujim.2019.100935

Bardin, L. (1977). Análise de conteúdo. Lisboa: Edições 70.

Cerato, M., Cerato, N. L., Passos, P., Treigue, A., & DAMIN, D. (2014). Tratamento cirúrgico das hemorroidas: uma análise crítica das atuais opções. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 27(1), 66-70. https://doi.org/10.1590/s0102-67202014000100016

Chekdaengphanao, P., Jaiseri, D., Sriraj, P., Aukkanimart, R., Prathumtet, J., Udonsan, P., Boonmars, T. (2022). Anticancer activity of Terminalia chebula, Terminalia bellirica, and Phyllanthus emblica extracts on cholangiocarcinoma cell proliferation and induction of apoptosis. Journal of Herbal Medicine, 35, 100582. https://doi.org/10.1016/j.hermed.2022.100582.

Cheng, T., Liu, B. F., Han, T. Y., Gu, Z. H., Pan, P., & Haifang, Y. (2021). Effectiveness and safety of Liuhedan for treating acute pancreatitis: A protocol for systematic review and meta-analysis. Medicine, 100(8), e24863. https://doi.org/10.1097/MD.0000000000024863

Chiaretti, M., Fegatelli, D. A., Pappalardo, G., Venti, M., & Chiaretti, A. I. (2020). Comparison of Centella with Flavonoids for Treatment of Symptoms in Hemorrhoidal Disease and After Surgical Intervention: A Randomized Clinical Trial. Scientific reports, 10(1), 8009. doi: 10.1038/s41598-020-64772-0

Clinical Practice Committee, American Gastroenterological Association (2004). American Gastroenterological Association medical position statement: Diagnosis and treatment of hemorrhoids. Gastroenterology, 126(5), 1461–1462. https://doi.org/10.1053/j.gastro.2004.03.001

Cocorullo, G., Tutino, R., Falco, N., Licari, L., Orlando, G., Fontana, T., Raspanti, C., Salamone, G., Scerrino, G., Gallo, G., Trompetto, M., & Gulotta, G. (2017). The non-surgical management for hemorrhoidal disease. A systematic review. Il Giornale di chirurgia, 38(1), 5–14. https://doi.org/10.11138/gchir/2017.38.1.005

Cordeiro, A. M., Oliveira, G. M., Rentería, J. M. & Guimarães, C. A. (2007). Revisão sistemática: uma revisão narrativa. Revista do Colégio Brasileiro de Cirurgiões, 34(6), 428-431. doi: 10.1590/S0100-69912007000600012

Correia A. M. R. & Mesquita A (2014). Mestrados e Doutoramentos. Porto: Vida Economica Editorial, 2ª edição, 217-218.

Cruz, G. M. G., Ferreira, R. M. R. S.; Neves, P. M. (2006). Doença hemorroidária: aspectos epidemiológicos e diagnósticos de 9.289 pacientes portadores de doença hemorroidária. Rev bras. colo-proctol, 26(1), 6-23. https://doi.org/10.1590/S0101-98802006000100001

Davis, B. R., Lee-Kong, S. A., Migaly, J., Feingold, D. L., & Steele, S. R. (2018). The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Diseases of the colon and rectum, 61(3), 284–292. https://doi.org/10.1097/DCR.0000000000001030

Dehdari, S., Hajimehdipoor, H., Esmaeili, S., Choopani, R., & Mortazavi, S. A. (2018). Traditional and modern aspects of hemorrhoid treatment in Iran: a review. Journal of Integrative Medicine, 16(2), 90-98. https://doi.org/10.1016/j.joim.2018.01.002.

Deus, J. R., & Rama, N. (2020). Doenças hemorroidárias – Recomendações (Guidelines). Revista Portuguesa de Coloproctologia. 17(1), 40-46.

Dey, Y. N., Wanjari, M. M., Kumar, D., Lomash, V., & Jadhav, A. D. (2016). Curative effect of Amorphophallus paeoniifolius tuber on experimental hemorrhoids in rats. Journal of Ethnopharmacology, (192) ,183-191. 10.1016/j.jep.2016.07.042.

Dönmez, C., Yalçın, F. N., Boyacıoğlu, O., Korkusuz, P., Akkol, E. K., Nemutlu, E., Balaban Y. H., & Çalışkan, U. K. (2020). From nutrition to medicine: Assessing hemorrhoid healing activity of Solanum melongena L. via in vivo experimental models and its major chemicals. Journal of Ethnopharmacology, (261), 113143. 10.1016/j.jep.2020.113143.

Froehner, I., Kotze, P. G., Rocha, J. G., Miranda, E. F., Sartor, M, C., Martins, J. F., Abou-Rejaile, V., Filho, A. S., & Correa, M. F. (2014). Postoperative topical analgesia of hemorrhoidectomy with policresulen and cinchocaine: a prospective and controlled study. Revista do Colégio Brasileiro de Cirurgiões, 41(2), 092-098. https://doi.org/10.1590/S0100-69912014000200004.

Gallo, G., Martellucci, J., Sturiale, A., Clerico, G., Milito, G., Marino, F., Cocorullo, G., Giordano, P., Mistrangelo, M., & Trompetto, M. (2020). Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease. Techniques in coloproctology, 24(2), 145–164. https://doi.org/10.1007/s10151-020-02149-1

Gan, T., Liu, Y. D., Wang, Y., & Yang, J. (2010). Traditional Chinese Medicine herbs for stopping bleeding from haemorrhoids. The Cochrane database of systematic reviews, (10), CD006791. https://doi.org/10.1002/14651858.CD006791.pub2

Gao, H., Cheng, X., Liu, R., Wang, X., Wang, W., Gong, F., Pan, R., & Hu, J. (2021). Clinical study of herbal mixture "Diding Oral Medicine" as an alternative to preventative antibiotics in perioperative hemorrhoids: A CARE-compliant article. Medicine, 100(18), e25661. https://doi.org/10.1097/MD.0000000000025661

Gupta, P. C. (2012). Biological and pharmacological properties of Terminalia chebula Retz. (Haritaki): An overview. International Journal of Pharmacy and Pharmaceutical Sciences, 4(3), 62-68.

Gupta P. J. (2007). Effect of red chili consumption on postoperative symptoms during the post-hemorrhoidectomy period: randomized, double-blind, controlled study. World journal of surgery, 31(9), 1822–1826. doi:10.1007/s00268-007-9148-6

Hall J. F. (2013). Modern management of hemorrhoidal disease. Gastroenterology clinics of North America, 42(4), 759–772. https://doi.org/10.1016/j.gtc.2013.09.001

Hardy, A., Chan, C. L., & Cohen, C. R. (2005). The surgical management of haemorrhoids--a review. Digestive surgery, 22(1-2), 26–33. https://doi.org/10.1159/000085343

Hassan-Bulbul, Md. R., Chowdhury, M. N. U., Naima, T. A., Sami, S. A., Imtiaj, Md. S., Huda, N., Uddin, Md. G. (2022). A comprehensive review on the diverse pharmacological perspectives of Terminalia chebula Retz. Heliyon, e10220. https://doi.org/10.1016/j.heliyon.2022.e10220.

Ibáñez, L., Ballarín, E., Vidal, X., & Laporte, J. R. (2000). Agranulocytosis associated with calcium dobesilate clinical course and risk estimation with the case-control and the case-population approaches. European journal of clinical pharmacology, 56(9-10), 763–767. https://doi.org/10.1007/s002280000190

Jiang, Z. M., & Cao, J. D. (2006). The impact of micronized purified flavonoid fraction on the treatment of acute haemorrhoidal episodes. Current medical research and opinion, 22(6), 1141–1147. https://doi.org/10.1185/030079906X104803

Júnior, I. F., Kotze P. G., Rocha J. G., Miranda E. F., Sartor M. C., Martins J. F., Rejaile V. A., Steckert F. A., Corrêa M. F. (2014). Analgesia tópica com policresuleno e chinchocaína no pós-operatório de hemorroidectomia: um estudo prospectivo e controlado. Rev Col Bras Cir., 41(2). https://doi.org/10.1590/S0100-69912014000200004

Kim, H. J., Song, H. K., Park, S. H., Jang, S., Park, K. S., Song, K. H., Lee, S. K., & Kim, T. (2022). Terminalia chebula Retz. extract ameliorates the symptoms of atopic dermatitis by regulating anti-inflammatory factors in vivo and suppressing STAT1/3 and NF-ĸB signaling in vitro. Phytomedicine: international journal of phytotherapy and phytopharmacology, 104, 154-318. https://doi.org/10.1016/j.phymed.2022.154318

Lee, J. H., Kim, H. E., Kang, J. H., Shin, J. Y., & Song, Y. M. (2014). Factors associated with hemorrhoids in korean adults: korean national health and nutrition examination survey. Korean journal of family medicine, 35(5), 227–236. https://doi.org/10.4082/kjfm.2014.35.5.227

Li, N., Zhang, L., Pan, P., Cheng, T., & Xu, S. Y. (2021). Effectiveness and safety of Liuhedan for treating cellulitis: A protocol for systematic review and meta-analysis. Medicine, 100(22), e26118. https://doi.org/10.1097/MD.0000000000026118

Lohsiriwat V. (2012). Hemorrhoids: from basic pathophysiology to clinical management. World journal of gastroenterology, 18(17), 2009–2017. https://doi.org/10.3748/wjg.v18.i17.2009

Lopes Neto, J. J., Almeida, T. S., Almeida Filho, L. C. P., Rocha, T. M., Nogara, P. A., Nogara, K. F., Rocha, J. B. T., Leal, L. K. A. M., & Carvalho, A. F. U. (2020). Triplaris gardneriana seeds extract exhibits in vitro anti-inflammatory properties in human neutrophils after oxidative treatment. Journal of Ethnopharmacology, (250), 112474. 10.1016/j.jep.2019.112474.

Mahboubi M. (2017). Effectiveness of Myrtus communis in the treatment of hemorrhoids. J Integr Med. 15(5): 351–358. 10.1016/S2095-4964(17)60340-6.

Malekzadeh, F., Ehsanifar, H., Shahamat, M., Levin, M., & Colwell, R. R. (2001). Antibacterial activity of black myrobalan (Terminalia chebula Retz) against Helicobacter pylori. International journal of antimicrobial agents, 18(1), 85–88. https://doi.org/10.1016/s0924-8579(01)00352-1

Ministério da Saúde. (2016). Política e Programa Nacional de Plantas Medicinais e Fitoterápicos. Organização: Ministério da Saúde, Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Departamento de Assistência Farmacêutica, Brasília, Brasil.

Ministério da Saúde. Política e Programa Nacional de Plantas Medicinais e Fitoterápicos. Organização: Ministério da Saúde, Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Departamento de Assistência Farmacêutica. Brasília, 2016.

Mosavat, S. H., Ghahramani, L., Sobhani, Z., Haghighi, E. R., Chaijan, M. R., Heydari, M. (2015). The effect of leek (Allium iranicum (Wendelbo)) leaves extract cream on hemorrhoid patients: A double blind randomized controlled clinical trial. European Journal of Integrative Medicine, 7(6), 669-673. https://doi.org/10.1016/j.eujim.2015.08.008.

Panpimanmas, S., Sithipongsri, S., Sukdanon, C., & Manmee, C. (2010). Experimental comparative study of the efficacy and side effects of Cissus quadrangularis L. (Vitaceae) to Daflon (Servier) and placebo in the treatment of acute hemorrhoids. Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 93(12), 1360–1367.

Perera, N., Liolitsa, D., Iype, S., Croxford, A., Yassin, M., Lang, P., Ukaegbu, O., & Issum, C. (2012). Phlebotonics for haemorrhoids. Cochrane Database of Systematic Reviews, 8, Art. No.: CD004322. 10.1002/14651858.CD004322.pub3.

Ray-Offor, E., & Amadi, S. (2019). Hemorrhoidal disease: Predilection sites, pattern of presentation, and treatment. Annals of African medicine, 18(1), 12–16. https://doi.org/10.4103/aam.aam_4_18

Shi, S. Y., Zhou, Q., He, Z. Q., Shen, Z. F., Zhang, W. X., Zhang, D., Xu, C. B., Geng, J., Wu, B. S., & Chen, Y. G. (2020). Traditional Chinese medicine (Liang-Xue-Di-Huang Decoction) for hemorrhoid hemorrhage: Study Protocol Clinical Trial (SPIRIT Compliant). Medicine, 99(16), e19720. 10.1097/MD.0000000000019720

Sturiale, A., Gallo, G., Brusciano, L., Cacace, C., Cafaro, D., Celedon Porzio, F., & Naldini, G. (2020). Safety and Efficacy of Proctosoll Allevia in the Management of Haemorrhoidal Disease in Adults: A Prospective Randomized Clinical Trial. Reviews on recent clinical trials, 15(2), 152–159. https://doi.org/10.2174/1574887115666200421110107.

Wang, Y. J., & Hua, G. H. (2015). Observation of curative effect of hemorrhoids lotion on pain, edema and bleeding after anorectal surgery. China journal of Chinese materia medica, 40(22), 4497–4500. PMID: 27097430

Wu, J., Lu, W., Yu, K., & Liu, H. (2019). Clinical study of external application of liuhe dan in the treatment of anal edge edema after mixed hemorrhoid operation. Pakistan journal of pharmaceutical sciences, 32(3 Special), 1431–1435.

Xu, X., Li, X., Zhang, L., Liu, Z., Pan, Y., Chen, D., Bin, D., Deng, Q., Sun, Y. U., Hoffman, R. M., Yang, Z., & Yuan, H. (2017). Enhancement of Wound Healing by the Traditional Chinese Medicine Herbal Mixture Sophora flavescens in a Rat Model of Perianal Ulceration. In vivo (Athens, Greece), 31(4), 543–549. 10.21873/invivo.11092

Zhang, H., Yao, X-y., Zhang, D-f., Guo, Q-l., Yang, J-j., Zhu, B-g., Shen, D-x., Ruan, K-f., Wang, Y., & Peng, J-l. (2020). Anti-hemorrhoidal activity of Lian-Zhi-San, a traditional Chinese medicine, in an experimental hemorrhoidal model in rats. Journal of Integrative Medicine. doi:10.1016/ j.joim.2020.09.006

Downloads

Publicado

21/01/2023

Como Citar

MOMM, G. C.; TORRESILHA, A. L.; SANTOS, C. H. M. dos . Uso de fitoterápicos na Doença Hemorroidária . Research, Society and Development, [S. l.], v. 12, n. 2, p. e9412239925, 2023. DOI: 10.33448/rsd-v12i2.39925. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/39925. Acesso em: 23 nov. 2024.

Edição

Seção

Ciências da Saúde