Plants, Liver and Biliary System

The liver is a gland located in the upper right quadrant of the abdomen immediately beneath the diaphragm. As an exocrine gland it secretes bile. Its other major functions are the synthesis of plasma proteins, heparin, fibrinogen, and prothrombin; destruc

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Diseases of the Liver Clinical Picture Hepato-protective Drugs Milk thistle Other Hepato-protective Drugs Picrorhiza Black catnip. Schizandra. Liquorice

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Biliary Tract

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Clinical Picture Cholagogue/Choleretic Drugs Artichoke. Boldo Turmeric, Dandelion Celandine Further Reading

F. Capasso et al., Phytotherapy © Springer-Verlag Berlin Heidelberg 2003

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Introduction

The liver is a gland located in the upper right quadrant of the abdomen immediately beneath the diaphragm. As an exocrine gland it secretes bile. Its other major functions are the synthesis of plasma proteins, heparin, fibrinogen, and prothrombin; destruction of red cells; detoxification; metabolism of proteins, carbohydrates, and fats; and the storage of glycogen and other important substances. The main diseases of the liver include hepatitis and liver cirrhosis.

Diseases of the Liver Clinical picture t Hepatitis is an inflammation of the liver, involving alteration of hepatocytes, either degenerative or necrotic. Most common is viral hepatitis, which is characterized by inflammation of the liver caused by hepatitis virus A, hepatitis virus B, or by hepatitis virus C. Hepatitis can also be caused by alcohol (alcoholic hepatitis) or drugs (drug-induced hepatitis). t Cirrhosis is a chronic disease of the liver characterized by nodular regeneration of hepatoxytes and diffuse fibrosis. It is caused by parenchymal necrosis followed by nodular proliferation of the surviving hepatocytes. The regenerating nodules and accompanying fibrosis interfere with blood flow through the liver and result in portal hypertension, hepatic insufficiency, jaundice, and ascites.

Hepato-protective Drugs Hepato-protective drugs are listed in Table 22.1. They are remedies which help to reduce the damage caused to the liver from hepatic stressors and diseases. With the exception of milk thistle (Silybum marianum) there is a lack of randomized, placebo-controlled clinical studies.

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Diseases of the Liver Table 22.1

Hepato-protective herbal medicines (ommon latin name name Black catnip Phyllanthus amarus liquorice GIycy"hiza glabra Milk thistle Silybum marianum Picrorhiza Schizandra Soy

Picrorhiza ku"oo Schizandra chinensis Glycine max

Turmeric

Curcuma domestica

Part(s) of lant used Aerial parts Roots Seeds

Key constituents

Daily dose a 5-15g 2 4g

Tannins, flavonoids,lignans Triterpene saponins, flavonoids Flavonolignans (silymarinl, flavonoids, fatty oil 0.4 1.5g Rhizome Iridoids Volatile oil, ascorbic acid,lignans 1.56g Fruit b Soy lecithin Phospholipids, fatty oil, phytosterols from say beans Rhizome Volatile oil, curcuminoids 1.5-3 9

* supported by German Commission E. for dyspeptic and liver complaints a. no reliable information is available b. the average dose of phospholipids is 3.5 9

8otany!Key constituents. Milk thistle is the dried ripe fruit of Silybum marianum (L.) Gaertner (Fam. Asteraceae), a biennial herb with purple tubulate florets and

leaves with white areas. The plant is native to Euro