curs 3 fitoterapie

8/11/2019 curs 3 fitoterapie

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AFECTIUNI INTESTINALE FUNCTIONALE

COLON IRITABIL = intestin iritabil

- sindrom fara substrat organic

- 2 forme clinice: colon spastic = nevroza colica,

colonopatie functionala

dureri abdominale, constipatie cu

scaune fragmentate/diaree

diareea fara dureri = colita muco-membranoasa,

enterita membranoasa

scaune moi, apoase

intermitente/continui


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Cauze

- afectiune psiho-somatica, corelata cu situatiile de stres

- hiperiritabilitate a mecanismului neuromuscular

- scadere a pragului de durere

- riscul creste dupa infectii acute gastro-intestinale

- mod de viata neregulat (alimentatie, regim de viata/munca, fumat)

Simptome

- tulburari de tranzit intestinal: constipatie/diaree

- dureri abdominale

- disconfort abdominal

- tulburari digestive: greata, varsaturi,

pirozis, inapetenta, balonare, flatulenta

- intoleranta la diferite alimente


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senzatie de evacuare incompleta a intestinului

reflux gastro-esofagian

simptome corelate cu stari de labilitate neuro-psihica sau neuro-

vegetativa: insomnie, oboseala, tahicardie/bradicardie

anxietate, depresie, migrena

dureri de spate, simptome genito-urinare

Tratament

- laxative

- antispastice (anticolinergice)

- agonisti/antagonisti serotoninergici- antidepresive triciclice (doze mici)

- domperidona

- psihoterapie

- probiotice


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Fitoterapie

Menth ae aethero leum

- capsule enterosolubile cu 0,2 ml ulei

volatil/capsula;

2 picaturi ulei vol./cana ceai de musetel

cald, dimineata si seara;

frectii la nivel abdominal, dimineata si seara

cu:

Rp. Menthae aetheroleum 10 g

Helianthii oleum 90 g

asigura (pe cale viscero-cutanato-reflexa) o

decontracturare a musculaturii netede a

colonului,

actioneaza spasmolitic (prin blocarea

canalelor de calciu),analgezic.


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Contraindicatii:

ocluzia cailor biliare, colecistita, insuficienta hepatica grava.

Actiuni adverse:

la supradozare (0,6 ml odata) provoaca stare de rau,

greturi, dureri abdominale slabe, senzatie de usturime in zona anala

in timpul defecarii (mentol incomplet absorbit).

Interactiuni medicamentoase:

nu se asociaza antacidelor deoarece reduce pH-ul.

Durata tratamentului: 2-3 saptamani


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Produse vegetale cu mucilagii

- se indica laxative vegetale in perioada de

constipatie

NU !tarte de gru: contine pentozane care

baloneaza

- se prescriu: seminte de in (Lini semen)

seminte de Plantago psyllium

au capacitate mare ce gonflare,

maresc volumul bolului

activeaza peristaltismul si favorizeaza

evacuarea (prin presiunea exercitata de bol

asupra peretilor intestinali)


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Anticolinergice

Tinctura Belladonnae

5 pic./ infuzie de musetel

postprandial creste activitatea

musculaturii intestinale.

- in perioada de diaree:Psylli semen

fixeaza apa,

normalizeaza tranzitul

Se poate asocia cu o dieta (2 zile) constituita din (de 2 ori /zi):

100g branza de vaci + 5 linguri suc de presare din afine/3 lingurite de

afine uscate, pulverizate


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Probiotice

- microorganisme vii care atunci cand

sunt administrate in concentratii

adecvate confera beneficii de sanatateorganismului gazda.

- bacterii lactice, bifidobacterii

- obisnuit consumate ca si parte

componenta a alimentelor fermentatecu adaos de culturii vii speciale

(iaurturi, suplimente alimentare)Efecte specifice:

- ameliorarea boli cronice

inflamatorii intestinale- prevenirea si tratamentul diareeii

patogen induse

- infectii urogenitale

- boli atopice


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- Actiuni probiotice

- cresc imunitatea organismului

- prevenirea infectiilor tractului

digestiv

- impiedica dezvoltarea bacteriilor

patogene in tubul digestiv


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Iberogast

- formula lichida prokinetica indicata

in colonul iritabil si in dispepsie

- amelioreaza simptomatologia prin

imbunatatirea motilitatii, cresterea

tonicitatii- efect dual

spasmolitic (duoden, jejun)

cresterea contractiei

segmentelor ileus aton

- carminativ
http://www.madaus.at/Produkte.asp?prodid=90513


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Angel ica

archangel ica

Matr icaria

chamomil la

Carum

carvi

Chel idonium

majus Melissaoff ic inal is

Mentha

piper i ta

Iberis amara

Si lybum

mar ianum

Glycyrrhizaglabra
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AFECTIUNI INTESTINALE INFLAMATORII

pancreatita acuta

pancreatita cronica

diverticuloza

boala Crohn

colita ulceroasa


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Produse vegetaleprescrise in tratamentul afectiunilor

intestinale inflamatorii

spasmolitice (Tinctura Opii, TincturaBelladonnae, preparate din musetel sau

Uzarae radix),

carminative (ulei de menta, chimion,

fenicul, anason),

adsorbtive si modificatoare ale

consistentei bolului intestinal (Lini semen,

Psyllii semen)

normalizatoare ale florei intestinale(preparate microbiene sau cu rutozida), dar

mai ales

antiinflamatoare(preparate ce contin acizi

boswellici, preparate ce contin mucilagii).


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Apartenenta chimica a structurilor importante pentru

afectiunile intestinale inflamatorii

- triterpene pentaciclice

- flavonoide

O

RO

COOH

acizi boswellici

OHO

OOH

OH

OH

OH

cvercetolrutozida

OHO

OOH

OH

OH

O Ru


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Pancreatita acuta cauzata de:

- suferinta biliara, - oreion, afectiuni endocrine,

- abuz de alcool, - alimentatie hiperlipidica,

- indusa iatrogen (azatioprina, clorotiazida, furosemid,

sulfonamide, tetracicline, estrogeni, acid valproic,

l-asparaginaza, clortalidona, corticosteroizi, acid etacrinic,

fenformina),

- hipercalcemia iatrogena

NU beneficiaza de

tratament fitoterapic !


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Pancreatita cronica caracterizata prin:

- dureri acute (pna la insuportabil) in segmentul

superior sau mijlociu al abdomenului cu iradiere in spate

- proces de atrofie progresiva a pancreasului cu

stingerea in cazuri grave, a functiei exocrinediabet

- cauze: abuz de alcool,

alimentatie hiperlipidica si metabolizarea deficitaraa grasimilor

Tratament

- dieta

- substitutie enzimatica

pancreatica

- antalgice

- chirurgical


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Fitoterapie

- substitutie enzimatica (papaina, bromelaina, ficina) si

- antiinflamatoare (Boswellia serrata)


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Papaina

- latexul (papaiotina) din fructele imature de Carica papaya

papaiotinacontine: papaina, chimopapainele A si B, amilaze,

pectinesteraze, lizozimpapaina: GM 21.000 D

pH optim = 6,5

usor oxidabila,

instabila in prezenta sucului gastric

preparate enterosolubile se prescriu in:

- gastrite hipoacide,

- substitutie enzimatica

- ascaridoza, oxiuraza
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Bromelaina

- glicoproteina din sucul de presare a frunzelor situlpinilor de ananas

- pH optim = 4,5 -5

- prescris ca antiinflamator, alaturi de rutozida,in tratamentul colitei ulceroase, bolii Crohn,

edemelor traumatice,- postoperator, deoarece potenteaza actiuneaanticoagulantelor (prelungeste timpul desangerare, inhiba agregarea plachetara)
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extracte de Olibanum resina

(Boswellia serrataRoxb./Burseraceae)

- extracte lipofile cu 37,5%-65% aciziboswellici

- inhibitori selectivi ai 5-LOX blocarea

sintezei de leucotriene

- nu influenteaza COX, 12-LOX, 15-LOX


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- H15 Ayurmedica

- reducerea inflamatiei intestinale

cronice, colici, diareea, hemoragia

- 350 mg extract/zi sau

350 mg x 2/zi (colita ulceroasa, boala

Crohn)

- durata administrare = 6 saptamani


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Ficina

- complex de 6 izoenzime, separat din latexul smochinului

- pH optim = 3,5-4,5

intra in compozitia:

preparatelor enzimatice de substitutie,

antiinflamatoarelor,

antihelminticelor


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Diverticuloza

- afectiune datorata imbatrnirii fiziologicea intestinului subtire si gros,

- apare o invaginare atrofica a mucoasei

(diverticul) cu infiltratie de inflamatie

cronica

- se caracterizeaza prin alternanta de

diaree / constipatie, pe fondul unor dureri

abdominale confuze


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Cauze

- presiune intraluminala crescuta (aerocolie,

constipatie, spasme colice, tuse cronica)- slabirea peretelui intestinal in zona de

deschidere a vaselor sanguine

- deshidratarea

- constipatia si colonul iritabil sunt stadiipremergatoare diverticulozei


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Fitoterapie

- antidiareice (Psyllii semen)

- laxative (Psyllii semen, Lini semen)

- tarate de grau

Tratament

- evitarea constipatiei, aerocoliei

- laxative usoare (constipatie)

- regim hidric, antibiotice, antiseptice

intestinale, repaus la pat (forme acute)


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- localizata in segmentul inferior al intestinului

subtire si in colon,

- caracterizata prin: diarei cronice /sanguinolente

dureri abdominale,

stari de rau,

scadere in greutate,

formare de fistule,fisuri anale, abcese

si/sau febra

- cauze:- predispozitie genetica,

- procese autoimune,

- infectii virale / bacteriene

- factori de mediu care modifica raspunsul

imun al organismului

- localizare: portiunea inferioara a intestinului

subtire, poate cuprinde toate segmentele tubului

digestiv.

Boala Crohn


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Tratament

- antibiotice

- antiinflamatoare (corticosteroizi,aminosalicilati)

- imunosupresoare

- naloxona (doze mici)

- hidratare adecvata

- dieta echilibrata

- renuntarea la fumat

- interventii chirurgicale


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Colita ulceroasa

- localizare initial la nivelul rectului

cauze: factori genetici,

procese autoimune,reactii de hipersensibilitate,

factori psihici.

simptomatologie: - dureri abdominale,

- diaree (sanguinolenta)

- greturi,

- scadere in greutate.

Complicatii:

- afectiuni articulare,

oculare, dermice

-megacolon toxic

= dilatare brusca a intreguluiintestin gros sau a unor

portiuni ale acestuia


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Tratament

-antiinflamatoare (aminosalicilati, corticosteroizi)

- imunosupresoare

- infliximab (anticorp monoclonal ce neutralizeaza activitatea

biologica a factorului de necroza tumorala )

- chirurgical

- clisme cu acizi cu catena scurta (butirat)

- bacterioterapie

- terapia antihelmintica


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-reducerea inflamatiei

- adsorbtia toxinelor si modificarea

consistentei materiilor fecale

- normalizarea florei intestinale

nefiziologice - substituirea enzimelor

digestive

Fitomedicatie

o stimulatori ai cresterii numarului deeubacterii butirat generatoare (glucide

greu digerabile + flavonoide tip rutozida)

oantiinflamatoare (extract de Boswellia,

bromelaina)

o carminative, spasmolitice (Asa

foetida, masaj abdominal cu sol. uleioasa

10% deAetheroleum Carvi)


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- acizii grasi cu catena scurta produsi prin

interventia eubacteriilor butirat generatoare =

esentiali pentru mentinerea integritatii

intestinale

- administrarea combinatiei de rutozida +

polizaharide greu digerabile:

reduce eliberarea de histaminaprevine dezvoltarea unor alterari tisulare

intestinale datorate stresului oxidativ

creste nivelul glutationului la nivelul colonului

stimuleaza cresterea fiziologica a celulelormucoasei colonului si previne degradarea

acesteia

normalizare barierei imunitare afectate


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absorbtie buna a rutozidei la asociere cu

bromelaina

biodisponibilitatea cea mai buna = rutozida

din ceapa (consum zilnic de 100 g

ceapa)


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Prezentare Rp

- Caracterizare farmacognostica a produselor vegetale

componente

- comentariu: indicatii terapeutice, precautii/contraindicatii,

reactii adverse

- durata de administrare (in functie de componente Rp)

- posologie posibila
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curs 3 fitoterapie

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