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Horse Chestnut
(Humulus lupulus)
DESCRIPTION
The horse chestnut tree is native to Asia and Northern Greece,
but is now cultivated in many areas of Europe.
Traditionally horse chestnut
has been used for the treatment of Varicose veins, Haemorrhoids,
phlebitis (Inflammation of the wall of the vein), Diarrhoea,
fever and enlargement of the prostate gland.
FOOD AND HERBAL USE
Horse chestnut has not been
used in cooking, but possesses a number of medicinal properties.
Horse chestnut has been useful particularly for the treatment
of Varicose veins, chronic venous insufficiency (CVI), and
related vascular disorders (1).
PHARMACOLOGY
Horse chestnut seeds contain
a complex mixture of triterpene saponins, including: triterpene
oligoglycosides eascins, Ia, Ib, Iia, Iib, IIIa, the acylated
polyhydroxyoleanene tritepene oligoglycosides eascins IIIb,
IV, V and VI and isoeascins Ia, Ib, and V, and the sapogenols
hippocaesculin and barringtogenol. Horse chestnut also contains
flavonoids, condensed tannins, quinones, sterols, including
stigmasterol, alpha spinasterol and betasitosterol and fatty
acids, such as linolenic, palmitic, and stearic acids (1).
SUPPLEMENTAL USES
Chronic venous insufficiency:
Conservative therapy of chronic venous insufficiency (CVI)
consists largely of compression treatment. However, this often
causes discomfort and has been associated with poor compliance,
whilst horse chestnut is more tolerable and has shown high
compliance. (2)
Many studies have shown
a significant reduction of capillary filtration, therefore
significant improvements in symptoms of CVI (sensation of
tiredness, heaviness and tension, pruritis, pain and swelling
in the legs) (1).
In a study involving more
than 800 general practitioners, more than 5,000 patients with
chronic venous insufficiency (CVI) were treated with standardised
horse chestnut extract and followed up at regular intervals.
The evolution of the symptoms, tolerability and adverse drug
reactions were recorded. All of the symptoms investigated
- pain, tiredness, tension and swelling in the leg, as well
as Itching and the tendency towards Oedema - all improved
markedly or disappeared completely. The results of this study
show that treatment with horse chestnut extract represents
an economical, practice-relevant therapeutic "pillar",
which in comparison with compression has the additional advantage
of better compliance (3).
SAFETY
The excellent tolerability
of horse chestnut indicates this treatment is of definite
clinical benefit in patients with clinical conditions resulting
in CVI, haemorrhoids or peripheral oedema formation (4).
Horse chestnut should not
be used in patients on oral anticoagulant and/or antiplatelet
therapy (5).
Horse chestnut has documented
reports of potential interactions with warfarin.
REFERENCES
1. "Herbal Medicine"
Commission E Monographs. 2000
2. Cochrane Database Syst Rev 2002;(1):CD003230
3. Fortschr Med 1996 May 30;114(15):196-200
4. Pharmacol Res 2001 Sep;44(3):183-93
5. Ann Ital Med Int 2000 Apr-Jun;15(2):139-43
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