In conventional medicine, obstructive uropathy is still a challenging problem. The available operative and lithotripsy procedures are not free from complications and recurrence of stone formation is quite common. On the other hand, in the traditional Indian system of medicine, several plants are claimed to be used successfully in the treatment of urolithasis. The medicinal value of Crateva nurvala has been described against a variety of urinary disorders, including urolithiasis. R Anand et al have studied these claims and have reported in their report that the proprietory extract of the stem bark of Crateva nurvala showed significant dose dependant (25-100mg/kg, p.o.) prophylactic activity against experimentally induced urolith formation in rats. The authors also reported that the drug reversed the biochemical parameters in urine, blood and serum and brought back histopathological changes towards normality.
Y S Prabhakar & D Suresh Kumar in a separate report have conducted an exhaustive investigation into the various activities of Crateva nurvala and the report shows that the drug provides significant increase in bladder tone leading to an increase in the expulsive force of urination. The same author has also reported that the drug had beneficial effects on neurogenic bladder. These effects were observed after three months of therapy. The same author has also reported that after administration of the drug for one month, it was noticed that the excretion of urinary calcium was reduced to a great extent, while the excretion of sodium and magnesium increased significantly. On plotting the electrolyte values on a triangular graph, a shifting of values towards the non-lithogenic zone was observed. The drug was also found to alter the relative proportion of calcium, magnesium and sodium which precipate in calculus formation.
Prasad et al studied the effect of an extract of Crateva nurvala stem-bark in various experimental models. It was found that it increases the tone of the smooth muscle intestine and ureters of guinea pig, dog and humans) and skeletal muscle (rectii of frog) in vitro. The PE extract of the bark inhibited acute, sub-acute and chronic inflammations in albino rats induced by carragenin, histamine, croton oil and formaldehyde. The mechanism of action was found to be similar to that of betamethasone, but without the latter’s side effects. Administration of 50 ml of stem-bark decoction twice a day to 46 patients with urinary stone caused a significant anti-urolithiatric action. Over a period of between 1-47 weeks, 28 patients were able to pass the stone, while 18 experienced symptomatic relief. The spontaneous passing of stones following C. nurvala therapy may be facilitated by the tonic contractile action of the drug on smooth muscle.
Singh, re-examined the lithotritic action of the stem-bark in patients suffering from calcium oxalate stones. After treatment for 12 weeks significant reduction in pain and dysuria was noted. There was also some reduction in the size of the stones
Y S Prabhakar and a co worker investigated the properties of C Nurvala in the treatment of urinary stones. The authors reported that the drug show promise in the treatment of the disease.
The cytoprotective action of luepol isolated from C. Nurvala stem bark against free radical toxicity has been investigated in experimental urolithiasis by R Baskar and co workers. The researchers reported that the administrating of the drug induced a remarkable decrease in kidney oxalate level and was also effective in counteracting the free radical toxicity by bringing about a significant decrease in peroxide levels and increase in antioxidant status.)
Anubha Singh and co workers conducted a study to investigate the effect of Boerhaavia diffusa in experimental acute Pylelonephritis in albino rats. The authors reported that the drug was found to be useful in a variety of renal diseases, they found that in experimental acute pylelonephritis, the drug reduced the inflammatory changes as well as abscess formation in the kidneys after E.coli inoculation. It also reduced the bacterial count in urine samples of the infected animals. The authors concluded that treatment with B. Diffusa extract definitely plays a protective role in renal disorders.
Prof. Vimaladevi at the Dept. of Pharmaceutical Sciences, Andhra University, Waltair, investigated the diuretic effect of Boerhaavia diffusa and phyllanthus niruri. The author reported that the mixture was found to be very effective . The diuretic activity of the plant is considered to play a vital role in the elimination of kidney stones and in the reduction in size of the stones
H.N. Verma and L.P. Awashti investigated the anti-viral properties of the plant and reported that the plant showed significant inhibitory activity
Shiv pal Singh studied the antileucorrhoeal activity of the plant and reported that the continued use of the drug was very encouraging. 40% of the patients showed marked improvement and became almost symptom free within a week and the other 60% were relieved after a fortnight. Since Leucorrhoea is only a symptom of an infection of the urinary tract, the drug shows activity against an unspecified infection
Lawsonia alba :
Lawsonia alba is one of natures most widely used herbs. The Egyptians have used it for centuries in cosmetic applications and it was one of Cleopatra’s favorite herbs. Traditional medicine men in India have prescribed this herb for a variety of diseases and these claims have been investigated by a number of modern day researchers. M.K. Bagi and co workers studied the pharmacological activity of the herb. An extract of the herb was found to have dose dependant analgesic activity when administered orally.
A Gupta et al studied the anti-inflammatory activity of some active principles of Lawsonia leaves. The authors noted that the drug demonstrated activity equivalent to phenylbutazone in the dose of 15mg/kg.
D. Le Mordant & J.P. Forestier at the Paul Selatier University reviewed the various uses of the herb in different schools of traditional medicine, especially with those pharmaceutical properties scientifically proven. In a systematic study, Abd. El Malek showed that the antibiotic activity of the leaf of plant was due to 4 compounds. Of these, Lawsone when tested alone had significant antibiotic activity, Gallic acid is a known antiseptic. The authors have noted in conclusion that the herb has diverse pharmacological activity.
Tribulus Terrestris :
R Anand et al, reported that the administration of ethanolic fraction of Tribulus terrestris fruit resulted in a varying degree of reduction is deposition of stone as compared to the untreated control animals.
B N Sannd et al undertook a study to evaluate the effect of the drug in the management of Urolithiasis. The authors have reported that the results of the study were very encouraging alongwith high rate of symptomatic relief. The study proved that pathologically and radiologically 28.57 % of patients of renal calculi and 75% of patients of ureteric calculi passed their calculi completely and in other patients there was a marked or partial expulsion of calculi or dislodgement of calculi or there was a change in shape, size and consistencies of calculi.
The product also contains other Ayurvedic herbs that have synergetic action in various kidney disorders. Several investigators have shown that the crude extracts of Bergenia ligulata had significant activity in dissolving preformed stones. The proprietory extract of the plant has marked anti-inflammatory activity and demonstrates diuretic action .