STUDIES ON THE SELECTED UNANI DRUGS FOR USE IN PEPTIC ULCER AND ANXIETY DISORDERS Thesis submitted in partial fulfillment of the requirement for the degree of Doctor of Philosophy (Unani Medicine) BY ABDUL HANNAN BUMS (Alig.) Dr. H.M.I. Institute of Pharmacology and Herbal Sciences Faculty of Pharmacy HAMDARD UNIVERSITY Karachi - 74600 2002CONTENT: Acknowledgement Abstract Herbal Medicine in Current Medical Practice PART-1 PEPTIC ULCER Introduction: Peptic Ulcer Disease. i. ii iii Ethnopharmacolo; Etiology. Clinical Finding, Differential Diagnosis. Glycyrrhiza Past and Present, Historical Account. Glycyrthiza Species. Ethnopharmacology. Botanical Description Liquorice (Powder Microscopy) Review of the Literature i. ii, Chemical Constituents of Glycyrrhiza glabra 21 Pharmacological and Medicinal Uses of Glycyrrhiza glabra 48 Experimental i ii, iff iv, v. vi vii. Peptic ulcer Duodenal ulcer Gastric ulcer Methodology and Methods Peptic ulcer and investigation Differential Diagnosis of Peptic ulcer Clinical Trial Protocols Results and Discussion i ii. iii, Stomach and Duodenal ulcer Clinical Studies on Peptic uleer Hyper acidity PART-Il ANXIETY DISORDER i ii. iti, REFERENCE, Anxiety Disorder Clinical Approach ‘The Safety Evaluation of Herbal Drug Used in Mental Disorder 62 64 66 68 B 89 OL 97 ut 137 151 164 169ACKNOWLEDGEMENT I remain in gratitude to Almighty Allah for giving me the strength, knowledge and wisdom for the completion of this dissertation. | take pride to acknowledge that Shaheed Hakim Mohammed Said is one person who is with us only in spirits and to whom we would always remain indebted for providing a platform that has benefited many and will continue to be so. I could not present this piece of work to him for his appreciation and guidance. T express my most sincere gratitude to Prof, S.1. Ahmad, Dean, Faculty of Pharmacy and Director, Dr. H.M.L. Institute of Pharmacology my Supervisor and to Prof. Dr, Usman Ghani Khan, Head, PreClinical Sciences, Faculty of Eastern Medicine, Hamdard University, Karachi, as Co-Supervisor for their invaluable guidance and assistance to complete this project. T extend my sincere thanks to Justice ® Ajmal Mian, Chancellor, Hamdard University, Mrs, Sadia Rashid, President, Hamdard Foundation Pakistan, Prof. Dr. Ismail Saad, Vice Chancellor, Hamdard University, Dr. Navaid ul Zafar, Managing Director, Hamdard Laboratories (Waqf) Pakistan, and Prof, Hakim Syed Zillur Rehman, Dean, Faculty of Unani Medicine, Aligarh Muslim University for their continuous encouragement and keen interest in my academic pursuit. I also wish to express my special thanks to all my colleagues for their cooperation, Last but not the least I would like to thank my wife and my children whose love and encouragement helped me to complete this excellent academic venture.ABSTRACT Ulcer is one of the most common diseases which effect the sizeable population of Pakistan, The natural drug Glycyrrhiza glabra and its formulations well known traditionally for ulcer cure have been investigated scientifically and evaluated from the clinical point of view. Glycyrrhiza glabra have been cited positively for the presence of flavanols, flavonones, isoflavones, carbohydrates, lactones, alcohols, alkanes, lipids, benzenoids, monoterpenes, triterpenes, phenylpropanoids, proteins, coumarins, alkaloids, steroids, chromones, etc. The different biological and pharmacological activities attributed to the different Glycyrrhiza species include influence on steroid metabolism, ulcer treatment, anti tumor, anti viral, hepatoprotective, anti microbial, anti parasitic, cardiovascular, anti inflammatory, anti tussive and expectorant effects. A detailed delineation of the ulcer methodology adopted is given in the experimental part. Acute peptic ulceration and chronic peptic ulceration are given a tension from both duodenal ulcer and gastric ulcer approaches from pathogenesis and clinical features prospective. The clinical evaluation on Glyeyrrhiza glabra Assal-us-Suss and drugs SUSI, and QARAHINE was carried out on out and indoor-patients at Hamdard Matab, Aram Bagh, Naveed-e-Sehet Karachi and Shifa-ul-Mulk Memorial Hospital for Eastem Medicine respectively. The different measures were taken to establish peptic and duodenal ulcer investigation. The clinical trial protocols were followed for diagnosing peptic ulcer, iiThe clinical evaluation on the therapeutic efficacy of different herbal medicine containing Glyeyrrhiza glabra was conducted on 158 cases of gastric and duodenal ulcer out of which 73 were selected for detail analysis. The herbal medicine, ASAL-US- SUSS, GR.SUSI and GR.QARAHINE were administered 16, 33 and 24 patients respectively The results were compiled on the basis of age and showing chronicity of disease (sign and symptoms) of ulcer such as anorexia, nausea and vomiting after taking food, nervousness, general weakness, epigastric pain, radiation and retrosternal burning, loss of ‘weight, attacks of colic pain, anemia, hemitemisis, constipation and epigastric burning. In the ultimate analysis the selected diseases pattern record showing sign and symptoms of diseases are given in table and on which graph was made. The nature of the disease and number of patients treated were as follows anemia (20), gastric uleer (57), backache (3), constipation (6), hemorrhoids (1), ut. infection (10), cholelithiasis (2), depression (1), splenomegaly (9), cholocicystitis (1), jaundice (1). All this shows that more than half of the patients recorded were of gastric ulcer. Similarly drug prescription records were also maintained and the detail of which is given in table 24 along with the graphics. The drugs administrated to the patients were Khamira Gaozaban (4), Sherbet- ‘olad (2), Sherbet-e-Abmed Shah (3), Sf. Somina (6), Qs. Jigreen-B (15), Gr. Endamali (13), Gr. Qarahine (24), Gr. Sussi (33), JW, Anaraine (19), Asal-us-Suss (16), Qs. Alkali (13), Sherbet-c-Hub-ul-Ass (3), Sf. Suss (24), Qs. Kaheruba (3), Qs. Jigreen (20), Qs. Mulaiyan (4). The clinical trial was conducted to assess the drugs Sussi and Qarhain the details of which are given in tables and its graphic representations and there in function and exertion of hyperacidity. It also contained appreciable amount of gum and starch which