Rheumatherapie mit Phytopharmaka Pharmakologische und klinische Wirkungen der Teufelskralle (Harpagophytum procumbens D.C.)

Abstract: Pharmacological treatment of rheumatic diseases is mainly symptomatic and aims at relieving the main complaints pain, inflammation, and impaired mobility. Commonly used drugs are non-steroidal antiinflammatory drugs (NSAID), which have specific side-effects due to their mode of action (inhibition of prostaglandin biosynthesis). Phytotherapy with Harpagophytum procumbens (Devil's Claw) extract may be an alternative with very low side-effects, or may be given as a supportive measure in the treatment of rheumatic diseases in order to reduce NSAID dosage and side-effects.The secondary roots of the plant Harpagophytum procumbens, which is endemic in Africa, contain high concentrations of iridoid glycosides, namely harpagosid, procumbid, and harpagid. In-vitro experiments have shown anti-inflammatory as well as anti-exsudative properties of the extract based on the inhibition of eicosanoid biosynthesis. In these investigations, the whole extract proved superior to the monosubstance harpagosid.The efficacy of Harpagophytum procumbens extract in the treatment of rheumatic diseases could also be shown in clinical trials. The outcome of a few more recent double-blind, placebo-controlled studies is emphasized. A French trial showed a distinct amelioration of the symptoms pain and impaired mobility in the treatment group as compared to the placebo group. The analgetic effectiveness of Harpagophytum procumbens extract was verified in a study with 118 patients suffering from low back pain. The pain index was significantly decreased in the treatment group as compared to the placebo group.In summary, the published data imply that Harpagophytum procumbens extract can be recommended for the treatment of degenerative diseases of the locomotor system as well as for mild or moderate forms of rheumatic disease.Moreover, the use of this herbal remedy may contribute to reducing the costs of treatment. lt seems justified to include Harpagophytum procumbens extract into the treatment plan for pain management as recommended by the WHO.

Keyword(s): Harpagophytum procumbens

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