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Today, multiple randomized controlled trials have demonstrated the efficacy and safety of comfrey preparations for the topical treatment of pain, inflammation and swelling of comfrey bei Prostatakrebs and joints in degenerative arthritis, acute myalgia in the back, sprains, contusions and strains after sports injuries and accidents, also in children aged 3 or 4 and over.
For centuries, comfrey has been used as a traditional medicinal plant for the treatment of painful muscle and joint complaints Kothmann, ; Englert et al. Commonly found throughout Comfrey bei Prostatakrebs and parts of Asia, the plant also naturalized in North America, where it rapidly spread. Native Americans also recognized its healing powers and included comfrey in their therapeutic armamentarium Hamel and Chiltoskey, ; Stammel, Comfrey has also been used in veterinary medicine Rabinovich, In addition, comfrey is described in the Hager Monographs Staiger, The comfrey bei Prostatakrebs of comfrey root include 0.
The total amount of comfrey bei Prostatakrebs alkaloids given by different authors varies from 0. The pyrrolizidine alkaloids echimidine and symlandine are not found in S. Special cultivars are also used Schmidt, The therapeutic properties of comfrey are based on its antiinflammatory and analgesic effects. Comfrey also stimulates granulation and tissue regeneration, and supports callus formation Kommission E, ab.
Allantoin and rosmarinic acid are probably of central importance to its pharmacodynamic effects Andres et al. Rosmarinic acid has comfrey bei Prostatakrebs shown to possess antiinflammatory activity in various test systems.
It inhibits comfrey bei Prostatakrebs formation of malondialdehyde in human platelets Gracza et al. Antiinflammatory properties of a dry extract from comfrey root were also demonstrated in rats with induced paw oedema Shipochliev et al. Both inhibited shrinkage comfrey bei Prostatakrebs the collagen comfrey bei Prostatakrebs van den Dungen et al.
Besides the comfrey roots, all the parts of the plant that grow above ground Symphyti herba or the leaves Symphyti folium are also utilized for medical purposes Schmidt, The indications for which randomized clinical trials of ointments containing these kinds of extracts have been conducted include wound healing, myalgia and acute ankle joint distortions.
From linear regression time to complete healing was determined to be 2. The physicians rated efficacy as good to very good in A subgroup analysis found no significant influence of abrasion area, gender or age on healing effects, albeit that a tendency towards better effects with increasing age was observed. No adverse effects comfrey bei Prostatakrebs problems with drug tolerability comfrey bei Prostatakrebs observed.
The primary efficacy parameter was pain in motion, assessed with the aid of a visual analogue scale. Secondary efficacy parameters included pain at rest, pain on palpation and functional impairment. A number needed to treat of 3. Tolerability of the highly concentrated study product was comfrey bei Prostatakrebs good to excellent in all patients. One comment on the trial emphasized that using a comparator containing very little of the active ingredient instead of a placebo might be a good approach for clinical trials with herbals, when blinding is difficult Schulz, a.
Comfrey bei Prostatakrebs symptoms pain on palpitation, pain in motion, functional impairment, oedema and haematoma were included in the evaluation. The average duration of the administration comfrey bei Prostatakrebs the trial sample was 7. The remission rates for the symptoms were No adverse drug reactions occurred. In another open uncontrolled study, the efficacy of the same registered drug containing comfrey herb extract was tested on patients suffering from locomotor system symptoms Kucera et al.
The cream was applied twice daily. Functional disturbances and pain completely resolved in 57 of the patients. A further 24 patients achieved normalization of comfrey bei Prostatakrebs with continued moderately severe pain.
Moderate improvement occurred in 21 patients, and three patients reported no improvement in their condition. Muscle pain proved most amenable to treatment with the cream, swelling and overstrain also responded well. The treatment was less efficacious against pain accompanying osteoporosis. In a study involving 30 patients, the effect of the same preparation was assessed in the treatment of acute supraspinatus tendon syndrome Mayer, Compared with the control group, the ointment containing comfrey extracts proved to have a significantly superior effect with regard to the reduction of pain and the associated functional restrictions.
Comfrey bei Prostatakrebs ointment containing comfrey herb extract was also used to treat 22 additional patients suffering from acute contusions and distortions of the knee joint, and the following clinical symptoms were measured afterwards: swelling of the joint, active and passive pain when moving and local pain when resting Mayer, Test criteria in this study also included pain at rest, pain when moving and swelling.
Symptoms improved significantly quicker during comfrey treatment than during cryotherapy. Application of the comfrey bei Prostatakrebs containing comfrey proved to be comfrey bei Prostatakrebs compliance friendly than cryotherapy.
In another study involving patients with acute comfrey bei Prostatakrebs and strain traumas of the knee joint, efficacy was proven to be good or comfrey bei Prostatakrebs very good and a significant therapeutic impact on the damaged joint became apparent Hess, Forty comfrey bei Prostatakrebs suffering from knee joint injuries, sprains and bruises were treated with ointment containing comfrey extract, achieving a significant reduction of pain pain at rest and on movement and swelling.
The mobility of the affected joint increased significantly. The healing time when using ointment containing comfrey extract was significantly shorter than comfrey bei Prostatakrebs applying comparative preparations. The medicinal use of preparations from the underground parts of the plants Symphyti radix is well established. Relevant medicinal products are now marketed in more than 10 countries and the present licences include the topical treatment of pain, inflammation and swelling of muscles and joints in the case of degenerative arthritis, acute myalgia in the back, sprains, contusions and strains after sports injuries and accidents, also in children aged 3 and over.
They used either a verum cream containing comfrey root fluid extract The trial comfrey bei Prostatakrebs four visits and was performed at the German Sport University in Cologne Deutsche Sporthochschule and three additional ambulatory centres for orthopaedics and sports medicine. The pain intensity on VAS was assessed at performance of standardized, muscle group specific tests. There was a significant treatment difference between comfrey root extract and placebo regarding the primary and secondary comfrey bei Prostatakrebs.
The pain intensity on active comfrey bei Prostatakrebs movement decreased on average median approximately Both the AUC of the reported back pain at rest, the AUC of the pressure algometry in the trigger point as well as the global assessment of the efficacy by the patients and the investigators showed a clinically relevant effect in reducing acute back pain.
A total of seven patients experienced adverse events in the course of the clinical trial, four in the comfrey extract group and comfrey bei Prostatakrebs in the placebo group. All adverse events were of mild severity. One comment on the trial asked for more data comfrey bei Prostatakrebs patients with different sorts comfrey bei Prostatakrebs other back pain but admits that the results are relevant and topical treatment is increasingly considered as a serious treatment option Rannou, Pain, functional impairment and stiffness are the most important symptoms patients seek to relieve.
Therefore, the primary target variable was the VAS sum score of pain at rest and pain on movement. During the course of the study, the total score of the primary target variable decreased by The secondary target comfrey bei Prostatakrebs reduced by A total of 22 AEs occurred in 22 patients 7 in the active therapy group, 15 in the placebo group.
No adverse drug reaction was reported in the active therapy group. One comment on the trial mentioned the difficulties that are usually associated with the production of placebos for herbal drugs. It emphasized that due to the low inherent smell of the extract and the same perfume used in both comfrey bei Prostatakrebs and comfrey bei Prostatakrebs, a very good blinding could be achieved for this preparation Schulz, comfrey bei Prostatakrebs The mean age of the patients was Local treatment of the afflicted ankle was performed with ca.
The primary variable, tenderness of the ankle joint, was measured by pressure algometry, meaning the difference in tolerated pressure between injured and healthy ankles. Under active treatment, no adverse drug reactions were reported. The primary efficacy variable was pain arising from pressure on the injured area, measured with a calibrated caliper algometer on days 0, 4 and 7 and evaluated by the area under the curve AUC of the pain—time curve.
The mean relative reductions comfrey bei Prostatakrebs VAS in motion were Ankle swelling decreased by The pain on pressure measured with an algometer was reduced by Efficacy was assessed using several pain parameters: tenderness when pressure applied, pain at rest and during exercise.
The antiinflammatory potency of the extract was found to be equal to or greater than that of diclofenac. The preparation was used to treat a variety of conditions such as contusions The ointment was applied to most of the children three times daily In the overall score of the findings pain on palpation, comfrey bei Prostatakrebs of movement and haematoma manifestation minimum 3, maximum 15 a notable improvement in the clinical result became clear: the initial value of Comfrey bei Prostatakrebs remission or improvement was revealed in every individual finding.
The most marked reduction was in pain at rest The median duration of treatment was During the observation period symptoms of pain at rest and during the night, pain during motion, tenderness when pressure applied, impaired mobility, painful muscle complaints and swellings improved markedly. The physicians assessed global efficacy as excellent in Most patients applied the preparation once Again, symptoms of pain at rest and pain during movement, impaired mobility, swelling and painful muscle complaints improved markedly during the observation period.
Global efficacy was assessed by the physicians as excellent in The findings are in line with the aforementioned results. A positive correlation could be demonstrated between efficacy and the concentration of a caffeic acid derivative in the extract, but not for allantoin Andres et al. The extract was investigated for its ability to induce gene mutations in Salmonella typhimurium strains TA 98, TATATA and TA with and without metabolic activation using the mammalian microsomal fraction S9 mix.
Reference mutagens were used to check the validity of the experiments. The comfrey bei Prostatakrebs root extract showed no biologically relevant increases in revertant colony numbers of any of the five tester strains, neither in the presence nor in the absence of metabolic activation. In conclusion, the fluid extract was not mutagenic in the bacterial reverse mutation assay.
Literature on comfrey often concentrates on PAs, recommending a restriction of the duration of treatment, also with externally applied comfrey preparations. As a consequence there are no restrictions in Germany on these products as regards the duration of treatment Bundesgesundheitsamt,