Use of traditional Chinese medicine in the management of urinary stone disease

Abstract

Objective: To assess the evidence-based literature supporting the use of traditional Chinese medicine Kampo herbal and Acupuncture in stone disease management. Materials and Methods: Four of the most commonly used herbal components of Kampo medicine in the treatment of stone disease are described according to their in vitro and in vivo effects. We also reviewed the role of Acupuncture in urologic clinical setting as well as its proposed mechanisms of action and results. Medline database was assessed using isolated and conjugated key words (Chinese Medicine, Kampo, Chinese Herbal, Calculi, Stone Disease, Kidney, Acupuncture, Herbal Medicine). Articles were reviewed and summarized. Results: Herbal medicine has been proven to be free from side-effects and therefore suitable for long term use therapy. Its antilithic beneficial effects include increased urinary volume, increased magnesium excretion (Takusya), inhibitory activity on calcium oxalate aggregation (Takusya, Wulingsan and Desmodyum styracyfolium), inhibition of calcium oxalate nucleation and hydroxyapatite internalization (Wulingsan). In contrast, acupuncture, has shown to be effective as a pre-treatment anxiolytic and analgesic during colic pain and extracorporeal shock wave lithotripsy treatment, reducing the need for complementary sedative drugs. Conclusion: Chinese traditional medicine is promising as regards its role in stone prevention. An effort must be made in order to standardize study protocols to better assess acupuncture results since each procedure differs in regards to selected acupoints, electrostimulation technique and adjunct anesthetics. Similarly, standardization of Kampo formulations and acceptable clinical endpoints (imaging vs. symptomatic events) is needed.

Diminution of oxalate induced renal tubular epithelial cell injury and inhibition of calcium oxalate crystallization in vitro by aqueous extract of Tribulus terrestris

“…Therefore, it is worthwhile to look for an alternative for the management of urolithiasis. Many medicinal plants have been employed during ages to treat urinary stones though the rationale behind their use is not well established through systematic and pharmacological studies, except for some composite herbal drugs and plants (9)(10)(11)(12). Plant medicines are in great demand both in the developed as well as developing countries for primary health care because of their wide range of biological and medicinal activities, higher safety margin and low cost.…”

Effect of biomolecules from human renal matrix of calcium oxalate monohydrate (CaOx) stones on in vitro calcium phosphate crystallization

“…Urolithiasis is known to be an affliction to humankind from ancient eras (12) and is the third most common cause of urinary tract disease (13). Among all types of kidney stones the frequency of calcium stone is 70-80%, struvite stone 5-10%, uric acid stone 5-10%, and cystine stone 1% (14).…”

Inhibition of Struvite Crystal Growth in the Presence of Herbal ExtractOrthosiphon AristatusBL.MIQ

“…Phosphate minerals, such as magnesium ammonium phosphate hexahydrate (MgNH4PO4.6H2O), mineralogically known as struvite, is one of the main components of the calculi. It was also reported that recurrence after treatment is relatively high (ElMahdy and Persad, 2014;Suguna et al, 2012;Chauhan, 2011;Miyaoka and Monga, 2009;Grohe et al, 2006).…”

“…These studies indicate that herbal extracts could inhibit the growth of the crystals forming the kidney stones. As opposed to treatment using antibiotics, these herbs were claimed to cause no bacterial resistance and other adverse effects (Miyaoka and Monga, 2009). As such, the herbal medicines have gained significant popularity.…”