Prevention and treatment of urogenital and gestational diseases with the effective herbal preparation Canephon® N
When treating urological disorders conservatively, herbal remedies play an important role. They are particularly important for the prevention of secondary urinary tract infections and kidney inflammation. These remedies increase urine flow and dilute urine, reducing the risk of urinary tract infections and the formation of kidney stones. In 2011, a well-known herbal remedy from the German pharmaceutical company Bionorica called Canephron® N was introduced to the Lithuanian pharmaceutical market. It has been produced since 1934 and is excellent for the supportive treatment of mild conditions caused by lower urinary tract inflammation.
Pharmacological properties of the herbal medicine Canephron® N
The 3 plant extracts included in the herbal remedy Canephron® N (common centaury root (Centaurium erythraea), lovage (Levisticum officinale), rosemary leaves (Rosmarinus officinalis)) act synergistically on the urinary excretory system:
· Spasmolytic – inhibits reflex spasms of the urinary tract, improves urine passage, and enhances renal tissue blood flow due to vasodilation of renal arterioles;
· Anti-inflammatory – suppresses the activation of a non-specific component and lipoxygenase, thereby inhibiting leukotriene synthesis;
· Antimicrobial – all components of the remedy have active substances with antibacterial properties;
· Diuretic effect – the essential oils of lovage improve epithelial reabsorption function by promoting blood flow in renal tubules; the essential oils dilate renal blood vessels, ensuring good blood flow in renal epithelium. Phenolcarboxylic acids entering the renal tubular lumen increase osmotic pressure, reducing water and sodium ion reabsorption. Thus, abundant water excretion occurs without ion imbalance (potassium-sparing effect);
· Protects the kidneys, with nephroprotective effects – prolonged use of the remedy reduces the permeability of renal capillaries and the amount of protein in urine, resulting in an antiproteinuric effect.
The herbal remedy Canephron® N also has antihypertensive effects by eliminating excess water and sodium salts from the body.
The main indications for prescribing Canephron® N are: chronic inflammation of the bladder and kidneys; chronic non-infectious kidney inflammation (glomerulonephritis, interstitial nephritis); prevention of kidney stones and/or after stone removal. The remedy can be prescribed during pregnancy and breastfeeding, but under medical supervision.
It is recommended for adults to take 2 tablets or 50 drops 3 times a day, for school-age children – 1 tablet or 25 drops, for young children – 15 drops 3 times a day, for infants – 10 drops 3 times a day.
Materials and methods of the study
The results of 17 cohort clinical studies conducted in Central and Eastern Europe were analyzed and evaluated (1, 2). The following aspects were assessed in the studies:
· Prevention and treatment of urinary tract infections in adults (4 studies; as adjunctive therapy) (3–6);
· Prevention and treatment of urinary tract infections and anomalies in children (4 studies; investigating the effect of the herbal remedy in vesicoureteral reflux, post-surgical reflux, and treatment of congenital megaureter) (7–10);
· Prevention and treatment of kidney stones in adults (4 studies; as adjunctive therapy) (1, 2, 11–13);
· Prevention and treatment of urinary tract infections and specific gestational diseases in pregnant women (3 studies;
intended as an adjuvant treatment for women, suffering / not suffering from diabetes mellitus) (14–16);
· the effect of the herbal product Canephron® N in treating children with congenital and postnatal developmental disorders (2 studies) (17, 18).
Research Results
Prevention and treatment of urinary tract infections in adults
The study involved 304 individuals to whom, in addition to basic treatment, an herbal product was prophylactically administered during the acute phase of the disease (6). Evaluation of the study results revealed improvement in daily diuresis, disappearance of bacteriuria, and shortened treatment and recovery periods.
In a prospective, randomized trial, a significant reduction in the number of recurrences was observed among patients with chronic pyelonephritis or cystitis when they were prophylactically treated with the herbal product for 3 months following the standard medical treatment.
Another group of researchers studied individuals with type 2 diabetes and metabolic syndrome (5). It was found that the frequency of urinary tract infection recurrences significantly decreased in the aforementioned study group when a 3-month prophylactic treatment with the herbal product for lower urinary tract infections and a 6-month prophylactic treatment for upper urinary tract infections were administered. Moreover, the efficacy of treatment was equal when comparing the effects of antimicrobial and herbal products. Importantly, a positive effect on proteinuria was observed among patients with diabetes and low to moderate microalbuminuria levels.
Treatment and prevention of urinary tract infections and anomalies in children
The prophylactic effect of the herbal product on urinary tract infections and pyelonephritis was assessed in 2 studies, while the prophylactic effect on vesicoureteral reflux, complicated acute pyelonephritis, or after surgical reflux treatment was evaluated in another 2 studies (7–10).
Children with lower urinary tract infections and acute or chronic pyelonephritis were treated with antibiotics alone or in combination with the herbal product, with the dosage adjusted according to age (9). With combined treatment, an early recovery of urine test results was observed. Evaluation of the study data confirmed the safety and good tolerance of the herbal product.
A total of 129 children with acute pyelonephritis participated in comparative studies. After antibacterial treatment, they were divided into 3 groups: the first group (n=43) received the herbal product (dosage adjusted by age); the second group (n=51) received nitrofurantoin at 1.5–2 mg/kg for 3 months; the third group (n=35) served as the control group, where no prophylactic treatment was given after antibacterial therapy (7). The results showed a significant decrease in recurrence rates in the second group receiving prophylactic treatment compared to the control group. The number of recurrences decreased significantly more in the group of children receiving the herbal product than in those taking nitrofurantoin. Additionally, children tolerated herbal products better than nitrofurantoin.
Another study involved 226 children with vesicoureteral reflux, complicated acute pyelonephritis, and after surgical reflux and congenital large ureter / megaloureter treatment, who received a combination of 3 herbs for 3 months (10). Evaluation of the results showed that this treatment was safe and well tolerated.
44 children were included in comparative studies after surgical treatment of grade III–IV vesicoureteral reflux. The subjects were treated with a combination of herbs a week before and 3 weeks after surgical treatment, and were monitored for 2 months post-operation. A positive effect was observed in the early postoperative period of about 3 weeks among children with vesicoureteral reflux after surgical reflux and congenital large ureter treatment (8). Following treatment, certain parameters significantly improved (compared to the control group): increased daily diuresis, rapid recovery of bladder function, accelerated kidney blood flow, decreased vascular resistance (as observed in ultrasound examination).
Prevention and treatment of kidney stones in adults
In 5 studies, as an adjunct treatment for patients with kidney stones, a combination of herbal preparation was used (1, 2, 11–13). After the treatment course, the manifestations of bacteriuria and leukocyturia decreased in patients treated for 4 weeks and followed up for another six months after treatment.
Patients with kidney stones were treated with the herbal preparation for 8 weeks. Evaluating the study data, it was found that there was a significant improvement (p<0.05) in daily diuresis, increased urine pH, and decreased urine acid concentration in the blood. All these parameters have a favorable effect on uric acid and oxalate kidney stones. The prophylactic treatment with the herbal preparation was safe and well tolerated.
In a randomized, open, cohort study, 237 patients with kidney and urinary tract stones with a diameter of over 0.7 cm, without urinary tract obstruction or acute obstructive pyelonephritis, participated. The participants were given standard treatment (anti-inflammatory drugs, analgesics, and/or antispasmodics) with (n=137) or without (n=102) the herbal preparation (12). In the first 10 days when patients were hospitalized, the results in the combination therapy group were better compared to the other group: spontaneous elimination of kidney stones was 72.4%, compared to 33.3%; from the upper urinary tract - 71.4%, compared to 37.5%; from the middle urinary tract - 66.6%, compared to 40%; from the lower urinary tract - 90%, compared to 55.5%. After 10 days of treatment, the frequency of leukocyturia in the study group was reduced from 64.4% to 6.9%. Urine pH increased from 5.6 to 6.4. Additionally, the treatment with the herbal preparation in all cases was safe and well tolerated.
Prevention and treatment of urinary tract infections and specific gestational diseases in pregnant women
The effect of the herbal preparation on urinary tract diseases during pregnancy and after childbirth was evaluated in studies (14–16). The study involved 300 pregnant women with asymptomatic bacteriuria, pregnant pyelonephritis, exacerbation of chronic pyelonephritis, or chronic urinary tract diseases without exacerbation (14).
In another study, in addition to drug treatment, the participants were also given the herbal preparation. The results of the study, which involved pregnant women with type 1 diabetes, pregnant women with pyelonephritis, or with exacerbation of chronic pyelonephritis, were compared with a control group (15). Evaluating the study results, scientists noticed a significantly faster normalization of pyuria (p<0.05), a significant reduction in recurrences of pyelonephritis for women with pregnant and/or chronic pyelonephritis (p<0.01).
In a prospective, randomized, controlled clinical trial, 85 pregnant women diagnosed with kidney pathology participated (16). Additional administration of the herbal preparation resulted in significant results (p<0.05), early improvement of symptoms (pain, dysuria, nocturia), noticeable normalization of pyuria after 7 days of therapy, a significant decrease in the number of microorganisms. The treatment was characterized by safety and effectiveness.
In the conducted clinical trials, no teratogenic, embryotoxic, or fetotoxic effects of the herbal preparation were observed.
Summary
· The combination of 3 plant extracts (lovage root, centaury, rosemary leaves) in the composition of the herbal preparation Canephron® N acts on the urinary system comprehensively due to synergistic interaction: spasmolytic, anti-inflammatory, antimicrobial, promotes urine excretion, and protects the kidneys.
· The main indications for prescribing Canephron® N are: chronic inflammation of the bladder and kidneys; chronic non-infectious inflammation of the kidneys inflammation(glomerulonephritis, interstitial nephritis); for the prevention of kidney stones and/or after stone removal. The drug can be prescribed during pregnancy and breastfeeding, but doctor supervision is necessary.
· A decrease in recurrent chronic pyelonephritis or cystitis was observed after medicinal treatment by prescribing a 3-month prophylactic treatment with a herbal preparation, including patients with type 2 diabetes. Positive effect on proteinuria in patients with diabetes and low and/or moderate microalbuminuria levels.
· A 3-month prophylactic treatment in children with acute pyelonephritis was as effective as treatment with nitrofurantoin. In addition, children tolerated the herbal preparation better than nitrofurantoin. Positive effect of herbal combination therapy in the early postoperative period for about 3 weeks in children with vesicoureteral reflux, after surgical reflux and congenital megaureter treatment, when the preparation is prescribed a week before and 3 weeks after the surgery. Some parameters significantly improved: increased daily diuresis, rapid recovery of bladder function, accelerated renal blood flow, decreased vascular resistance.
· When prescribing the herbal preparation in addition to the main treatment, a positive effect on stone elimination (not larger than 0.7 cm) is ensured within the first 10 days of treatment.
· When additionally prescribing the herbal preparation for treatment or prevention in pregnant women with urinary tract infections, a faster normalization of pyuria is ensured, preventing recurrent pyelonephritis. The herbal preparation does not exhibit teratogenic, embryotoxic, or fetotoxic effects.
Prepared by Dr. Oksana Valentij