Polyherbal formulation: A Concept of ayurveda for Kidney Disease

Longevity and health are totally depending on the present developments in This combination of many herbs (polyherbal) is advantageous since the powerful phytochemical elements of individual plants are insufficient to deliver the desired therapeutic effect. More than two plants with diverse phytoconstituents and therapeutic potential have been shown to work synergistically to treat human illnesses. The broad therapeutic range of polyherbal formulations, which are efficacious at low doses and safe at large doses yet exhibit fewer negative effects when overused, has made them very popular. Natural ingredients included in Ayurveda make it one of the best methods for treating illness since it restores the body's natural balance while also avoiding additional recurrences. Approximately 80% of the world's population, according to the WHO, still relies on traditional or Ayurvedic treatments for their health and well-being (1-3). When it comes to treating human ailments, the Indian philosophy behind Ayurveda aims to minimise suffering while also utilising the significant biodiversity centres provided by the approximately 45,000 herbal plant species, of which approximately 15,000 have been documented for their use in treating a variety of human ailments through the use of single or multiple herbs(4). Ayurvedic medicine makes use of a wide variety of plant components, including seeds, roots, bark, stems, gum, leaves, flowers, and fruit. Tablets containing root extracts of different plants with potent phytoconstituents that have been scientifically shown to be useful in the treatment of Glomerulonephritis were produced and assessed in this research. Plants included in the research include Angelica officinalis (Umbelliferae), Boerhavia diffusa (Nyctaginaceae), Carica papaya (Caricaceae), Cassia fistula (Fabaceae), Ficus hispida (Moraceae), Fumaria indica (Fumariaceae MATERIALS AND METHODS) and Vitex negundo (Vitexaceae) (Verbenaceae). Tolerability tests and effective doses based on toxicology studies were utilised to determine the amount of medicines included in the formulation. For polyherbal dispersible tablets, 25 mg of extract

An injury or sickness may be treated using traditional herbal medicine using plants or plant material. This can be done in the raw or processed form. Screening is now being place on ethnomedicinal medicinal herbs. The social and natural sciences are both included in the ethnopharmacological approach to studying and appraising traditional and herbal medications. Anthropogenic ethnopharmacological investigations are based on ethnographic studies of local usage of nature-derived medicines. Throughout history, herbal products have been utilised extensively to treat a variety of ailments. Because of the wide variety of functionally significant secondary metabolites generated by microbes and plants, natural products and their related structures are valuable sources of innovative medicines (6).

In Chinese medicine, polyherbal treatment, or the use of many herbs at once, has been practised for hundreds of years, although there is little empirical evidence to support its efficacy. When compared to a single medicine, a pharmacological combination typically shows encouraging results in the treatment of disorders. Over the last several decades, Western medicine has been using the notion of medication combination to great effect. Cancer and infectious illness patients have found fresh hope in pharmacological combination therapy in recent years. The combination of plants and herbal compounds in a specific recipe has been found to have possible interactions. These include enhancing one another, assisting one another, restraining one another, and being antagonistic to one another. Various infections are treated using polyherbal substances in the Ayurvedic medical system. Hedychium spicatum, Inula racemosa, and Clerodendrum serratum, make up the Bharangyadi polyherbal. Indukantha Ghritha (IG) is a regularly recommended ayurvedic polyherbal mixture containing plant components. The outstanding clinical efficacy of the formulations in the Unani system of medicine is also helping it achieve worldwide appeal (7-9). Even though Unani remedies have been used for centuries, there is no recorded proof of their safety or efficacy. As a result of the absence of review, the creation of laws and legislation has been hampered. With the use of Cissus rotundifolia leaves and bark and leaves and Zanthoxylum chalybeum bark and leaves and Zanthoxylem chalybeum bark extract, a polyherbal formulation has been tried and assessed for further in-vitro investigations with great success (9).

There are several chemical components in ayurveda and herbal medications, which may give the plant-based formulations. In spite of the general belief that herbal remedies are safe, many people take them in combination, and they are derived from plants, which themselves vary widely in species, growing circumstances, and chemical contents that are physiologically active. The availability of numerous active components that combined may generate a potentiating effect that may not be possible by any single molecule gives botanicals a theoretical edge over traditional single-component medications. In polyherbal formulations, pharmacological substances derived from plants are combined to produce synergistic, potentiative, agonistic, and antagonistic effects. Pharmacological principles interact together dynamically to generate maximal treatment effectiveness with minimal adverse effects. Depending on the context, synergism may function in one of two ways. pharmacokinetic synergism refers to a herb's ability to increase the other herbs' absorption, distribution, metabolism, and excretion. However, pharmacodynamic synergism examines the synergistic impact when active elements with equal therapeutic action are directed to a same receptor or physiological system.. In addition, a variety of variables and complications are thought to be the root of illness in the majority of instances, resulting in both apparent and unseen symptoms. Multiple herbs may work together to alleviate the symptoms at the same time. There are several advantages to polyherbalism over single plant formulations due to the synergism. It is clear that a single multi-component formulation may have a superior therapeutic impact. In order to obtain desired pharmacological effects, a lesser dosage of the herbal product would be required, minimising the potential of adverse effects. In addition, patients benefit from PHFs since they eliminate the need to take many herbal formulations at the same time, which promotes greater compliance and a more effective therapeutic outcome. PHF is more popular than single herbal formulations because of all of these advantages. To treat a specific difficulty, polyherbal formulations use many different types of molecules, each of which works via a different method (10, 11).

Ayurvedic medications are split into three categories based on the source of their ingredients: herbal, mineral, and animal. Herbal formulation is one of them that has lately grown in prominence and drawn increasing attention from across the world. This is the most likely scenario, given the dramatic rise in the use of herbal formulations in industrialised nations like the United States and Europe over the previous several years. According to the WHO, almost 80% of the world's population still receives One of the world's most biodiverse regions, the Indian subcontinent is home to more than 45,000 species of plants. Its long-standing role as a repository for herbal remedies may be traced in part to its very diverse flora. Seven thousand seven hundred and fifty of the approximately 15,000 species of medicinal plants that have been discovered in India are now being used to cure a range of maladies by the country's native people. In Ayurveda's medicinal systems, there are 700 distinct plant species. Chakara Samhita and Sushruta Samhita reference the usage of these herbals in ancient Ayurvedic literature. There are many different ways to isolate and purify herbs, as well as several types of preparations that may be used. An "herbal drug" is a word used to describe the components of a plant that are employed in the preparation of medicines (leaves, flowers, seeds, roots, barks, stems, and etc.). All of the herb's constituent parts are used to their full potential in herbal preparations such as Kwatha (Decoction), Phanta (Hot infusion), Hima (Cold infusion), Arka (Liquid Extract), Churna (Powders), Guggul (Resins and balsams), and Taila (Medicated oil), among others (12). More and more pharmacologically active components in Ayurvedic medicines, as well as the therapeutic value of these compounds, have been discovered as a result of modern scientific advances. Saponins and tannins, alkaloids, alkenylphenols, flavonoids and terpenoids are the primary phytochemical components of herbal medicines that are responsible for the intended therapeutic effect. These include sesquiterpene lactones and sesquiterpene esters. There may be more than one phytochemical ingredient in a single plant that acts together to produce pharmacological effects. The following are some examples of Ayurvedic herbs: Because of its high concentration of saponin glycosides, Arjuna (Terminalia arjuna) is particularly effective in improving heart muscle function and pumping capacity, while its flavonoids provide antioxidant protection and vascular support. Sesquiterpenes, shogaols, and gingerols are found in the volatile oil of the ginger plant (Zingiber officinale), whereas bisapolene, zingiberene, and the antibacterial zingiberol are found in the volatile oil of the ginger plant (Zingiber officinale). Aromatic buds of Syzygium aromaticum and the leaves of Cinnamomum zeylanicum were dried and pressed to produce eugenol-rich clove oil and cinnamon leaf oil (13). There are three primary phytoconstituents in lemongrass (Cymbopogon citrates) essential oil: geraniol, neral, and myrcene. Myrcene has no antibacterial effect in vitro like the first two did. In contrast, when myrcene was added to either of the two ingredients, it boosted their effectiveness (14). Two ideas underlie Ayurvedic medication formulation: the use of a single drug and the use of many medicines, which is referred to as "PHF." Traditionally, a therapeutic herbal technique known as polypharmacy or polyherbalism relies on the synergistic effects of many medicinal plants. While it is widely documented that plants contain active phytochemical elements, they are often present in little amounts and are seldom adequate to provide desired therapeutic effects. For this reason, scientific research have showed that the total of the different effects of these plants of variable strength may potentially generate a bigger outcome than the individual usage of the plant. Synergism refers to the phenomena of beneficial herb-herb interactions. The pharmacological effects of several herbal active ingredients are amplified when combined with those of other plants, although they are not readily apparent when taken on their own. (15) There are two ways in which synergism works depending on the nature of the interaction (i.e.,pharmacodynamics and pharmacokinetic). When one herb aids another in absorption, distribution, metabolism, and excretion, it is called synergism. On the other hand, pharmacodynamic synergism is a study of the synergistic impact when active elements with comparable therapeutic action are addressed to the same receptor or physiological system as one another. In addition, a variety of variables and complications are thought to be the root of illness in the majority of instances, resulting in both apparent and unseen symptoms. To give comprehensive treatment, a mixture of herbals may work on many targets at once. (16)

Due to the fact that PHF offers various benefits that are not present in allopathic medications, it has lately become popular across the globe. Furthermore, PHFs are proven to be very effective in a wide range of illnesses. It is well known that phytoconstituents in herbal medicines have a positive impact on their therapeutic properties, and this is further enhanced when they are combined in PHFs. The efficacy of PHF has been extensively studied and documented in several studies that have appeared in prestigious international publications. According to a UK statistical analysis, the primary driver for the usage of medicinal herbalism is the treatment's efficacy and beneficial results. (17) The second thing to keep in mind is that PHFs tend to have a broad therapeutic spectrum. Even at modest doses, most of these drugs are effective and safe; as a result, they have a low risk to benefit ratio. Diakyur, a hypoglycemic PHF, is an excellent example. At the high dosage of 12800 mg/kg p.o., Diakyur did not cause any toxic symptoms in the experimental animals for 72 hours; nevertheless, at the lower dose of 1600 mg/kg p.o., Diakyur is safe for long-term therapy. At a dosage of 1600 mg/kg, the PHF demonstrates hypoglycemic and antioxidant properties (p.o.). [38] Allopathic hypoglycemia medicines such tolbutamide, glipizide, and glicazide, which have a restricted therapeutic range, are in direct opposition to this approach. (18) PHFs, as long as they are made and administered correctly, have less negative effects than allopathic medications on average. There are numerous undesirable side effects associated with the administration of modern allopathic medications, mouth as well as impotence and confusion. Dyspepsia, stomach ulcers, salt and fluid retention, and hypertension are common adverse effects of nonsteroidal anti-inflammatory medications (NSAIDs) given for the treatment of rheumatoid arthritis (RA). These negative effects may be avoided or minimised by using Ayurvedic therapy. RA patients who received a year of Ayurvedic therapy utilising internal herbal medications showed significant improvement without any indication of organ toxicity, according to the findings of one recent research. [40] According to a research by Jawla et al., none of the 500 people who filled out a questionnaire reported any negative side effects from herbal medicines, and 48% of those people chose the Ayurvedic approach for treating common illnesses. The public's acceptability of the medicine system seems to be affected by the side-effect criteria. [41,42] The fact that PHFs are derived from natural sources means that they are less expensive, less harmful to the environment, and easier to get than allopathic medications. Because of their lower cost and easier availability, they are becoming more popular across the world, particularly in underdeveloped nations and rural regions that lack access to more expensive contemporary therapies. To add to the historical significance, in certain cultures, polyherbal treatments have long been revered as a core part of folklore, rooted in centuries of trial and error. Simply put, PHF are more widely accepted in society and culture. (19) PHF is a great therapy because of its effectiveness, safety, affordability, ubiquity, and ease of use; hence, patients are more likely to adhere to treatment and achieve outstanding therapeutic outcomes.

There are certain inherent limitations to Ayurvedic PHFs that limit their ability and usefulness in therapy, despite their immense benefits to humans. In addition to patients and Ayurvedic practitioners, the sources and manufacturing process of PHFs are at fault as well as laws and regulations in place to protect them all. That Ayurvedic PHFs are inherently safe is a widely held belief, which is false. When Ayurvedic medications are produced or used incorrectly, as outlined in the Charaka Samhita, they might have negative consequences. The usage of PHFs with allopathic medications is on the rise since most patients do not tell their doctors of the simultaneous therapy. But many people are unaware of the probable drug-herb interactions, which may alter their pharmacological or toxicologic effects, resulting according to the literature. (20) An Ayurvedic PHF's clinical repeatability in clinical trials is difficult to obtain Standardizing the production of Ayurvedic PHFs was made easier thanks to monographs in the Ayurvedic Pharmacopoeia of India, commonly known as the "Ayurvedic formulary of India." This, however, would not be enough to assure that every batch of PHFs would be identical. When deciding on the beginning material for PHFs, the environment, growing season, harvesting circumstances, storage technique, and pharmaceutical processing are all things to keep in mind, according to Charaka samhita. It is difficult to standardise the final product for repeatable quality since the components of crude raw herb materials might vary as a result of varied geographical locations, climate conditions, environmental dangers, harvesting techniques, collecting procedures, and so on. As a result of this batch-to-batch variance, the efficacy and safety of PHFs would be directly affected. Changing the dose regimen to get the desired therapeutic effect seems to be a hassle as well.

There are certain inherent limitations to Ayurvedic PHFs that limit their ability and usefulness in therapy, despite their immense benefits to humans. In addition to patients and Ayurvedic practitioners, the sources and manufacturing process of PHFs are at fault as well as laws and regulations in place to protect them all. (21) That Ayurvedic PHFs are inherently safe is a widely held belief, which is false. When Ayurvedic medications are produced or used incorrectly, as outlined in the Charaka Samhita, they might have negative consequences. The usage of PHFs with allopathic medications is on the rise since most patients do not tell their doctors of the simultaneous therapy. But many people are unaware of the probable drug-herb interactions, which may alter their pharmacological or toxicologic effects, resulting in negative health outcomes. Table 3 lists Ayurvedic herbs that have been implicated in drug-herb interactions when used in PHF formulations. Ayurvedic PHFs are notoriously difficult to reproduce clinically. Standardizing the production of Ayurvedic PHFs was made easier thanks to monographs in the Ayurvedic Pharmacopoeia of India, commonly known as the "Ayurvedic formulary of India." This, however, would not be enough to assure that every batch of PHFs would be identical. When deciding on the beginning material for PHFs, the environment, growing season, harvesting circumstances, storage technique, and pharmaceutical processing are all things to keep in mind, according to Charaka samhita. It is difficult to standardise the final product for repeatable quality techniques, collecting procedures, and so on. As a result of this batch-to-batch variance, the efficacy and safety of PHFs would be directly affected. Changing the dose regimen to get the desired therapeutic effect seems to be a hassle as well.

Use of PHF in traditional Ayurvedic medicine is still beneficial today. PHFs use the Ayurvedic ideas of Panchamahabhutas and Tridoshas to treat ailments holistically. Science has enhanced Ayurvedic formulations of PHFs by studying various phytoconstituents and discovering beneficial herb combinations that work together to produce desired results. Ayurvedic PHFs are presently witnessing a "renaissance" over the globe because of their equivalent efficacy, less side effects, and more acceptability than allopathic drugs. Understanding and misperceiving PHF safety might result in the opposite effect, such as toxicity and undesirable interactions. As a result of insufficient regulatory control and the irresponsibility of manufacturers, the quality of the PHFs produced has also been damaged. To prevent PHFs from wreaking havoc on the environment, governmental oversight and public awareness campaigns are essential. It is only when they are utilised appropriately and reasonably that Ayurvedic PHFs may have a good influence on health.

1. Subramani Parasuraman, Gan Siaw Thing, and Sokkalingam Arumugam Dhanaraj (2014). "Polyherbal formulation: Concept of ayurveda". Pharmacogn. Rev. 8 (16): 73–80. 2. Tayade Jayshri A has completed her MPharm in 2007 from CU Shah College of Pharmacy, SNDT University Mumbai and she is currently pursuing PhD from North Maharashtra University. She has published 1 paper in international journal. 3. Farnsworth NR, Akerele O, Bingle AS, Sojarto DD, Guo Z. Medicinal plant in therapy. Bulletin of the world health organization. 1985; 63:965-981. 5. Abraham R, Paridhavi M. A review of comprehensive study on medicinal plants of polyherbal formulation- Churna. Asian J Pharm Clin Res 2013; 6(4):11-18. 6. Ngo LT, Okogun JI, Folk WR. 21st century natural product research and drug development and traditional medicines. Nat Prod Rep 2014; 30(4):584-92. 7. Kunwar RM, Shrestha KP, Bussmann RW. Traditional herbal medicine in far-west Nepal: a pharmacological appraisal. J Ethnobiol Ethnomed 2010; 6:35. 8. Risberg K, Fodstad Ø, Andersson Y. Synergistic anticancer effects of the 9.2.27PE immunotoxin and ABT-737 in melanoma. PLoS One 2011;6 (9) 9. Che CT, Wang ZJ, Chow MSS, Lam CWK. Herb-herb combination for therapeutic enhancement and advancement: Theory, practice and future perspectives. Molecules. 2013; 18(5):5125–41. 10. Ramaiah M, Chakravathi G, Yasaswini K. In vitro biological standardization, formulation and evaluation of directly compressed polyherbal anthelmintic tablets. Pharmacogn J 2013; 5(3):130-4. 11. Reddy MS, Reddy DRK, Prasad NAV. Herbal and pharmaceutical drugs enhanced with probiotics. 2000, US006080401A 12. Ajazuddin, Saraf S. Evaluation of physicochemical and phytochemical properties of Safoof-E-Sana, a Unani polyherbal formulation. Pharmacognosy. Res 2010; 2(5):318–22. 13. Benzie IFF, Wachtel-Galor S. Herbal Medicine: Bimolecular and Clinical Aspects, 2nd edn. CRC Press/Taylor & Francis 2011. 14. Bhope SG, Nagore DH, Kuber VV, Gupta PK, Patil MJ. Design and development of a stable polyherbal formulation based on the results of compatibility studies, Pharmacognosy Res. 2011; 3(2): 122-129. 15. Chorgade MS. Drug Discovery and Development: Drug development Vol. 2. John Wiley and Sons Inc; Hoboken, New Jersey: 2007. 16. Spinella M. The importance of pharmacological synergy in psychoactive herbal medicines. Altern Med Rev. 2002; 7:130-137. 17. Sarwar M, Attitalla IH and Abdollahi M. A review on the recent advances in pharmacological studies on medicinal plants: Animal studies are done but clinical studies needs completing. Asian J Anim Vet Adv 2011; 6(8): 867-883. 18. Parasuraman S, Thing GS, Dhanaraj SA. Polyherbal formulation: concept of ayurveda Pharmacogn Rev 2014; 8(16): 73-80. 19. Kavitha AN, Deepthi V, Nayeem N. Design, formulation and evaluation of a polyherbal ointment for its wound healing activity. Pharmacophore 2013; 4 (5):175-180. 20. Rastogi S, Chiappelli F, Ramchandani MH, Singh RH, editors. Evidence based Practice in Complimentary and Alternative Medicine Ayurveda Integr Med 2012; 3:168 72. 59. 22. Lee H-S, Lee B-C, Ku S-K Effect of DHU001, a Polyherbal Formula, on Dinitrofluorobenzene-induced Contact Dermatitis (Type I allergy), Toxicol Res. 2010; 26(2):123-130.

Research Scholar, Shridhar University, Pilani, Rajasthan