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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

AvaliaÃÃo de seguranÃa e eficÃcia terapÃutica da associaÃÃo de Cassia fistula L, Cassia angustifÃlia Vahl, Tamarindus indica L, Coriandrum sativum L e Glycyrrhiza glabra L em pacientes com constipaÃÃo intestinal / Evaluation of safety and therapeutic efficacy of the combination of l cassia fistula, cassia angustifolia vahl, tamarindus indica l, coriandrum sativum l and glycyrrhiza glabra l in patients with constipation

Aline KÃrcia Alves Soares 21 November 2008 (has links)
nÃo hà / ConstipaÃÃo à um problema clÃnico comum que compreende uma constelaÃÃo de sintomas como excessivo esforÃo, fezes duras, sensaÃÃo de evacuaÃÃo incompleta, uso de manobras digitais, ou defecaÃÃo infreqÃente. Seu tratamento emprega medicamentos que aumentem a freqÃÃncia e facilitem as evacuaÃÃes, bem como mudanÃas nos hÃbitos de vida. O objetivo desse estudo foi avaliar seguranÃa, eficÃcia terapÃutica e validar um mÃtodo analÃtico para a gelÃia TamarineÂ, um fitoterÃpico largamente utilizado como laxante, em pacientes com constipaÃÃo intestinal funcional. Foi realizado o perfil cromatogrÃfico da gelÃia Tamarine para confirmaÃÃo dos seus constituintes e anÃlise de estabilidade empregando cromatografia lÃquida de alta eficiÃncia (CLAE), onde seus principais constituintes foram identificados atravÃs dos tempos de retenÃÃo caracterÃsticos. A anÃlise de estabilidade da formulaÃÃo foi executada comparando os cromatogramas de lotes recÃm-fabricados com lotes apÃs 2 anos de fabricaÃÃo. O mÃtodo desenvolvido comprovou a qualidade das amostras testadas e sua estabilidade apÃs 2 anos de armazenamento. O estudo de toxicologia clÃnica foi do tipo aberto, realizado em 24 voluntÃrios saudÃveis de ambos os sexos que receberam diariamente a administraÃÃo de 5g da gelÃia Tamarine por 28 dias consecutivos. Os voluntÃrios foram avaliados antes, durante e ao final do perÃodo de administraÃÃo atravÃs de histÃria mÃdica, exame fÃsicos e laboratoriais. A formulaÃÃo foi bem tolerada e foram observados feitos adversos como cÃlicas (83,3%), aumento de evacuaÃÃes (58,3%), diarrÃia (20,8%), flatulÃncia e nÃuseas (12,5%). Os parÃmetros hematolÃgicos, metabÃlicos, funÃÃo renal e hepÃtica sofreram variaÃÃes pontuais ao longo do estudo, entretanto, consideradas sem significado clÃnico. O estudo de eficÃcia terapÃutica foi do tipo controlado, paralelo, aberto e randomizado empregando 124 voluntÃrios com constipaÃÃo intestinal funcional, selecionados de acordo com os critÃrios de Roma II e distribuÃdos aleatoriamente entre os grupos de tratamento com a gelÃia Tamarine (TAM) ou Metamucil (MET). Os pacientes em tratamento eram avaliados quinzenalmente para levantamento de efeitos adversos e avaliaÃÃo da eficÃcia feita pelo registro das evacuaÃÃes diÃrias, consistÃncia das fezes e pela melhora global referida pelos mesmos. A maioria dos pacientes apresentou dieta pobre em fibras e baixa ingestÃo de lÃquidos, entretanto, suas dietas nÃo foram alteradas durante o tratamento, as orientaÃÃes nutricionais foram realizadas ao final do estudo para nÃo interferir nos resultados. O uso do TAM aumentou o nÃmero de evacuaÃÃes nos pacientes apÃs 14 e 28 dias de tratamento, quando comparado com o perÃodo inicial de seleÃÃo. No 7o, 14 o, 21 o e 28 o dias a resposta dos pacientes que faziam seu uso foi maior do que o grupo tratado com MET (p&#61500;0,001), bem como a taxa de melhora 166,7% (p=0,003). A consistÃncia das fezes tambÃm melhorou, tornando-se mais amolecidas nos dois grupos. Tratamento com TAM reduziu a consistÃncia das fezes em todo o perÃodo de tratamento (p<0,001) enquanto que o controle teve reduÃÃo apenas na terceira semana (p<0,05). A avaliaÃÃo global dos pacientes (p=0,01 e 0,0367) e do investigador (p=0,0083 e 0,0193) realizadas no 14 e 28 dias de tratamento mostrou melhor aceitaÃÃo para o grupo tratado com TAM nos dois perÃodos de avaliaÃÃo. Nenhum sinal de toxicidade clÃnica ou laboratorial foi observado em todo o perÃodo de tratamento. O presente ensaio clÃnico conclui que a administraÃÃo de 5g da gelÃia Tamarine à segura e eficaz no tratamento da constipaÃÃo intestinal. / Constipation is a common clinical problem that comprises a constellation of symptoms that include excessive straining, hard stools, feeling of incomplete evacuation, use of digital maneuvers, or infrequent defecation. The treatment is composed by behavioral measures and a therapeutic approach. Initial intervention should include dietary measures and fiber supplements; however, if fiber supplement action is ineffective, substances that increase the fecal bolus, lubricants, osmotic agents and laxatives can be used. The aim of the present study was to establish the efficacy, safety and validate an analytical method. Tamarine jelly, a phytotherapic product from Barrenne IndÃstria FarmacÃutica Ltda. a phytomedicine used as laxative. The research project with the experimental protocol and informed consent, were submitted to and approved by the Research Ethics Committee of UFC. The chromatographic profiles of Tamarine jelly was done for confirmation of their constituents and stability analysis using high performance liquid chromatography (HPLC). The method showed the quality of the samples tested and its stability after 2 years of storage. The toxicology clinical trial consisted of an open study with 24 healthy volunteers of both sexes, with a mean age of 26.8 &#61617;&#61472;7.8 years, who orally received a daily dose of 5g Tamarine for 28 uninterrupted days. The volunteers were included in the study only when considered healthy after clinical evaluation, physical examination and laboratory tests which preceded the study. The laboratory tests included: heamatologic, biochemical and serologic analysis. This evaluation was repeated after the first, second, third and fourth week of treatment and at post-study. The jelly was well tolerated, however, some adverse gastrointestinal events were observed. Twenty volunteers (83.3%) reported episodes of light intestinal colic followed by hyperdefecation, five (20.8%) reported diarrhea and three (12.5%) flatulence and nausea. The clinical, electrocardiographic and laboratory tests did not show evidence of toxicity in the various organs and systems evaluated. The efficacy was evaluated in 124 constipated patients selected by Rome II criteria. The investigation was designed as a controlled, parallel and opened. After the selection period, Tamarine (TAM) or Metamucil (MET) was administered. Patients were provided with diary sheets to record each bowel movement and associated subjective symptoms rating stool consistency, abdominal pain and flatus. The efficacy and safety analyzed after each 14 days of treatment by the information recorded on diary and a global assessment of efficacy. Volunteers continuing with their routine activities and maintaining their normal general diets even showing a low consumption of fiber and liquids. The nutritional guidelines were implemented at the end of the study not to interfere in the results. TAM increased bowel frequency after 14 and 28 days when compared with no treatment period and on 7o, 14 o, 21o and 28o days was higher the MET (p<0,001). The stool consistency was changed and became softer in both groups. The alterations improved by TAM was observed in all treatment period (p<0,001) and MET changed only on the third week (p<0,05) . The patientâs global efficacy score (p=0,01 e 0,0367) and investigatorâs (p=0,0083 e 0,0193) realized that on 14 and 28 days of treatment was superior for the TAM group compared with MET. No signs of clinical or laboratory toxicity was observed throughout the treatment period. Confirming their traditional use, the administration of 5g of jelly Tamarine  phytotherapic proved to be safe and effective in the treatment of constipation.

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