대한약침학회지 (Journal of Pharmacopuncture)

  • 제24권4호
  • /
  • Pages.196-205
  • /
  • 2021
  • /
  • 2093-6966(pISSN)
  • /
  • 2234-6856(eISSN)
대한약침학회 (KOREAN PHARMACOPUNCTURE INSTITUTE)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Comfrey on Enoxaparin-Induced Bruise in Patients with Acute Coronary Syndrome: A Randomised Clinical Trial

  • Bagheri, Zahra (Department of Medical Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences) ;
  • Azizi, Azim (Chronic Diseases (Home Care) Research Center, Malayer School of Nursing, Hamadan University of Medical Sciences) ;
  • Oshvandi, Khodayar (Department of Medical Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences) ;
  • Mohammadi, Younes (Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences) ;
  • Larki-Harchegani, Amir (Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences)
  • 투고 : 2021.07.29
  • 심사 : 2021.11.26
  • 발행 : 2021.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: Bruising is an important side effect of enoxaparin injection. Comfrey (Symphytum officinale) is used to treat different types of wounds, bone fractures, and bruising in traditional medicine in many countries for centuries. This study aimed to determine the effects of the Comfrey ointment on the bruise size and color following enoxaparin injection. Methods: This double-blind randomized clinical trial was conducted on 80 patients with acute coronary syndrome (ACS). The participants were randomly divided into two groups of 40, namely Comfrey and Placebo. Changes in bruise size and color in both groups were assessed daily before and after the intervention. Results: The Comfrey and Placebo groups were homogeneous in demographic and clinical variables. A downward trend was observed in the bruise size in both groups throughout the study. However, the bruise size was smaller in the Comfrey group than the Placebo group on day 2-5 of the intervention. Moreover, there was a significant difference in bruise color between the groups, with a shorter healing course in the Comfrey group. Conclusion: The Comfrey ointment accelerated the healing process of enoxaparin injection-induced bruising in patients with ACS. It is recommended as a safe and simple approach for these patients.

키워드

과제정보

The authors thank the patient for participating in this study and all clinical staff at Farshchian Heart Hospital (Department of Heart and CCU, Hamadan University of Medical Sciences) for their excellent technical assistance. Financial support for this study was provided by Vice-chancellor for Research and Technology, Hamadan University of Medical Sciences (Grant number: 9709275652).

참고문헌

  1. Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF. Braunwald's heart disease e-book: a textbook of cardiovascular medicine. 11th ed. Philadelphia: Elsevier; 2018.
  2. Galli M, Andreotti F, D'Amario D, Vergallo R, Vescovo GM, Giraldi L, et al. Antithrombotic therapy in the early phase of non-ST-elevation acute coronary syndromes: a systematic review and meta-analysis. Eur Heart J Cardiovasc Pharmacother. 2020;6(1):43-56. https://doi.org/10.1093/ehjcvp/pvz031
  3. Martinez BK, White CM. Pharmacologic considerations in the management of acute coronary syndrome in elderly patients. Expert Opin Pharmacother. 2019;20(15):1787-90. https://doi.org/10.1080/14656566.2019.1639670
  4. Jupalli A, Iqbal AM. Enoxaparin. Treasure Island: StatPearls Publishing; 2019.
  5. Zeitouni M, Kerneis M, Nafee T, Collet JP, Silvain J, Montalescot G. Anticoagulation in acute coronary syndrome-state of the art. Prog Cardiovasc Dis. 2018;60(4-5):508-13. https://doi.org/10.1016/j.pcad.2018.01.004
  6. Jameson JL, Fauci A, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's principles of internal medicine. 20th ed. New York: McGraw-Hill Education; 2018.
  7. Hess CT. Clinical guide to skin and wound care. 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2012.
  8. Zaybak A, Khorshid L. A study on the effect of the duration of subcutaneous heparin injection on bruising and pain. J Clin Nurs. 2008;17(3):378-85. https://doi.org/10.1111/j.1365-2702.2006.01933.x
  9. Bindon SL. Professional development strategies to enhance nurses' knowledge and maintain safe practice. AORN J. 2017;106(2):99-110. https://doi.org/10.1016/j.aorn.2017.06.002
  10. Amaniyan S, Varaei S, Vaismoradi M, Haghani H, Sieloff C. Effect of local cold and hot pack on the bruising of enoxaparin sodium injection site: a randomized controlled trial. Contemp Nurse. 2016;52(1):30-41. https://doi.org/10.1080/10376178.2016.1190289
  11. Poursafar Z, Jafroudi S, Baghaei M, Kazemnezhad Leyli E, Zarrizei M. Incidence and extent of bruising after subcutaneous injection of enoxaparin sodium in patients hospitalized at coronary care units. J Holist Nurs Midwifery. 2019;29(2):90-6.
  12. Chan H. Effects of injection duration on site-pain intensity and bruising associated with subcutaneous heparin. J Adv Nurs. 2001;35(6):882-92. https://doi.org/10.1046/j.1365-2648.2001.01925.x
  13. Chenicek TE. Effects of injection duration on site-pain intensity and bruising associated with subcutaneous administration of Lovenox (enoxaparin sodium) [master's thesis]. [Tallahassee (FL)]: Florida State University; 2004. 70 p.
  14. Taylor CR, Lillis C, Lemone P, Lynn P, Lebon M. Study guide for Fundamentals of nursing: the art and science of nursing care. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2011.
  15. Bartell JC, Roberts KA, Schutte NJ, Sherman KC, Muller D, Hayney MS. Needle temperature effect on pain ratings after injection. Clin J Pain. 2008;24(3):260-4. https://doi.org/10.1097/AJP.0b013e31816111c0
  16. Candiotti K, Rodriguez Y, Koyyalamudi P, Curia L, Arheart KL, Birnbach DJ. The effect of needle bevel position on pain for subcutaneous lidocaine injection. J Perianesth Nurs. 2009;24(4):241-3. https://doi.org/10.1016/j.jopan.2009.04.003
  17. Chen S, Shang H, Yang J, Li R, Wu H. Effects of different extraction techniques on physicochemical properties and activities of polysaccharides from comfrey (Symphytum officinale L.) root. Ind Crops Prod. 2018;121:18-25. https://doi.org/10.1016/j.indcrop.2018.04.063
  18. Jedlinszki N, Balazs B, Csanyi E, Csupor D. Penetration of lycopsamine from a comfrey ointment through human epidermis. Regul Toxicol Pharmacol. 2017;83:1-4. https://doi.org/10.1016/j.yrtph.2016.11.015
  19. Miskulin I, Lalic Z, Miskulin M, Dumic A, Sebo D, Vcev A, editors. Efficacy of ointment containing comfrey and propolis in the treatment of mild acute sports injuries. Proceedings of World Congress Integrative Medicine & Health 2017; 2017 May 3-5; Berlin, Germany. London (UK): BioMedCentral; c2017.
  20. Nossa GDL, Talero PYV, Rozo NEW. Determination of polyphenols and antioxidant activity of polar extracts of comfrey (Symphytum officinale L). Rev Cubana Plant Med. 2016;21(2):125-32.
  21. Sowa I, Paduch R, Strzemski M, Zielinska S, Rydzik-Strzemska E, Sawicki J, et al. Proliferative and antioxidant activity of Symphytum officinale root extract. Nat Prod Res. 2018;32(5):605-9. https://doi.org/10.1080/14786419.2017.1326492
  22. Staiger C. Comfrey root: from tradition to modern clinical trials. Wien Med Wochenschr. 2013;163(3-4):58-64. https://doi.org/10.1007/s10354-012-0162-4
  23. Trifan A, Opitz SEW, Josuran R, Grubelnik A, Esslinger N, Peter S, et al. Is comfrey root more than toxic pyrrolizidine alkaloids? Salvianolic acids among antioxidant polyphenols in comfrey (Symphytum officinale L.) roots. Food Chem Toxicol. 2018;112:178-87. https://doi.org/10.1016/j.fct.2017.12.051
  24. European Scientific Cooperative on Phytotherapy. ESCOP monographs. 2nd ed. Exeter: ESCOP; 2003.
  25. Frost R, O'Meara S, MacPherson H. The external use of comfrey: a practitioner survey. Complement Ther Clin Pract. 2014;20(4):347-55. https://doi.org/10.1016/j.ctcp.2014.07.003
  26. Smith DB, Jacobson BH. Effect of a blend of comfrey root extract (Symphytum officinale L.) and tannic acid creams in the treatment of osteoarthritis of the knee: randomized, placebo-controlled, double-blind, multiclinical trials. J Chiropr Med. 2011;10(3):147-56. https://doi.org/10.1016/j.jcm.2011.01.003
  27. Jafroudi S. Study of effect of subcutaneous enoxaparin sodium injection duration on incidence and extent of bruising at injection site in hospitalized patient [master's thesis]. [Rasht]: Shahid Beheshti Nursing and Midwifery College; 2015.
  28. Amidi N, Moradkhani S, Sedaghat M, Khiripour N, Larki-Harchegani A, Zadkhosh N, et al. Effect of green tea on inflammation and oxidative stress in cisplatin-induced experimental liver function. J HerbMed Pharmacol. 2016;5(3):99-102.
  29. Hemmati AA, Larki-Harchegani A, Shabib S, Jalali A, Rezaei A, Housmand G. Wound healing property of milk in full thickness wound model of rabbit. Int J Surg. 2018;54(Pt A):133-40. https://doi.org/10.1016/j.ijsu.2018.04.030
  30. Barna M, Kucera A, Hladicova M, Kucera M. [Wound healing effects of a Symphytum herb extract cream (Symphytum x uplandicum NYMAN): results of a randomized, controlled doubleblind study]. Wien Med Wochenschr. 2007;157(21-22):569-74. German. https://doi.org/10.1007/s10354-007-0474-y
  31. Chaiet SR, Marcus BC. Perioperative Arnica montana for reduction of ecchymosis in rhinoplasty surgery. Ann Plast Surg. 2016;76(5):477-82. https://doi.org/10.1097/SAP.0000000000000312
  32. Gilca M, Tiplica GS, Salavastru CM. Traditional and ethnobotanical dermatology practices in Romania and other Eastern European countries. Clin Dermatol. 2018;36(3):338-52. https://doi.org/10.1016/j.clindermatol.2018.03.008
  33. Alamgir A. Therapeutic use of medicinal plants and their extracts: volume 2: phytochemistry and bioactive compounds. Vol 74. Cham: Springer; 2018.
  34. Jaric S, Kostic O, Mataruga Z, Pavlovic D, Pavlovic M, Mitrovic M, et al. Traditional wound-healing plants used in the Balkan region (Southeast Europe). J Ethnopharmacol. 2018;211:311-28. https://doi.org/10.1016/j.jep.2017.09.018
  35. Andres R, Brenneisen R, Clerc J. Relating antiphlogistic efficacy of dermatics containing extracts of Symphytum officinale to chemical profiles. Planta Med. 1989;55(7):643-4. https://doi.org/10.1055/s-2006-962224
  36. Staiger C. Comfrey: a clinical overview. Phytother Res. 2012;26(10):1441-8. https://doi.org/10.1002/ptr.4612
  37. Dehghani K, Najari Z, Dehghani H. Effect of subcutaneous Enoxaparin injection duration on bruising size in acute coronary syndrome patients. Iran J Nurs Midwifery Res. 2014;19(6):564-8.
  38. Duke JA. Handbook of medicinal herbs: herbal reference library. Boca Raton: CRC Press; 2018.
  39. Weiss R, Fintelmann V. Herbal medicine. 2nd ed. Stuttgart: Thieme; 2000.
  40. Korac RR, Khambholja KM. Potential of herbs in skin protection from ultraviolet radiation. Pharmacogn Rev. 2011;5(10):164-73. https://doi.org/10.4103/0973-7847.91114