Copyright © 2022 The Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited

¹ Research Scholar, Department of Pharmacognosy, Maharshi Dayanand University, Near Delhi Bypass, Rohtak, Haryana-124001, India

²Assistant Professor, Department of Pharmacognosy, Rao Neki Ram Memorial College of Pharmacy,Turkapur, Pataudi, Gurugram, Harayana-122503, sarswatiranga@gmail.com

³Research Scholar, Department of Pharmacognosy, Maharshi Dayanand University, Near Delhi Bypass, Rohtak, Haryana-124001, India, Chattarpalsfd@gmail.com

⁴Research Scholar, Department of Pharmaceutics, Lovely Institute of Technology (Pharmacy), Lovely Professional University, Punjab-144411, India, Sdevender350@gmail.com

⁵Associate Professor, Department of Pharmaceutics, R. J. World College of Pharmacy Education and Technology, Jakhod, Surajgarh, Rajasthan -333033, India

Article Info:

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Article History:

Received 10 November 2021

Reviewed 13 December 2021

Accepted 18 December 2021

Published 15 January 2022

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Cite this article as:

Parihar S, Sarswati, Chattarpal, Sharma D,A Brief Review on Herbs Used in the Treatment of Varicose Veins, Journal of Drug Delivery and Therapeutics. 2022; 12(1):158-162

DOI: http://dx.doi.org/10.22270/jddt.v12i1.5161

Abstract

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A weakening of the venous valves and walls is a common cause of varicose veins. Blood might flow back and pool in veins due to damaged valves, causing them to enlarge. Weakened vein walls are longer, broader, and less elastic than normal, causing valve flaps to split, resulting in increased blood pooling and twisted veins. Primary varicose veins are characterised by valvular incompetence and reflux, which have long been assumed to be the cause. Recent research, on the other hand, reveals that valve dysfunction may be preceded by alterations in the vein wall. This condition is referred to as "Siragranthi" in Ayurvedic literature (ie.Varicose vein). As a result, the current review critically assesses the possible utility of herbal medications in the treatment of varicose veins.

Keywords- Herbal Plants, Varicose veins, Types, Pathophysiology

*Address for Correspondence:

Shweta Parihar, Research Scholar, Department of Pharmacognosy, Maharshi Dayanand University, Near Delhi Bypass, Rohtak, Haryana-124001, India

Varicose veins are veins that are tortuous, twisted, or extended. Size alone does not suggest abnormalities unless the growth is extreme, because size can change depending on ambient temperature and, in women, hormonal factors. Furthermore, in a thin individual, typical superficial veins may appear enormous, but varicose veins in an obese person may be inconspicuous ^5,7.

Trunk varicose veins, reticular varicose veins, and telangiectasia varicose veins are the three types of varicose veins. Spider veins, star bursts, thread veins, and matted veins are all terms used to describe telangiectasia. Only a small percentage of varicose veins are caused by secondary disorders including deep vein thrombosis and occlusion, pelvic tumours, or arteriovenous fistulae².

A network of superficial veins connects to the deep veins via small perforator veins to provide venous drainage to the lower limbs. Varicose veins can be caused by disease in any of these venous systems, but the number of systems affected increases the severity of the symptoms. The vein wall weakens due to a variety of pathophysiological causes, resulting in varicosity over time. Varicosities are most commonly found in the larger and smaller saphenous veins, but they can also appear in branch channels. Varicose veins can be caused by obstruction of the iliac veins or inferior vena cava^4,8.

The belief that varicose veins are caused by valve failure in the superficial veins, resulting in venous reflux and vein dilatation, has been replaced by the theory that valve incompetence occurs after a change in the vein wall, rather than before it. As a result, the vein wall in varicose veins is naturally weak, causing dilation and separation of valve cusps, rendering them ineffective. Varicose veins are caused by advancing age and parity, as well as vocations that entail a lot of standing. There is no indication that the prevalence of varicose veins is influenced by social class, smoking, or genetic makeup. In women, obesity is linked to the development of varicose veins, but not in men².

A wide variety of therapeutic plants can be found all over the world. Many weeds in our environment are highly effective medicinal plants that can help with a variety of significant health issues ^11,12,13. India has long been known as a great store of natural remedies among ancient cultures ^14,15,16. TABLE- 1. List of herbal plants that are used in the treatment of varicose veins^1,3. TABLE-2. List of herbs used to support liver and decrease blockage in the blood flow^1,3. TABLE-3. List of oils that are used in the treatment of varicose veins. some ayurvedic marketed formulations of varicose veins are- Sahacharadi Kashaya, Sahacharadi Thailam, Rasa Thailam, Chamomile Ointment^3,5.

Table 1: List of herbal plants that are used in the treatment of varicose veins^1,3

Supporting the liver decreases blockage in the flow of blood from the rectal veins to the portal vein and therefore decreases venous distention and hemorrhoids due to liver disfunction.

Table 2: List of herbs used to support liver and decrease blockage in the blood flow^1,3

All of the medications covered in this study play a significant function in the treatment of varicose veins. In contrast, the mode of action of bioactive phyto-molecules found in plants is less well understood, but there is no doubt about the importance of plants in the treatment of varicose veins. In the treatment of varicose veins and ulcers, Ayurveda can offer a glimpse of hope. Traditional drug formulations, on the other hand, must be investigated and re-standardized using new methodologies and approaches for controlling varicosis.

1. Palanisamy JK, Ponnu S, Mani S, Balakrishnan S. A critical review on traditional herbal drugs: an emerging alternative drug for varicose veins. World Journal of Pharmaceutical Research. 2018 Jan 8; 7(5):316-38.

3. Garg N, Jain A. Ayurvedic perspective of varicose veins. World J Pharm Res. 2017; 6(3).

4. Lim CS, Davies AH. Pathogenesis of primary varicose veins. Journal of British Surgery. 2009 Nov; 96(11):1231-42. https://doi.org/10.1002/bjs.6798

5. Ionescu N, Neagu AM, Popescu M. Preparation and Characterization of Vegetable Oils And Plant Extracts with Effect in the Treatment of Varicose Veins. U.P.B. Sci. Bull., Series B, 2021; 83(3):185-192

7. Gawas M, Bains A, Janghu S, Kamat P, Chawla P. A Comprehensive Review on Varicose Veins: Preventive Measures and Different Treatments. Journal of the American College of Nutrition. 2021 Jun 16:1-2. https://doi.org/10.1080/07315724.2021.1909510

8. Raffetto JD, Khalil RA. Mechanisms of varicose vein formation: valve dysfunction and wall dilation. Phlebology. 2008 Apr; 23(2):85-98. https://doi.org/10.1258/phleb.2007.007027

9. Tunalier Z, Koşar M, Küpeli E, Çaliş İ, Başer KH. Antioxidant, anti-inflammatory, anti-nociceptive activities and composition of Lythrum salicaria L. extracts. Journal of Ethnopharmacology. 2007 Apr 4; 110(3):539-47. https://doi.org/10.1016/j.jep.2006.10.024

11. Chaudhary, K, Parihar, S, Sharma, D. A Critical Review on Nanoscience Advancement: In Treatment of Viral Infection. Journal of Drug Delivery and Therapeutics 2021 Nov; 11(6):225-237. https://doi.org/10.22270/jddt.v11i6.5030

12. Parihar S, Sharma, D. Cynodondactylon: A Review of Pharmacological Activities. Sch Acad J Pharm Nov 2021; 11:183-189.

13. Parihar S, Sharma, D. Navagraha (nine planets) plants: the traditional uses and the therapeutic potential of nine sacred plants of india that symbolises nine planets. IJRAR 2021; 8(4):96-108.

14. Parihar S, Sharma, D. A brief overview on Asparagus racemous. IJRAR Dec 2021; 8(4):96-108.

15. Telrandhe UB, Lokhande RR, Lodhe VN, Kosalge SB, Parihar S, Sharma D. Review on Herbal Drugs used in Dental Care Management. Asian Journal of Pharmaceutical Research and Development. 2021; 9(6):71-9.

16. Parihar S, Sharma D, A Brief Overview on Crinum Latifolium. International Journal of Science and Research (IJSR) 2021; 10 (12):725-728.

17. Parihar S, Chattarpal, Sharma D. Literature review on the list of plants used in the treatment of lung cancer. World journal of pharmacy and pharmaceutical sciences. 2022; 11(1). DOI: https://doi.org/10.20959/wjpps20221-21068.

S.N.	Plant Name	Plant Part Used	Scientific Names And Family	Mode Of Action
1	Butcher’s broom	Root	Ruscus aculeatus (Liliaceae)	Anti-inflammatory, vasoconstrictor, antihemorrhagic
2	Gotu kola	Whole plant	Centella asiatica (Umbelliferae)	Anti-inflammatory, diurectic, laxative, antiseptic, stimulant, heals wound and ulcers, improve memory, sluggish digestion, leprosy, skin eruptions, varicose veins, improve capillary permeability, ulcers, fever
3	Horse chestnut	Ripe chestnut and bark	Asculus hippocastanum (Hippocastanaceae)	Improve vascular resistance, reduced pathologically induced capillary wall permeability, antringent
4	Stone roots	Roots	Collinsonia canadensis (Lamiaceae)	Act as gastro-intenteritis with diarrhoea, hemorrhoids and laryngeal inflammations, hemorroids, vasoconstriture, stimulants, tones alimentary mucos membranes, diurectics, astringent
5	Cayenne	Leaves and fruits	Capsicum frutescent (Solanaceae)	Fibrinolytic action which is helpful in varicose veins treatment
6	Garlic	Flower bulb	Allium sativum (Amaryllidaceae)	Treat rheumatism, arthritis, gout, fluid retention, obesity, diuretic remedy, improve blood circulation, reduces blood pressure, antibiotic
7	Ginger	rhizome (underground stem)	Zingiber officinale (family Zingiberaceae)	relief from rheumatoid arthritis (RA), osteoarthritis, menstrual pain, upper respiratory tract infections, cough, respiratory problems, migraine headache, bronchitis, and diabetes.
8	Agrimony	Aerial parts	Agrimonia spp. (Rosaceae)	Diurectics, astringent, stimulating gastrointestinal tonic, hepatic atony, enuresis
9	Bayberry	Bark	Myrica cerifera (Myricaceae)	Astringent, styptic, tonifying the atonic tissues, used in passive hemorrhages, ulcerations, venous atony, congestion
10	Cinnamon	Inner bark	Lauraceae	Astringent, stimulant, carminatives, hemostatic, flavoring, antibacterial, antifungal, gastrointestinal tonic, warming herb, passive pulmonary, gastric, intestinal, and renal bleeding, used in nausea and vomiting
10	Geranium	Root	Geranium maculatum (Geraniaceae)	Used as styptic, atonic tissues, passive hemorrhages, ulcerations in mucous membranes, digestive tract, venous atony, congestion
11	White oak	Bark	Quercus alba (Fagaceae)	Astringent, styptic, mucous membrane irritation, passive hemorrhages, venous laxity, congestion, bleeding hemorrhoids, varicosities
12	Witch Hazel	Bark	Hamamelis virginiana (Hamamelidaceae)	Astringent, styptic, mucous membrane irritation, passive hemorrhages, venous laxity, congestion, bleeding hemorrhoids, varicosities, heal wounds and local inflammatons
13	Yarrow	Flowers and leaves	Achillea millefolium (Asteraceae)	Bitter tonic, antiseptic, styptic, stimulating diaphoretic, anti-inflammatory, anodyne, atonic, relaxed tissues where thre is free discharge bleeding of bright red blood, diarrhea, hemorrhoids, excessive menstural flow, vaginitis, Hemostatic
14	Slippery elm	Inner bark	Ulmus spp. (rubra, fulva)	Demulcent, diuretic, anti-inflammatory, soothing mucos membrane irritation in GIT, respiratory tract, and urinary tract. Used internally in inflammations of mouths, throat, stomach, intestines, bladder, urethra, used externally in burns, ulcers, skin disorders, wounds, respiratory tract disorders
15	Psyllium	Seed	Plantago ovata (Plantaginaceae)	Soothe GIT mucosa, demulcent, bulking agents, helps in constipation, diarrhea
16	Flax seeds	Seed	Linum usitatissimum (Linaceae)	Mucilaginous, bulking, lubricating agents, chronic constipations, arthritis, psoriasis, anthrosclerosis
17	Calendula	Flowers prior to fully opening	Calendula officinalis (Asteraceae)	Antiseptic, anti-inflammatory, choleretic, demulcent, vulnerary, immune stimulant, antiviral, support creation of normal connective tissues structures, wound healing, burns, boils, rashes, formulations of granulations tissues
18	Comfrey	Root and main rib	Symphytum officinalis (Boraginaceae)	Heal inflammation of thrombophlebitis and phlebitis, skin wounds, irritations, sprains, contusions, burns, ulcer, skin disorders
19	Plantain	Leaf	Plantago spp. (Plantaginaceae)	Antiseptic, astringent, anti-inflammatory, cooling agent for use with haemorrhoid, vulnerary
20	Saint john’s wort	Flowering tops	Hypericum perforatum (Guttiferae)	Antiviral, Antiseptic, astringent, anti-inflammatory, antibacterial, nervine, sedative, trophorestorative, lymphagogues, haemorrhoid, vulnerary
21	Cleavers	Fresh succulent aerial parts in flowering/seed forming stage	Gallium aparine (Rubiaceae)	Diuretic, nutritive, vulnerary, hypotensive, lymphagogues, bladder and kidney problems, prostatic hypertrophy, reduce stones
22	Red root	Root	Ceanothus americanus (Rhamnaceae)	Expectorant, astringent, lymphatic, splenic, liver congestion, enlarged lymph nodes, sinustitis, tonsillitis, laryngitis, pharyngitis, chronic post-nasal drip, mononucleosis, increase platelates counts, reduce cysts, subacute and chronic conditions, lymphagogues
23	Bhrami	Whole plant	Centella Asiatic (Apiaceae)	Alzheimer's disease, improving memory, anxiety, attention deficit-hyperactivity disorder (ADHD), allergic conditions, irritable bowel syndrome, and as a general tonic to fight stress
24	Guduci	Stem, leaf	Tinospora cordifolia Willd (Menispermaceae)	Curing liver diseases, blood purification capabilities help in fighting bacteria, antipyretic properties, treat fevers like dengue, malaria, and swine flu.
25	Onion	Bulb	Allium cepa	treating digestion problems including loss of appetite, upset stomach, and gallbladder disorders; for treating heart and blood vessel problems including chest pain (angina) and high blood pressure; and for preventing “hardening of the arteries” (atherosclerosis).
26	Manjistha		Rubia cordifolia (Rubiaceae)	treat uric acid and arthritis, urinary infections, diarrhea, dysentery, and chronic fevers.
27	Raw potatoes grated	Fruit	Solanum tuberosum (Solanaceae),	Paste is use on varicose veins legs
28	Raw grated apples	Fruit	Malus pumila (Rosaceae)	Apple cider vinegar is used in treatment of varicose veins
29	Red rose petals	Leaves, flower	Rosaceae	Use to wash varicose veins legs with warm water

S.N.	Plant Name	Scientific Name And Family	Plant Part Used	Pharmacological Activity
1	Burdock	Atrium lappa (Asteraceae)	Root	Diuretic, stimulant, blood and lymp cleanser, liver tonic, choleretic, mild laxative, stimulates natural flow of lymphatic fluid thereby supporting excreation of toxic products of cells, helps in removing accumulated toxic byproducts of skin, kidney, liver, gallbladder, mucous, serous membrane through catabolism
2	Dandelion	Taraxacum officinalis (Asteraceae)	Whole plant, leaves, flower, roots	Diuretic, stomachic, mild laxative, cholagogue, choleretic, lower blood pressure, cholesterol, decrease edema, normalize sugar level, arthritis, gout, skin diseases
3	Licorice	Glycyrrhiza glabra (Fabaceae)	Root	Demulcent, adaptogen, adrenal-modulator, antibacterial, antiviral, expectorant with secretolytic ans secretomotor activity, nutritive, spasmolytic, antioxidant, anti-inflammatory, estrogenic, immune stimulant, liver tonic, protectant, Glycyrrhizinic acid and aglycone Glycyrrhizinic acid decrease inflammation by increasing the movement of leucocytes towards inflamed area, Glycyrrhizin inhibits the activity of phospholipase A and formation of prostaglandin E2 in activated peritoneal macrophages
3	Milk thistle	Silybum marianum (Asteraceae)	Seed	Hepatoprotective, antioxidant, it stimulate RNA polymerase A which enhances ribosome proteins synthesis and activates the regenerative capacity of liver cells
4	Turmeric	Curcuma longa (Zingiberaceae)	Rhizome	Antiarthritic, antibacterial, antifungal, hypotensive, anti-atherosclerotic, cholagogue, choleretic, emmenagogue, anti-inflammatory, lower cholesterol, stimulates digestive enzymes, carminative, hepatoprotective, vulnerary, anticoagulant, flatulence, jaundice, menstrual difficulties, gallstones, haemorrhages, toothache, bruises, colic, arthritis, sprains, wounds, anticancer
5	Corylus avellana	Corylus avellana (Betulaceae)	Fruit	Venotonic action, protective effect against hypertension, chronic heart diseases
6	Vaccinium myrtillos	Vaccinium myrtillos (Ericaceae)	Fruit wild blueberries	Use in venous insufficiency by varicose veins and hemorrhoids, vascular disorders

S.N.	Oil Name	Plants Name And Family	References
1	Pumpkin	Cucurbita (Cucurbitaceae)	5
2	Sunflower	Helianthus annuus (Asteraceae)	5
3	Grapes seed oil	Vitis vinifera (Vitaceae)	5
4	Rice bran oil	Oryza sativa L (Poaceae)	5