Chinese herbal remedies
Kangfuxin
Kang fu xin is a pure Chinese herbal medicine extracted from Periplaneta
Americana (the American cockroach) and is used in the treatment of
several ulcerative conditions. The key components of Kangfuxin are
polyhydric alcohols, peptides, mucin, amino acids and other active
substances. Kangfuxin improves the gastrointestinal mucosa
microcirculation, promotes the growth of granulation tissue and
angiogenesis, it accelerates shedding of necrotic tissue, therefore
expediting the wound or ulcer healing process. This accelerated wound
healing process and gastro- protective properties play an important part
in the treatment of oral, gastric and duodenal ulcers.28Kangfuxin has also been noted to significantly
increase the production of superoxide dismutase which has anti-oxidant
and anti-inflammatory properties. 28In addition, its
anti-inflammatory properties not only reduce associated inflammatory
edema but also aid in pain reduction. Kangfuxin solution can also be
used in the formation of compounded mouth washes, this formulation aids
in the management of oral erosions and ulcers caused by paraquat
ingestion. 29We recognized two clinical trials that
used Kangfuxin in the management of paraquat induced oral mucositis.
Both studies used Kangfuxin for oral care prior to the application of
the other intervention. 18 28 All
two trials reported positive outcomes in terms of reduction in oral
mucositis severity and improvement of healing time.
Tea oil (Camellia oil)
Tea oil also known as camellia oil or camellia seed oil is natural
herbal oil extracted from Camellia oleifera Abel. It has been used
through history mainly because of its anti-inflammatory and anti-oxidant
properties. Squalene, polyphenols and flavonoids present in camellia oil
have good bactericidal and anti-inflammatory effects, these effects ward
of secondary infections and also aid in the reduction of associated
pain. 30 31 32The
protective properties of camellia oil in relation to its antioxidant
activity help neutralize the excessive production of Reactive Oxygen
Species and ulcerative destruction of the already compromised mucosa
after the ingestion of paraquat. One clinical trial was recognized. The
clinical trial used tea oil as one of the ingredients in a compounded
paste preparation. 20 mls of tea oil was used in the preparation and the
paste was used 3-5 times a day. The control group only received oral
care using qingkou gargle. The results of this randomized study showed
significant difference for average number of days to mucositis
resolution or pain scores. 25
MEBO (moist exposed burn ointment)
MEBO is an herbal formulation containing b-sitosterol, baicalin, and
berberine as active ingredients in a base of beeswax and sesame oil.33 MEBO not only has analgesic and antimicrobial
effects but also has been noted to promote the formation of granulation
tissue and therefore shorten the healing duration of ulcers and wounds.
It increases gene expression of vascular endothelial growth factor and
basic fibroblast growth factor (bFGF), which help in the regulation of
angiogenesis and tissue repair. 2834 35 It can be directly applied on
the surfaces of the oral ulcers induced by paraquat or prepared into a
compounded formulation. One clinical trial used kangfuxin and MEBO for
the management of oral mucositis. The treatment group used Kangfuxin for
oral care prior to the application of MEBO that was used to adequately
cover the oral mucosa 3 times/day. The control group only used Kangfuxin
for oral care. MEBO proved to be effective alternative in the treatment
of paraquat induced oral mucositis.28
Colloidal silver (yin er tong/ activated ionized silver)
Silver and is a non-antibiotic antibacterial agent that has been used
through history for its antimicrobial effects. 36Through time, its use diminished after the discovery of penicillin and
other antibiotics. With the rising cases of antibiotic resistance, the
use of silver and other non-antibiotic antibacterial treatments have
been on the rise as an alternative for antimicrobial coverage.37Colloidal silver, silver nanoparticles and ionized
silver, exhibit a broad-spectrum antimicrobial capability against many
micro-organisms (gram-positive bacteria, gram-negative bacteria, fungi
and rhinovirus). 38 39 The
effectiveness of silver’s broad-spectrum antimicrobial capability is
attributed to ability of the silver ions in binding non-specifically to
many different targets, thus affecting bacteria in many components of
their metabolism and structure.94 One clinical trial
used yin er tong in conjunction with other interventions in the
management of oral mucositis. The treatment group received yin er tong,
recombinant human epidermal growth factor, Kangfuxin and Vit C, while
the control group received conservative management for their symptoms.
The patients were asked to gargle with 10 mls of yin er tong for 3-5
minutes for approximately 3 times a day. The treatment group was more
effective in terms of pain reduction and severity of oral
mucositis.18