Transcript THE EFFICACY OF TSAANG GUBAT (Ehretia microphylla Lam)

BUDAO, Cherry Pinky M.
BAŇAREZ, Karla Kristel A.
BAQUIRAN, Jessica Aevan U.
BASMAYOR, Edwin Marlon C.
BASTE, Charisse Liz P.
BAUTISTA, Jose Antonio L.
BEESLA, Sundeep Kaur B.
BELMONTE, Carlo Alphonso
BONDOC, Hidelisa E.
BORROMEO, Christian Leo P.
BRION, Marco Alberto C.
BUENSALIDA, Rainier John
BULAONG, Marie Veronica G.
BUMANGLAG, Niña M.
BURGO, Terence Aaron L.
BUŇAG, Mark Chester Victor T.
CACDAC, Maybelle Chris
CAMACLANG, Marie Len A.
CANADALLA, Kristine Joyce L.
CAOILI, Sylvia Nica J.
CASTILLO, Maria Carmella P.
CHAN, Jose Carlos A.
CHAVEZ, Frances Joy T.
THE EFFICACY OF
TSAANG GUBAT (Ehretia
microphylla Lam)
DECOCTION AS AN ANTIDIARRHEAL AGENT
VERSUS ATROPINE
SULFATE
GROUP 2A
INTRODUCTION
ABSTRACT

Diarrhea


↑ stool mass, ↑ stool frequency, ↑ stool
fluidity

> 200 gm/da

severe: > 14 L/da

w/o fluid resuscitation: death
increase in stool features

acute: > 2 wks

persistent: 2-4 wks

chronic: > 4 wks
PATHOGENESIS



Agents / Factors:

Escherichia coli

Campylobacter jejuni

Shigella spp.

Aeromonas spp.
side effects from medications i.e.
antibiotics, bronchodilators, antacids,
laxatives
assoc DO: lactose intolerance, IBS
PATHOGENESIS

Other Assoc'ns

ingestion of poisonous substances e.g.
organophosphate insecticides

amanita and other mushrooms

arsenic cpds

preformed environmental toxins
APPROACH TO DIARRHEA

fluid and electrolyte replacement




oral rehydration solutions : replace lost
fluids
antibiotics : elimination of any causative
agent
elimination of dietary lactose :
suppressing the underlying mechanism
mild opiate i.e. Loperamide® : cases of
mild to moderate diarrhea
LOCAL HERBAL MEDICATIONS

primary health care

increasing cost

found to be effective in tx of common
ailments attested by the NSDB

advocated by the DOH

“Tsaang Gubat”

Ehretia microphylla Lam.

tx: diarrhea, stomachache
BACKGROUND OF THE STUDY



to determine the efficacy of “Tsaang Gubat” as an
alternative anti-diarrheal drug
tested along with Atropine Sulfate and Normal Saline
Solution
“Tsaang Gubat” as effective as Atropine, as a very good
alt drug for diarrheal cases in poverty-stricken
communities due to lack of funds for purchasing
expensive anti-diarrheal drugs
STATEMENT OF THE PROBLEM




Philippines is the second largest contributor to diarrhea
morbidity in the world, next to China.
DOH and UNICEF:

over 70,000 Filipino children die

span of 7 years
WHO:

fourth leading cause of death among children ≤ 4 y.o.

third leading cause of death among Filipino children
Philippines ranks second among 13 countries with most
number of diarrhea cases
OBJECTIVE

to determine the effectiveness of Tsaang Gubat, one of
the 10 herbal medicines launched by the DOH as an antidiarrheal medication, compared to the standard drug,
Atropine
1) By using the test drug Tsaang Gubat, was the distance
travelled by the charcoal meal shortened?
2) Is Tsaang Gubat for treatment of diarrhea?
3) Is Tsaang Gubat as effective as the standard drug,
Atropine, for the treatment of diarrhea?
SIGNIFICANCE OF THE STUDY




trend of utilizing medicinal plants from treating common
ailments (e.g. colds) to extreme cases (e.g. cancer)
more scientific tests conducted to verify the efficacy
commonly advocated by our forefathers and our
neighborhood albularios
government introduced several programs aimed at
promoting and further developing this to bolster the
health care sector
SIGNIFICANCE OF THE STUDY

Tsaang Gubat




one of the herbal medicines listed in “Sampung
Halamang Gamot” program in the early 1990's
shrub commonly found in the Philippines
endorsed as anti-spasmodic for abdominal pains and
for other GI DO (diarrhea, dysentery)
listed in the BFAD as medicinal plant
SCOPE AND LIMITATION




limited to the effects of the medicinal plant in decreasing
intestinal motility = beneficial of diarrhea or LBM
no other forms of treatment for diarrhea or LBM have
been included
Normal Saline Solution has no known effect on GI
motility
Atropine is a known muscarinic (cholinergic) blocker =
inhibits GI motility
SCOPE AND LIMITATION (con't)


starved mice of the same sex and about the same weight
as subjects = prevent bias d/t diff in sex and wt
starvation so as not to affect drug absorption and prevent
any obstruction in the GIT for the charcoal sol'n
SCHEMATIC DIAGRAM
METHODOLOGY


% distance travelled as indicator of antidiarrheal activity
parameter measured is the length of the
small intestine travelled by the charcoal
METHODOLOGY



Male and female albino mice obtained from UERM
day prior to the expt, mice were placed in wire meshed
cages, given standard pellet diet and water
experimentation carried out accdg to the IAEC
guidelines

mice were weighed and labeled for proper ID

divided into three groups:

Positive Control (Atropine Sulfate)

Negative Control (Normal Saline Solution)

Test Drug (“Tsaang Gubat”)
METHODOLOGY (con't)




9 mice in total; 3 mice per group
Negative control: Normal Saline Solution via gavage 0.5
mL/kg orally
Positive control: Atropine Sulfate via gavage 10mg/kg
Test drug: Ehretia microphylla Lam. (Tsaang Gubat”)
extract via gavage 10g/kg orally
METHODOLOGY (con't)

Charcoal sol'n



10 gm charcoal mixed with 100 mL castor oil
20 mL of charcoal-castol oil suspension then mixed
with 10 mL coconut oil
suspension stirred constantly to obtain uniform
suspension
METHOLODOGY (con't)


2 kg dried leaves of “Tsaang Gubat” chopped into small
pieces, consequently boiled in 1L of distilled water for 8
hrs
boiled after filtering using filter paper, collected in a
beaker

repeated twice until dark-brown extract was obtained

refrigerated for 1 hr prior to the expt
METHODOLOGY

ANIMATION OF METHODOLOGY
COLLECTION OF DATA

20 mins after, mice were sacrificed

intestines were excised (from pylorum to cecum)


distance travelled by activated charcoal measured and
recorded corresponding to the different doses
administered
total length was also measured
Percentage Distance = Activated charcoal___
Total length of intestine
X 100
ANALYSIS OF DATA

weight of the rat

dose of drug administered

length of intestine

charcoal distance

length of the small intestine travelled by the charcoal
percent of distance travelled
= Length travelled by activated charcoal x 100
total length of intestine
RESULTS AND DISCUSSION
RESULTS AND DISCUSSION
Table 1.0. Mean and Standard Deviation of the Percentage of Distance
Travelled by Charcoal with administration of Atropine and Normal
Saline Solution
Group Statistics
Distance Travelled by Charcoal
DISTRA
DRUGS
atropin
NSS
N
18
18
Mean
23.2267
46.6561
Std. Deviation
23.85315
22.05226
Std. Error
Mean
5.62224
5.19777
RESULTS AND DISCUSSION
Table 2.0. T-test Values for the Individual Samples in the Positive Control
Group and the Negative Control Group
Independent Samples Test
Levene's Test for
Equality of Variances
F
DISTRA
Equal variances
assumed
Equal variances
not assumed
.249
Sig.
.621
t-test for Equality of Means
t
df
Sig. (2-tailed)
Mean
Difference
Std. Error
Difference
95% Confidence
Interval of the
Difference
Lower
Upper
-3.060
34
.004
-23.4294
7.65679
-38.98991
-7.86898
-3.060
33.793
.004
-23.4294
7.65679
-38.99343
-7.86546
RESULTS AND DISCUSSION
Table 3.0. Mean and Standard Deviation of the Percentage of Distance
Travelled by Charcoal with administration of Tsaang Gubat and
Normal Saline Solution
Group Statistics
Distance Travelled by Charcoal
DISTRA
DRUGS
tsaang
NSS
N
18
18
Mean
31.3539
46.6561
Std. Deviation
15.68023
22.05226
Std. Error
Mean
3.69587
5.19777
Independent Samples Test
Levene's Test for
Equality of Variances
F
DISTRA
Equal variances
assumed
Equal variances
not assumed
1.313
Sig.
.260
t-test for Equality of Means
t
df
Sig. (2-tailed)
Mean
Difference
Std. Error
Difference
95% Confidence
Interval of the
Difference
Lower
Upper
-2.399
34
.022
-15.3022
6.37779 -28.26345
-2.34099
-2.399
30.690
.023
-15.3022
6.37779 -28.31513
-2.28931
Group Statistics
Distance Travelled by Charcoal
DISTRA
DRUGS
tsaang
atropin
N
18
18
Mean
31.3539
23.2267
Std. Deviation
15.68023
23.85315
Std. Error
Mean
3.69587
5.62224
Independent Samples Test
Levene's Test for
Equality of Variances
F
DISTRA
Equal variances
assumed
Equal variances
not assumed
3.028
Sig.
.091
t-test for Equality of Means
t
df
Sig. (2-tailed)
Mean
Difference
Std. Error
Difference
95% Confidence
Interval of the
Difference
Lower
Upper
1.208
34
.235
8.1272
6.72823
-5.54618
21.80062
1.208
29.381
.237
8.1272
6.72823
-5.62581
21.88025
RESULTS AND DISCUSSION



Mouse 1: 10 cm distance (27% of the total intestinal
length of 36 cm)
Mouse 2: 12 cm distance (30% of the total intestinal
length of 40 cm)
Mouse 3: 18 cm distance (50% of the total intestinal
length of 36 cm)
RESULTS AND DISCUSSION
Treatment
Atropine Sulfate
Norrmal Saline Solution
Tsaang Gubat
Dose
10 mg/kg
0.5 mL/kg
10 g/kg
% Distance Traveled
27.7
30
50
CONCLUSION

Negative Ctrl Grp (NSS)



isotonic solution; same conc as body cells; N
physiologic conditions in the intestine
ACTUAL: shorter % distance travelled in the
intestine
THEORETICAL: longer % distance travelled in the
intestine

Atropine Sulfate


antimuscarinic / anticholinergic agent
competitive antagonist of Ach on the muscarinic
receptor

↓ GI motility & secretion

ACTUAL: longer % distance travelled in the intestines

THEORETICAL: shorter % distance travelled in the
intestine
RECOMMENDATIONS
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