Use of phytotherapy in treating diabetic foot in older adults: an integrative review

José Mateus Pires; Gabriella Farias Lopes; Caroline Ribeiro de Sousa; Francisco Gerlai Lima Oliveira; Rodrigo Lopes de Paula Souza; Janaína Fonseca Victor Coutinho; Marília Braga Marques

doi:10.15253/2175-6783.20232485110

Authors

José Mateus Pires Universidade Federal do Ceará https://orcid.org/0000-0003-4176-6291
Gabriella Farias Lopes Universidade Federal do Ceará https://orcid.org/0000-0002-5767-5055
Caroline Ribeiro de Sousa Universidade Federal do Ceará https://orcid.org/0000-0003-2998-9214
Francisco Gerlai Lima Oliveira Universidade Federal do Ceará https://orcid.org/0000-0002-2887-2631
Rodrigo Lopes de Paula Souza Universidade Federal do Ceará https://orcid.org/0000-0001-8634-2383
Janaína Fonseca Victor Coutinho Universidade Federal do Ceará https://orcid.org/0000-0001-7451-0132
Marília Braga Marques Universidade Federal do Ceará https://orcid.org/0000-0002-7483-1435

DOI:

https://doi.org/10.15253/2175-6783.20232485110

Keywords:

Nursing; Diabetes Mellitus; Health of the Elderly; Diabetic Foot; Phytotherapy.

Abstract

Objective: to identify the scientific evidence on herbal medicines used in treating diabetic foot in older adults. Methods: an integrative review conducted in the Medical Literature Analysis and Retrieval System, SCOPUS, EMBASE, Web of Science and Latin American and Caribbean Health Sciences Literature databases. The Rayyan platform was used as a supporting tool for archiving, organizing and selecting articles. Results: the search resulted in 158 articles. After identifying, selecting, evaluating eligibility, systematization and performing a full reading of the articles, the final sample consisted of 10 articles. We identified herbal medicines derived from Calendula officinalis, Ageratina pichinchensis, Phellodendron chinense, Curcumin phytosome, Capsicum spp., Rehmannia Glutinosa and Astragalus membranaceus. Conclusion: investigations of herbal compounds derived from four plants used in treating diabetic foot in older adults predominated. Considerations for practice: supported by legislation, nurses can guide users interested in using phytotherapy as an accessible solution with proven efficacy.

References

International Diabetes Federation. IDF diabetes atlas [Internet]. 2021 [cited May 13, 2023]. Available from: https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf

Cobas R, Rodacki M, Giacaglia L, Calliari L, Noronha R, Valerio C, et al. Diagnóstico do diabetes e rastreamento do diabetes tipo 2. Diretriz Oficial da Sociedade Brasileira de Diabetes. 2022. doi: https://doi.org/10.29327/557753.2022-2

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. doi: https://doi.org/10.1016/j.diabres.2021.109119

Sacco ICN, Lucovéis MLS, Thuler SR, Parisi MCR. Diagnóstico e prevenção de úlceras no pé diabético. Diretriz Oficial da Sociedade Brasileira de Diabetes [Internet]. 2022 [cited May 17, 2023]. Available from: https://diretriz.diabetes.org.br/diagnostico-e-prevencao-de-ulceras-no-pe-diabetico-2/#citacao

Sergio FR, Silveira IA, Oliveira BGRB. Clinical evaluation of patients with leg ulcers attended in outpatient clinic. Esc Anna Nery. 2021;25(1):e20200139. doi: https://dx.doi.org/10.1590/2177-9465-EAN-2020-0139

Barbosa A, Franzolim RAF, Oliveira PG, Castilho JC. Percepção dos enfermeiros na terapia de feridas: tratamento e coberturas. Rev Feridas. 2020;8(40):1447-53. doi: https://dx.doi.org/10.36489/feridas.2020v8i40p1447-14533

Alves ASAM, Cavalcante FS, Lima RA. As plantas medicinais no tratamento de feridas: uma revisão bibliográfica do ponto de vista da Enfermagem. Rev Educ Amazônia [Internet]. 2021 [cited Mar 6, 2023];13(2):127-41. Available from: https://periodicos.ufam.edu.br/index.php/educamazonia/article/view/9095

Carvalho LN, Andrade LL, Sousa ATO, Lima JAP. Tratamento convencional e fitoterápico de lesões crônicas em um ambulatório: comparação de custos. Rev Enferm Atual In Derme. 2019;88(26):1-7. doi: http://doi.org/10.31011/reaid-2019-v.88-n.26-art.147

Choudhury A, Singh PA, Bajwa N, Dash S, Bisht P. Pharmacovigilance of herbal medicines: concerns and future prospects. J Ethnopharmacol. 2023;309:116383. doi: http://doi.org/10.1016/j.jep.2023.116383

Ferreira ET, Santos ES, Monteiro JS, Gomes MSM, Menezes RAO, Souza MJC. A utilização de plantas medicinais e fitoterápicos: uma revisão integrativa sobre a atuação do enfermeiro. Braz J Health Rev [Internet]. 2019 [cited Mar 6, 2023];2(3):1511-23. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/1383

Souza MT, Silva MD, Carvalho R. Integrative review: what is it? How to do it?. Einstein. 2010;8(1):102-6. doi: https://doi.org/10.1590/S1679-45082010RW1134

Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016;5:210. doi: https://doi.org/10.1186/s13643-016-0384-4

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372(71):1-9. doi: https://doi.org/10.1136/bmj.n71

Forst T, Pohlmann T, Kunt T, Goitom K, Schulz G, Löbig M, et al. The influence of local capsaicin treatment on small nerve fibre function and neurovascular control in symptomatic diabetic neuropathy. Acta Diabetol. 2002;39(1):1-6. doi: https://doi.org/10.1007/s005920200005

Appendino G, Belcaro G, Cornelli U, Luzzi R, Togni S, Dugall M, et al. Potential role of curcumin phytosome (Meriva) in controlling the evolution of diabetic microangiopathy. A pilot study. Panminerva Med [Internet]. 2011 [cited Mar 3, 2023];53(3 suppl 1):43-9. Available from: https://pubmed.ncbi.nlm.nih.gov/22108476/

Li S, Zhao J, Liu J, Xiang F, Lu D, Liu B, et al. Prospective randomized controlled study of a Chinese herbal medicine compound Tangzu Yuyang Ointment for chronic diabetic foot ulcers: a preliminary report. J Ethnopharmacol. 2011;133(2):543-50. doi: https://doi.org/10.1016/j.jep.2010.10.040

Ko CH, Yi S, Ozaki R, Cochrane H, Chung H, Lau W, et al. Healing effect of a two-herb recipe (NF3) on foot ulcers in Chinese patients with diabetes: a randomized double-blind placebo-controlled study. J Diabetes. 2014;6(4):323-34. doi: https://doi.org/10.1111/1753-0407.12117

Romero-Cerecero O, Zamilpa A, Díaz-García ER, Tortoriello J. Pharmacological effect of Ageratina pichinchensis on wound healing in diabetic rats and genotoxicity evaluation. J Ethnopharmacol. 2014;156:222-7. doi: https://doi.org/10.1016/j.jep.2014.09.002

Buzzi M, Freitas F, Winter MB. Pressure ulcer healing with Plenusdermax® Calendula officinalis L. extract. Rev Bras Enferm. 2016;69(2):230-6. doi: https://doi.org/10.1590/0034-7167.2016690207i

Carvalho AFM, Feitosa MCP, Coelho NPMF, Rebêlo VCN, Castro JG, Sousa PRG, et al. Low-level laser therapy and Calendula officinal is in repairing diabetic foot ulcers. Rev Esc Enferm USP. 2016;50(4):626-32. doi: http://doi.org/10.1590/S0080-623420160000500013

Musharraf MU, Ahmad Z, Yaqub Z. Comparison of topical capsaicin and topical turpentine Oil for treatment of painful diabetic neuropathy. J Ayub Med Coll Abbottabad [Internet]. 2017 [cited Mar 3, 2023];29(3):384-87. Available from: https://pubmed.ncbi.nlm.nih.gov/29076666/

Liu Y, Li Y, Du Y, Huang T, Zhu C. Multicenter clinical trials analyzing efficacy and safety of topical cortex phellodendri compound fluid in treatment of diabetic foot ulcers. Med Sci Monit. 2020;26:e923424. doi: https://doi.org/10.12659/MSM.923424

Mokhtari M, Razzaghi R, Momen‐Heravi M. The effects of curcumin intake on wound healing and metabolic status in patients with diabetic foot ulcer: a randomized, double-blind, placebo-controlled trial. Phytother Res. 2021;35(4):2099-107. doi: https://doi.org/10.1002/ptr.6957

Martins A, Bezerra JNA. Ensino de práticas integrativas em saúde em uma universidade pública do Amazonas: incluindo a medicina tradicional Chinesa na formação de médicos, enfermeiros e odontólogos. Braz J Health Rev. 2020;3(5):12129-38. doi: https://doi.org/10.34119/bjhrv3n5-060

Tomchinsky B, Ming LC. As plantas comestíveis no Brasil dos séculos XVI e XVII segundo relatos de época. Rodriguésia. 2019;70:e03792017. doi: https://doi.org/10.1590/2175-7860201970040

Sousa IJO, Araújo S, Negreiros PS, França ARS, Rosa GS, Negreiros FS, et al. A diversidade da flora brasileira no desenvolvimento de recursos de saúde. Uningá Rev [Internet]. 2017 [cited Mar 20, 2023];31(1):35-9. Available from: https://www.mastereditora.com.br/periodico/20170803_155440.pdf

AshwlayanVD, Kumar A, Verma M, Garg VK, Gupta SK. Therapeutic potential of calendula officinalis. Pharm Pharmacol Int J. 2018;6(2):149-55. https://doi.org/10.15406/ppij.2018.06.00171

Li M, Jiang H, Hao Y, Du K, Du H, Ma C, et al. A systematic review on botany, processing, application, phytochemistry and pharmacological action of Radix Rehmnniae. J Ethnopharmacol. 2022;285:114820. doi: https://dx.doi.org/10.1016/j.jep.2021.114820

Ramalho MP, Santos SLF, Castro NM, Vasconcelos LMO, Morais ICO, Pessoa CV. Plantas medicinais no processo de cicatrização de feridas: revisão de literatura. Rev Expr Catól Saúde. 2018;3(2):64-70. doi: https://doi.org/10.25191/recs.v3i2.2429

Schaper NC, Netten JJ, Apelqvist J, Bus SA, Hinchliffe RJ, Lipsky BA. Practical guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update). Diabetes Metab Res Rev. 2020;36(Suppl 1):e3266. doi: https://doi.org/10.1002/dmrr.3266

Lima SQF, Oliveira VB. Uso de plantas medicinais por idosos de uma unidade de saúde em São José dos Pinhais – PR. Rev Bras Prat Int Comp Saúde [Internet]. 2021 [cited Feb 27, 2023];1(1):84-96. Available from: https://www.revistasuninter.com/revistasaude/index.php/revista-praticas-interativas/article/view/1237