PDF(Pubmed)
Abstract：
Background: Most pregnant women living in high malaria endemic regions of Nigeria use herbal remedies for the management of malaria-in-pregnancy, rather than the commonly prescribed drugs. Remedies common to this area involve a suspension of A. indica (AI) leaves and in some cases, a suspension containing a mixture of AI and D.edulis (PS). Aim: This study examined the therapeutic efficacies of AI, PS, or a combination of AI and PS in a pregnant rat model for exoerythrocytic stages of Plasmodium falciparum parasite. Method: A predetermined sample size of 30 dams was used (for a power level and confidence interval of 95%), and divided equally into six groups made up of non-malarous dams, untreated malarous dams, and malarous dams either treated exclusively with 1 mL of 3000 mg/kg b.w AI, 1000 mg/kg b.w PS, AI + PS (50% v/v), or 25 mg/kg b.w CQ. Result: No maternal mortality was recorded. AI significantly improved maternal weight gain from 32.4 to 82.2 g and placental weight from 0.44 to 0.53 g. In the curative test, AI and AI + PS significantly reduced the average percentage parasitemia (APP) in the pregnant rats from >80% to <20%. No significant difference in the APP was found between the pregnant rats treated with any of CQ or AI during the suppressive test. Results for the prophylactic test of the study groups showed that the APP was significantly reduced from 24.69% to 3.90% when treated with AI and 3.67% when combined with PS. AI + PS reduced diastolic blood pressure from 89.0 to 81.0 mm/Hg and compared with that of the non malarous dams. AI or AI + PS significantly increased the platelet counts (103 µL) from 214.1 to 364.5 and 351.2, respectively. AI and AI + PS improved birth weight from 2.5 to 3.9 g and crown rump length from 2.6 to 4.1 cm. For biomarkers of preeclampsia, combining AI and PS led to the reversal of the altered levels of creatine kinase, lactate dehydrogenase, cardiac troponin, soluble Fms-Like Tyrosine Kinase-1, and placental growth factor. Conclusions: This study validates the use of A. indica for the treatment of gestational malaria due to its antiplasmodial and related therapeutic effects and in combination with pear seeds for the management of malaria-in-pregnancy-induced preeclampsia.
摘要：
背景：大多数生活在尼日利亚疟疾高流行地区的孕妇使用草药来管理妊娠期疟疾，而不是常用的处方药。该地区常见的补救措施包括悬挂A.indica（AI）叶子，在某些情况下，含有AI和D.edulis(PS)混合物的悬浮液。目的：这项研究检查了AI的治疗效果，PS,或在恶性疟原虫寄生虫的红细胞外化阶段的妊娠大鼠模型中AI和PS的组合。方法：使用30个大坝的预定样本量（功率水平和置信区间为95％），平均分为六组，由非恶意水坝组成，未经处理的恶意水坝，和仅用1毫升3000毫克/千克b.wAI处理的恶性水坝，1000mg/kgb.wPS，AI+PS(50%v/v),或25mg/kgb.wCQ。结果：没有孕产妇死亡记录。AI显着改善母体体重增加从32.4g至82.2g，胎盘重量从0.44g至0.53g。在治疗试验中，AI和AI+PS将孕鼠中的平均寄生虫血症百分比(APP)从>80%显著降低至<20%。在抑制测试期间，用CQ或AI中的任何一种处理的妊娠大鼠之间的APP没有发现显着差异。研究组的预防性测试结果显示，当使用AI治疗时，APP从24.69％显着降低到3.90％，当与PS联合治疗时，APP从3.67％显着降低。AIPS将舒张压从89.0降至81.0mm/Hg，与非恶性水坝相比。AI或AI+PS使血小板计数（103微升）分别从214.1增加到364.5和351.2。AI和AIPS可将出生体重从2.5g提高到3.9g，将冠部臀部长度从2.6cm提高到4.1cm。对于先兆子痫的生物标志物，结合AI和PS导致肌酸激酶水平改变的逆转，乳酸脱氢酶,心肌肌钙蛋白,可溶性Fms样酪氨酸激酶-1和胎盘生长因子。结论：本研究通过抗疟药和相关治疗作用，以及与梨种子联合用于治疗妊娠性疟疾引起的先兆子痫，验证了A.ina用于治疗妊娠性疟疾。
