-IBIS-1.7.0-
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herb
Aesculus hippocastanum (Horse Chestnut)
Botanicals

definition

botanical name(s): Aesculus hippocastanum
synonyms: horse chestnut
part(s) used: seed, bark, leaves, twig bark.
qualities: astringent, pungent, cool, dry somewhat bitter
affinities: venous system, blood, liver
actions: Arterio-venous tonic; astringent, anti edemic. Anti-inflammatory, expectorant, antiviral, anti-capillary fragility,
diuretic.
dosage:
» seed tincture: (1:5 fresh, 60-100%) 0.5 - 1.2 ml TID
» bark tincture: 2 - 4 ml. TID
» standardised extracts: standardised to~ 16-20% aescin.
» specific indications: Venous insufficiency
pulse:
» heartbeat feels too close together (Wood)
therapy: Venous disease (incl. acute thrombophlebitis, contusions, varicose veins); Venous stasis (leg ulcers); Portal venous stasis; Liver swelling; Liver congestion; Constipation, Haemorrhoids; Chronic gastritis; Enteritis; Tracheitis; Prostatitis; Varicocele; Whooping cough (leaves); (seed) Intermittent fevers (bark) Lower back myalgia.
constituents:
» Flavonol glycosides (0.2-0.3% incl. kampferol-3- glucoside, -xyloside-glucoside);
» Triterpene saponins (incl. -aescin, kryptoaescin, alpha-aescin, aescinole);
» Coumarin glycosides: (incl aesculin, fraxin, scopolin)
» Other: Tannins (mainly in bark and leaves) Allantoin, amino acids.
pharmacology:
Aescin is absorbed (5-11%) by the gut. Greatest concentration in blood after 1 hour. Long lasting. Excreted by liver (via bile) and kidney.Aescin bound to albumin, thus reducing haemolysing properties of the saponin mixture.
Aescin reduces arterial, venous and capillary permeability and tones venous wall muscle wall. It is anti-inflammatory, and can increase production of glucocorticoids, and PGE2. One study showed inhibition of enzymes - glycosaminoglycan hydrolases - (which are elevated in varicose disease and cause breakdown of proteoglycans that affect capillary pre size and rigidity) Anti-inflammatory effects of whole extract greater than aescin alone (animal studies) .
clinical trials:
Several studies using proprietary standardised extract at =100mg aescin/day have confirmed the anti-edemic properties of horse chestnut extract (measurement of leg volume) over periods of 14-84 days. One single dose prophylactically can reduce foot/ankle swellling due to long haul flight caused statsis edema. Recent metastudies, e.g. Pittler, 1998, have reviewed favourably the possible applications of the herbs.

toxicity: 3;
Rare reports of poisoning (pediatric) after raw seed consumption. Excess doses can cause gastric irritation. Two reports of human nephrotoxicity.
.
contraindcations: bleeding disorders

drug interactions: Potentially due to saponin effects and reduced coagulability, Aesculus potentiates aspirin, warfarin taken for blood thinning.


footnotes

Horse-chestnut seed extract for chronic venous insufficiency. A criteria-based
systematic review. Pittler MH; Ernst E. Arch Dermatol 1998
Nov;134(11):1356-60
Abstract: OBJECTIVE: To assess the evidence for or against horse-chestnut seed extract (HCSE) as a symptomatic treatment of chronic venous insufficiency (CVI). DATA SOURCES: Computerized literature searches were performed in MEDLINE, EMBASE, BIOSIS, CISCOM, and the Cochrane Library (all from their respective institution to December 1996). The search terms were "horse chestnut," "Aesculus hippocastanum," "escin," and "Rosskastanie" (German for "horse chestnut"). There were no restrictions on the language of publication. STUDY SELECTION: Double- blind, randomized controlled trials of oral HCSE for patients with CVI were included.
Identifiers were removed from all publications before assessment. DATA
EXTRACTION: Data were extracted in a standardized, predefined manner. Trial
outcomes and the methodological quality of each trial were independently assessed
by the 2 reviewers. DATA SYNTHESIS: The superiority of HCSE is suggested by all
placebo- controlled studies. The use of HCSE is associated with a decrease of the
lower-leg volume and a reduction in leg circumference at the calf and ankle.
Symptoms such as leg pain, pruritus, and a feeling of fatigue and tenseness are
reduced. Five comparative trials against the reference medication indicate that
HCSE and O-(beta-hydroxyethyl)- rutosides are equally effective. One trial
suggests a therapeutic equivalence of HCSE and compression therapy. Adverse
effects are usually mild and infrequent. CONCLUSIONS: These data imply that HCSE
is superior to placebo and as effective as reference medications in alleviating
the objective signs and subjective symptoms of CVI. Thus, HCSE represents a
treatment option for CVI that is worth considering.