naturopathydigest.com -- Herbs to Help Healing and Repair

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Herbs to Help Healing and Repair

By Kerry Bone, BSc (hons), Dip. Phyto, FNIMH, FNHAA, MCPP

The basic response of all living organisms to damage or loss of body tissues is to initiate repair and regenerate the damaged part. So, while surgeons might claim they save the lives of their patients (and they often do), without this capacity of the body to heal itself, surgery would in fact be a death sentence.

The basic steps involved in healing are outlined below, and can be found in any textbook on pathology.
The Healing Process
There are three basic processes involved in wound healing: regeneration of damaged tissue (such as skin); regeneration of damaged connective tissue, the building block of the body, providing the structural matrix for the functional tissues; and the replacement by fibrous tissue of dead cells which cannot regenerate.
When the body is wounded, the basic sequence of events is as follows. The damaged tissue and the bleeding around it stimulate the body's inflammatory response. White blood cells, especially the macrophages, invade the damaged tissue in large numbers and begin engulfing (via phagocytosis) and processing the large amounts of debris. This usually takes several days. During this process, fine and delicate new blood vessels begin to form by the process known as angiogenesis.
These new blood vessels are now able to provide nutrition to support the next stage of healing, which is the regeneration of connective tissue. During this time, other necessary tissues, such as nerve cells and lymph vessels, begin to form.
Fibroblasts are the cells that synthesize the noncellular constituents of connec tive tissue, namely collagen (elastic fibers made from protein) and glycosaminoglycans, the jelly-like ground substance into which the collagen is embedded. With the passage of time, there is organization and remodelling of the new connective tissue, which becomes progressively denser. The zone of new dense connective tissue is a scar.
Regeneration of connective tissue is one half of wound healing; the other half is restoration of the cells which line the surfaces of tissue (epithelium). For a superficial wound, the skin cells around the margin of a wound begin to multiply and cover the gap created by the wound.
Other tissues (apart from skin) regenerate by a similar process, if they are capable of doing so. For example, bone heals in a very similar way, except that a different type of cell to the fibroblast, one that regenerates bone tissue (osteoblast) is involved.
Impairment of Wound Healing
If the scavenging phase of the macrophages is disturbed, say by infection, healing will be slow. Also, a good blood supply to the general area is essential for efficient healing. Vital nutrients such as ascorbic acid and zinc must be in adequate supply. Excess movement of the wound edges can also impair healing; this is the main reason broken limbs are placed in a cast.
Herbs to Assist Healing
The basic healing process, as outlined above, involves the following:

cleaning up of debris by immune cells (infection can slow this down);
establishing new blood vessels;
regenerating connective tissue elements;
regenerating epithelial cells.

There are herbs that can assist in all of these processes. Echinacea purpurea or angustifolia root (or their combination) will not only enhance the activity of the phagocytic cells, but also will help to prevent any complicating infection. Recent research has highlighted again the effects of Echinacea on supporting the nonspecific arm of the immune response, which is most important at this stage of healing.¹
Ginkgo will ensure that the wounded area receives an adequate blood supply, and also will help maintain the integrity of the newly-formed blood vessels.²
Bilberry is the best herb for the microcirculation, as evidenced by its positive effects on damage to the retina of the eye, so it will additionally support the role of the Ginkgo in supporting the new blood supply.³ Grape seed extract not only supports the microcirculation,^4,5 it also helps to maintain the strength of connective tissue.^6,7
Finally, gotu kola (Centella asiatica) is a significant part of the protocol to stimulate the activity of both the fibroblasts (or osteoblasts) and epithelial cells to ensure efficient regeneration and repair. It can be taken internally and/or applied topically to the healing wound.
The triterpenes in gotu kola were found to have wound healing activity in many experimental models (by injection, oral and topical administration). The mechanism of action includes the stimulation of maturation of the scar by the production of type I collagen (hence collagen synthesis) and a resulting decrease in the inflammatory reaction.⁸ The constituents of gotu kola also stimulate glycosaminoglycan production (glycosaminoglycans are the first component of the extracellular matrix to be synthesized during the wound healing process),⁹ and act specifically to shorten the immediate phase of healing.¹⁰ Aqueous extract of gotu kola, particularly as a gel formulation, may promote healing in experimental open wounds.¹¹ Oral and topical administration of gotu kola extract produces faster skin growth and a higher rate of wound contraction compared to controls.¹²
One interesting point from the lab research is that gotu kola promotes healing when taken orally. This is a significant finding. There are many herbs that can promote healing when put directly on the skin (as does gotu kola), but there are relatively few we know of that can promote healing after being absorbed into the bloodstream following ingestion. This suggests that the healing potential of gotu kola is not just confined to the skin, and this certainly is how it can be used (in other words, to promote healing in any tissue: skin, bones or other organs).
For example, oral administration of the triterpenes from gotu kola has been used successfully to treat keloids and hypertrophic scars. In a study of 227 patients, treatment with gotu kola actives for a period of two to 18 months had therapeutic value in both preventing and reducing keloids (excessive scar formation on the skin).¹³
Benefit also has been recorded in uncontrolled trials for the treatment of gastric and duodenal ulcers (the triterpenes from gotu kola, oral),^14,15 gastritis (asiaticoside, oral)¹⁶ and bladder lesions caused by infection (the triterpenes from gotu kola, injection).¹⁷ No benefit was observed in the healing of leg ulcers for patients treated with asiaticoside (by injection) compared with placebo.¹⁸ However, positive results were obtained for oral use of the triterpenes from gotu kola taken for three to eight weeks in 50 patients with leg ulcers.¹⁹
Gotu kola has been used to successfully treat leprosy patients from very early times and in more recent years in uncontrolled trials^20,21,22 and a controlled trial (gotu kola powder or asiaticoside compared to the drug diaminodiphenylsulfone over a period of one year).²³
Topical application of gotu kola (or the triterpenes from gotu kola) to the skin has been used successfully to treat a wide variety of problems, including: varicose veins (double-blind, placebo-controlled trial; the triterpenes from gotu kola),²⁴ chronic venous insufficiency (single-blind, controlled; the triterpenes from gotu kola, against oral administration of the drug tribenoside),²⁵ psoriasis (uncontrolled trial; water and oil extract of gotu kola),²⁶ leg ulcers (uncontrolled trial;²⁷ placebo-controlled trial, the triterpenes from gotu kola, injection or topical²⁸), soiled wounds resistant to other treatment (standardized gotu kola extract combined with essential oils; uncontrolled trial),²⁹ burns (topical and/or injection; uncontrolled trials; the triterpenes from gotu kola and gotu kola extract),^30,31 and cellulitis (uncontrolled trial; standardized gotu kola extract).³²
Gotu kola is best used as a 1:1 liquid extract with a defined level of triterpenes. An effective dose of such a preparation is in the range of 4 mL to 8 mL per day.
Treatment Coordination
Depending on the healing time involved, these herbs can be administered simultaneously or in sequence. For example, for a broken bone that naturally takes some time to heal, they are best taken sequentially in the order of echinacea, vascular herbs and gotu kola. Some overlap should be used; for example start with echinacea and then progress to echinacea plus the vascular herbs, then to just vascular herbs and so on. For surgical wounds (where healing is quicker) or varicose ulcers (where healing and damage are occurring on an ongoing basis), simultaneous administration is preferred.
References

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About the Author: Kerry Bone was an experienced research and industrial chemist before studying herbal medicine full-time in the U.K., where he graduated from the College of Phytotherapy and joined the National Institute of Medical Herbalists. He is a practicing herbalist; co-founder and head of Research and Development at MediHerb; and principal of the Australian College of Phytotherapy. Kerry is a regular contributor to various journals and has co-authored several books, including Principles and Practice of Phytotherapy and The Essential Guide to Herbal Safety.