A composition of medicinal plants with hepatoprotective, choleretic and anti-inflammatory action for the use in the form of herbal tea (decoction) was developed by the author of thesis in cooperwtion with her colaborators from Nargiz Medical Center (Republic of Azerbaijan). The preparation includes medicinal plants with proven antioxidant, anti-inflammatory, choleric and cholelitic properties: knotweed (Polygonum aviculare L.), St. John's wort (Hypericum perforatum L.), calendula (Calendula officinalis L.), dandelion (Taraxacum officinale Wigg.), immortelle or cumin (Helichrysum arenarium L.), chamomile (Matricaria recutita L.) and peppermint (Mentha piperita L.). A unique additional component of the preparation is vegetable raw material of common purslane (Portulaca oleracea L.) - a plant whose exceptional property is the high content of poly unsaturated omega-3 fatty acids, which have a wide spectrum of biological action, including anti-inflammatory, antioxidant, hepatoprotective and immunomodulatory properties. Qualitative phytochemical analysis of studied phytopreparation revealed water-soluble and water-insoluble phenolic compounds, alkaloids, a significant amount of flavonoids, tannins, coumarins, cardiac glycosides and saponins. According to the results of quantitative phytochemical analysis, it was found that the concentration of tannins is 0.334 ± 0.051 mg of catechin equivalent / g of dry weight, water-insoluble and water-soluble phenolic compounds - 0.165 ± 0.027 mg of gallic acid equivalent / g of dry weight, and flavonoids - 16.114 ± 1.068 of routine equivalent / g of dry weight.
According to the results of fatty acid profiling of studied phytopreparation, it was found that the predominant polyunsaturated fatty acid is palmitic acid with a concentration of 7.04 mg / g dry weight. The second most common polyunsaturated fatty acids is stearic acid with a concentration of 2.36 mg / g dry weight. The aqueous extract of the studied phytopreparation also contains 4 polyunsaturated fatty acids: (Z, Z) -9,12-octadecadienoic (cis-linolenic) acid at a concentration of 11.46 mg / g dry weight, (Z, Z, Z) -9 , 12,15-octadecatrienic (alpha-linolenic) acid - 10,61 mg / g of dry weight, (Z) -9-octadecenoic (oleic) acid - 4,87 mg / g and a small amount of (Z) -11- octadecenoic (cis-vaccine) acid. For the first time, the distinctive feature of the fatty acid profile of vegetable raw material of purslane growing in the Tovuz-Quazakh district of the Republic of Azerbaijan was established: the presence of a small amount of palmitoleic acid - monounsaturated fatty acid, which possesses lipokine-like anti-inflammatory immunomodulating activity.
For the first time it was found that the studied composition of medicinal plants in the form of herbal tea exerts anti-inflammatory immunomodulatory effect in vivo in patients with chronic cholecystitis and minimize the manifestations of systemic inflammation regardless of age, sex and the presence or absence of cholelithiasis. Herbal tea consumption for 45 days is accompanied by normalization of biochemical indicators of liver function: reduction to reference values of elevated serum levels of cholesterol, ALT, AST and unconjugated bilibubin. A more pronounced effect of normalization of biochemical indices was registered in patients with calculous form of the disease. Hemogram parameters, which indicate the presence of a systemic inflammatory process in patients with chronic cholecystitis (leukocytosis, significantly elevated ESR, moderate leukocyte left shift) are completely normalized even after the 30 days of phytopreparation consumption.
The systemic anti-inflammatory immunomodulating effect of the studied polyherbal composition was proven by the normalization of the neutrophil-to-lymphocyte ratio, as well as by changes in the serum cytokine profile with a decrease in the concentration of interleukin 6 simultaneously with an increase in the concentration of interleukin 4.
It has been proved for the first time that the use of a polyherbal composition with hepatoprotective, choleretic and anti-inflammatory action in the form of herbal tea helps to restore exhausted patrol function of circulating neutrophils. Polyherbal tea consumption is accompanied by transitory slight elevation of the levels of total and active form of MPO in blood plasma. Normalization of laboratory parameters was accompanied by the improvements in clinical outcome in 77.6% of participants (59 patients) as was confirmed by the results of ultrasonography and patient surveys. Clinical deterioration and/or adverse effects were not detected.
