zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2009-6-4-6zdor-880Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEПРЕПАРАТЫ РАСТОРОПШИ: МЕХАНИЗМЫ ДЕЙСТВИЯ И ПРИМЕНЕНИЕ ПРИ ЗАБОЛЕВАНИЯХ ПЕЧЕНИHETRBAL PREPARATIONS FROM MILK THISTLE: MECHANISMS OF ACTION AND APPLICATION IN LIVER DISEASESБрельЮ. И.BrelY. I.noemail@neicon.ruЛызиковА. Н.LyzikovA. A.noemail@neicon.ruПиткевичЭ. С.PitkevichE. S.noemail@neicon.ruГомельский государственный медицинский университетGomel State Medical University200928122009043642Copyright © Брель Ю.И., Лызиков А.Н., Питкевич Э.С., 20092009Брель Ю.И., Лызиков А.Н., Питкевич Э.С.Brel Y.I., Lyzikov A.A., Pitkevich E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/880

Препараты расторопши пятнистой обладают выраженными гепатопротекторными свойствами. В настоящее время рост интереса к данному лекарственному растению связан как с увеличением распространенности различных форм патологии печени, так и с открытием новых свойств его действующих компонентов. Предлагаемый обзор содержит информацию о фармакологии, механизме действия, эффективности применения препаратов расторопши при заболеваниях печени и демонстрирует возможности их использования при других патологических состояниях.

Herbal preparations from Milk Thistle possess documented hepatoprotective properties. Nowadays the increase of interest to this herbal drug is connected with the prevalence of different forms of liver pathology and with the discovery of new properties of its active components. This review contains information on pharmacology, mechanism of action, efficiency of Milk Thistle preparations applications in liver diseases and demonstrates possibilities of their using in other pathological states.

расторопша пятнистаясилимарингепатопротекторные свойствагепатитцирроз печениMilk Thistlesilymarinhepatoprotective propertieshepatitisliver cirrhosisReferencesPharmacology of Silymarin / F. Fraschini [et al.] // Clin. Drug Invest. - 2002. - Vol. 22, № 1. - P. 51-65.Pharmacology of Silymarin / F. Fraschini [et al.] // Clin. Drug Invest. - 2002. - Vol. 22, № 1. - P. 51-65.Silymarin treatment of viral hepatitis: a systematic review / K. E. Mayer [et al.] // Journal of Viral Hepatitis. - 2005. - Vol. 12. - P. 559-567.Silymarin treatment of viral hepatitis: a systematic review / K. E. Mayer [et al.] // Journal of Viral Hepatitis. - 2005. - Vol. 12. - P. 559-567.Kren, V. Silybin And Silymarin - new effects and applications / V. Kren, D. Walterova // Biomed. Papers. - 2005. - Vol. 149, № 1. - P. 29-41.Kren, V. Silybin And Silymarin - new effects and applications / V. Kren, D. Walterova // Biomed. Papers. - 2005. - Vol. 149, № 1. - P. 29-41.Pharmacokinetic studies with silymarin in human serum and bile / D. Lorenz [et al.] // Methods Find. Exp. Clin. Pharmacol. - 1984. - Vol. 6, № 10. - P. 655-661.Pharmacokinetic studies with silymarin in human serum and bile / D. Lorenz [et al.] // Methods Find. Exp. Clin. Pharmacol. - 1984. - Vol. 6, № 10. - P. 655-661.Pradhan, S. C. Hepatoprotective herbal drug, silymarin from experimental pharmacology to clinical medicine / S. C. Pradhan, C. Girish // Indian J. Med. Res. - 2006. - Vol. 124, № 5. - P. 491-504.Pradhan, S. C. Hepatoprotective herbal drug, silymarin from experimental pharmacology to clinical medicine / S. C. Pradhan, C. Girish // Indian J. Med. Res. - 2006. - Vol. 124, № 5. - P. 491-504.Effect of free radical scavengers on superoxide dismutase (SOD) enzyme in patients with alcoholic cirrhosis / J. Feher [et al.] // Acta Medica Hungarica. - 1988. - Vol. 45, № 3/4. - P. 265-276.Effect of free radical scavengers on superoxide dismutase (SOD) enzyme in patients with alcoholic cirrhosis / J. Feher [et al.] // Acta Medica Hungarica. - 1988. - Vol. 45, № 3/4. - P. 265-276.Silybin dihemisuccinate protects against glutathione depletion and lipid peroxidation induced by acetaminophen on rat liver / R. Campos [et al.] // Planta Med. - 1989. - Vol. 55, № 5. - P. 417-419.Silybin dihemisuccinate protects against glutathione depletion and lipid peroxidation induced by acetaminophen on rat liver / R. Campos [et al.] // Planta Med. - 1989. - Vol. 55, № 5. - P. 417-419.Sonnenbichler, J. Mechanism of action of silibinin. V. Effect of silibinin on the synthesis of ribosomal RNA, mRNA and tRNA in rat liver in vivo / J. Sonnenbichler, I. Zetl // Hoppe Seylers Z Physiol. Chem. - 1984. - Vol. 365, № 5. - P. 555-566.Sonnenbichler, J. Mechanism of action of silibinin. V. Effect of silibinin on the synthesis of ribosomal RNA, mRNA and tRNA in rat liver in vivo / J. Sonnenbichler, I. Zetl // Hoppe Seylers Z Physiol. Chem. - 1984. - Vol. 365, № 5. - P. 555-566.Inhibition of Kupffer cells as an explanation for the hepatoprotective properties of silibinin / C. Dehmlow [et al.] // Hepatology. - 1996. - Vol. 24, № 4. - P. 749-754.Inhibition of Kupffer cells as an explanation for the hepatoprotective properties of silibinin / C. Dehmlow [et al.] // Hepatology. - 1996. - Vol. 24, № 4. - P. 749-754.Selective inhibition of NF-kB activation by the flavonoid hepatoprotector silymarin in HepG2. Evidence for different activating pathways / C. Saliou [et al.] // FEBS Lett. - 1998. - Vol. 440. - P. 8-12.Selective inhibition of NF-kB activation by the flavonoid hepatoprotector silymarin in HepG2. Evidence for different activating pathways / C. Saliou [et al.] // FEBS Lett. - 1998. - Vol. 440. - P. 8-12.Effects of silibinin and of a synthetic analogue on isolated rat hepatic stellate cells and myofibroblasts / E. C. Fuchs [et al.] // Arzneimittelforschung. - 1997. - Vol. 47, № 12. - P. 1383-1387.Effects of silibinin and of a synthetic analogue on isolated rat hepatic stellate cells and myofibroblasts / E. C. Fuchs [et al.] // Arzneimittelforschung. - 1997. - Vol. 47, № 12. - P. 1383-1387.Characterization of a transporting system in rat hepatocytes: studies with competitive and noncompetitive inhibitors of phalloidin transport / K. Munter [et al.] // Biochem. Biophys. Acta. - 1986. - Vol. 860, № 1. - P. 91-98.Characterization of a transporting system in rat hepatocytes: studies with competitive and noncompetitive inhibitors of phalloidin transport / K. Munter [et al.] // Biochem. Biophys. Acta. - 1986. - Vol. 860, № 1. - P. 91-98.Silymarin: potent inhibitor of cyclic AMP phosphodiesterase / H. P. Koch [et al.] // Methods Find. Exp. Clin. Pharmacol. - 1985. - Vol. 7, № 8. - P. 409-413.Silymarin: potent inhibitor of cyclic AMP phosphodiesterase / H. P. Koch [et al.] // Methods Find. Exp. Clin. Pharmacol. - 1985. - Vol. 7, № 8. - P. 409-413.Antiproliferative and apoptotic effects of silibinin in rat prostate cancer cells / A. Tyagi [et al.] // Prostate. - 2002. - Vol. 153, № 3. - P. 211-217.Antiproliferative and apoptotic effects of silibinin in rat prostate cancer cells / A. Tyagi [et al.] // Prostate. - 2002. - Vol. 153, № 3. - P. 211-217.Antitumour activity of the silybin-phosphatidylcholine complex IdB 1016, against human ovarian cancer / D. Gallo [et al.] // Eur. J. Cancer. - 2003. - Vol. 39. - P. 2403-2410.Antitumour activity of the silybin-phosphatidylcholine complex IdB 1016, against human ovarian cancer / D. Gallo [et al.] // Eur. J. Cancer. - 2003. - Vol. 39. - P. 2403-2410.Anticancer potential of silymarin: from bench to bed side / R. Agarwal [et al.] // Anticancer Res. - 2006. - Vol. 26, № 6B. - P. 4457-4498.Anticancer potential of silymarin: from bench to bed side / R. Agarwal [et al.] // Anticancer Res. - 2006. - Vol. 26, № 6B. - P. 4457-4498.The flavonoid silibinin decreases glucose-6-phosphate hydrolysis in perfused rat hepatocytes by an inhibitory effect on glucose-6-phosphatase / B. Guigas [et al.] // Cell Physio. Biochem. - 2007. - Vol. 20, № 6. - P. 925-934.The flavonoid silibinin decreases glucose-6-phosphate hydrolysis in perfused rat hepatocytes by an inhibitory effect on glucose-6-phosphatase / B. Guigas [et al.] // Cell Physio. Biochem. - 2007. - Vol. 20, № 6. - P. 925-934.Skottova, N. Silymarin as a potential hypocholesterolaemic drug / N. Skottova, V. Kreeman // Physiol Res. - 1998. - Vol. 47. - P. 1-7.Skottova, N. Silymarin as a potential hypocholesterolaemic drug / N. Skottova, V. Kreeman // Physiol Res. - 1998. - Vol. 47. - P. 1-7.Silymarin protects dopaminergic neurons against lipopolysaccharide-induced neurotoxicity by inhibiting microglia activation / M. J Wang [et al.] // Eur. J. Neurosci. - 2002. - Vol. 16. - P. 2103-2112.Silymarin protects dopaminergic neurons against lipopolysaccharide-induced neurotoxicity by inhibiting microglia activation / M. J Wang [et al.] // Eur. J. Neurosci. - 2002. - Vol. 16. - P. 2103-2112.Jung, H. J. Synergistic antibacterial effect between silybin and N,N'-dicyclohexylcarbodiimide in clinical Pseudomonas aeruginosa isolates / H. J. Jung, D. G. Lee // J. Microbiol. - 2008. - Vol. 46, № 4. - P. 462-467.Jung, H. J. Synergistic antibacterial effect between silybin and N,N'-dicyclohexylcarbodiimide in clinical Pseudomonas aeruginosa isolates / H. J. Jung, D. G. Lee // J. Microbiol. - 2008. - Vol. 46, № 4. - P. 462-467.In vitro antimalarial activity of flavonoid derivatives dehydrosilybin and 8-(1;1)-DMA-kaempferide / De F. Monbrison [et al.] // Acta Trop. - 2006. - Vol. 97, № 1. - P. 102-107.In vitro antimalarial activity of flavonoid derivatives dehydrosilybin and 8-(1;1)-DMA-kaempferide / De F. Monbrison [et al.] // Acta Trop. - 2006. - Vol. 97, № 1. - P. 102-107.Ethanol elimination in man under influence of hepatoprotective silibinin / M. Varga [et al.] // Blutalkohol. - 1991. - Vol. 28, № 6. - P. 405-408.Ethanol elimination in man under influence of hepatoprotective silibinin / M. Varga [et al.] // Blutalkohol. - 1991. - Vol. 28, № 6. - P. 405-408.Liver protective action of silymarin therapy in chronic alcoholic liver diseases / I. Feher [et al.] // Orv. Hetil. - 1989. - Vol. 130. - P. 2723-2727.Liver protective action of silymarin therapy in chronic alcoholic liver diseases / I. Feher [et al.] // Orv. Hetil. - 1989. - Vol. 130. - P. 2723-2727.Salmi, H. A. Effects of silymarin on chemical, functional and morphological alterations of the liver. A double-blind controlled study / H. A. Salmi, S. Sarna // Scand. J. Gastroenterol. - 1982. - Vol. 17. - P. 517-521.Salmi, H. A. Effects of silymarin on chemical, functional and morphological alterations of the liver. A double-blind controlled study / H. A. Salmi, S. Sarna // Scand. J. Gastroenterol. - 1982. - Vol. 17. - P. 517-521.Effects of silymarin MZ-80 on oxidative stress in patients with alcoholic cirrhosis Results of a randomized, double-blind, placebo-controlled clinical study / M. I. Lucena [et al.] // Int. J. Clin. Pharmacol. Therapeut. - 2002. - Vol. 40, № 1. - P. 2-8.Effects of silymarin MZ-80 on oxidative stress in patients with alcoholic cirrhosis Results of a randomized, double-blind, placebo-controlled clinical study / M. I. Lucena [et al.] // Int. J. Clin. Pharmacol. Therapeut. - 2002. - Vol. 40, № 1. - P. 2-8.Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver / P. Ferenci [et al.] // J. Hepatol. - 1989. - Vol. 9, № 1. - P. 105-113.Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver / P. Ferenci [et al.] // J. Hepatol. - 1989. - Vol. 9, № 1. - P. 105-113.Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial / A. Pares [et al.] // J. Hepatol. - 1998. - Vol. 28, № 4. - P. 615-621.Effects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial / A. Pares [et al.] // J. Hepatol. - 1998. - Vol. 28, № 4. - P. 615-621.Protection by silibinin against Amanita phalloides intoxication in beagles / G. Vogel [et al.] // Toxicol. Appl. Pharmacol. - 1984. - Vol. 73. - P. 355-362.Protection by silibinin against Amanita phalloides intoxication in beagles / G. Vogel [et al.] // Toxicol. Appl. Pharmacol. - 1984. - Vol. 73. - P. 355-362.Treatment of amatoxin poisoning: 20-year retrospective analysis / F. Enjalbert [et al.] // J. Toxicol. Clin. Toxicol. - 2002. - Vol. 40, № 6. - P. 715-757.Treatment of amatoxin poisoning: 20-year retrospective analysis / F. Enjalbert [et al.] // J. Toxicol. Clin. Toxicol. - 2002. - Vol. 40, № 6. - P. 715-757.Chemotherapy of Amanita phalloides poisoning with intravenous silibinin / K. Hruby [et al.] // Hum. Toxicol. - 1983. - Vol. 2, № 2. - P. 183-195.Chemotherapy of Amanita phalloides poisoning with intravenous silibinin / K. Hruby [et al.] // Hum. Toxicol. - 1983. - Vol. 2, № 2. - P. 183-195.Results of a double blind study on the effect of silymarin in the treatment of acute viral hepatitis, carried out at two medical centres / E. Magliulo [et al.] // Med. Klin. - 1978. - Vol. 73, № 28/29. - P. 1060-1065.Results of a double blind study on the effect of silymarin in the treatment of acute viral hepatitis, carried out at two medical centres / E. Magliulo [et al.] // Med. Klin. - 1978. - Vol. 73, № 28/29. - P. 1060-1065.Therapeutic effect of silipide in patients with chronic hepatitis C non-responders (NTs) to interferon (IFN) treatment / G. Buzzelli [et al.] // J. Hepatol. - 1994. - Vol.21, № 1. - P. 100.Therapeutic effect of silipide in patients with chronic hepatitis C non-responders (NTs) to interferon (IFN) treatment / G. Buzzelli [et al.] // J. Hepatol. - 1994. - Vol.21, № 1. - P. 100.A pilot study on the liver protective effect of silybin-phosphatidylcholine complex (IdB1016) in chronicactive hepatitis / G. Buzzelli [et al.] // Int. J. Clin. Pharmacol. Ther Toxicol. - 1993. - Vol. 31, № 9. - P. 456-460.A pilot study on the liver protective effect of silybin-phosphatidylcholine complex (IdB1016) in chronicactive hepatitis / G. Buzzelli [et al.] // Int. J. Clin. Pharmacol. Ther Toxicol. - 1993. - Vol. 31, № 9. - P. 456-460.Randomized open study of the dose-effect relationship of a short course of IdB 1016 in patients with viral or alcoholic hepatitis / A. Vailati [et al.] // Fitoterapia. - 1993. - Vol. 64, № 3. - P. 219-228.Randomized open study of the dose-effect relationship of a short course of IdB 1016 in patients with viral or alcoholic hepatitis / A. Vailati [et al.] // Fitoterapia. - 1993. - Vol. 64, № 3. - P. 219-228.Treatment with silybin-vitamin E-phospholipid complex in patients with hepatitis C infection / K. Falasca [et al.] // J. Med. Virol. - 2008. - Vol. 80, № 11. - P. 1900-1906.Treatment with silybin-vitamin E-phospholipid complex in patients with hepatitis C infection / K. Falasca [et al.] // J. Med. Virol. - 2008. - Vol. 80, № 11. - P. 1900-1906.

The authors declare that there are no conflicts of interest present.