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EFFECT OF HYPERURICEMIA HERBS FORMULA ON THE FUNCTIONS OF LIVER

Agus Triyono and Peristiwan RidhaMedicinal Plants and Traditional Medicine Research and Development Center, Tawangmangu

Jalan Lawu No 11 Tawangmangu Karanganyar Central Java (agustriyono_21@yahoo.com)

ABSTRACT

Hyperuricemia herbs formula can be used in formal health services if proven safe and

effective. Previous clinical trials showed that the formula decreased blood uric acid levels.

Safety of the formula on the functions of the liver need to be investigated before it is

recommended. The study aims to find out the safety information of the formula herbs on

functions of liver. The formula consisted of several herbs, i.e. Stelechocarpus burahol,

Sonchus arvensis, Caesalpinia sappan, Curcuma xantorriza, C. domestica and Phillanthus

niruri. This formula has been tasted safe from the preclinical tests. Clinical trial of the

formula was conducted by using the pre - post design research involving 40 subjects who

have met the inclusion and exclusion criteria. The protocol was approved by the research

ethics of the Ethics Committee for Health Research, Health Research and Development

Center Jakarta. The pre-intervention was performed anamnesis (a preliminary case historyof

a medical or psychiatric patient) of the subject's identity, medical history, clinical symptoms,

physical examination diagnostic, laboratory tests of liver function (SGOT and SGPT). Every

week during 8 weeks, the subjects were given the herbal formula and once a week their liver

functions were controlled. On the first day (H1), the subjects were drinking the prepared

boiled formula simplisia, then they given the protocol to prepare it for use at home. Every

day they need to drink the formula three times. Research subject was control once a week to

do anamnesis complaint, the possibility of side effects and performed a physical examination

diagnostic. The liver functions (SGOT and SGPT) of the subjects were checked every

month. The study showed that the anamsesis and physical examination of the subject during

intervention and after intervention did not cause significant side effects. The analysis of

paired test showed there was no significant difference levels on the SGOT (t = 1.58, p =

0.120 (p>0.05)) and SGPT (t = 0.63, p = 0.533 (p>0,05)) before and after the intervention of

hyperuricemia herbs formula both at day 28th and 56th days. The use of herbs hyperuricemia

herbs formulafor for 56 days did not interfere with liver function and found no symptoms of

serious side effects. Therefore, the formula is safe for liver if used in health services.

Keywords: Clinical trials, hyperuricemia herbs formula, liver function

INTRODUCTION

Uric acid is the final waste of the metabolism product of purines. Uric acid is actually an

antioxidants in humans and animals, but when its amount is excessive or reaching saturated in the

blood they experience an efflorescence which lead to gout. The process of uric acid metabolism stars

from the chemical process of food containing protein and cellulose that will generate energy. If the

process is deviated, uric acid will be a build up and called hiperuricemia. (Soenarta and Arieska,

2005).

Hyperuricemia is the condition when uric acid levels in the blood is not normal i.e.> 7 mg/dl

in men and > 6 mg/dl in women. Hyperuricemia is a metabolic disorder that required long-term

intervention. Hyperuricemia can be caused by abnormalities of enzyme and changes in lifestyle of

eating foods that contain high levels of purines. Increase levels of uric acid in the blood will

eventually end up with the accumulation of monosodium urate in soft tissues especially soft joints.

Hyperuricemia can lead to complications such as gout arthritis, uric acid stones, and urate

nephropathy. (Horrison, 2001)

Hyperuricemia is a problem of metabolic disease that requires a long-term therapy or long

life intervention. Patient of hyperuricemia and treated with conventional intervention suffer from

bored and looking for alternative treatments such as herbal formula. (Hidayat, 2011)

Liver is the largest gland of the body; 1000-1500 g in weight. It consists of two main lobes,

right lobe and left lobe. Liver has many functions and complex. Its function is divided into four,

namely formation and excretion of bile function, metabolic function, immune function and liver

vascular function. Because of its strategic location and its function is complex, function of the liver is

easily getting disorders, such as viral hepatitis, hepatitis due to herbal medicine, drug or toxic

foodstuffs, liver cirrhosis, fatty liver and liver tumors. (McGilvery and Golstein, 1996)

Symptoms of liver disease varies from asymptomatic to severe; liver disease usually

associated with enzyme abnormalities. Liver produce many enzymes, such as lactate dehydrogenase,

serum transaminase (SGOT, SGPT), gamma glutamyl transpeptidase (Gamma GT), and alkaline

phosphatase (ALP). When lever is damage, enzyme produced will be excessive and excretes into the

extracellular space. (McGilvery and Golstein, 1996).

An herbal formula for treatment of hyperuric acid such as SGOT and SGPT has been tested

and it is safefor lowering uric acid in the blood.

The study was aimed to assess the effect of hyperuricemia herbs formula for liver function

(SGOT and SGPT).

MATERIALS AND METHODS

Simplicia raw materials consisted of Stelechocarpus burahol L, Sonchus arvensis L,

Caesalpinia sappan L, Curcuma xantorriza, Curcuma domestica Val, Phillanthus niruri L. were

taken from the Tawangmangu and Karangpandan. The plant materials were washed with tap water to

remove debris, then aerated in acontinued drying oven at 50 0 C for 7 hours. The dried plants were

packaged in a plastic bags.

Preparation of herbal drink

Starting the first day of the study, subjects were given the herb botanicals (dried preparation)

blood uric acid-lowering formula, which has been packed and accompanied by rules boil and drink

herbs (one package boiled with 5 cups (200 cc) of water to a boil so that 3 cups of water to drink in

the morning, noon and afternoon), one package for one day, the next day boil the new packaging.

Herbs taken continuously for 56 days.

This research is a quasi experimental pre and post test design conducted in Saintification

Herbal Clinic. Study involved 40 research subjects who have met the inclusion and exclusion criteria.

Inclusion criteria were: age 20-65 years old, men or women, subjects with blood uric acid levels 7-10

mg / dL, willing to follow study / schedule follow-up by signing informed consent. Exclusion criteria

were: pregnant or lactating women (based recognition), subjects taking medications that affect disease

were observed, subject with severe disease complications (eg advanced cancer , etc), subjects had

other comorbidities that affect the clinical condition.

Research subjects who had signed informed consent were performed anamnesis subject's

identity, medical record, clinical symptoms, diagnostic physical examination, laboratory tests of liver

function, kidney function, and blood routine. Research subjects were given the test material in a

number of studies to use for seven days, then once a week they were controlled up to confirm that

they have taken the test material as required. On the first day (H1), subjects were given the boiling

concoction hyperuricemia drink three times a day for 56 days. The subjects were controlled once a

week for a complaint history, development of clinical symptoms, and possibility of side effects by

physical examinations, followed with the examination of SGOT and SGPT conducted every four

weeks.

This study has received an ethical clearance from the Ethics Committee of National Institute

of Health Research and Development, Ministry of Health Jakarta.

RESULTS AND DISCUSSION

To assess the effect of hyperuricemia herbs formula on the functions of the liver, there has

been carried out laboratory tests SGOT and SGPT for 40 subjects at three different times, before the

intervention, the 28th day and the 56th day after the intervention. The mean level of SGOT and SGPT

study subjects are shown in Table 1.

 

Table-1. Mean level of SGOT and SGPT of the patients before and treated with hyperuricemiua

herbs formula

Liver

function

Before

Intervention

Day-28 Day-56

SGOT 27.93 21.91 20.74

SGPT 21.54 20.71 20.76

 

To determine the effect of hyperuricemia herbs formula on liver function, it is conducted to

analyze the differences in levels of SGOT and SGPT before and after 28 days intervention, with a

paired t test. The analysis results are shown in Table 2.

 

Table-2. Analysis of levels of SGOT and SGPT of the patients before and after treated with

hyperuricemiua herbs formula

Liver

function

Before intervention

(H0)

After intervention

(H28) t p

Mean* SD mean* SD

SGOT 26.71 17.60 22.71 10.86 1.58 0.120

SGPT 28.47 17.05 27.06 14.99 0.63 0.533

 *Number of treated samples were 40

Table 2 shows that there is no significant difference in levels of SGOT (t = 1.58, p = 0.120

(p> 0.05)) and SGPT (t = 0.63, p = 0.533 (p> 0.05) ) before and after intervention of hyperuricemia

herbs formula day 28.

To determine the effect of hyperuricemia herbs formula on liver function, to analyze

differences in levels of SGOT and SGPT before and after 56 days, with a paired t test. The analysis

results are shown in Table 3.

Table 3. Analysis of levels of SGOT and SGPT Differences before and after treated eith the

herbal formula

Liver

function

Before intervention

(H0)

After intervention

(H56) t p

mean SD mean SD

SGOT 26.19 17.62 24.34 11.40 0.78 0.439

SGPT 27.87 16.88 29.08 24.55 0.37 0.717

 

Table 3. shows that there is no significant difference in levels of SGOT (t = 0.78, p = 0.439

(p> 0.05)) and SGPT (t = 0.37, p = 0.717 (> 0.05)) before and after intervention hyperuricemia herbs

formula day 56.

Enzyme of SGOT (serum glutamic oxaloacetic transminase) and SGPT (serum glutamic

pyruvic transaminase) is a serum transaminase sensitive to damage liver cells. Increase two times or

more than the normal level of SGOT and SGPT enzyme is diagnostic of impaired liver cells. The

increase of these enzymes could be due to damage to the liver cells by herbs or drugs are toxic to the

cells of the liver (hepatotoxic). These analysis results obtained SGOT and SGPT before and after

intervention intervention of herbs hyperuricemia were not significantly different, means the

intervention of herbs hyperuricemia for 56 days did not interfere with liver function. (Mc.Gilvery and

Golstein, 1996)

CONCLUSION

The use of hyperuricemia herbs formula for 56 days did not interfere with liver function,

therefore the formula safe for liver, if used in health services.  

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