نقش تغذیه در درمان بیماران مبتلا به خونریزی زیاد قاعدگی از دیدگاه طب سنتی ایرانی و طب نوین

نوع مقاله : مقاله مروری

نویسندگان

1 دانشجوی دکتری، گروه طب ایرانی، دانشکده‌ی طب ایرانی و مکمل، دانشگاه علوم پزشکی مشهد، مشهد، ایران

2 دانشجوی دکتری، گروه تغذیه، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

3 استادیار، گروه طب ایرانی، دانشکده‌ی طب ایرانی و مکمل، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

مقدمه: خونریزی زیاد رحمی در زمان قاعدگی که در طب سنتی ایرانی تحت عنوان «افراط طمث» نامیده می‌شود. یکی از شایع‌ترین علل مراجعه زنان به مراکز درمانی می‏باشد. مطالعه‌ی حاضر، با هدف ارایه‌ی دستور‌های تغذیه‌ای توصیه شده در منابع طب ایرانی که اثرات کاهنده‌ی خونریزی آن‌ها در طب رایج نیز اثبات شده است، طراجی و اجرا گردید.روش‌ها: در مرحله‌ی اول این مطالعه، منابع طب سنتی ایرانی و در مرحله‌ی دوم، پایگاه‌های الکترونیک مانند Pubmed، Scopus و Magiran با واژگان کلیدی «Menoragia»، «Hypermenorrhea»، «افراط طمث»، «خونریزی زیاد رحمی»، «تغذیه» و «مکمل‌های غذایی» مورد بررسی قرار گرفتند. پس از فیش‌برداری از این منابع، شباهت‌ها و تفاوت‌ها استخراج و طبقه‌بندی شدند و داده‌های حاصل مورد تحلیل قرار گرفتند.یافته‌ها: از دیدگاه طب سنتی ایرانی، خوراکی‌هایی مانند زرده‌ی تخم‌مرغ، عدس، عصاره‌ی گوشت، انار، به و سماق برای کاهش خونریزی در بیماران مبتلا به خونریزی زیاد قاعدگی تجویز می‌شوند و مطالعات جدید اثرات ضد التهاب، آنتی‌اکسیدانی، خون‌سازی و ضد فیبرینولیتیک تعدادی از این غذاها را اثبات کرده است.نتیجه‌گیری: تدوین برنامه‌ی غذایی مناسب برای بیماران مبتلا به خونریزی زیاد قاعدگی در کنار درمان‌های رایج، می‌تواند به ارتقای سلامتی زنان کمک شایانی نماید.

کلیدواژه‌ها


عنوان مقاله [English]

The Role of Nutrition in the Treatment of Patients with Menorrhagia from the Perspective of Traditional Persian Medicine and Modern Medicine

نویسندگان [English]

  • Mojdeh Khodabakhsh 1
  • Fateneh Roudi 2
  • Zohreh Feyzabadi 3
1 PhD Student, Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 PhD Student, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Assistant Professor, Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
چکیده [English]

Background: Heavy menstrual bleeding during menstruation or hypermenorrhea or menorrhagia, which is called "Efrate Tams" in Traditional Iranian Medicine, is one of the most common causes of visiting health centers by women. The present study aimed to provide nutritional guidelines recommended in the Traditional Iranian Medicine for this complaint which their effects on bleeding regulatory pathways are also proven in conventional medicine.Methods: In first phase of this study, we conducted a review with a focus on the sources of Traditional Iranian Medicine; in second phase, electronic databases of PubMed, Scopus, and Magiran were studied with the key words of "Menorrhagia", "Hypermenorrhea", "Efrate Tams", "Heavy Menstrual Bleeding", "Nutrition", and “Food supplements”. Similarities and differences of our search results were extracted and classified, and the resulting data were analyzed.Findings: From the perspective of Traditional Iranian Medicine, foods such as egg yolk, lentils, meat extracts, pomegranate, quinceand, and Sumac are prescribed to reduce bleeding in patients with menorrhagia, and new studies have demonstrated anti-inflammatory, anti-oxidant, hematopoietic, and anti-fibrinolytic effects of some of these foods.Conclusion: Designing an appropriate diet for women with menorrhagia, along with common treatments, may help promoting health states of these patients.

کلیدواژه‌ها [English]

  • Hypermenorrhea
  • Menorrhagia
  • Diet
  • Dietary supplements
  • Traditional Medicine
  • Iran
  1. Munro MG. Classification of menstrual bleeding disorders. Rev Endocr Metab Disord 2012; 13(4): 225-34.
  2. Tansaz M, Memarzadehzavareh H, Qaraaty M, Eftekhar T, Tabarrai M, Kamalinejad M. Menorrhagia management in Iranian traditional medicine. J Evid Based Complementary Altern Med 2016; 21(1): 71-6.
  3. Telner DE, Jakubovicz D. Approach to diagnosis and management of abnormal uterine bleeding. Can Fam Physician 2007; 53(1): 58-64.
  4. Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility. Philadelphia, PA: Lippincott Williams and Wilkins; 2011.
  5. Bano F. Clinical study of usere wazifi nazfe raham (dysfunctional uterine bleeding) and its management with unani drugs [MD Thesis]. Bangalore, Karnataka, India: Rajiv Gandhi University of Health Sciences, National Institute of Unani Medicine; 2007.
  6. Shobeiri SF, Sharei S, Heidari A, Kianbakht S. Portulaca oleracea L. in the treatment of patients with abnormal uterine bleeding: a pilot clinical trial. Phytother Res 2009; 23(10): 1411-4.
  7. Javan R, Yousefi M, Nazari SM, Amiri P, Mosavi-Jarrahi A, Modiramani P, et al. Herbal medicines in idiopathic heavy menstrual bleeding: A systematic review. Phytother Res 2016; 30(10): 1584-91.
  8. Gorin AG. Chemical investigation of the polysaccharides of the leaves of Plantago major L. Chem Nat Compd 1965; 1(5): 232-5.
  9. Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 2011; 113(1): 3-13.
  10. Gibbs RS, Danforth DN. Danforth's obstetrics and gynecology. Philadelphia, PA: Lippincott Williams and Wilkins; 2008.
  11. Kaczensky P, Burnik SM, Sablin MV, Voigt CC, Smith S, Ganbaatar O, et al. Stable isotopes reveal diet shift from pre-extinction to reintroduced Przewalski's horses. Sci Rep 2017; 7(1): 5950.
  12. Kavousi M, Khadem Ghaebi N, Tansaz M, Bioos S, Feyzabadi Z. Comparison of the causes of infertility induced by ovulation disorders in Persian medicine and traditional medicine. Iran J Obstet Gynecol Infertil 2018; 21(6): 80-91. [In Persian].
  13. Yargholi A, Zareian MA, Hafizi S, Faryabi R, Tabarraei M. Review on invasive and semi-invasive procedures to treat abnormal uterine bleeding in Iranian traditional medicine. Iran J Obstet Gynecol Infertil 2017; 20(Suppl): 46-55. [In Persian].
  14. Zafarghandi N, Jafari F, Moradi F, Alizadeh F, Karimi M, Alizadeh M. Frequency of positive symptoms of dystemperament in patients with excess uterine hemorrhage from the Iranian medicine perspective. Iran J Obstet Gynecol Infertil 2012; 15(24): 8-16. [In Persian].
  15. Falahat F, Tavakkoli M, Mokaberinejad R, Ayati S, Feyzabadi Z. Natural treatments of oligomenorrhea based on Persian medicine. Iran J Obstet Gynecol Infertil 2018; 21(Suppl): 55-66. [In Persian].
  16. Meyari A, Tansaz M, Yavari M, Bahman M, Memarzadeh Zavareh H, Nabi Meybodi R, et al. Nutritional recommendations for patients with uterine discharge in Iranian traditional medicine. Iran J Obstet Gynecol Infertil 2017; 20(Suppl): 68-77. [In Persian].
  17. Feyzabadi Z, Jafari F, Feizabadi PS, Ashayeri H, Esfahani MM, Badiee AS. Insomnia in Iranian traditional medicine. Iran Red Crescent Med J 2014; 16(3): e15981.
  18. Javan R, Feyzabadi Z, Kiani M. Management of infantile colic; based on traditional Iranian medicine. Int J Pediatr 2015; 3(5-1): 909-13.
  19. Khodabakhsh M, Mehri M, Ghorbani F, Feyzabadi Z. Measles from the perspective of Rhazes and traditional Iranian medicine: A narrative review. Int J Pediatr 2016; 4(10): 3661-8.
  20. Razi MZ. Al-Havi. Beirut: Lebanon: Dar Ihya al-Turath al-Arabi; 2002. [In Arabic].
  21. Badri M. Abu Zayd al-Balkhi's sustenance of the soul: The cognitive behavior therapy of a ninth century physician. London, UK, Washngton, DC: International Institute of Islamic Thought ; 2013.
  22. Tibi S. Al-Razi and Islamic medicine in the 9th century. J R Soc Med 2006; 99(4): 206-7.
  23. Russell GF. Psychological and nutritional factors in disturbances of menstrual function and ovulation. Postgrad Med J 1972; 48(555): 10-3.
  24. Mahan LK, Escott-Stump S, Krause MV. Krause's food and nutrition therapy. Philadelphia, PA: Saunders/Elsevier; 2008.
  25. Krakau AS, Jonsar M. Tallriksmodellen och måltidsmåttet: En utvärdering av pedagogiska hjälpmedel för måltidssammansättning [BSc Thesis]. Uppsala, Sweden: Uppsala University; 2012.
  26. Munro MG. Classification of menstrual bleeding disorders. Rev Endocr Metab Disord. 2012; 13(4): 225-34.
  27. Montagnese C, Santarpia L, Buonifacio M, Nardelli A, Caldara AR, Silvestri E, et al. European food-based dietary guidelines: A comparison and update. Nutrition 2015; 31(7-8): 908-15.
  28. Avicenna. Canon on medicine (Al-Qanon fi Al-Tibb). vol. 2. Beirut, Lebanon: Alalami Library Publication; 2005. [In Arabic].
  29. Jorjani S. Zakhireh Kharazmshahi (Treasures of the Khwarazm Shah). Tehran, Iran: Iranian Cultural Organization Press; 1976.
  30. Majoosi AA, Kamel al Sanaat al Tebbiah. Qom, Iran: Moasseseie Ehiae Tebbe Tabiee; 2008; p. 228. [In Persian].
  31. Aghili M. Qarabadin Kabir. Tehran, Iran: Tehran University of Medical Science Press; 1999.
  32. Kosar M, Bozan B, Temelli F, Baser KHC. Antioxidant activity and phenolic composition of sumac (Rhus coriaria L.) extracts. Food Chem 2007; 103(3): 952-9.
  33. Rahimi-Madiseh M, Lorigoini Z, Zamani-Gharaghoshi H, Rafieian-Kopaei M. Berberis vulgaris: Specifications and traditional uses. Iran J Basic Med Sci 2017; 20(5): 569-87.
  34. Guyot S, Marnet N, Sanoner P, Drilleau JF. Variability of the polyphenolic composition of cider apple (Malus domestica) fruits and juices. J Agric Food Chem 2003; 51(21): 6240-7.
  35. Ganesan K, Xu B. Polyphenol-rich lentils and their health promoting effects. Int J Mol Sci 2017; 18(11): E2390.
  36. Reddy MK, Gupta SK, Jacob MR, Khan SI, Ferreira D. Antioxidant, antimalarial and antimicrobial activities of tannin-rich fractions, ellagitannins and phenolic acids from Punica granatum L. Planta Med 2007; 73(5): 461-7.
  37. Chouchouli V, Kalogeropoulos N, Konteles SJ, Karvela E, Makris DP, Karathanos VT. Fortification of yoghurts with grape (Vitis vinifera) seed extracts. LWT-Food Sci Technol 2013; 53(2): 522-9.
  38. Fattouch S, Caboni P, Coroneo V, Tuberoso CI, Angioni A, Dessi S, et al. Antimicrobial activity of Tunisian quince (Cydonia oblonga Miller) pulp and peel polyphenolic extracts. J Agric Food Chem 2007; 55(3): 963-9.
  39. Today's Dietitian Continuing Education Learning Library. Understanding Triglycerides: Strategies for Counseling Clients - Learn the Current Research on Triglycerides and Recommendations and Strategies RDs Can Use to Counsel Clients to Manage and Prevent CVD [Online]. [cited 2018]; Available from: URL: https://ce.todaysdietitian.com/node/68382#group-tabs-node-course-default1
  40. Breymann C, Auerbach M. Iron deficiency in gynecology and obstetrics: clinical implications and management. Hematology Am Soc Hematol Educ Program 2017; 2017(1): 152-9.
  41. Livdans-Forret AB, Harvey PJ, Larkin-Thier SM. Menorrhagia: A synopsis of management focusing on herbal and nutritional supplements, and chiropractic. J Can Chiropr Assoc 2007; 51(4): 235-46.
  42. Mahan LK. Krause's Food and the nutrition care process. St Louis, MO: Elsevier Health Sciences; 2016.
  43. Doyle BJ, Frasor J, Bellows LE, Locklear TD, Perez A, Gomez-Laurito J, et al. Estrogenic effects of herbal medicines from Costa Rica used for the management of menopausal symptoms. Menopause 2009; 16(4): 748-55.
  44. Andersen CJ. Bioactive Egg Components and Inflammation. Nutrients 2015; 7(9): 7889-913.
  45. Zubair M, Ekholm A, Nybom H, Renvert S, Widen C, Rumpunen K. Effects of Plantago major L. leaf extracts on oral epithelial cells in a scratch assay. J Ethnopharmacol 2012; 141(3): 825-30.
  46. de Morais Lima GR, de Albuquerque MC, de Almeida CL, de Athayde-Filho PF, Barbosa-Filho JM, Batista LM. Database survey of anti-inflammatory plants in South America: a review. Int J Mol Sci 2011; 12(4): 2692-749.
  47. Kashefi F, Khajehei M, Alavinia M, Golmakani E, Asili J. Effect of ginger (Zingiber officinale) on heavy menstrual bleeding: A placebo-controlled, randomized clinical trial. Phytother Res 2015; 29(1): 114-9.
  48. Qaraaty M, Kamali SH, Dabaghian FH, Zafarghandi N, Mokaberinejad R, Mobli M, et al. Effect of myrtle fruit syrup on abnormal uterine bleeding: a randomized double-blind, placebo-controlled pilot study. Daru 2014; 22: 45.
  49. Goshtasebi A, Mazari Z, Behboudi GS, Naseri M. Anti-hemorrhagic activity of Punica granatum L. flower (Persian Golnar) against heavy menstrual bleeding of endometrial origin: a double-blind, randomized controlled trial. Med J Islam Repub Iran 2015; 29: 199.
  50. Medscape. General gynecology [Online]. [cited 2016]; Available at: URL: http://emedicine.medscape.com/obstetrics_gynecology
  51. Najafian Y, Hamedi SS, Farshchi MK, Feyzabadi Z. Plantago major in traditional Persian medicine and modern phytotherapy: A narrative review. Electron Physician 2018; 10(2): 6390-9.
  52. Achraf A, Hamdi C, Turki M, Abdelkarim O, Ayadi F, Hoekelmann A, et al. Natural pomegranate juice reduces inflammation, muscle damage and increase platelets blood levels in active healthy Tunisian aged men. Alexandria Journal of Medicine 2018; 54(1): 45-8.
  53. Sreekumar S, Sithul H, Muraleedharan P, Azeez JM, Sreeharshan S. Pomegranate fruit as a rich source of biologically active compounds," Biomed Res Int 2014; 2014: 686921.
  54. Zarfeshany A, Asgary S, Javanmard SH. Potent health effects of pomegranate. Adv Biomed Res 2014; 3: 100.
  55. Murray F. Health benefits derived from sweet orange: Diosmin supplements from citrus. North Bergen, NJ: Basic Health Publications; 2007.
  56. Pirson Y, van Ypersele de SC. Renal side effects of nonsteroidal antiinflammatory drugs: clinical relevance. Am J Kidney Dis 1986; 8(5): 338-44.
  57. Lukes AS, Moore KA, Muse KN, Gersten JK, Hecht BR, Edlund M, et al. Tranexamic acid treatment for heavy menstrual bleeding: A randomized controlled trial. Obstet Gynecol 2010; 116(4): 865-75.