PDR for Herbal Medicines

HERBAL MONOGRAPHS ECHINACEA / 263

production of lymphokines by lymphocytes (Coeugriiet,

1987). Echinacea purpurea herb has shown some short-term

viral resistance against influenza, herpes, and vesicular

stomatitis viruses, which has been credited to an interferon-

like effect (Wacker, 1978).

Collagen Protectant

The caffeic acid derivatives exert a protective effect on the

free-radical-induced degradation of Type HI collagen. Colla-

gen degradation was inhibited the greatest by echinacoside

and chicoriic acid, then cynarine and chlorogenic acid. The

collagen protection from free radical damage is through a

scavenging effect on reactive oxygen species and/or C-, N-,

S-centered secondary radicals. These activities may be useful

for the treatment/protection of photodamage of the skin by

UVA/UVB radiation, in which oxidative stress plays a

critical role (Facino, 1995).

CLINICAL TRIALS

A randomized, placebo-controlled, double-blind trial evalu-

ated the effect of a fluid extract of Echinacea purpurea on the

incidence and severity of colds and respiratory infections.

There were 109 patients with a history of more than 3 colds

jtL or respiratory infections in the previous year included in the

study. The fluid extract, given 4 mL twice daily for 8 weeks,

did not significantly decrease the incidence, duration or

severity of colds and respiratory infections compared to

placebo (Grimm, 1999).

The efficacy and safety of Echinaforce® (Echinacea purpu-

rea preparation from 95% herb and 5% root), Echinacea

concentrate (same preparation at 7 times higher concentra-

tion), and special Echinacea purpurea root preparation were

evaluated in the treatment of the common cold. There were

559 volunteers with a common cold included in the study.

The participants received 2 tablets 3 times daily. The

primary endpoint was the relative reduction of the complaint

index, which is a group of 12 symptoms that occur during

common cold. Echinaforce® and its concentrated prepara-

tion were significantly more effective than the special extract

or placebo treatment group. All treatments were well

tolerated with the frequency of adverse events not signifi-

cantly higher than in the placebo group (Brinkeborn, 1999).

m The safety and efficacy of Echinacea angustifolia and
Echinacea purpurea ethanolic root extracts for the prevention
of upper respiratory tract infections (URTI) was determined
in a double-blind, placebo-controlled study. The time until
the first URTI (time and event) and adverse effects were
evaluated in 302 patients. The root extract dosages were 50
drops twice daily for 12 weeks from Monday to Friday. The
time until occurrence of a URTI was 66 days in the
Echinacea angustifolia group, 69 days in the Echinacae
purpura group and 65 days in the placebo group. Though the

results do not prove efficacy of prophylaxis, the authors

conclude that Echinacea may reduce the risk of developing a

URTI by 10 to 20% (Melchart, 1998).

A randomized, placebo-controlled, double-blind study was

conducted to determine the effect of an extract of Echinaceae

pallidae root with influenza infections of the upper respira-

tory tract. A dose of 900 mg daily was evaluated for the

relief of symptoms, including shortening of the illness period

and curing cough and hoarseness. The length of the illness

period was reduced significantly with the extract from 13 to

9 days compared with placebo. The strongest effects on the

clinical symptoms were achieved after 8-10 days (Brauning.

1993).

INDICATIONS AND USAGE

ECHINACEA PURPUREA HERB

Approved by Commission E:

• Common cold


• Cough/bronchitis


• Fevers and colds


• Infections of the urinary tract


• Inflammation of the mouth and pharynx


• Tendency to infection


• Wounds and burns
  Echinacea purpurea herb is used internally as supportive
  therapy for colds and chronic infections of the respirator)
  tract and lower urinary tract. It can also be applied locally to
  poorly healing superficial wounds.

ECHINACEA PURPUREA ROOT

Unproven Uses: Echinacea purpurea root is used for acute

and chronic respiratory tract infections (of viral and bacterial

origin); increased susceptibility to infection due to temporar-

ily lowered resistance, treatment of leukopenia following

radio and cytostatic therapy and in support of anti-infectious

chemotherapy.

ECHINACEA PALLIDA ROOT

Approved by Commission E:

• Fevers and colds
  Echinacea pallida root is used as a supportive therapy for
  influenza-like infections.
  ECHINACEA ANGUSTIFOLIA HERB AND ROOT
  Unproven Uses: In folk medicine, native Americans use the
  drug externally for burns, swelling of the lymph nodes, and
  insect bites. The drug is used internally for pain associated
  with headaches and stomach aches, measles, coughs and
  gonorrhea. The drug has also been used for rattlesnake bites.
  Today the drug is used for prophylaxis and treatment of 'flu'
  infections, sepsis, and mild to moderate cold infections.
  Externally, the drug is used for treatment of poorly healing