Couch Grass Root – ESCOP Herbal Monograph 2016
Graminis RhizomaCouch Grass RhizomeAgropyron repens (L.)Published 2016SUMMARY:The herbal monograph selects and summarises scientific studies and textbooks regarding efficacy, dosage and safety to support the therapeutic uses of couch grass rhizome. This herbal drug by definition consists of the whole or cut, washed and dried rhizomes of Agropyron repens (L.) Beauv. , Elymus repens (L.) Gould or Triticum repens L. Studies with its main characteristic constituents polysaccharides, principally a branched fructosan, triticin and flavonoids are included. The therapeutic indications are irritable bladder and other urinary tract disorders. Administration of couch grass rhizome addresses posology; its duration of use; contra-indications; special warnings; special precautions for use; interactions with other medicinal products; other forms of interaction; in pregnancy and lactation; its effects on ability to drive; undesirable effects; overdose. In vitro experiments with an extract of couch grass rhizome showed antiadhesive activity towards bacteria. In vivo experimentswith couch grass rhizome or its extracts in animals demonstrate diuretic, sedative, lipid-lowering and hypoglycaemic properties. Open clinical studies in humans with couch grass rhizome extract demonstrated its use in patients with irritable bladder, cystitis, prostatitis and/or urethritis. Preclinical safety data were assessed in toxicity studies and showed no mutagenic activity. Safety data were assessed in two human studies and were well tolerated in 96% of the patients. One case with gastrointestinal symptoms was reported. The selection of literature cited in the monograph is aimed at bringing together relevant information about the possible physiological roles of couch grass rhizome and its major constituents. Examples are given below.
KEYWORDS:
Agropyron repens (L.) Beauv., Elymus repens (L.) Gould., Triticum repens
L.Graminis rhizoma
Couch grass rhizome
Irritable bladder: Urinary tract disorders
REFERENCES:
– Arni PC, Percival EGV. Studies on fructosans. Part II. Triticins from the rhizomes of couch grass (Triticum repens L.). J Chem Soc 1951:1822-30. http://dx.doi.org/10.1039/jr9510001822
– Boesel R, Schilcher H. Composition of the essential oil of Agropyrum repens rhizome. Planta Med 1989;55:399-400. http://dx.doi.org/10.1055/s-2006-962045
– Eddouks M, Maghrani M, Michel JB. Hypoglycaemic effect of Triticum repens P.Beauv. in normal and diabetic rats. J Ethnopharmacol 2005;102:228-32. http://dx.doi.org/10.1016/j.jep.2005.06.019
– Grases F, Ramis M, Costa-Bauzá A, March JG. Effect of Herniaria hirsuta and Agropyron repens on calcium oxalate urolithiasis risk in rats. J Ethnopharmacol 1995;45:211-4. http://dx.doi.org/10.1016/0378-8741(94)01218-O
– Maghrani M, Lemhadri A, Zeggwagh N-A, El Amraoui M, Haloui M. Jouad H, Eddouks M. Effects of an aqueous extract of Triticum repens on lipid metabolism in normal and recent-onset diabetic rats. J Ethnopharmacol 2004;90:331-7. http://dx.doi.org/10.1016/j.jep.2003.10.011
– Mascolo N, Autore G, Capasso F, Menghini A, Fasulo MP. Biological screening of Italian medicinal plants for anti-inflammatory activity. Phytother Res 1987;1:28-31. http://dx.doi.org/10.1002/ptr.2650010107
Agropyron > Agropyron repens (L.) P. BEAUV. > Agropyri repentis rhizoma (Queckenwurzelstock)
Piotr Gorecki, Renate Seitz uit Hagers Handbuch
Synonyme
Graminis rhizoma; Radix Agropyri; Radix Cynagrostis; Radix Graminis albi; Radix Graminis arvensis; Radix Graminis canini; Radix Graminis officinarum; Radix Graminis repentis; Radix Graminis vulgaris; Radix Tritici repentis; Rhizoma Agropyri; Rhizoma graminis; ritici rhizoma; Stolones graminis
Sonstige Bezeichnungen
dt.:Ackergraswurzel, Bayerwurzel, Graswurzel, Fegwurzel, Knotengraswurzel, Kriechweizenwurzel, Laufqueckenwurzel, Pädenwurzel, Queckenwurzel, Quecksilberwurzel, Saatgraswurzel, Schließgraswurzel; Couch grass root, Quick grass root, Quitch grass root; Rhizome de chiedent, Chiedent; Gramigna; Grama, Raiz de grama; pol.:Klacza perzu.
Offizinell
Rhizoma Graminis – EB 6; ÖAB 8; Helv V; Chiedent – PF X; Tritici rhizoma – Belg IV; Rhizoma Agropyri – Pol IV
Definition der Droge
Der getrocknete, im Frühling vor der Entwicklung der Halme oder im Herbst gesammelte Wurzelstock; [29] der von anhaftenden Wurzeln weitgehend befreite, getrocknete Wurzelstock [13], [30].
Charakteristik [-]
Stammpflanzen: Agropyron repens (L.) P. BEAUV.
Herkunft: Droge ausschließlich aus Wildvorkommen, Hauptlieferland ist Ungarn, seltener Importe aus Jugoslawien und Rumänien [14].
Gewinnung: Sammlung durch Auseggen von Feldern; nach dem Reinigen und Waschen der Wurzeln Lufttrocknung oder künstliche Trocknung bei etwa 55 °C [15].
Pharmakognosie & Inhaltsstoffe [-]
Ganzdroge: Aussehen. Lange, ästige, 2 bis 4 mm dicke Rhizome mit 2 bis 5 cm langen, hohlen, außen längsgefurchten, glatten, glänzenden, blaß strohgelben Stengelgliedern. Nur an den nicht hohlen und nicht verdickten Knoten sehr dünne Wurzeln und kurze weißliche, gefranste, häutige Scheiden von Niederblättern. In den Achseln der Niederblätter die zur Verzweigung des Rhizoms führenden Seitensprossen EB 6.
Längs- und Querschnitt von Agropyri repentis rhizoma (Queckenwurzelstock) 200 : 1. Aus [26] 1. Querschnitt: ed = Endodermis; l = Leptom. 2. Radialer Längsschnitt durch die Epidermis mit einem Kurzzellenpaar, Hypoderm und äußerste Rindenschichten. 3. Epidermis in Flächenansicht, mit durchschimmerndem Hypoderm. 4. Radialer Längsschnitt durch Endodermis „ed“ und äußere Teile des Zentralstranges mit einem Tüpfelgefäß. 5. Äußere Epidermis eines Niederblattes mit einer der wenigen Spaltöffnungen.
Schnittdroge: Geschmack. Fade, schwach süßlich. Geruch. Fehlt. Aussehen. Die Schnittdroge besteht aus strohgelben, glänzenden längsgefurchten, hohlen Stengelgliedern und den mit sehr dünnen, fadenförmigen Wurzeln und kurzen, gefransten häutigen Niederblattscheiden besetzten Knotenstücken. Im Lupenbild in der stärkemehlfreien Rindenschicht als äußerst feine Punkte die etwa sechs in die Blätter abzweigenden Gefäßbündel erkennbar. Die Leitbündel in einem fast zitronengelben, dichten Ring angeordnet; das Markgewebe in der Mitte zerrissen, ein unregelmäßig begrenzter zentraler Hohlraum EB 6.
Mikroskopisches Bild: Epidermis aus zweierlei Zellen in Längsrichtung abwechselnd aus großen, gestreckten Zellen mit dicken, gewellten Wandungen und kleinen, rundlichen, fast quadratischen, dünnwandigen Zellen. Letztere zuweilen in ein kurzes Haar ausgewachsen. Zellen der Endodermis an den Seitenwänden und an der Innenwand verdickt und verholzt (U-förmige Zellen). Im Zentralzylinder nahe der Epidermis zwei Kreise dicht aneinanderstoßender und miteinander wechselnder, kollateraler Gefäßbündel, die des äußeren Kreises kleiner als die des inneren. Sämtliche Bündel eingebettet in dickwandiges, einen geschlossenen Ring bildendes, sklerenchymatisches Gewebe. Das Markgewebe mehr oder weniger stark geschwunden. Stärke und Oxalatkristalle fehlen. Die Niederblätter beiderseits von Epidermis aus dünnwandigen, im Sinne des Nervenlaufs stark gestreckten Zellen, mit Spaltöffnungen bedeckt. Mesophyll aus rechteckigen Zellen. Nerven mit Faserbalg der Gefäßbündel.
Pulverdroge: Mikroskopisches Bild. Das weißlichgelbe Pulver ist gekennzeichnet durch die langgestreckten, schwach welligen Epidermiszellen, durch zahlreiche Bruchstücke unverdickter Fasern, durch Ring- und Tüpfelgefäße und durch stärkefreie Parenchymfetzen EB 6.
Verfälschungen/Verwechslungen: Häufigste Verfälschung mit den Rhizomen von Cynodon dactylon (L.) PERS., Hundszahngras, Poaceae – auch als Rhizoma Graminis italici bezeichnet – und den Rhizomen von Carex-Arten, z. B. C. arenaria L. und C. disticha HUDS., Cyperaceae. Rhizoma italici und Rhizoma Caricis enthalten Stärke und sind daher durch die Jodreaktion zu unterscheiden: Schnittflächen färben sich beim Betupfen mit Jod blauschwarz. Histologisches Unterscheidungsmerkmal stellen Form und Größe der Epidermiszellen dar. Verfälschungen mit Rhizomen von Imperata zylindrica (L.) RAUSCH., Poaceae, sind an den 2 bis 3 cm langen, nur sehr fein längsgerunzelten Internodienabschnitten zu erkennen [15], [16], [17].
Inhaltsstoffe: Wirksamkeitsbestimmende oder analytisch auffallende Inhaltsstoffe sind nicht bekannt. Die Hauptmenge der Extraktivstoffe besteht aus wasserlöslichen Polysacchariden – Hauptkomponente ist das Polyfructosan Triticin (nach älteren Angaben zwischen 3 bis 8 %), das dem Inulin verwandt ist [15], [18] – Schleimen (bis 10 %), 2 bis 3 % Zuckeralkoholen, u. a. Mannit und Inosit und lösliche Kieselsäure und Silikate [16]. Ältere Angaben über das Vorkommen von Saponinen sind bisher nicht bestätigt worden. Auch das Vorkommen des Acetylenderivates Agropyren als Hauptkomponente des ätherischen Öls wurde nach einer neueren Untersuchung nicht bestätigt [19]. Nach [19] bestehen die mit Wasserdampf flüchtigen Komponenten aus Fettsäuren und aus terpenoiden Komponenten von denen 49 identifiziert worden sind, darunter Carvacrol (10,8 %), Carvon (5,5 %); Thymol (4,3 %) u. a.
Identitaet: a) Durch makroskopische und mikroskopische Prüfung EB 6, PF X. b) Schnitte der Droge in einen Tropfen 1-Naphthol-Lsg. eingebracht und anschließend mit Schwefelsäure versetzt, müssen sich an den Schnittflächen violett färben (Triticin) [13]. c) DC nach PF X. Zur Herstellung der Prüflsg. wird 1 g Droge mit Schwefelsäure 4 % drei Stunden am Rückfluß hydrolisiert und dann die überstehende, getrocknete Lsg. in Methanol aufgenommen. Nach dem zweimaligen Entwickeln im Fließmittel Wasser/Isopropanol/ n-Butanol (12 : 33 : 55) und Besprühen mit 10 % ethanolischer Anilinlsg. und anschließendem Erhitzen auf 110 °C liefert das Chromatogramm der Prüflsg. bei Auswertung im Tageslicht zwei hellbraune Flecke mit den Rf-Werten 0,5 und 0,55, in Farbe und Lage ähnlich den Flecken der beiden Referenzsubstanzen Glucose und Levulose, und eine breite hellbraune Zone mit dem Rf-Wert 0,7.
Reinheit: a) Fremde Bestandteile: Drogenteile, deren Schnittflächen sich mit Jod-Lsg. nach einer Minute blau färben, dürfen nicht vorhanden sein [13], [29], [30]. Die Droge darf nicht mehr als 2 % andere Pflanzenbestandteile und höchstens 15 % grau- bis schwarzverfärbte Bestandteile haben [13], [30]. b) Maximaler Aschegehalt: 5 % EB 6, PF X; 3 % ÖAB 8; 6 % Helv V.
Anwendungsgebiete
Zur Durchspülung bei entzündlichen Erkrankungen der ableitenden Harnwege und als Vorbeugung bei Nierengrieß. Aufbereitungsmonographie der Kommission E am BGA [20].
Dosierung & Art der Anwendung [-]
Als mittlere Einzeldosen der Drogen gelten: 3 g EB 6/ 5 bis 10 g [13] auf eine Tasse Abkochung. Tagesdosen: 6 bis 9 g Aufbereitungsmonographie der Kommission E am BGA; [20] 20 bis 40 g [13] und 12 bis 24 g [31] als Tee zubereitet. Art der Anwendung: Zerkleinerte Droge für Abkochungen sowie andere galenische Zubereitungen zum Einnehmen [20]. Teezubereitung: Die Droge wird mit siedendem Wasser überbrüht, nach 10 min. abgeseiht und frisch getrunken. Dosierung der Zubereitungen: Fluidextrakt (1:1) BHP 83 : 4 bis 8 mL bis zu dreimal täglich; Tinktur (1:5) BHP 83 : 5 bis 15 mL bis zu dreimal täglich.
Gegenanzeigen/ Anwendungsbeschränkungen
Nicht bekannt. Hinweis: Keine Durchspülungstherapie bei Ödemen infolge eingeschränkter Herz- und Nierenfunktion. Aufbereitungsmonographie der Kommission E am BGA [20].
Volkstümliche Anwendungen & andere Anwendungsgebiete [-]
Neben der Anwendung bei Blasenkatarrhen und Nierensteinleiden wird die Droge auch bei Gicht, rheumatischen Beschwerden und chronischen Hauterkrankungen verwendet [16], [21]. Auf Grund des Schleimgehaltes gilt sie als reizlinderndes Hustenmittel bei Katarrhen der oberen Luftwege und findet in Form eines Infuses bei Verstopfung Verwendung [13], [22], [23]. Die Wirksamkeit bei den genannten Anwendungen ist gegenwärtig nicht belegt. Bei Diabetes als Diätetikum; [23] auf Grund des Fructosangehalts erscheint dieses Anwendungsgebiet plausibel.
Literatur [-]
1. Engler E (1964) Syllabus der Pflanzenfamilien, Bd. 2, Bornträger Verlag, Berlin-Nikolassee
2. Hess HE, Landolt E, Hirzel R (1967) Flora der Schweiz, Bd. 2, Birkenhäuser, Basel Stuttgart
3. Heywood VH (1968) Botanical J Linnean Soc 77:369–384
4. FEu, Bd. 5, S. 192
5. Clayton WD, Renvoize SA (1986) Genera Graminum, Grasses of the World, Kew Bulletin Add. Series XIII, HM Stationary Office, London
6. Frohne D, Jensen U (1985) Systematik des Pflanzenreiches unter besonderer Berücksichtigung chemischer Merkmale und pflanzlicher Drogen, 3. Aufl., Fischer, Stuttgart, S. 309
7. Stinissen HM, Reumans WU, Carlier AR (1983) Planta Med 159:105–111
8. Tulloch AP, Hoffman LL (1976) Phytochemistry 15:1.145–1.151
9. Tulloch AP (1976) Phytochemistry 15:1.153–1.156
10. Tulloch AP (1983) Phytochemistry 22:1.605–1.613
11. Löve A (1984) Feddes Repertorium 95:425–521
12. Stinissen HM, Chrispees MJ, Penmans WJ (1985) Planta Med 164:278–286
13. Standardzulassungen für Fertigarzneimittel (1988) Govi-Verlag und Deutscher Apotheker-Verlag, Frankfurt
14. Fa. Müggenburg, Hamburg. 06.06.1991
15. Berger F (1960) Handbuch der Drogenkunde, Bd. 5, Maudrich Verlag, Wien Bonn Bern, S. 226
16. Nagell A (1989) Queckenwurzelstock. In: Wichtl M, Teedrogen, 2. Aufl., Wissenschaftliche Verlagsgesellschaft, Stuttgart, S. 385–386
17. Schier W (1983) Z Phytother 4:537–545
18. Colin R, De Cugnac L (1927) Bull Soc Chim biol 8:621–627
19. Boesel R, Schilcher H (1989) Planta Med 55:399–400 [PubMed]
20. BAz Nr. 22a vom 1.2.1990
21. Nartowska J (1987) Wiadomosci Zielarskie 29:10–11
22. Pahlow M (1988) Dt Apoth Ztg 128:1.837–1.838
23. Braun H, Frohne D (1987) Heilpflanzen-Lexikon für Ärzte und Apotheker, 5. Aufl., Gustav Fischer, Stuttgart
24. Moskalenko SA (1987) J Ethnopharmacol 21:231–251 [PubMed]
25. BAz Nr. 66a vom 7.4.1989
26. Brandt W, Wasicky R (1929) Handbuch der praktischen und wissenschaftlichen Pharmazie, Bd. V, 11. Teil, S. 480, Urban & Schwarzenberg, Berlin Wien
27. Heg, Bd. I, Teil 3, S. 488 ff
28. Zan
29. EB 6
30. PF X
31. BHP 83
Assessment report on Agropyron repens (L.) P. Beauv., rhizoma / EMEA
In the Ph. Eur. monograph ref. 01/2008:1306, cough grass rhizome (Graminis rhizoma) is defined as the whole or cut, washed and dried rhizome of Agropyron repens (L.) Beauv. (Elymus repens (L.) Gould); the adventitious roots are removed (Ph. Eur. 2008).
Couch grass rhizome is known under the following common names:
English: Scutch, Twitch grass root, Quack grass root, Triticum;
German: Queckenwurzelstock, Laufqueckenwurzel, Schließgraswurzel, Graswurzel, Kriechwurzel;
French: Rhizome de chiendent, Chiendent rampant;
Spanish: Rizoma de grama de las boticas, Rizoma de grama del Norteo grama oficinal.
Polish: Kłącze perzu
Other names: Agropyron, Dogs Grass, Grama, Graminis Rhizoma, Juolavehnänjuurakko, Kvickrot,
Pýrový oddenek, Tarackbúza-gyökértörzs, Triticum, Twitch, Varpučių šakniastiebiai and Пырей Ползучий
The herbal substance can also be defined as the whole or cut, washed and dried rhizomes and short pieces of stem of Agropyron repens (L.) P. Beauv. (synonyms: Agropyron caesium J.U.C. Presl., Bromus glaber Scop., Elymus repens L., Elymus dumetorium Hoffm., Elytrygia repens Desv. ex Nevski, Triticum arundinaceum Poulsen ex Fries, Triticum repens L., Triticum sepitum Thuill.), Poaceae (Hagers Handbuch 1992).
The shiny yellowish, light brown or yellowish brown rhizome and stem pieces are hollow, longitudinally furrowed and about 2-3 mm thick. At the unthickened nodes are the remains of very thin, more or less branched roots and fiber-like scales. The taste is bland and slightly sweet (Wichtl 1994).
Couch grass is widely distributed weed throughout the Northern hemisphere. The material of commerce is imported from Eastern and South-Eastern European countries.
Constituents:
Couch grass contains 3-8% triticin (similar to inulin), which yields fructose upon hydrolysis. The drug also contains 3-4% fructose, 2-3% sugar alcohols (mannitol, inositol). Presence of agropyrene has been disputed. Furthermore small amounts of vanillin monoglucoside, vanillic acid, phenolic carboxylic acids, hydroxycinnamic acid alkyl ester, silicic acid and silicates are present. Small amounts of anthraquinones were also detected (Steinegger 1972, Hoppe 1958, Hagers Handbuch 1949, Karsten 1956, Jaretzky 1937, Claus 1956, Wallis 1955, Hagers Handbuch 1992, Hiller 1999, Bruneton 1999, Newall 1996, Borkowski 1952; 1974, Koetter 1993 and Mueller 1999).
Carbohydrates: The rhizome is free of starch.
Polysaccharides: The active substances of the aqueous extract of couch grass rhizome consisted of: polysacharide fraction (45.30.3%), flavonoids (0.960.03%), tannins (4.90.4%). Polysaccharides were separated by fractional extraction for: monosaccharides-glucose, D-fructose, rhamnose; pectins and hemicelluloses A and B (Petrova et al. 2009, Steinegger and Hänsel 1972). About 10% mucilage and possibly saponins occur (haemolytic activity is detectable) (Steinegger 1972, Haensel 1992).
Sugar alcohols: Inositol, mannitol (2-3%) (Stoop et al. 1996).
Fructans: (storage carbohydrates) 3-10% (Arni and Percival 1951, Bruneton 1999, Biggs and Hancock 2001, Steinegger and Hänsel 1972).
Triticin: Laevorotatory carbohydrate high-branched out polysaccharide resembling inulin (3-18%) (Steinegger and Hänsel 1972).
Free fatty acids: 36% (particularly palmitic acid).
Phenol compounds: P-hydroxybenzoic, vanilic and p-coumaric acids (Whitehead et al. 1982). Chlorogenic acid, p-hydroxycinnamic acids (Petrova et al. 2009). P-hydroxycinnamic acid esters: (E)- and (Z)-p-coumaric acid hexadecyl ester and (E)-and (Z)-p-coumaric acid-16-hydroxyhexadecylester (Koetter et al. 1993) and bis-(E)- and bis-(Z)-diesters of analogous structure (Koetter et al. 1994). Presence of agropyrene has been disputed.
Essential oil: (0.01-0.02%): 25% monoterpens (carvacrol, carvon, trans-anethole, thymol and menthol, among others), 0.85% sesquiterpenes(Boesel and Schilcher 1989) and other compounds including 2-hexyl-3-methyl-maleic acid anhydride.
Flavonoids: Tricin, rutin, baicaleine, hyperoside (Petrova et al. 2009).
Anthraquinones: Sum of anthraquinones (0.2-0.7 mg/kg): emodin (0.06-0.2 mg/kg), chrysophanol 0.05-0.2 mg/kg, physcion 0.08-0.3 mg/kg (Mueller et al. 1999).
Steroids: oestrogen, androstenone, progesterone and androgens in trace amounts (Simons and Grinwich 1989).
Lectins: which can be found in the seedlings and leaves of Agropyron repens may also be present in the rhizome. Purified leaf lectin (ARLL) corresponds to a Mr of 19,500 compared to Mr of 18,000 for the embrio lectins (AREL). ARLL polypeptide is slightly larger than cereal embrio lectins. They also exhibit different agglutination properties: ARLL is GalNAc-specific and agglutinates preferentially red blood cells of group A, since AREL is GlcNAc-specific and has no blood group specificity at all (Cammue et al. 1985).
Saponins: presence has not been confirmed.
Microelements: Concentrations of an iron and zinc in infusions prepared from raw Agropyron repens rhizomes was estimated in the range of 3.78-6.84 g/g and 7.12-10.80 g/g respectively (Arceusz et al. 2009).
Silicic acid and silicates: Total Si level (%) in rhizomes of Agropyron repens at various stages of its vegetation between June and October increased in the range of 0.37-0.43. The maximum concentrations in decoction were obtained after boiling 3 g of rhizomes in a glass of water for 2 hours under a cover. One glass of decoction contains 2.6 mg of assimilable silicon equivalent to 5.6 mg of Si02 (Pasławska and Piekos 1976).
Herbal preparation(s)
Comminuted herbal substance
Liquid extract (1:1) extraction solvent: ethanol 20-25% V/V
Tincture (1:5) extraction solvent: ethanol 40% V/V
Combinations of herbal substance(s) and/or herbal preparation(s) including a description of vitamin(s) and/or mineral(s) as ingredients of traditional combination herbal medicinal products assessed, where applicable.
The herbal substance is also available in combination products. Main plants used in combination are: Achillea millefolium, Allium cepa , Althea officinalis, Betula pendula, Calendula officinalis, Carum carvi,Cichorium intybus, Cynara scolymus, Equisetum arvense, Frangula alnus, Levisticum officinale, Linum usitassimum, Matricaria chamomilla, Mentha piperita, Petroselinum crispum, Phaseolus vulgaris, Polygonum avicularis, Rheum officinale, Ribis nigrum, Sambuccus nigra, Silybum marianum, Solidago virgaurea, Taraxacum officinalis, Tilia cordata, Trigonella foenugraecum, Urtica dioica and Viola tricolor
Herbal Drugs and Phytopharmaceuticals (Wichtl, 2002)
Diuretic in cases of bladder inflammation and bladder and kidney stones. According to folk tradition as a cough remedy to alleviate the irritation in bronchial catarrh and in rheumatic disorders, gout and chronic skin conditions.
Dosage: 5-20 g of the chopped drug in boiling water, after 5-10 minutes passed through a tea strainer.
It is also recommended to put the herbal substance in cold water and slowly bring it to the boil(1 teaspoon = ca. 1.5 g). Unless otherwise prescribed, a cup is drunk up to 4 times daily.
Historical data on medicinal use
Couch grass rhizome has been traditionally used as diuretic, mainly in compositions (Borkowski 1952; 1974, Claus 1956, Frohne 1994, Hiller and Melzig 1999, Oppermann 1995 and Receptariusz Zielarski 1963; 1967).
Agropyron repens has been traditionally used in treatment since ancient times. Its name was mentioned in the publications of Dioskurides, Plinius, Tabermontanus-Bauhinus 1588 and Matthiolus 1626 according to Madaus “Lehrbuch der Biologischen Heilmittel”, 1938.
The herbal substance is mentioned in several well known handbooks such as Barnes et al. 2002, Bradley 2006, Duke’s Handbook of Medicinal Herbs 2002, ESCOP Monographs 2009, German Commission E Monograph 1990, Hagers Handbuch 1949; 1992, Hiller and Melzig 1999, Hoppe 1958, Madaus 1938, Martindale 2009, Jaretzky 1937, Karsten 1956, Newall et al. 1996, PDR for Herbal Medicines 2000; 2004, Schulz et al. 1998, Wallis 1955 and Wichtl 1994; 2002.
In Greece according to ethnobotanical tradition, Agropyron repens is used not only in urinary tract disorders (cystitis, kidney stones, prostate enlargement) but also in gastrointestinal problems (gallstones), in arthritis and rheumatism and to reduce increased cholesterol levels
(Hanlidou et al. 2004).
In Bulgaria and Italy, couch grass rhizomes are traditionally used as diuretic and laxatives (Leporatti and Ivancheva 2003). It is also used as a diuretic by ethnic Albanian communities living in the Vulture area in Southern Italy (Pieroni et al. 2002).
In Bosnia and Herzegovina, traditional use of couch grass as diuretic and in rheumatic complaint is described (Redžić 2007).
Agropyron repens (L.). rhizomes, dried, ground and made into flour used to make bread or thick soup in famine conditions were used in Poland until the mid-20th century and might have been used to make beer until the 18th century (Łuczaj and Szymański 2007, Łuczaj 2008).
The pulverised rhizomes of Agropyron repens (2-3 g 3 times daily for 10-12 days) were used in orderto reduce irritable condition of bladder and to promote urination (Ballabh et al. 2008).
Agropyron repens is also used in ethnoveterinary medicine to treat endoparasites and gastrointestinal problems in Italy and in Canada (Lans et al. 2007, Viegi et al. 2003).
Overall conclusion on the traditional medicinal use
Preparations from Agropyron repens rhizome have long been used for diuresis stimulation. The traditional medicinal use is made plausible by pharmacological data.
Diuretic activity
Diuretic activity was shown by Racz-Kotilla and Mozes (1974) in rats after oral administration of an aqueous extract (1% macerate). After receiving 50 ml/kg body weight, diuretic index increased by 1.42 compared to control rats receiving water only. Stronger diuretic effect (index of 1.62) was observed after i.p. administration of an equivalent dose of the dry hydroalcoholic extract dissolved in water corresponding to 10% of dried rhizome at 5 ml/kg body weight.
Clinical studie: Effect of fluid extract of Agropyron repens in urinary tract infections and irritable bladder
In the open clinical trial in 99 patients with micturition disorders (12 female and 87 male), a 20% ethanol fluid extract of Agropyron repens was administered for 28-31 days (60 drops 3 times daily). The complaints of urge incontinence, dysuria, nycturia and tenesmus due to adenoma of prostate, prostatitis and cystitis were successfully significantly reduced in 44.4-100 % of patients. Laboratory markers of inflammation (protein, epithelia, leucocyte and erythrocyte in urine) were also normalised. In result, 96% of patients estimated results as good or very good. Adverse effects were not recorded (Barsom 1981).
The efficacy and tolerability of a fluid extract of couch grass in 313 patients with urinary tract infections or irritable bladder was analysed in a multicenter open post-marketing study. The patients with diagnosis of irritable blader, urethritis, cystitis and prostatitis were included to the test. The patients were treated on average for 12 days with 50-60 drops of 20% fluid ethanolic extract of Agropyron repens. Primary efficacy criterion was the clinically relevant improvement and change of urologic symptoms during the course of therapy: urge incontinence, painful micturition, dysuria, pollakisuria, nycturia and tenesmus. Dependent on the underlying urologic diagnosis, between 32% and 53% of the patients were completely free of symptoms following treatment (32% of patients with irritable bladder, 44% with urethritis, 53% with cystitis and 42% with prostatitis) No side effects were reported (Hautmann and Scheithe 2000).
Effects on the calcium oxalate urolithiasis urinary risk factors
The effects on the calcium oxalate urolithiasis urinary risk factors of administration of Agropyron repens L. (Gramineae), in herb infusion form, combined with different diets (standard, high glucidic, high protein) have been studied using Wistar rats. From this study, it is deduced that administration of the Agropyron repens infusion cannot be associated to any positive effects on the main urolithiasis risk factors.
According to Grases 1995, some significant diuretic effects (p<0.005) with infusion of Agropyron repens herbal tea were registered with calciuria increased (p<0.005) and magnesiuria decreased (p<0.005) when standard diet was used. Moreover, citratruria decreased when couch grass infusionwas associated with a high glucidic diet. In conclusion, the authors concluded that the conditional diuretic effect of couch grass infusion cannot be attributed to the diet.
Anti-inflammatory activity
Moderate inhibition of carrageenin foot oedema of the rat hind-paw (14%) was found after oraladministration of 80% ethanol extract of rhizomes of Agropyron repens (100 mg/kg) compared to indometacin effects (45% of inhibition) at 5 mg/kg (Mascolo et al. 1987).
In the animal model of allergic contact dermatitis induced topically in rats after depilation with two applications of 0.1 ml of 5% alcoholic solution 2.4-dinitrochlorobenzene (DNCB), the cream containing dry couch grass extract was tested. After DNCB use the skin was hyperemic, edematous with serous purulent changes and itching. Couch grass extract cream was applied 3 days after the beginning of sensitization. Evaluation of the anti-inflammatory activity of the cream was monitored 4, 6 and 10 days after the experiment started. Plasma lipid peroxidation parameters: malondialdehyde (MDA), diene conjugates (DC) and catalase activity were registered. After 2 days of treatment with couch grass cream (4th day of experiment) decrease of erythema, edema and infiltration was seen. On the 6th day of experiment the skin of rats treated with cream containing couch grass returned to baseline valueswith reduction of edema and erythema. The visual symptoms of recovery of the control untreated rats were seen at 10 days. The activity of the antioxidant enzyme catalase increased by 30% at the 4th day and by 15% at the 6th day of experiment compared to the control. Biochemical parameters showed, at the end of the experiment on the 10th day, control levels of MDA and increased the activity of catalase, a major antioxidant defense enzyme. The couch grass cream application resulted in quickening the recovery by 4-5 days as compared with untreated control animals. The antiinflammatory effects of the couch grass cream were comparable to the standard glucocorticoid cream activity (Petrova et al. 2009).
Effect on lipid metabolism
The effect of single and repeated oral administration of the lyophilized aqueous extract of rhizomes of Agropyron repens (20 mg/kg) on lipid metabolism in normal and streptozotocin-induced diabetic rats was tested by Maghrani et al.. In normal rats, the aqueous extract induced a significant decrease in the plasma triglycerides concentrations 4 days and 1 week after repeated oral administration. This reduction was abolished 2 weeks after once daily repeated oral administration. A significant decrease of plasma cholesterol levels was observed only 1 week after repeated oral administration.
In diabetic rats treatment caused a significant decrease in plasma cholesterol after single and repeated oral administration. A strong decrease in cholesterol levels was observed 6 hours after a single oral administration of the extract. Four days after repeated oral administration of the extract, the plasmacholesterol level was significantly decreased and remained still diminished after 2 weeks. The repeated oral administration of the aqueous extract of Agropyron repens rhizomes caused a significant decrease in body weight 2 weeks after oral treatment. In severely hyperglycaemic rats Agropyron repens extract treatment induced reduction of lipid levels and body weight (Maghrani et al. 2004).
Antidiabetic effects
The hypoglycaemic effect of an aqueous extract of Agropyron repens was investigated in normal and streptozotocin-induced diabetic rats. After a single oral administration (20 mg/kg) of the daily prepared and lyophilized aqueous extract (1 g/100 ml of water) a significant decrease in blood glucose levels in diabetic rats was observed. The blood glucose levels were normalized after 2 weeks of daily oral administration of 20 mg/kg of the extract. Significant reduction of blood glucose levels were also noticed in normal rats after acute and chronic treatment. No changes were observed in basal plasma insulin concentrations after treatment in either normal or diabetic rats. The authors remarked that traditionally an aqueous extract of Agropyron repens rhizoma is used in Maroc as antidiabetic treatment (Eddouks et al. 2005; 2007).
Effect on motility
Experiments were performed on rota-rod with male mice (20-30 g body weight). Each group of mice (N=30) received either orally or i.p. 10% infusum of Rhizoma graminis (either 40 or 80 mg/ 20 g mouse). Control mice received orally or i.p. 0.9% NaCl solution. Motility tests were performed after 2 and 8 hours after administration of the tested solutions. Other groups of mice received equivalent doses of Valerianae radix or Radix Helenae infusum. All tested plant products induced comparable significant dose-dependent inhibition of motility. Similar comparable effects were obtained with use of the ether extracts of plants tested. The unspecific sedative effects of assayed plants with an unknown mechanism of action are discussed by the authors (Kiesewetter and Müller 1958)