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A recently published meta-analysis of clinical trials on patients with intermittent claudication shows that a multi-herb formula on the basis of Tibetan Medicine, Padma 28®, sold in the United States as Padma Basic® (Padma Ltd., Schwerzenbach, Switzerland) helps relieve symptoms and improve distance walked in patients.1 Researchers from four medical centers in Germany and Switzerland reviewed 19 clinical trials conducted on a total of 2084 patients. Of 6 clinical trials on this condition known also as peripheral arterial occlusive disease (PAOD) 5 trials conducted on 302 patients met the inclusion criteria for the meta-analysis.
The meta-analysis showed that Padma 28 increased maximum walking distance by over 100 meters in 18.2% of the patients taking the herbal combination, versus only 2.1% of patients taking a placebo. The safety profile analyzed in all 19 trials that were initially reviewed for possible inclusion appears to be favorable with reports of side effects in the same range as with placebo. According to the researchers, the evidence from the clinical trials reviewed shows that Padma 28 provides significant relief from PAOD-related symptoms (i.e. increase in walking distance), probably of the same order of magnitude as other employed therapies, such as physical training and may be larger than those reported with the conventional drugs pentoxifylline and naftidrofuryl, smoking cessation or the use of ginkgo (Ginkgo biloba) extract, which has also shown efficacy for treating PAOD. However, they note, that larger confirmatory randomized trials are desirable.
Padma 28* consists of the following botanicals and other ingredients: Bengal quince fruit (Aegle marmelos); allspice (Pimenta officinalis); columbine leaf (Aquilegia vulgaris); marigold flower (Calendula officinalis); cardamom fruit (Elletaria cardamomum); clove flower (Syzygium aromaticum); Indian costus root (Saussurea lappa); ginger lily rhizome (Hedychium spicatum); lettuce leaf (Lactuca sativa); Iceland moss (Cetraria islandica); licorice root (Glycyrrhiza glabra); neem fruit (Azadirachta indica): myrobalan fruit (Terminalia chebula); plantain tops (Plantago lanceolata); knot-grass tops (Polygonum aviculare); golden cinquefoil tops (Potentilla aurea); red sandalwood (Pterocarpus santalinus); country mallow tops (Sida cordifolia); aconite bulb (Aconitum napellus)*; and valerian root (Valeriana officinalis). The formula also includes two non-herbals: camphor (a botanically-derived ingredient) and gypsum (a mineral).2
PAOD is a sub-classification of peripheral arterial disease (PAD). PAD afflicts 14-18 million Americans, yet less than 20% of patients are actually diagnosed with the problem.3 PAD typically first manifests as pain in the legs, which then disappears at rest. In the later stages of the disease, the pain does not dissipate at rest, and blood flow to the limbs often becomes so inadequate that ulcerations and gangrene occur. Some pharmaceutical drugs exist for the treatment of PAD, but they are reportedly associated with severe side-effects.
---Mark Blumenthal and Courtney Cavaliere
*The formulation of Padma Basic® differs from Padma 28 only in the removal of the aconite bulb (Aconitum napellus) in order to meet regulatory requirements for the United States and some European countries.
References
1. Melzer J, Brignoli R, Diehm C, et al. Treating intermittent claudication with Tibetan medicine Padma 28: Does it work? Atherosclerosis 2006; doi:10.1016/j.atherosclerosis.2006.02.042 PMID: 16600251
2. EcoNugenics announces new clinical study on peripheral arterial disease; meta-analysis of Padma Basic® Tibetan herbal formula shows its effectiveness for improving PAD [press release]. San Francisco: St. John Group; May 18, 2006.
3. Webb G. Antioxidant effect of Tibetan plant preparation. HerbalGram. 1996;37:14.
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