Talk:Triphala/Archive 1

External Review Comments
Hello, Triphala article writers and editors. This article currently a priority article for the Wikipedia talk:WikiProject Medicine/Google Project. The goal of this project to is provide a useful list of suggested revisions to help promote the expansion and improvement of this article.

BSW-RMH (talk) 03:48, 2 August 2010 (UTC)

General comments
This article falls within the scope of WikiProject Alternative medicine and should present a balanced point of view when discussing health claims. Much of the Health benefits and Research sections require rewriting so as to not make unsupported claims that could be misleading or harmful to the public.

Specificallty, the article requires editing in line with the following guidelines: "All Wikipedia articles should be based on reliable, published secondary sources. Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors, or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources”
 * WikiProject Alternative medicine/Standards of Quality
 * SQG #4-To attribute means to footnote an assertion
 * SQG #6-Sources of information cited must be reliable and not idiosyncratic
 * SQG #11-Complementary treatments are recommended
 * SQG #12-Footnotes are required for health claims of any type.
 * Identifying reliable sources (medicine-related articles)

The article right now has very little useful information and would benefit greatly from expansion using an outline like this:
 * Description
 * Medicinal use
 * Active constituents
 * Research
 * References

BSW-RMH (talk) 03:48, 2 August 2010 (UTC)

Introduction
The introduction would probably benefit from using more common terms in place of technical terms. The technical terms can be defined in the next section. While references are not necessary in Wikipedia introductory paragraphs, a better reference for the definition of triphala is:
 * Ayurvedic pharmacopoeia committee. The Ayurvedic Formulary of India, Part I, 2nd English ed. New Delhi: Controller of Publications; 2003

BSW-RMH (talk) 03:48, 2 August 2010 (UTC)


 * Citation added BSW-RMH (talk) 03:23, 10 August 2010 (UTC)

Mechanism
The one article cited here is a primary research article from 2006, and uses only preliminary evidence in cell lines. There is not enough evidence to support anti-cancer properties of Triphala or mechanisms of action. This section will be removed because it is inaccurate and misleading.

BSW-RMH (talk) 03:48, 2 August 2010 (UTC)

This section was removed. BSW-RMH (talk) 03:24, 10 August 2010 (UTC)

Description
The description can be expanded by discussing the way this formulation is typically made available, ie. in powder and tablet form.
 * Pawar V, Lahorkar P, Anantha Narayana DB. Development of a RP-HPLC method for analysis of Triphala curna and its applicability to test variations in Triphala curna preparations. Indian J Pharm Sci [serial online] 2009 [cited 2010 Aug 1];71:382-6. Available from: http://www.ijpsonline.com/text.asp?2009/71/4/382/57286

BSW-RMH (talk) 03:48, 2 August 2010 (UTC)

Medicinal use
The current Health benefits section can be moved here, though unsupported claims must be removed. In this section, a neutral POV is critical and needs to be balanced with the requirements for making only supported health claims. One way this can be accomplished in to give the context (see general comments) followed by the traditional Ayurvedic medicinal uses, a disclaimer if any are not supported by reliable controlled studies, and then give any additional supported medicinal uses.

Traditional Ayurvedic medicinal uses:
 * immune system stimulation (Juss 1997)
 * improvement of digestion (Nadkarni 1976) (Formulary 2003)
 * relief of constipation (Nadkarni 1976) (Formulary 2003)
 * gastrointestinal tract cleansing (Nadkarni 1976)
 * relief of gas (Formulary 2003)
 * treatment of diabetes (Formulary 2003)
 * treatment of eye disease (Formulary 2003)

References
 * Juss SS. Triphala - the wonder drug. Indian Med Gaz 1997;131:94-6.
 * Nadkarni AK. Indian Materia Medica. 3rd ed. Mumbai: Popular Press; 1976. p. 1308-15.
 * Ayurvedic pharmacopoeia committee. The Ayurvedic Formulary of India, Part I, 2nd English ed. New Delhi: Controller of Publications; 2003

I did not find evidence of clinical studies to support these claims. In addition, I did not find any additional medicinal uses supported by secondary sources that reflect modern Western medical consensus.

BSW-RMH (talk) 03:48, 2 August 2010 (UTC)

These changes were made BSW-RMH (talk) 03:41, 10 August 2010 (UTC)

Active constituents
The active constituents are unknown. Triphala contains several compounds that have been proposed to be responsible for its claimed health benefits, including gallic acid, chebulagic acid, and chebulinic acid.
 * Reddy TC, Aparoy P, Babu NK, Kalangi SK, Reddanna P. Kinetics and Docking Studies of a COX-2 Inhibitor Isolated from Terminalia bellerica Fruits. Protein Pept Lett. 2010 May 5. PMID: 20441561
 * Pawar V, Lahorkar P, Anantha Narayana DB. Development of a RP-HPLC method for analysis of Triphala curna and its applicability to test variations in Triphala curna preparations. Indian J Pharm Sci [serial online] 2009 [cited 2010 Aug 1];71:382-6. Available from: http://www.ijpsonline.com/text.asp?2009/71/4/382/57286

BSW-RMH (talk) 01:50, 7 August 2010 (UTC)

This section was added. BSW-RMH (talk) 03:44, 10 August 2010 (UTC)

Research
There is not enough evidence to support anti-neoplastic properties of Triphala. This is not a consensus of the biomedical research community. I will remove this information because it is misleading. It is based on two citations::
 * Sandhya 2006- This is a primary research article where cancer cell lines and mice with xenograft tumors are treated with Triphala. The results are insufficient to claim “potential anti-cancer properties”.
 * Indolink.com-This is an unreliable unreferenced online article on an advertising network linking India related articles.

There is evidence of antioxidant activity of Triphala. However, most of what is presented in the current article is unsupported evidence. Again it is either unreferenced or uses the Indolink.com citation debunked above. Unsupported material will be removed.

A simple statement that; “There is there is preliminary evidence that Triphala contains compounds with antioxidant properties in isolated cells and rats.” Is all that is supported by the current research. Unfortunately there is no research community consensus on this, but it is supported by the following primary studies:
 * Mahesh R, Bhuvana S, Begum VM. Effect of Terminalia chebula aqueous extract on oxidative stress and antioxidant status in the liver and kidney of young and aged rats. Cell Biochem Funct. 2009 Aug;27(6):358-63. PMID: 19548245
 * Sandhya T, Lathika KM, Pandey BN, Bhilwade HN, Chaubey RC, Priyadarsini KI, Mishra KP. Protection against radiation oxidative damage in mice by Triphala. Mutat Res. 2006 Oct 10;609(1):17-25. PMID: 16860592
 * Srikumar R, Parthasarathy NJ, Manikandan S, Narayanan GS, Sheeladevi R. Effect of Triphala on oxidative stress and on cell-mediated immune response against noise stress in rats. Mol Cell Biochem. 2006 Feb;283(1-2):67-74. PMID: 16444587
 * Reddy TC, Aparoy P, Babu NK, Kalangi SK, Reddanna P. Kinetics and Docking Studies of a COX-2 Inhibitor Isolated from Terminalia bellerica Fruits. Protein Pept Lett. 2010 May 5. PMID: 20441561

BSW-RMH (talk) 03:48, 2 August 2010 (UTC)

I have removed the unsupported claims for the reasons above, and replaced it with a reliable summation of the current research. The article is now reliable, sourced, and accurate. Unfortunately, this has greatly reduced the overall length of the article. Expansion using the reference suggested here would be most welcome. Please contact me if you can't access sme of the sources. BSW-RMH (talk) 03:58, 10 August 2010 (UTC)

Additional sources that may be useful (removed from article)
Not sure these comply with WP:MEDRS but here they are for reference: