Ethnopharmacological Survey of Medicinal Plants Used in Traditional Treatment of Kidney Diseases in Fez–Meknes Region, Morocco
- By M. Chebaibi,
- D. Bousta,
- I. Iken,
- H. Hoummani,
- Claudine Ach,
- A. Najdi,
- T. S. Houssaini
- and S. Achour
Pages 99 to 114
Cite this article
- CHEBAIBI, M.,
- BOUSTA, D.,
- IKEN, I.,
- HOUMMANI, H.,
- ACH, Claudine,
- NAJDI, A.,
- HOUSSAINI, T. S.
- and ACHOUR, S.,
- Chebaibi, M..,
- et al.
- Chebaibi, M.,
- Bousta, D.,
- Iken, I.,
- Hoummani, H.,
- Ach, C.,
- Najdi, A.,
- Houssaini, T.-S.
- and Achour, S.
https://doi.org/10.3166/phyto-2019-0189
Cite this article
- Chebaibi, M.,
- Bousta, D.,
- Iken, I.,
- Hoummani, H.,
- Ach, C.,
- Najdi, A.,
- Houssaini, T.-S.
- and Achour, S.
- Chebaibi, M..,
- et al.
- CHEBAIBI, M.,
- BOUSTA, D.,
- IKEN, I.,
- HOUMMANI, H.,
- ACH, Claudine,
- NAJDI, A.,
- HOUSSAINI, T. S.
- and ACHOUR, S.,
https://doi.org/10.3166/phyto-2019-0189
Introduction
1 Traditional medicine is the set of skills, knowledge, and practices based on the theories, beliefs, and experiences indigenous to different cultures applied to maintain health, as well as to prevent, diagnose, improve, or treat physical and mental illnesses. According to the World Health Organization (WHO), 80% of the emerging world's population relies on traditional medicine for therapy. During the past decades, the developed world has also witnessed an ascending trend in the utilization of herbal remedies [1]. Moreover, at least, 70% of the country's population developed like Canada and Germany, have tried herbal remedies at least once [1,2]. In Africa, medicinal plants are a valuable resource for the majority of rural populations, where more than 80% of these people use them to provide health care [3,4]. In fact, of the 300,000 plant species recorded on the planet, more than 200,000 species live in the tropical countries of Africa and have medicinal properties. The Moroccan biodiversity is very rich in plants with 5,200 species and subspecies [5], and 600 species are medicinal plants [6]. The use of medicinal plants by the Moroccan population to cure diseases has since immemorial time and patients are more dependent on traditional medicine [7–9].
2 For a long time, the region of Fez–Meknes has a great interest in herbal medicine, thanks to the cultural heritage of these cities. The city of Fez located in the center of the region has always been considered the cultural and spiritual capital of Morocco. Al Quaraouiyine University in Fez is considered the oldest in the world by UNESCO and included a medical section [10,11]. In addition, the region is characterized by the great biodiversity in aromatic and medicinal plants, thanks to its climate and its geographical position. However, very little information is available on medicinal plants in central Morocco [7,12], and there is no documentation on the use of plants for the traditional treatment of kidney disease.
3 The purpose of this study was to inventory and collect information on plants and mixtures commonly used by herbalists to treat kidney disease in the Fez–Meknes region. We also aimed to compare the results obtained with the results of the other studies and exploit the correlations between different factors.
Materials and Methods
Study Area
4 The ethnopharmacological study was conducted in Fez–Meknes region, situated in the North Center of Morocco between the latitudes 34° 02′ 00″ north, 5° 00′ 00″ west with a surface of 40,075 km2 (Fig. 1). The relief of the region consists mainly of the hills at the foot of the Rif in the northern zone, the mountains of the Middle Atlas, the high hills of the Missour, and the plains of Saïss. The region is subject to three types of climates: a continental climate in the northern part, a cold and humid climate in the mountainous zone, and a semi-arid climate in the high hills of Boulmane. According to the latest census (2014), the number of population in this province is 4,236,892 inhabitants, including 1,672,672 inhabitants in rural areas.
Study area
Study area
Ethnopharmacological Survey
5 An ethnopharmacological survey was conducted from February to July 2016; all the information were obtained from 289 local herbals in eight different areas of Fez–Meknes region: Fez, Meknes, Taza, Sefrou, Taounate, Missour, Boulemane and Outat El Haj (Table 1).
Number of herbalists in each areas in Fez–Meknes region
| Areas | Effective | Percentage |
|---|---|---|
| Fez | 82 | 28.3 |
| Meknes | 80 | 27.6 |
| Sefrou | 31 | 10.7 |
| Boulemane | 26 | 9 |
| Missour | 14 | 4.8 |
| Outat El Haj | 10 | 3.4 |
| Taza | 30 | 10.3 |
| Taounate | 16 | 5.5 |
Number of herbalists in each areas in Fez–Meknes region
6 The questionnaire for each herbalist contains the following information:
- Sociodemographic and professional characteristics: age, sex, level of education, the source of acquisition of knowledge, and years of experience;
- Ethnomedicinal data:
- Vernacular name of plants used,
- Therapeutic and traditional uses of the plants,
- Used part, methods of preparation and modes of administration, and
- Risks of toxicity of plants used.
7 The medicinal plant species used by the local communities of the study area were authenticated using the international plant name index (http://www.ipni.org), the plant list (www.theplantlist.org) and GRIN taxonomy site (http://www.ars-grin.gov/cgi-bin/npgs/html/queries.pl), while that of families follow A.P.G. system [29].
Data Analysis
Use Value (UV)
8 The use value (UV) gives the relative importance of plant mixture known locally in the traditional medicine to treat kidney disease. It was calculated using the following formula [13]:
9 where
10 U is the number of use reports for a given plant mentioned by each herbalist.
11 N is the total number of herbalists interviewed for a given plant species.
The botanical family use value (FUV)
12 The significance of medicinal plant families was assessed using the family use values (FUV), which was calculated according to the following equation:
13 where
14 FUV = family use value, which equals the average total use value for each species in the family,
15 UV = use value of the species belonging to the family, and
16 n = number of species in the family (Hoffman and Gallaher, 2007).
Fidelity level (FL)
17 Fidelity level is the percentage of herbalists who mentioned the uses of certain plant species to treat a particular ailment in a study area. The FL index is calculated using formula as reported previously [42,43]:
18 where:
19 Np is the number of use reports cited for a given species for a particular ailment category.
20 N is the total number of use reports cited for any given species.
Rank Order Priority (ROP):
21 ROP is a correction factor, used for appropriate ranking of the plant species with different FL and RP values. The ROP is derived from FL, by multiplying RP and FL values as explained earlier [43,44].
22 ROP = FL × RP
23 where
24 ROP = rank-order priority.
FL = fidelity level.
RP = relative popularity.
25 The RP is the ratio between the number of ailments treated by a particular plant species and the total number of informants for any disease. The RPL value may be determined for each specific plant in accordance with its exact position on the graph [43,44].
Informant Consensus Factor (Fic).
26 Fic is used to see whether there is an agreement on the use of plants in the ailment categories between the plant users in the study area. The Fic was calculated using the following formula (Bağcı, 2000):
27 where
28 Nur is the number of use reports for a particular ailment category
29 Nt refers to the number of taxa used for a particular ailment category by all informants
Correlation Analysis
30 The variables were described by the use of descriptive statistics. For qualitative variables, they were described in percentage terms and the quantitative variables were described in terms of mean, extreme values, and standard deviation. Data entry and statistical analysis were carried out by the SPSS21 software.
Results
31 During our ethnopharmacological study, 289 herbalists (13 women, 276 men) were questioned. Sixty-nine plant species belonging to 38 families were cited by herbalists for traditional treatment of kidney disease.
Sociodemographic Characteristics
32 In the present survey, 289 herbalists were questioned with the mean age of 47.01 ± 0.44 years and 13 (4.49%) of them are women. When 78.20% of the herbalists located in the field urban, the sociodemographic data revealed that herbalists have a primary level of education in 32.2%,35.5% have a secondary level, 12.5% with higher levels of education, and 19.8% were illiterate. The main source of knowledge was based on ancestral experience (57.09%) and 50.51% had experienced in the herbalism between 7 and 12 years. In addition, 153 (52.94%) consider that no plants are toxic (Table 2).
Sociodemographic data of the herbalists
| Sociodemographic variables | Effective | Percentage | |
|---|---|---|---|
| Gender | Mal | 276 | 95.50 |
| Female | 13 | 4.49 | |
| Age | < 30 years | 4 | 1.38 |
| 30–60 years | 258 | 89.27 | |
| 60–80 years | 26 | 8.99 | |
| > 80 years | 1 | 0.34 | |
| Mean age | 47.01 ± 0.44 | ||
| Level of education | Illiterate | 57 | 19.72 |
| primary level | 95 | 32.87 | |
| Secondary level | 102 | 35.29 | |
| University | 35 | 12.11 | |
| Source of acquisition of knowledge | Ancestral experience | 165 | 57.09 |
| Ancestral experience and Internet | 3 | 1.03 | |
| Ancestral experience and media | 75 | 25.95 | |
| Media and Internet | 9 | 3.11 | |
| Books | 37 | 12.80 | |
| Years of experience | < 6 years | 13 | 4.49 |
| 7–12 years | 146 | 50.51 | |
| 13–20 years | 90 | 31.14 | |
| > 20 years | 40 | 13.84 | |
| Locality | Urban | 226 | 78.20 |
| Rural | 63 | 21.79 | |
| Knowledge of toxic plants | Yes | 136 | 47.05 |
| No | 153 | 52.94 |
Sociodemographic data of the herbalists
Medicinal Plants Used in Traditional Treatment of Kidney Diseases in Fez–Meknes Region
The Use Value (UV)
33 Sixty-nine plant species belonging to 38 families were cited by herbalists for traditional treatment of kidney disease. The following plant species:
Herniaria glabraL.,Zea maysL.,Zizyphus lotus(L.) Lam. and Opuntia ficus-indica(L.) Mill. represent the highest values of UV at 0.79,0.69,0.65 and 0.55 respectively, whereas lowest values of UV correspond to the following species:
Eruca sativaMill.,Malva sylvestrisL.,Syzygium aromaticumL.,Polygonum aviculareL.,Fraxinus angustifoliaVahl.,Salix albaL., and Lippia citriodoraH.B & K. with UV value of 0.03 (Table 3).
List of plant species used by herbalists to treat kidney disease recorded in Fez–Meknes region
| Plant number | Name of plants | Families | Vernacular name | Part of plant | TNC | UV | FUV |
|---|---|---|---|---|---|---|---|
| EPK-1 | Agave americana L. | Agavaceae | Sebar | Leaves | 12 | 0.04 | 0.041 |
| EPK-2 | Petroselinum sativum Hoffm. | Apiaceae | Maadnous | Stem and leaves | 145 | 0.50 | 0.185 |
| EPK-3 | Ammodaucus leucotrichus Coss. & Dur. | Apiaceae | Kamoun soufi | Seeds | 133 | 0.46 | |
| EPK-4 | Pimpinella anisum L. | Apiaceae | Habat Hlawa | Seeds | 39 | 0.13 | |
| EPK-5 | Apium graveolens L. | Apiaceae | Krafes | Stem and leaves | 27 | 0.09 | |
| EPK-6 | Carum carvi L. | Apiaceae | Karwiya | Seeds | 27 | 0.09 | |
| EPK-7 | Ammi visnaga L. | Apiaceae | Bechnikha | Fruits | 26 | 0.08 | |
| EPK-8 | Foeniculum vulgare Mill. | Apiaceae | Nafae | Seeds | 17 | 0.05 | |
| EPK-9 | Daucus carota subsp. sativus(Hoffm.) | Apiaceae | Jaada | Rhizome | 15 | 0.05 | |
| EPK-10 | Asparagus officinalis L. | Asparagaceae | Sekoum | Root | 12 | 0.04 | 0.041 |
| EPK-11 | Chamaemelum nobile(L.) All. | Asteraceae | Babounej | Flowers | 135 | 0.46 | 0.156 |
| EPK-12 | Artemisia herba alba Asso | Asteraceae | Chih | Stem and leaves | 22 | 0.07 | |
| EPK-13 | Cynara cardunculus L. | Asteraceae | Khorchef | Fruits | 12 | 0.04 | |
| EPK-14 | Anacyclus pyrethrum L. | Asteraceae | Oud Atras | Stem and leaves | 12 | 0.04 | |
| EPK-15 | Brassica oleracea L. | Brassicaceae | Carnabe | Leaves | 12 | 0.04 | 0.038 |
| EPK-16 | Eruca sativa Mill. | Brassicaceae | Jarjir | Leaves | 10 | 0.03 | |
| EPK-17 | Opuntia ficus – indica(L.) Mill. | Cactaceae | Hendia | Flowers | 160 | 0.55 | 0.553 |
| EPK-18 | Cassia absus L. | Caesalpiniaceae | Haba souda | Seeds | 13 | 0.04 | 0.044 |
| EPK-19 | Herniaria glabra L. | Caryophyllaceae | Haraset lhjar | Stem and leaves | 230 | 0.79 | 0.795 |
| EPK-20 | Juniperus phoenicea L. | Cupressaceae | Arar | Leaves | 12 | 0.04 | 0.041 |
| EPK-21 | Equisetum telmateia Ehrh. | Equisetaceae | Dil lhassane | Stem and leaves | 12 | 0.04 | 0.041 |
| EPK-22 | Euphorbia falcata L. | Euphorbiaceae | Hayat noufous | Stem and leaves | 37 | 0.12 | 0.073 |
| EPK-23 | Caralluma europaea Guss | Euphorbiaceae | Daghmous | Stem | 15 | 0.05 | |
| EPK-24 | Ricinus communis L. | Euphorbiaceae | Kharwaa | Seeds | 12 | 0.04 | |
| EPK-25 | Trigonella foenum-graecum L. | Fabaceae | Halba | Seeds | 24 | 0.08 | 0.063 |
| EPK-26 | Glycyrrhiza glabra L. | Fabaceae | Arek sous | Root | 23 | 0.07 | |
| EPK-27 | Vicia faba L. | Fabaceae | Foul | Seeds | 14 | 0.04 | |
| EPK-28 | Ceratonia siliqua L. | Fabaceae | Kharoub | Fruits | 12 | 0.04 | |
| EPK-29 | Pelargonium odoratissimum L. | Geraniaceae | Atracha | Leaves | 14 | 0.04 | 0.048 |
| EPK-30 | Crocus sativus L. | Iridaceae | Zaafrane | Style | 19 | 0.06 | 0.065 |
| EPK-31 | Juncus acutus L. | Juncaceae | Smar | Seeds | 37 | 0.12 | 0.128 |
| EPK-32 | Lavandula officinalis | Lamiaceae | Khzaama | Stem and leaves | 142 | 0.49 | 0.195 |
| EPK-33 | Rosmarinus officinalis L. | Lamiaceae | Azir | Leaves | 140 | 0.48 | |
| EPK-34 | Origanum compactum Benth. | Lamiaceae | Zaater | Stem and leaves | 50 | 0.17 | |
| EPK-35 | Mentha gatefossei Maire | Lamiaceae | Fluo | Stem and leaves | 26 | 0.08 | |
| EPK-36 | Satureja calamintha L. | Lamiaceae | Mantha | Stem and leaves | 14 | 0.04 | |
| EPK-37 | Marrubium vulgare L. | Lamiaceae | Mriwa | Stem and leaves | 12 | 0.04 | |
| EPK-38 | Ocimum basilicum L. | Lamiaceae | Rayhane | Stem | 12 | 0.04 | |
| EPK-39 | Cinnamomum cassia Blume | Lauraceae | Karfa | Bark | 23 | 0.07 | 0.079 |
| EPK-40 | Allium cepa L. | Liliaceae | Bsal | Rhizome | 12 | 0.04 | 0.041 |
| EPK-41 | Linum usitatissimum L. | Linaceae | Ketane | Seeds | 18 | 0.06 | 0.062 |
| EPK-42 | Punica granatum L. | Lythraceae | Ramane | Fruits | 18 | 0.06 | 0.062 |
| EPK-43 | Malva sylvestris L. | Malvaceae | Khebiza | Stem and leaves | 10 | 0.03 | 0.034 |
| EPK-44 | Syzygium aromaticum L. | Myrtaceae | Kronfol | Seeds | 10 | 0.03 | 0.034 |
| EPK-45 | Olea europaea L. | Oleaceae | Zitoun | Leaves | 12 | 0.04 | 0.038 |
| EPK-46 | Fraxinus angustifolia Vahl. | Oleaceae | Lsan tour | Stem | 10 | 0.03 | |
| EPK-47 | Piper cubebaL.F. | Piperaceae | Kababa | Stem and leaves | 23 | 0.07 | 0.079 |
| EPK-48 | Zea mays L. | Poaceae | Dra | Silks | 201 | 0.69 | 0.215 |
| EPK-49 | Hordeum vulgare L. | Poaceae | Chair | Seeds | 23 | 0.07 | |
| EPK-50 | Avena sativa L. | Poaceae | Khertale | Seeds | 13 | 0.04 | |
| EPK-51 | Cynodon dactylon L. | Poaceae | Njem | Root | 12 | 0.04 | |
| EPK-52 | Polygonum aviculare L. | Polygonaceae | Batbat | Leaves | 10 | 0.03 | 0.034 |
| EPK-53 | Nigella sativa L. | Ranunculaceae | Sanouj | Seeds | 39 | 0.13 | 0.134 |
| EPK-54 | Zizyphus lotus(L.) Lam. | Rhamnaceae | Nbeg | Fruits | 189 | 0.65 | 0.347 |
| EPK-55 | Rhamnus cathartica L. | Rhamnaceae | Oud lkiset | Root | 12 | 0.04 | |
| EPK-56 | Prunus amygdalus Stokes | Rosaceae | Louz lmor | Fruits | 16 | 0.05 | 0.053 |
| EPK-57 | Rubus ulmifolius Schott | Rosaceae | Alik | Fruits | 15 | 0.05 | |
| EPK-58 | Rubia peregrina L. | Rubiaceae | Fouwa | Stem | 54 | 0.18 | 0.186 |
| EPK-59 | Ruta montana L. | Rutaceae | Fijel | Rhizome | 22 | 0.07 | |
| EPK-60 | Citrus limon(L.)Burm. f | Rutaceae | Hamed | Fruits | 14 | 0.04 | |
| EPK-61 | Populus alba L. | Salicaceae | Safsafe | Leaves | 16 | 0.05 | 0.044 |
| EPK-62 | Salix alba L. | Salicaceae | Oud lma | Stem and leaves | 10 | 0.03 | |
| EPK-63 | Camellia thea Link | Theaceae | Atay | Leaves | 12 | 0.04 | 0.041 |
| EPK-64 | Daphne gnidium L. | Thymelaeaceae | Matnane | Stem | 24 | 0.08 | 0.083 |
| EPK-65 | Tilia cordata Mill. | Tiliaceae | Zayzafoune | Stem and leaves | 15 | 0.05 | 0.051 |
| EPK-66 | Urtica dioica L. | Urticaceae | Heriga | Stem and leaves | 36 | 0.12 | 0.124 |
| EPK-67 | Lippia citriodoraH.B & K. | Verbenaceae | Lwiza | Leaves | 10 | 0.03 | 0.034 |
| EPK-68 | Alpinia officinarum Hance | Zingiberaceae | Khoudnjal | Rhizome | 20 | 0.06 | 0.055 |
| EPK-69 | Curcuma longa L. | Zingiberaceae | Korkom | Rhizome | 12 | 0.04 |
List of plant species used by herbalists to treat kidney disease recorded in Fez–Meknes region
The Botanical Family Use Value (FUV)
34 Thirty-eight families were cited by herbalists for traditional treatment of kidney disease, the highest value of FUV corresponds to the following families: Caryophyllaceae (FUV = 0.795), Cactaceae (FUV = 0.553), Rhamnaceae (FUV = 0.347), Poaceae (FUV = 0.215), Lamiaceae (FUV = 0.195) and Apiaceae (FUV = 0.185), while the lowest values of FUV have been shown in the families of Agavaceae, Asparagaceae, Cupressaceae, Equisetaceae, Liliaceae and Theaceae with FUV value of 0.041, followed by the families of Brassicaceae and Oleaceae with FUV value of 0.038, and the families of Malvaceae, Myrtaceae, Polygonaceae and Verbenaceae with FUV value of 0.034 (Table 3).
Traditional Medicine Knowledge
Part Used, Mode of Preparation and Mode of Administration
35 Table 3 illustrates all the part used for each plant species, when figure 2 shows that the stem and leaves are the parts most used followed by seeds and leaves. Concerning the mode of preparation, figure 3 presented that the infusion was the main mode of preparation at 75.4% followed by decoction (20.4%) and maceration (4.2%). The main route of administration is oral and dosage frequency is two times a day with 46.02% followed by three times a day (37.37%) (Fig. 4).
Frequency of part used of plants cited by herbalists in Fez–Meknes region for traditional treatment of kidney disease
Frequency of part used of plants cited by herbalists in Fez–Meknes region for traditional treatment of kidney disease
Frequency of mode of preparation of plants cited by herbalists in Fez–Meknes region for traditional treatment of kidney disease
Frequency of mode of preparation of plants cited by herbalists in Fez–Meknes region for traditional treatment of kidney disease
Dosage frequency of plants cited by herbalists in Fez–Meknes region for traditional treatment of kidney disease
Dosage frequency of plants cited by herbalists in Fez–Meknes region for traditional treatment of kidney disease
Fidelity Level (FL)
36 The highest values of FL correspond to the following plant species: Ammodaucus leucotrichus Coss. & Dur. (100%), Chamaemelum nobile(L.) All. (97%), Lavandula officinalis (92%), Rosmarinus officinalis L. (95%), and Petroselinum sativum Hoffm. (89%) for treating edema and renal colic, where Opuntia ficus-indica(L.) Mill. (97%), Zea mays L. (97%), Zizyphus lotus(L.) Lam. (95%), and Herniaria glabra L. (91%) for treating lithiasis renal, and in addition, Polygonum aviculare L. (70%), Rubia peregrina L. (74%), and Ruta montana L. (86%) for treating acute pyelonephritis (Table 4).
Fidelity level and rank order priority values for the principal plant species and their principal uses
| Plant number | Name of plants | Ailments | Np | N | FL (%) | RP | ROP (%) |
|---|---|---|---|---|---|---|---|
| EPK-2 | Petroselinum sativum Hoffm. | Edema and renal colic | 130 | 145 | 89 | 0.63 | 56 |
| EPK-3 | Ammodaucus leucotrichus Coss. & Dur. | Edema and renal colic | 133 | 133 | 100 | 0.57 | 57 |
| EPK-4 | Pimpinella anisum L. | lithiasis renal | 22 | 39 | 56 | 0.16 | 9 |
| EPK-5 | Apium graveolens L. | Hematuria | 16 | 27 | 59 | 0.11 | 6 |
| EPK-6 | Carum carvi L. | Urinary infections | 20 | 27 | 74 | 0.11 | 8 |
| EPK-7 | Ammi visnaga L. | lithiasis renal | 22 | 26 | 84 | 0.11 | 9 |
| EPK-8 | Foeniculum vulgare Mill. | Lithiasis renal | 12 | 17 | 70 | 0.07 | 5 |
| EPK-9 | Daucus carota subsp. sativus(Hoffm.) | Acute Pyelonephritis | 10 | 15 | 66 | 0.06 | 4 |
| EPK-10 | Asparagus officinalis L. | Acute Pyelonephritis | 8 | 12 | 66 | 0.05 | 3 |
| EPK-11 | Chamaemelum nobile(L.) All. | Edema and renal colic | 132 | 135 | 97 | 0.58 | 57 |
| EPK-12 | Artemisia herba alba Asso | Lithiasis renal | 14 | 22 | 63 | 0.09 | 6 |
| EPK-13 | Cynara cardunculus L. | Urinary infections | 7 | 12 | 58 | 0.05 | 3 |
| EPK-16 | Eruca sativa Mill. | Urinary infections | 5 | 10 | 50 | 0.04 | 2 |
| EPK-17 | Opuntia ficus-indica(L.) Mill. | Lithiasis renal | 156 | 160 | 97 | 0.69 | 67 |
| EPK-19 | Herniaria glabra L. | Lithiasis renal | 211 | 230 | 91 | 1 | 91 |
| EPK-21 | Equisetum telmateia Ehrh. | Lithiasis renal | 9 | 12 | 75 | 0.05 | 3 |
| EPK-22 | Euphorbia falcata L. | Hematuria | 29 | 37 | 78 | 0.16 | 12 |
| EPK-23 | Caralluma europaea Guss | Kidney cancer | 11 | 15 | 73 | 0.06 | 4 |
| EPK-24 | Ricinus communis L. | Lithiasis renal | 9 | 12 | 75 | 0.05 | 3 |
| EPK-25 | Trigonella foenum-graecum L. | Edema and renal colic | 17 | 24 | 70 | 0.10 | 7 |
| EPK-26 | Glycyrrhiza glabra L. | Urinary infections | 20 | 23 | 86 | 0.1 | 8 |
| EPK-27 | Vicia faba L. | Edema and renal colic | 8 | 14 | 57 | 0.06 | 3 |
| EPK-29 | Pelargonium odoratissimum L. | Urinary infections | 11 | 14 | 78 | 0.06 | 4 |
| EPK-30 | Crocus sativus L. | Lithiasis renal | 10 | 19 | 52 | 0.08 | 4 |
| EPK-31 | Juncus acutus L. | Lithiasis renal | 30 | 37 | 81 | 0.16 | 13 |
| EPK-32 | Lavandula officinalis | Edema and renal colic | 132 | 142 | 92 | 0.61 | 57 |
| EPK-33 | Rosmarinus officinalis L. | Edema and renal colic | 133 | 140 | 95 | 0.60 | 57 |
| EPK-34 | Origanum compactum Benth. | Urinary infections | 41 | 50 | 82 | 0.21 | 17 |
| EPK-35 | Mentha gatefossei Maire | Urinary infections | 18 | 26 | 69 | 0.11 | 7 |
| EPK-38 | Ocimum basilicum L. | Urinary infections | 7 | 12 | 58 | 0.05 | 3 |
| EPK-39 | Cinnamomum cassia Blume | Edema and renal colic | 17 | 23 | 73 | 0.1 | 7 |
| EPK-40 | Allium cepa L. | Edema and renal colic | 6 | 12 | 50 | 0.05 | 2 |
| EPK-41 | Linum usitatissimum L. | Urinary infections | 9 | 18 | 50 | 0.07 | 3 |
| EPK-42 | Punica granatum L. | Lithiasis renal | 14 | 18 | 77 | 0.07 | 6 |
| EPK-43 | Malva sylvestris L. | Acute Pyelonephritis | 6 | 10 | 60 | 0.04 | 2 |
| EPK-45 | Olea europaea L. | Lithiasis renal | 7 | 12 | 58 | 0.05 | 3 |
| EPK-47 | Piper cubebaL.F. | Edema and renal colic | 16 | 23 | 69 | 0.1 | 6 |
| EPK-48 | Zea mays L. | Lithiasis renal | 195 | 201 | 97 | 0.87 | 84 |
| EPK-49 | Hordeum vulgare L. | Urinary infections | 16 | 23 | 69 | 0.1 | 6 |
| EPK-52 | Polygonum aviculare L. | Acute Pyelonephritis | 7 | 10 | 70 | 0.04 | 3 |
| EPK-53 | Nigella sativa L. | Urinary infections | 28 | 39 | 71 | 0.16 | 12 |
| EPK-54 | Zizyphus lotus(L.) Lam. | Lithiasis renal | 180 | 189 | 95 | 0.82 | 78 |
| EPK-56 | Prunus amygdalus Stokes | Urinary infections | 10 | 16 | 62 | 0.06 | 4 |
| EPK-57 | Rubus ulmifolius Schott | Hematuria | 11 | 15 | 73 | 0.06 | 4 |
| EPK-58 | Rubia peregrina L. | Acute Pyelonephritis | 40 | 54 | 74 | 0.23 | 17 |
| EPK-59 | Ruta montana L. | Acute Pyelonephritis | 19 | 22 | 86 | 0.09 | 8 |
| EPK-60 | Citrus limon(L.)Burm. f | Lithiasis renal | 10 | 14 | 71 | 0.06 | 4 |
| EPK-61 | Populus alba L. | Lithiasis renal | 13 | 16 | 81 | 0.06 | 5 |
| EPK-64 | Daphne gnidium L. | Hematuria | 18 | 24 | 75 | 0.10 | 7 |
| EPK-65 | Tilia cordata Mill. | Edema and renal colic | 11 | 15 | 73 | 0.06 | 4 |
| EPK-66 | Urtica dioica L. | Urinary infections | 27 | 36 | 75 | 0.15 | 11 |
| EPK-67 | Lippia citriodoraH.B & K. | Urinary infections | 6 | 10 | 60 | 0.04 | 2 |
| EPK-68 | Alpinia officinarum Hance | Hematuria | 9 | 20 | 45 | 0.08 | 3 |
Fidelity level and rank order priority values for the principal plant species and their principal uses
Rank-Order Priority (ROP)
37 Table 4 showed the following plant species: Herniaria glabraL.,Zea maysL., and Zizyphus lotus(L.)Lam., which had the highest values at 91%, 84%, and 78%, respectively, while the lowest values correspond to Eruca sativaMill.,Allium cepa L, Malva sylvestrisL., and Lippia citriodoraH.B & K. with ROP values of 2%.
Informant Consensus Factor (Fic)
38 Table 5 presented the highest value of informant consensus factor corresponding to acute pyelonephritis (Fic = 0.94), edema and renal colic (Fic = 0.93), kidney cancer (Fic = 0.93), urinary infections (Fic = 0.90), lithiasis renal (Fic = 0.89) and hematuria (Fic = 0.80).
Informant consensus factor values of ailments categories
| Ailments categories | Ailments | Nur | Nt | Fic |
|---|---|---|---|---|
| Kidney disease | Lithiasis renal | 260 | 27 | 0.89 |
| Edema and renal colic | 245 | 16 | 0.93 | |
| Urinary infections | 144 | 14 | 0.90 | |
| Acute Pyelonephritis | 89 | 6 | 0.94 | |
| Hematuria | 37 | 5 | 0.88 | |
| Kidney cancer | 17 | 2 | 0.93 |
Informant consensus factor values of ailments categories
Correlation Between Socio-demographic Characteristics of Herbalists and Plants Knowledge
Relationship Between Herbalists’ Age and Number of Plants Species Cited
39 The test of Pearson revealed a significant correlation (r = 0.203,p = 0.001) between herbalists’ age and number of plant species cited. Number of plants cited increased with increasing herbalist age.
Relationship Between Sociodemographic Characteristics and Knowledge of Toxic Plants
40 Sociodemographic characteristics such as level of education and source of acquisition of knowledge had a significant (p-value = 0.00) impact on the knowledge of toxic plants, when the years of experience had a significant impact on the knowledge of toxic plants with p-value of 0.03 (Table 6).
Results of correlation between knowledge of toxic plants and sociodemographic Variables
| Knowledge of toxic plants | p-value | |||
|---|---|---|---|---|
| No | Yes | |||
| Level of education | Illiterate | 47 | 10 | 0.00 |
| primary level | 77 | 18 | ||
| High school | 24 | 78 | ||
| university | 5 | 30 | ||
| Source of acquisition of knowledge | Ancestral experience | 102 | 63 | 0.03 |
| Ancestral experience and Internet | 0 | 3 | ||
| Ancestral experience and media | 34 | 41 | ||
| Media and internet | 2 | 7 | ||
| Books | 15 | 22 | ||
| Years of experience | <6 years | 3 | 10 | 0.00 |
| 7–12 years | 103 | 43 | ||
| 13–20 years | 32 | 58 | ||
| >20 years | 15 | 25 |
Results of correlation between knowledge of toxic plants and sociodemographic Variables
Mixtures of Plants Used to Treat Kidney Diseases
41 During our study, we noticed the use of plant mixtures to treat kidney diseases. Table 7 presents eight plant mixtures with the frequency of quotation by herbalists, the most quoted mixture (TNC = 257) used to treat renal lithiasis, composed of four plants Herniaria glabraL.,Zizyphus lotus(L.)Lam.,Opuntia ficus-indica(L.)Mill., and Zea maysL.; the mode of preparation of this mixture is infusion (85%), and the dosage frequency is three times a day. The second mentioned mixture is used to treat edema and renal colic (TNC = 235); this mixture is composed of five plant species: Ammodaucus leucotrichus Coss. & Dur.,Petroselinum sativumHoffm.,Chamaemelum nobile(L.)All.,Rosmarinus officinalisL., and Lavandula officinalis. The main mode of preparation is infusion (82%), and dosage frequency is three times a day.
List of Mixtures of plants cited by herbalists in Fez–Meknes
| Ailments | Plants Mixtures | Families | Vernacular name | Used part | Mode of preparation | Dosage | TNC |
|---|---|---|---|---|---|---|---|
| Lithiasis renal | Herniaria glabra L. | Caryophyllaceae | Haraset lhjar | Stem and leaves | Infusion, Decoction | 3 times a day | 257 |
| Zizyphus lotus(L.) Lam. | Rhamnaceae | Nbeg | Fruit | ||||
| Opuntia ficus-indica(L.) Mill. | Cactaceae | Hendia | Flowers | ||||
| Zea mays L. | Poaceae | Dra | Silks | ||||
| Rosmarinus officinalis L. | Lamiaceae | Azir | Leaves | Infusion, Decoction | 3 times a day | 109 | |
| Nigella sativa L. | Ranunculaceae | Sanouj | Seeds | ||||
| Juncus acutus L. | Juncaceae | Smar | Seeds | ||||
| Euphorbia falcata L. | Euphorbiaceae | Hayat noufous | Stem and leaves | ||||
| Origanum compactum Benth. | Lamiaceae | Zaater | Stem and leaves | ||||
| Petroselinum sativum Hoffm. | Apiaceae | Maadnous | Stem and leaves | ||||
| Urtica dioica L. | Urticaceae | Heriga | Stem, leaves and seeds | ||||
| Edema and renal colic | Ammodaucus leucotrichus Coss. & Dur. | Apiaceae | Kamoun soufi | Seeds | Infusion, Decoction | 3 times a day | 235 |
| Petroselinum sativum Hoffm. | Apiaceae | Maadnous | Stem and leaves | ||||
| Chamaemelum nobile(L.) All. | Asteraceae | Babounej | Flowers | ||||
| Rosmarinus officinalis L. | Lamiaceae | Azir | Leaves | ||||
| Lavandula officinalis | Lamiaceae | Khzaama | Stem and leaves | ||||
| Herniaria glabra L. | Caryophyllaceae | Haraset lhjar | Stem and leaves | Infusion, Decoction | 2 times a day | 76 | |
| Zea mays L. | Poaceae | Dra | Silks | ||||
| Origanum compactum Benth. | Lamiaceae | Zaater | Stem and leaves | ||||
| Zizyphus lotus(L.) Lam. | Rhamnaceae | Nbeg | Fruit | ||||
| Mentha gatefossei Maire | Lamiaceae | Fluo | Stem and leaves | ||||
| Urinary infections | Herniaria glabra L. | Caryophyllaceae | Haraset lhjar | Stem and leaves | Infusion, Decoction | 2 times a day | 36 |
| Zizyphus lotus(L.) Lam. | Rhamnaceae | Nbeg | Fruit | ||||
| Origanum compactum Benth. | Lamiaceae | Zaater | Stem and leaves | ||||
| Pimpinella anisum L. | Apiaceae | Habat Hlawa | Seeds | ||||
| Hematuria | Zea mays L. | Poaceae | Dra | Silks | Infusion, Decoction | 3 times a day | 31 |
| Alpinia officinarum Hance | Zingiberaceae | Khounaj | Rhizome | ||||
| Herniaria glabra L. | Caryophyllaceae | Haraset lhjar | Stem and leaves | ||||
| Ruta montana L. | Rutaceae | Fijel | Rhizome | ||||
| Opuntia ficus-indica(L.) Mill. | Cactaceae | Hendia | Flowers | ||||
| Daphne gnidium L. | Thymelaeaceae | Matnane | Stem and leaves | ||||
| Acute Pyelonephritis | Euphorbia falcata L. | Euphorbiaceae | Hayat noufous | Stem and leaves | Infusion, decoction | 17 | |
| Polygonum aviculare L. | polygonaceae | Batbat | Feuilles | ||||
| Malva sylvestris L. | Malvaceae | Khebiza | Feuilles, tiges | ||||
| Ruta montana L. | Rutaceae | Fijel | Rhizome | ||||
| Lavandula officinalis | Lamiaceae | Khzaama | Stem and leaves | ||||
| Apium graveolens L. | Apiaceae | Krafes | Stem and leaves | ||||
| Asparagus officinalis L. | Asparagaceae | Sekoum | Root | ||||
| Kidney cancer | Caralluma europaea Guss | Euphorbiaceae | Daghmous | Stem | Powder of Caralluma europaea mixed with honey and added few drops of lemon juice | 1 time a day | 2 |
| Citrus limon(L.)Burm. f. | Rutaceae | Hamed | Fruits | ||||
| Honey | ** | ** | ** |
List of Mixtures of plants cited by herbalists in Fez–Meknes
42 Other mixtures with an unknown plant composition are quoted by herbalists in Fez–Meknes region, these mixtures are packaged and labeled, the most used are HERBO-REIN (80%) (Fig. 5), HERBOVESSIEREIN (10%) (Fig. 6), and others (10%). Ninety-four percent of these mixtures are without with no information on adverse reactions, dosage frequency, duration of treatment, frequency, and mode of administration.
Mixtures with an unknown plant composition (herbo-rein)
Mixtures with an unknown plant composition (herbo-rein)
Mixture with an unknown vegetal composition (HERBOVESSIEREINS)
Mixture with an unknown vegetal composition (HERBOVESSIEREINS)
Discussion
Sociodemographic Characteristics
43 The practice of herbalism in Fez–Meknes region was preserved of mature men. Of the 289 herbalists surveyed, 95.50% were male, the age ranged between 20 and 70 years, with a mean age of 47 years. This result is in agreement with a study where the Moroccan men dominate the practice of traditional medicine [14] and among Algerian men, according to a study in northern Algeria [15]. Regarding the level of education of herbalists, 35.29% of them had a secondary level, primary level (32.87%), university level (12.11%) and illiterate (19.72%); this result showed that the majority of herbalists have a secondary or primary education, unlike many studies in the regions of Morocco where the majority of herbalists are illiterate, with percentages of 60.27%, 40%, and 41%, respectively [16–18].
44 The main source of knowledge for herbalists of Fez–Meknes region is the ancestral experience (57.09%) from their fathers or grandfathers. This finding is in concordance with other ethnopharmacological studies where the learning of the trade among Moroccan herbalists has been passed from generation to generation [14,19]. Similar findings were observed in Northern Thailand where the source of medicinal knowledge has been transmitted orally among family members [20]. We notice that some herbalists use the ancestral experience and Internet as a source of knowledge (1.03%), other herbalists use the media in addition to the ancestral experience (25.95%), when other herbalists rely only on the media (3.11%), while others use the books (12.80%), which explains the role of radio and television programs and Internet in dissemination of knowledge of medicinal plants. The use of books by herbalists is in agreement with a study conducted in Daraa–Tafilalet region at the South Eastern Morocco, where the main source of acquisition of knowledge for herbalists is literature [21], whereas our study is the first that cites the integration of new media and the Internet as sources of knowledge for herbalists.
45 According to our survey, most herbalists are older, which explains their great experience, where 50.51% have experienced between 7 and 12 years, while 44.98% have more than 13 years of experience. This result is in concordance with studies performed in Morocco [19,21], where the elder informants including herbalists play a special role in an ethnobotany survey because of their great experiences.
Medicinal Plants Used in Traditional Treatment of Kidney Diseases in Fez–Meknes Region
46 Sixty-nine plant species belonging to 38 families were cited by herbalists for traditional treatment of kidney disease; this richness in medicinal plants can be explained by the geographical position of the region and its climate. To quantitatively study the data collected on the use of plants in the treatment of kidney diseases, two indices were calculated: The Use Value (UV) and the Use Value of the Botanical Family (FUV) (Table 3).
The Use Value (UV)
47 The use value index (UV) is used to show the relative importance of each plant species used to treat different diseases in traditional medicine. In connection with our ethnopharmacological survey on the plants used in the traditional treatment of kidney diseases in Fez–Meknes region, the following plant species: Herniaria glabraL.,Zea maysL.,Zizyphus lotus(L.)Lam., and Opuntia ficus-indica(L.) Mill. represent the highest values of UV at 0.79,0.69,0.65 and 0.55, respectively. Herniaria glabra L. is well known in the traditional treatment of kidney diseases in Morocco [22,23] and in other countries such as Turkey [24]. In the South Eastern and North Center of Morocco, it is used as antidiabetic and hypertensive plant [11,22,25]. On the other hand, this plant is used in other countries such as India as antioxidant plant [26] and in Bulgaria as diuretic and spasmolytic [27]. Zea maysL., other ethnopharmacological studies in Morocco confirm the use of this plant to treat kidney disease [23,28] and in other countries such as Jordan and Italy [29,30]. In Western Nigeria and South Eastern Morocco, it is used as antidiabetic and hypertensive plant [25,31], when in Northern of Portugal, it is used as antidiabetic, anti-inflammatory,anti-podagric, cardiotonic, cholagogue, and diuretic [30].
48 Zizyphus lotus(L.) Lam. (UV = 0.65): Traditionally, in several regions of Morocco, this plant is used to treat kidney diseases [11,32]; in other regions of Morocco and Algeria, it is used as antidiabetic and hypertensive [19,25,33–35]. In North Algeria, this plant is used as anti-inflammatory, wound healing and to treat eczema [15], when in south west of this country, it is used to treat urinary tract infections and prostate [36]. Opuntia ficus-indica(L.) Mill (UV = 0.55): the flowers of this plant are used in north centeral region and South Eastern Morocco as hypertensive and antidiabetic [11,25], when in oriontal, it is used to treat allergy, digestive, and dermal pathology [32]. This plant is used in the Mediterranean countries to treat several diseases such as digestive and muscular diseases in Algeria, kidney diseases in Cyprus, respiratory diseases in Spain, and skin diseases in Palestine [37,38].
The Family Use Value (FUV)
49 In the family use value (FUV), which represents the relationship between botanical families and the total number of plant species in these families, in agreement with our investigation, 38 families were cited by herbalists for traditional treatment of kidney disease. This number represents 24.35% of the total number of botanical families found in Morocco (150 botanical families according to Hmamouchi) [39]. The highest value of FUV corresponds to the following families: Caryophyllaceae (FUV = 0.795), Cactaceae (FUV = 0.553), Rhamnaceae (FUV = 0.347), Poaceae (FUV = 0.215), Lamiaceae (FUV = 0.195) and Apiaceae (FUV = 0.185).
50 The families of Caryophyllaceae and Cactaceae have the highest values of the family use value (FUV = 0.795) and (FUV = 0.553), respectively and were represented by just one species, Herniaria glabra L. and Opuntia ficus-indica(L.) Mill, respectively. These plant species are known among most herbalists as antilithiasis plants, which gives its botanical families the greatest values. The family of Rhamnaceae occupied the third position; two plant species belonging to this family are Zizyphus lotus(L.) Lam. and Rhamnus cathartica L. Several ethnopharmacological surveys show the importance of this family [40]. On the other hand, ethnopharmacological surveys in numerous regions of Morocco have revealed that the species of Zizyphus lotus(L.) Lam. is responsible for the popularity of this family [11,19,21,25,32].
51 The family of Lamiaceae occupied the fifth position with FUV value of 0.195. In our survey, this family is represented by seven plants: Lavandula officinalis, Rosmarinus officinalisL.,Origanum compactumBenth.,Mentha gatefossei Maire, Satureja calaminthaL.,Marrubium vulgareL.,and Ocimum basilicumL.; the popularity of this family is related to its aromatic and medicinal plants and it is presented with an advanced ranking in several ethnopharmacological surveys in Morocco [19,21,32,41], in Algeria [15], and in Turkey [42].
Traditional Medicine Knowledge
Plant Parts Used, Mode of Preparation and Mode of Administration
52 The results of our investigation showed that the stem and the leaves are the most used parts, followed by the seeds than by the leaves. The use of the aerial part (stem and leaves or leaves only) can be explained by the ease of the harvest and also by the availability of these parts throughout the year. Another reason is that the aerial part is the seat of photosynthesis. Similar results are found in Morocco, where aerial parts are the most used for traditional treatment of diseases [19,21,32]. The same results are found in Algeria [15], in Bangladesh [31], and in Portugal [30].
53 Moreover, the most used methods of preparation were infusion, decoction, and maceration in that order. The use of these three modes of preparation can be explained by the majority of the plants mentioned by the herbalists, which are bound by the internal use. Contrarily, the other modes of preparations reserved normally for external use as the massage, and the mask is absent. Several ethnopharmacological studies in Morocco and in other countries have reported the use of these three modes of preparation [28,43–45].
54 Regarding the mode of administration, our investigation has shown that the most common mode of administration is the oral route. This result can be explained by most of the plant species being prepared for drinking two times a day (46%) or three times a day (37.3%). Concerning the mode of administration, similar types of results were obtained in other studies in Morocco [32] and in Algeria [46].
Fidelity Level (FL)
55 Table 7 shows the plant species that are used in the treatment of kidney disease. For example, Ammodaucus leucotrichus Coss. & Dur. (FL = 100%), all herbalists agree for its use in the treatment of edema and renal colic. This plant is also used in other regions in Morocco for the same ailment [18] and to treat other ailments as pathologies of the digestive system, pathologies of the reproductive system, and cardiac diseases [11,32]. Chamaemelum nobile(L.) All. is another plant used to treat edema and renal colic with FL value of 97%; this result is in concordance with a study performed in Portugal where this plant is used to treat the same ailment [47]. It is also used in south east region of Morocco for traditional treatment of hypertension and cardiac diseases [11].
56 Concerning the traditional treatment of renal lithiasis, Opuntia ficus-indica(L.) Mill. and Zea mays L. have the highest value of FL equal to 97%, and this result is in concordance with a study in the North Center of Morocco [11].
Rank-Order Priority (ROP)
57 The following plant species, Herniaria glabra L. (ROP = 91%), Zea mays L. (ROP = 84%), Zizyphus lotus(L.) Lam. (ROP = 78%), and Opuntia ficus-indica(L.) Mill. (ROP = 67%) have the greatest values of ROP; this means that these plants are the most used by herbalists in the treatment of kidney disease. However, the following plant species: Eruca sativaMill.,Allium cepaL.,Malva sylvestrisL.,Lippia citriodoraH.B & K. with a value of ROP equal to 2% and Asparagus officinalis L. Cynara cardunculusL.,Equisetum telmateiaEhrh.,Ricinus communisL.,Vicia fabaL.,Ocimum basilicumL.,Linum usitatissimumL.,Olea europaeaL.,Polygonum aviculareL., and Alpinia officinarum, hence, with a value of ROP equal to 3%, are the least used by herbalists in the treatment of kidney disease in the Fez–Meknes region.
Informant Consensus Factor (FIC)
58 To treat a category of diseases by given plant species, the informant consensus factor (FIC) was used to reveal the homogeneity of information provided by informants on these plants. In this study, ailments with highest values of Informant Consensus Factor were Acute Pyelonephritis (FIC = 0.94), Edema and renal colic (FIC = 0.93) and Kidney cancer (FIC = 0.93). These findings reflect the importance given to these ailments by the herbalists in Fez–Meknes region. Other ailments also have a high FIC value such as renal lithiasis (FIC = 0.89), urinary infections (FIC = 0.90), and Hematuria (FIC = 0.88). Generally, the importance given to kidney disease has been cited in several recent ethnopharmacological studies in other countries such as Algeria [48], Bangladesh [49], and Jordan [50].
Correlation Between Socio-demographic Characteristics of Herbalists and Plants Knowledge
Relationship Between Herbalists’ Age and Number of Plants Species Cited
59 The test of Pearson revealed a significant correlation (r = 0.203,p = 0.001) between herbalists’ age and number of plant species cited. Therefore, older herbalists cite more plant species than young herbalists and number of plants cited increased with increasing herbalist age. This finding is in line with other ethnopharmacological surveys carried out in Northern Thailand [20].
Relationship Between Sociodemographic Characteristics and Knowledge of Toxic Plants
60 Table 6 illustrates the correlation between the sociodemographic characteristics and knowledge of toxic plants. The level of education and source of acquisition of knowledge had a significant (p = 0.00) impact on the knowledge of toxic plants. This means that the level of education plays an important role in plant knowledge; herbalists with a higher level of education know that many plants can be toxic and mention less toxic plants. The same result for the source of knowledge, herbalists based on the ancestral experiences only knows less toxic plants. Although the herbalists based on Internet, media, and books are experiencing a large number of toxic plants, the use of media, books, and websites as a source of knowledge has already been cited in ethnopharmacological studies [51,52].
61 Moreover, the years of experience had a significant impact on the knowledge of toxic plants with p-value equal to p = 0.03, where herbalists with great experience (13–20 years or > 20 years), know several plants that can be toxic. Herbalists with less than 6 years of experience, are also sensitized on toxic plants; this may be explained by young herbalists are influenced by the Internet and new media and this reflects his knowledge.
Mixtures of Plants Used to Treat Kidney Diseases
62 In herbal medicine, the mixtures of the compounds are more effective than the individual compounds [53]. In our survey, several mixtures were cited by herbalists. Generally, herbalists prefer to mix the best-known plants in the treatment of a given pathology to obtain an effective result. For example, in traditional treatment of renal lithiasis by the herbalists of the Fez–Meknes region, the most cited mixture (TNC = 257) is composed of four plants; these are the plants with the highest value of UV and FL: Herniaria glabra L. (UV = 230, FL = 91%), Zizyphus lotus(L.) Lam. (UV = 189, FL = 95%), Opuntia ficus – indica(L.) Mill. (UV = 160, FL = 97%) and Zea mays L. (UV = 201, FL = 97%). Other mixtures with an unknown plant composition are quoted by herbalists, and these mixtures are packaged and labeled; the most used are HERBO-REIN (80%), HERBOVESSIEREIN (10%), and other (10%). These mixtures may contain toxic compounds, and hence the need to evaluate its toxicities.
Conclusion
63 The region concerned by the present study has revealed a cultural heritage linked to herbalism and a great wealth of medicinal plants, whose valorization and protection are necessary. Several studies are needed, first to extract and examine the possible active constituents that could be new drugs, second to evaluate the toxicity of plants and mixtures used in the traditional treatment of kidney diseases, third to sensitize herbalists and population on the danger of toxic plants.
Conflicts of Interest:
the authors have no conflicts of interests to declare.References
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Publisher keywords: Ethnopharmacological survey, Fez–Meknes region, Fidelity level (FL), Kidney diseases, Mixture and medicinal plants, Rank-order priority (ROP)
Uploaded: 09/27/2024
https://doi.org/10.3166/phyto-2019-0189