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Orange Journal / Volumen 6 Número 11/Enero-junio 2024
DOI: https://doi.org/10.46502/issn.2710-995X/2024.11.04
Cómo citar:
Fong Lores, O., Pütz Claro, S.M., de la Vega Acosta, J.E., & Berenguer Rivas, C.A. (2024). Ethnopharmacological study of
medicinal plants with activity on the Central nervous system in the Eastern Region of Cuba. Orange Journal, 6(11), 43-55.
https://doi.org/10.46502/issn.2710-995X/2024.11.04
Ethnopharmacological study of medicinal plants with activity on the Central
nervous system in the Eastern Region of Cuba
Estudio etnofarmacológico de plantas medicinales con actividad sobre el Sistema Nervioso
Central, en la región oriental de Cuba
Recibido: 11 de marzo de 2024 Aceptado: 21 de junio de 2024
Escrito por:
Onel Fong Lores1
https://orcid.org/0000-0001-8595-3107
Sara María Pütz Claro2
https://orcid.org/0009-0001-0940-1594
Jorge Eduardo de la Vega Acosta3
https://orcid.org/0000-0003-4285-1789
Clara Azalea Berenguer Rivas4
https://orcid.org/0000-0002-1259-3910
Abstract
In the eastern region of Cuba, there is a traditional use of medicinal plants for various pharmacological
purposes, although an inventory of these plant species necessary for the future search for new
phytomedicines does not exist in all cases. This is the case for those used to treat central nervous system
(CNS) disorders. To evaluate the traditional knowledge in two regions of Eastern Cuba: Santiago de Cuba
and Holguín, regarding the use of medicinal plants with sedative, hypnotic, and anxiolytic effects, an
ethnopharmacological study was conducted in two health areas of the main municipalities of these two
provinces. A total of 400 people were surveyed, performing the socio-demographic characterization of the
evaluated population as well as the qualitative characterization and evaluation of quantitative
ethnopharmacological indicators such as the use value index and the significant use level of the medicinal
plants used. The surveyed population in both provinces was predominantly female and over 60 years old,
with a high level of preparation and professional training. A total of 27 plants were reported in the
interviews conducted among the 1637 citations obtained, with similar results between the two provinces.
The highest number of citations in both regions corresponded to plants used as sedatives, followed by
hypnotics, and finally anxiolytics. Among the most used parts of these plants, the use of leaves prepared in
the form of infusions predominated. Of the 8 plant species with the highest acceptance by the population,
the plants P. neochilus, J. pectoralis, L. inermis, and P. incarnata obtained the best values for the evaluated
ethnopharmacological indicators.
Keywords: Medicinal plants, Sedative, Hypnotic, and Anxiolytic Properties.
1 Licenciado en Bioquímica. Centro de Toxicología y Biomedicina, Cuba.
2 Licenciada en Ciencias Farmacéuticas. Empresa de Farmacia y Ópticas OPTIMED, Holguín, Cuba.
3 Licenciado en Ciencias Farmacéuticas. Centro de Toxicología y Biomedicina, Cuba.
4 Licenciada en Ciencias Farmacéuticas. Doctora en Ciencias Farmacéuticas. Dpto. de Farmacia, Universidad de Oriente, Cuba.
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Resumen
En la región oriental de Cuba existe un uso tradicional de plantas medicinales con diferentes fines
farmacológicos, no existiendo en todos los casos el inventario de estas especies vegetales necesario para la
futura búsqueda de nuevos fitomedicamentos, tal es el caso de las que se usan para tratar afecciones del
sistema nervioso central. Con el objetivo de evaluar el conocimiento tradicional de dos regiones del Oriente
de Cuba: Santiago de Cuba y Holguín sobre el empleo de plantas medicinales con efectos sedantes,
hipnóticos y ansiolíticos, se realizó un estudio etnofarmacológico en dos áreas de salud de los principales
municipios de estas dos provincias. Se encuestaron un total de 400 personas, realizando la caracterización
socio-demográfica de la población evaluada, así como la caracterización cualitativa y evaluación de los
indicadores etnofarmacológicos cuantitativos índice de valor de uso y el nivel de uso significativo de las
plantas medicinales empleadas. La población encuestada de ambas provincias fue predominantemente del
sexo femenino y en edades superiores a los 60 años, con un alto nivel de preparación y formación
profesional. Se refirieron en las entrevistas realizadas un total de 27 plantas entre las 1637 citaciones
obtenidas, con resultados similares entre ambas provincias. La mayor cantidad de citaciones en ambas
regiones correspondieron a las plantas empleadas como sedantes, seguido de las hipnóticas y finalmente
las ansiolíticas. Dentro de las partes más empleadas de estas plantas predominó el uso de las hojas,
preparadas en forma de infusión. De las 8 especies vegetales con mayor aceptación por parte de la
población, las plantas P. neochilus, J. pectoralis, L. inermis y P. incarnata obtuvieron los mejores valores
de indicadores etnofarmacológicos evaluados.
Palabras claves: Plantas medicinales, propiedades sedantes, hipnóticas y ansiolíticas.
Introduction
Medicinal plants have been used since ancient times for the treatment of various diseases and ailments,
being an important source of natural therapeutic compounds. Over the years, the traditional knowledge of
medicinal plants and their use in different cultures has been one of the main objectives of
ethnopharmacological studies, which have proven to be a useful tool for identifying and validating bioactive
compounds (Upadhyay, 2023). Moreover, considering the need to make sustainable use of natural
resources, contemporary society has become aware of the economic importance of biodiversity and
recognized the contribution of traditional knowledge to science and society. This has an important role in
the discovery process of new species and the suggestion of their pharmacological activities
(Salmerón-Manzano et al., 2020).
The central nervous system (CNS) is one of the most important systems in the human body, and its proper
functioning is essential for maintaining health. However, various diseases and disorders can affect the CNS,
such as depression, anxiety, Alzheimer's disease, Parkinson's disease, among others (Rahman et al., 2021).
Therefore, the identification of natural compounds that act on the CNS and can be used as complementary
or alternative therapies is of great interest to the pharmaceutical industry (Wahid et al., 2020). In this regard,
in recent years, ethnopharmacological studies have allowed the identification of a wide variety of medicinal
plants with activity on the CNS, and research has been conducted to identify the bioactive compounds
present in these plants and study their mechanism of action (Luthra & Roy, 2022).
The combination of ethnopharmacology and preclinical investigations has enabled the discovery of new
medicinal plants with therapeutic potential for CNS diseases and disorders (Sharifi-Rad et al., 2020).
Furthermore, these studies have also provided valuable information about traditional medicinal plants used
by local populations (Chaachouay et al., 2020).
In Cuba, the use of medicinal plants is deeply rooted in its population. This practice has its roots in
Caribbean aboriginal, African, Spanish, Arab, and Asian cultures, and its vast diversity of plant species
(Puig et al., 2019). The eastern region of Cuba is known for its rich flora and for having a large number of
plants with medicinal properties. Many of these are used by local communities to treat a wide variety of
ailments, including CNS diseases. Ethnobotanical and ethnopharmacological studies conducted by Cuban
authors in recent years have documented in international scientific literature the long tradition in the use of
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medicinal plants by the Cuban population, especially in this area of the country. These studies have shown
that the Cuban population, based on traditional knowledge transmitted from generation to generation,
makes extensive use of a significant number of plants that have been identified and classified to treat various
diseases. Additionally, the widespread use of these plants across the island is similar regardless of the
geographical region where these plants are used (Heredia-Díaz et al., 2018).
However, there are still insufficient reports of ethnopharmacological studies focused on the use of certain
medicinal plants in the eastern region of Cuba, especially in the treatment of important conditions such as
CNS disorders, which could not only lead to the discovery of new drugs but also contribute to the
preservation of the region's plant variety and promote the sustainable use of natural resources. Considering
also that the cities of Santiago de Cuba and Holguín within this region are the most important from a
population, economic, and cultural standpoint, this study seeks to characterize the ethnopharmacological
use of medicinal plants with action on the CNS in these two provinces of the eastern region of Cuba.
Theoretical Framework
Ethnobotany: Ethnobotany is the science that studies the relationship between humans and plants. It is an
interdisciplinary field that consists of studying the biological, ecological, and cultural foundations of the
interactions and relationships between plants and humans over time, evolution, and socio-geographical
space. This science studies the relationships between plants and different cultures throughout history and
how they influence the development of a community's traditions (Pirintsos et al., 2022).
Ethnopharmacology: Ethnopharmacology is the interdisciplinary scientific exploration of the traditional
use of indigenous drugs and active biomolecules. This science combines information acquired from the
traditional use of medicinal plants by local communities and the results of phytochemical and
pharmacological studies conducted in specialized laboratories (Pirintsos et al., 2022).
Sedative medicinal plants or drugs are those that reduce the activity of the central nervous system (CNS),
causing a calming and relaxing effect (Rang et al., 2016). In contrast, a drug or substance with hypnotic
properties acts on certain receptors in the brain to slow down brain activity and promote sleep. They are
effective in helping people fall asleep faster and stay asleep longer (Kryger et al., 2010). On the other hand,
according to the American Psychiatric Association (2013), drugs or medicinal plants used to treat anxiety
symptoms such as feelings of fear, terror, discomfort, and muscle tension that can occur in response to
stress are known as anxiolytics. Most anxiolytics block the action of certain chemicals in the nervous
system.
Materials and Methods
Research Characteristics
An ethnopharmacological study with a qualitative and quantitative approach was conducted to characterize
the use of medicinal plants with action on the CNS during the period from May to November 2022. The
study was conducted in the communities of the "Camilo Torres" health area in Santiago de Cuba province
and "Pedro Díaz Coello" health area in Holguín province, both corresponding to the main municipalities of
each province.
Description of the Study Area
The provinces of Holguín and Santiago de Cuba are part of the so-called eastern region of Cuba, located in
the eastern part of the island. This region has a tropical climate with a rainy season starting in May and
ending in October and another dry season. The average annual temperature ranges between 24 and 27
degrees Celsius. Additionally, the eastern provinces of Cuba are characterized by having a mountainous
topography with the presence of the Sierra Maestra and the Sierra Cristal, which gives the region great
biodiversity in its botanical richness (high endemism) but also combines some flat areas that give rise to
different types of vegetation: coastal xerophytic scrub and tropical forests.
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Figure 1. Geographical location of the study areas.
Source: National Institute of Physical Planning. https://www.ipf.gob.cu/es/content/mapas
The study was conducted in two health areas belonging to the provincial capitals, where the urban
population predominated. This population was characterized by having workers from various sectors where
the industrial sector predominates with a good level of preparation, and another significant portion
represents retirees.
Sample Selection
The study universe consisted of all the inhabitants of both health areas. The sample was heterogeneous,
selected through non-probabilistic random sampling, including people of both sexes of legal age, workers,
housewives, retirees, students, professionals, and sellers of medicinal plants from the study areas. Always
considering that the informants gave their consent to collaborate with the research.
Information Collection
A face-to-face interview was conducted using a semi-structured questionnaire designed for the study to
collect information about ethnopharmacological use. The questionnaire was designed following the
requirements established by the Applied Research Program for Caribbean Folk Medicine (TRAMIL) with
minor modifications that respond to the research objectives (Germosén-Robineau, 1995).
The variables collected in the questionnaire were of two types: socio-demographic and
ethnopharmacological. Socio-demographic variables included: sex, educational level, occupation, and age.
In the case of ethnopharmacological variables, they included: forms of use and preparation, administration
routes, part of the plant used, and medicinal use of the plant species. In this study, medicinal uses were
established for sedative, hypnotic, and anxiolytic properties, for which a group of experts consisting of 3
psychologists, 5 doctors, and 5 pharmacists included terms in the surveys related to the use of the plant for:
stress, mental or emotional tension, sleep disorders, insomnia, anxiety, restlessness, worry, depression,
sadness, nervousness, agitation.
To determine the medicinal uses of the plants, the testimonies of the interviewees were analyzed, taking
into account the diseases they mentioned. These diseases were subsequently classified and grouped into
homogeneous pharmacological categories. Plants with sedative action were defined as those that the
interviewees reported using to calm the state of nervous excitement, hypnotic when used to induce
drowsiness and facilitate the onset and maintenance of sleep. And in the case of plants with anxiolytic
effects, only those that the interviewees used to calm the state of anxiety without producing a state of
sedation or sleep.
Collection and Taxonomic Identification of Plant Species
According to the survey results, the plants were classified and grouped by Family, scientific name, and
vernacular name. The most reported families of the total plants informed were determined. All species were
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taxonomically identified by specialists from the Center for Environmental Research and Services (CISAT)
in Holguín province and the Eastern Center for Ecosystems and Biodiversity (BIOECO) in Santiago de
Cuba province. The methods employed by the interviewees for the preparation of the plants, the parts most
frequently used, the most used administration routes, and their usage knowledge were determined.
Considering:
Forms of use: Fresh plant, dried, indistinctly, other. Forms of preparation: Decoction, infusion, maceration,
poultice, amulet, other. Administration routes: Internal route (oral, sublingual, inhalation, other), External
route (dermal). Part used: Leaf, foliage, fruit, seed, root, bark, flowers, whole plant, latex, resin.
Qualitative Analysis
The ethnopharmacological information collected in each interview was organized in Excel sheets for
subsequent statistical processing (statistical program). The comparison between provinces of parameters
with a binomial nature, such as sex, was performed using the Chi-square test (χ²) for independent samples.
For parameters with responses considering multiple options, the Kruskal-Wallis mean comparison test was
used.
Calculation of Quantitative Ethnopharmacological Indicators
For the quantitative analysis, the ethnobotanical indices were determined: use value index (UVI) and
significant use level (SUL), which are related below.
Use Value Index (UVI): It is a quantitative method used to demonstrate the relative importance of locally
known species considering the number of uses mentioned by an informant for a particular medicinal plant
species. UVI is useful for determining the most frequently indicated plants in the treatment of a disease.
The calculation was performed for each of the plant species according to the methodology proposed by
Phillips (1996), using the equation:
UVI = ΣUvis / Nis [Equation 1]
Where: Uvis: number of uses mentioned by each informant (i) for each species (s). Nis: number of
informants interviewed.
Significant Use Level (SUL): For each species and to verify its cultural acceptance, the methodology
proposed by Germosén-Robineau (1995) was used, where those medicinal uses cited with a frequency equal
to or greater than 20% by the interviewed people who use plants as the first resource for a particular health
problem can be considered significant and therefore deserve scientific evaluation and validation. The
equation used is:
SUL = (Use species (s) * 100) / Nis [Equation 2]
Where: Use species (s): number of citations for each species. Nis: number of informants interviewed.
The plants with the most citations by the interviewees were collected and organized by botanical families,
searching for information through databases such as ScienceDirect, Wiley, Springer, PubMed, and Google
Scholar, as well as specialized scientific journals such as: Journal of Ethnopharmacology, Phytochemistry,
British Journal of Phytotherapy, Journal of Natural Products, Chinese Medical Journal, Plantes Medicinales
et Phytotherapie, Revista Paulista Medica (Brazil), Revista Cubana de Plantas Medicinales, Revista
Brasileira de Farmacognosia, and the Latin American and Caribbean Bulletin of Medicinal and Aromatic
Plants (BLACPMA), among others, about the reported pharmacological properties and active chemical
compounds responsible for the biological activity.
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Results and Discussion
Characterization of the Study Sample
A total of 400 interviews were conducted, of which 200 were conducted with people belonging to the
"Camilo Torres" health area of Santiago de Cuba province and 200 people belonging to the "Pedro Díaz
Coello" health area of Holguín province. Of the total respondents, 252 (63.00%) were female, and 148
(27.00%) were male. The average age in both sexes was over 60 years, results that are in line with the
population aging in these areas, with 42.50% of the total for women surveyed, while for men, it was 14.00%
of the total. According to the National Office of Statistics and Information (ONEI) of the Republic of Cuba,
in the report issued in 2023, 22.5% of the population of Holguín municipality is over 60 years old, while
Santiago de Cuba municipality has an aging rate of 21.7% of its total population (ONEI, 2023).
This is related to the fact that women must take care of household chores and health-related tasks of the
family, so cultural and popular knowledge about the use of home remedies based on medicinal plants is
transmitted to them from generation to generation, and for this reason, they generally have a greater
understanding of how to cure different ailments with medicinal plants. Similar results have been reported
by different authors in this type of research in Cuba, Mexico, Peru, China, and Brazil (Urdaneta et al., 2022;
Leyva et al., 2022; Gao et al., 2019).
Regarding the level of education and occupation, people with a university education level predominated
among the interviewees (192 for 48.00% of the total), followed by people with a high school education
level (92 for 23.00% of the total). 71.75% of the respondents (287 people) were people with active
professions in both the state and private sectors, where health professionals, pharmacists, medicinal plant
sellers, and workers in commerce and gastronomy predominated. Only 28.25% (113 people) of the
respondents were not employed, with retirees, housewives, and students predominating. Therefore, it is
observed that there are many users of traditional medicine who are detached from working life due to their
age, but the use of medicinal plants as an alternative route for the treatment of various diseases does not
demonstrate a relationship with the level of education or occupation; rather, it is an established and common
practice among the population of the two studied localities.
Report on Medicinal Plants with Sedative, Hypnotic, and Anxiolytic Properties
The survey results showed a total of 1637 citations corresponding to all the reports of plants by each
informant for both provinces. Of this total, 873 citations corresponded to Santiago de Cuba province and
764 to Holguín. The average number of plants used by each respondent was 4. The lowest number of plants
used was 2, while the highest reports in the surveys were of more than 6 plants administered alone or in
combinations with other plants.
A total of 27 medicinal plants with action on the CNS are used by the population of the eastern provinces
of Cuba. These medicinal plants belong to 16 families, with the Lamiaceae, Asteraceae, and Rutaceae
families standing out with the highest number of species. Table 1 lists the same, reflecting the species
consumed in each eastern region, scientific and popular names, parts used, and preparation method. These
results are consistent with other similar studies conducted in rural areas of Eastern Cuba (Urdaneta et al.,
2022) and other research conducted in Brazil, Ethiopia, India, Peru, and other regions where these families
are the most used by the population to treat various diseases, including those affecting the CNS (Malla,
2015; López Sáez & Pérez Soto, 2010; Teixeira Pires Gomides et al., 2022; Gebre & Chinthapalli, 2021;
Rao, 2019; Mostacero-León et al., 2022).
It is also noteworthy that there were no marked differences in the consumption of medicinal plants between
both regions of Eastern Cuba, as the total number of species used in Santiago was 25, while in Holguín, it
was 26. However, when comparing the number of citations, it can be seen that Santiago de Cuba reached
the highest number. Of the 27 species cited, only the species Pluchea carolinensis (Jacq.) D. Don (Salvia)
was found to be consumed only in Santiago de Cuba and not in Holguín, and in the case of the species
Bursera graveolens (Kunth) Triana & Planch, the opposite occurred.
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Table 1.
List of the most used medicinal plants to treat CNS disorders.
Scientific name/ Family
Local name
Part used/
Plant state
Use reports
Total
reports
No
Santiago
de Cuba
Holguín
1
Argemone mexicana L.
APAVERACEAE
Cardo santo
Flower, root,
seeds/ Fresh,
dried
22
17
39
2
Bursera graveolenss (Kunth)
Triana & Planch.
BURSERACEAE
Sasafrá o
Palo Santo
Aerial parts/
Fresh
-
2
2
3
Citrus aurantiifolia
(Christm.) Swingle
RUTACEAE
Limón
Leaves/ Fresh
10
13
23
4
Citrus sinensis (L.) Osbeck
RUTACEAE
Naranja dulce
Leaves/ Fresh
18
25
43
5
Citrus x aurantium L.
RUTACEAE
Naranja agria
Leaves/ Fresh
30
24
54
6
Eugenia caryophyllata
Thumb.
Clavo de olor
Buttons/
Dried
5
11
16
7
Pilea micropylla L.
URTICACEAE
Lloviznita o
Frescura
Aerial parts/
Fresh
65
12
77
8
Hibiscus rosa-sinensis L
MALVACEAE
Amapola o
marpacífico
Flower/ Fresh
32
29
61
9
Hypericum perforatum
HYPERICACEAE
Hierva de
San Juan
Aerial parts/
Dried
-
11
11
10
Justicia pectoralis Jacq.
ACANTHACEAE
Tilo
Stem/ Fresh
79
99
178
11
Lactuca sativa
Lechuga
Stem/ Fresh
10
2
12
12
Lawsonia inermis L.
LYTHRACEAE
Resedá
Leaves,
Flower/ Fresh
79
86
165
13
Phania matricaroides
(Spreng.) Griseb.
ASTERACEAE
Manzanilla
Aerial parts/
Fresh, Dried
36
59
95
14
Melissa officinalis L.
Toronjil
Aerial parts/
Fresh
27
21
48
15
Mentha spicata L.
LAMIACEAE
Yerba buena
Leaves/ Fresh
24
16
40
16
Mimosa pudica L.
FABACEAE
Morivivi,
dormilona
Aerial parts/
Dried
35
4
39
17
Moringa oleífera Lam
MORINGACEAE
Moringa
Flower/ Fresh
31
20
51
18
Ocimum basilium L.
LAMIACEAE
Albahaca
blanca
Aerial parts/
Fresh
34
22
56
19
Ocimum tenuiflorum L.
LAMIACEAE
Albahaca
morada
Aerial parts/
Fresh
81
12
93
20
Origanum majorana L.
LAMIACEAE
Mejorana
Aerial parts/
Fresh
26
25
51
21
Passiflora incarnata L.
PASSIFLORACEAE
Pasiflora
Leaves,
Flower, Fruit/
Fresh
48
77
125
22
Plectranthus neochilus
Schltr LAMIACEAE
Meproba-
mato
Aerial parts /
Fresh
125
138
263
23
Portulaca oleracea
PORTULACACEAE
Verdolaga
Aerial parts/
Fresh
5
7
12
24
Pluchea carolinensis (Jacq.)
D.Don LABIACEAE
Salvia
Leaves/ Fresh
8
-
8
25
Tagetes erecta L.
ASTERACEAE
Copetúa
Flower/ Fresh
10
8
18
26
Tradescantia spathacea Sw.
COMMELINACEAE
Barquito o
Cordobán
Leaves/ Fresh
15
9
24
27
Valeriana scandens L.
Valeriana
Aerial parts/
Dried
18
15
33
Total
873
764
1637
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Some authors report that the predominant use of one species or another can vary regardless of geographical
location, the flora of the place, sociodemographic characteristics, and prevailing health problems. In this
study, very few differences were observed in the species used to treat CNS disorders (Hurtado et al., 2010).
Regarding the use of plants for their properties on the CNS, 1183 citations were for medicinal plants used
as sedatives, 393 citations for plants used for their hypnotic properties, and 61 as anxiolytics. It is
noteworthy that in both regions, there was a similar behavior, as shown in Figure 2. Of the reported species,
only three of them, Justicia pectoralis Jacq. (Tilo), Matricaria recutita L. (Chamomile), and Passiflora
incarnata L. (Passion flower), are included in the National Formulary of Phytopharmaceuticals and
Apipharmaceuticals of the Republic of Cuba with sedative pharmacological action, whose biological
activity has been demonstrated (MINSAP, 2017). The species Ocimum basilicum L. (Basil) was excluded
from this formulary since 2010 due to reports of mutagenicity and moderate cytotoxicity, so it is necessary
to alert the health authorities of this locality about the use of this species by the population. The rest of the
medicinal plants lack experimental verification for the attributed activity, although their traditional use for
this purpose is reported in the literature.
Figure 2. Most frequent medicinal uses in both provinces.
Among the main methods employed by the respondents for the preparation of medicinal plants is in their
fresh form (see Table 2), values that coincided for both provinces, although many respondents stated that
they use the fresh or dried form of the plant indistinctly in periods when the plants are not in their optimal
vegetative state.
Table 2.
Forms in which the interviewed population of both provinces uses medicinal plants.
Main ways in which respondents use medicinal plants
Santiago de Cuba
Holguín
No.
%
No.
%
Plant state
Fresh
631
72.28
594
77.75
Dried
175
20.05
119
15.58
Indistinctly
67
7.67
51
6.68
Total
873
100
764
100
Preparation
Decoction
256
29.32
302
39.53
Infusion
561
64.26
440
57.59
Others
56
6.41
22
2.88
Total
873
100
764
100
Part used
Leaves
518
59.34
452
59.16
Aerial parts
235
26.92
166
21.73
Flowers
40
4.58
70
9.16
Whole plant
55
6.30
60
7.85
Fruits
25
2.86
11
1.44
Others
-
-
5
0.65
Total
873
100
764
100
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Leaves were the most used plant organ (970 citations of the total respondents), followed by aerial parts.
These observations are likely related to the fact that they are the most abundant and accessible parts of the
plant, regenerate faster, their use allows for proper management, and preservation of the plant species.
However, many respondents report using more than one plant organ in some species, such as Passiflora
incarnata L. (known by the popular name passionflower or maracuja), where the population uses leaves,
flowers, and fruits.
Regarding the administration route, 100% of the respondents stated that they use the internal route, and
within this route, the oral route (98%) was predominant, being the most convenient and most used by the
population. It is important to highlight the use of the inhalation route within internal administrations.
Several studies agree with the use of decoction and infusion as a popular way of obtaining plant extracts.
Both are simple and quick preparation methods, do not require equipment, only an appropriate container
that can be glass or stainless steel, and also use water as the menstruum; being very economical.
There were no marked differences in the plants consumed in both localities of the Eastern region of Cuba
nor in the uses attributed to the species by the interviewees, parts used, preparation methods, and other
aspects analyzed. Ethnobotanical studies conducted in these regions emphasize the broad culture that
Eastern populations have regarding the use of medicinal plants, which has been transmitted from generation
to generation. For these reasons, quantitative indicators were calculated.
Quantitative Analysis
The uses of the identified medicinal plant species with effect on the CNS were described, and the Use Value
Index (UVI) and Significant Use Level (SUL) were determined (Table 3). Both indices express the
ethnobotanical knowledge of a species by the studied population, where species that reach values greater
than 20% indicate that the plant is used more frequently to treat a specific health problem.
Of the 27 identified species, eight plant species exceeded 20%. In the Santiago de Cuba region, the species
with the highest SUL are: P. neochilus (62.5%), J. pectoralis (39.5%), L. inermis (39.5%), O. tenuiflorum
(44.5%), P. incarnata (24%), and P. micropylla (32.5%). Similarly, the species with the highest SUL in the
Holguín region are: P. neochilus (69%), J. pectoralis (49.5%), L. inermis (43%), P. incarnata (38.5%),
P. oleracea (35%), and the species P. Matricaroide (29.5%), demonstrating a high coincidence among the
most used species. Only differ between one region and another in the plants O. tenuiflorum, P. micropylla,
P. oleracea, and P. Matricaroide.
Table 3.
Use Value Index (UVI) and Significant Use Level (SUL) of medicinal plants reported by the interviewees
in the eastern region of Cuba.
No
Scientific name/ Family
Local name
Medicinal uses
UVI
SUL
SCU
H
SCU
H
1
Argemone mexicana L.
PAPAVERACEAE
Cardo santo
Sedative,
Hypnotic
0.110
0.085
11.0
8.5
2
Bursera graveolenss (Kunth) Triana &
Planch. BURSERACEAE
Sasafrá o Palo
Santo
Sedative
-
0.010
-
1
3
Citrus aurantiifolia (Christm.) Swingle
RUTACEAE
Limón
Sedative,
Anxiolytic
0.050
0.065
5.0
6.5
4
Citrus sinensis (L.) Osbeck
RUTACEAE
Naranja dulce
Sedative,
Anxiolytic
0.090
0.125
9.0
12.5
5
Citrus x aurantium L. RUTACEAE
Naranja agria
Sedative,
Anxiolytic
0.150
0.120
15.0
12
6
Eugenia caryophyllata Thumb.
Clavo de olor
Sedative
0.025
0.055
2.5
5.5
7
Pilea micropylla L.
URTICACEAE
Lloviznita o
Frescura
Sedative
0.325
0.060
32.5
6
8
Hibiscus rosa-sinensis L MALVACEAE
Amapola o
marpacífico
Sedative,
Hypnotic,
Anxiolytic
0.160
0.145
16.0
14.5
9
Hypericum perforatum
HYPERICACEAE
Hierva de San
Juan
Sedative,
Hypnotic
-
0.055
-
5.5
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10
Justicia pectoralis Jacq.
ACANTHACEAE
Tilo
Sedative
0.395
0.495
39.5
49.5
11
Lactuca sativa
Lechuga
Sedative,
Hypnotic
0.050
0.010
5.0
1.0
12
Lawsonia inermis L. LYTHRACEAE
Resedá
Sedative
0.395
0.430
39.5
43.0
13
Phania matricaroides (Spreng.) Griseb.
ASTERACEAE
Manzanilla
Sedative,
Hypnotic
0.180
0.295
18
29.5
14
Melissa officinalis L.
Toronjil
Sedative,
Hypnotic
0.135
0.105
13.5
10.5
15
Mentha spicata L.
LAMIACEAE
Yerba buena
Sedative
0.120
0.080
12.0
8.0
16
Mimosa pudica L.
FABACEAE
Morivivi,
dormilona
Sedative,
Hypnotic,
Anxiolytic
0.175
0.020
17.5
2
17
Moringa oleífera Lam
MORINGACEAE
Moringa
Sedative
0.155
0.100
15.5
10
18
Ocimum basilium L. LAMIACEAE
Albahaca blanca
Sedative,
Hypnotic
0.015
0.110
1.5
11
19
Ocimum tenuiflorum L. LAMIACEAE
Albahaca morada
Sedative
0.445
0.060
44.5
6.0
20
Origanum majorana L. LAMIACEAE
Mejorana
Sedative
0.130
0.125
13.0
12.5
21
Passiflora incarnata L.
PASSIFLORACEAE
Pasiflora
Sedative,
Hypnotic
0.240
0.385
24.0
38.5
22
Plectranthus neochilus Schltr
LAMIACEAE
Meprobamato
Sedative,
Hypnotic
0.625
0.690
62.5
69.0
23
Portulaca oleracea
PORTULACACEAE
Verdolaga
Sedative
0.025
0.350
2.5
35.0
24
Pluchea carolinensis (Jacq.) D.Don
LABIACEAE
Salvia
Sedative
0.040
-
4.0
-
The species Plectranthus neochilus Schltr., known popularly as Meprobamato, is a recently introduced
plant in Cuba, and its cultivation has spread throughout the island due to the medicinal properties attributed
by the Cuban population, where it is widely used for its sedative and hypnotic effect. These ethnomedicinal
uses are different from those reported in other South American countries, as the species used in other
latitudes is employed to treat respiratory diseases, digestive disorders, as an antimicrobial and antiparasitic
mainly. Rodríguez-Ferreiro in 2023 identified 18 compounds in the water extract of P. neochilus leaves,
corresponding to 8 flavonoids and 10 abietane diterpenes, which could be responsible for its action on the
CNS, showing a variation in behavior and motor coordination in OF1 male mice at a dose of 500 mg/kg.
The gene expression study showed a positive modulation of the expression of genes related to the
dopamine/opioid system, as well as the concomitant inhibition of GABAergic pathways, metabolic-
energetic signaling, inflammation, and muscle contraction (Rodríguez-Ferreiro, 2023).
The plant Justicia pectoralis, known as Tilo, is reported for its analgesic, anti-inflammatory, antiasthmatic,
expectorant, diuretic, sedative, anxiolytic, antidiabetic, antihypertensive, antibacterial, and other properties
in regions of Ecuador, Cuba, and Colombia (Lima et al., 2020; Guimarães et al., 2020). Similarly, ethanolic
extracts of Tilo leaves have been reported for the treatment of epilepsy and anxiety in in-vitro and in-vivo
studies, demonstrating their ability to inhibit the enzyme GABA transaminase (GABA-T) or bind to the
GABA-A benzodiazepine receptor, two main pharmacological targets in epilepsy and anxiety. Heredia and
collaborators, in an ethnobotanical study of medicinal plants used by the inhabitants of Holguín, highlight
that 16 species had citations for their effect on the CNS (Heredia et al., 2018).
In the case of the species Lawsonia inermis, the scientific literature indicates that it has antihypertensive,
anticatarrhal, anti-inflammatory, antimicrobial properties and is used to treat diabetes and rheumatism,
among other ailments, but its most important effect is its action on the CNS due to its sedative properties.
These results coincide with the study conducted in Santiago de Cuba in the José Martí District by Urdaneta
and collaborators in 2020, where among all the reported uses for this species, calming the nerves was the
most cited (Urdaneta et al., 2020). This use could be associated with the pharmacological activity exhibited
by secondary metabolites present in the chemical composition of the species. According to reports, the
presence of essential oils and coumarins has been identified, metabolites responsible for hypnotic and
sedative action (Moutawalli et al., 2023).
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Passiflora incarnata is another of the most used species to treat CNS disorders and is internationally
recognized for its sedative and hypnotic effects due to its rich composition in flavonoids such as apigenin,
luteolin, vitexin, quercetin, orientin, among others. It also contains indole alkaloids derived from
β-carboline, such as harmalol, harmol, harmaline, phenolic acids, maltol, among other metabolites. The tea
made from this plant has been used as a sedative and also to cure subjects affected by opioid dependence
in India. Additionally, preclinical studies conducted on mice have shown that a dose of 60-250 mg/kg body
weight of an extract made with 30% or 40% ethanol resulted in reduced movement in mice. The 40%
ethanol extract dose increased sleep duration at 60 mg/kg body weight, while the 50 mg/kg body weight
dose delayed the onset of seizures. Similarly, the evaluation of an aqueous extract at a dose of 160-250
mg/kg body weight reduced seizures, increased sleep duration, and decreased motor movement (Gupta and
Yadav, 2023; Nikolova et al., 2024). Similarly, Zanardi and collaborators in 2023 conducted a study on
186 depressed and anxious patients undergoing long-term treatment with benzodiazepines using dried drug
capsules of this plant. The results obtained suggest that this phytomedicine can be used as an effective
complementary treatment during the reduction of benzodiazepine doses (Zanardi et al., 2023).
Regarding medicinal use, only two species were used by the population concerning the three surveyed
pharmacological properties, these were H. rosa-sinensis L. and M. pudica L., respectively. The species
H. rosa-sinensis L. has shown anxiolytic and sedative effects in albino mice after treatment with alcoholic
extracts of the leaves of this plant (Begum & Younus, 2018; Khalid et al., 2014). For its part, Hossain and
Sultana demonstrated that extracts of the plant M. pudica L. have anxiolytic and sedative activity in albino
mice similar to the effect of benzodiazepines (Hossain & Sultana, 2019; Sultana & Hossain, 2019), while
Naldi and collaborators showed the hypnotic and sedative effects of ethanolic extracts of the leaves of this
plant in male mice (Naldi et al., 2022).
These results demonstrate the traditional roots of these species by the population of eastern Cuba, who use
them in many cases as therapeutic substitutes for drugs obtained by chemical synthesis. This constitutes
evidence that contributes to the validation of their ethnopharmacological use and, consequently, points
towards the search for new therapeutic alternatives with certified quality, safety, and efficacy, which is an
interest and priority today for the National Health System of the Republic of Cuba, allowing for a more
rational, safe, and effective use of them.
Conclusions
This research allowed us to evaluate the traditional knowledge of two regions of Eastern Cuba: Santiago de
Cuba and Holguín, regarding the use of medicinal plants to treat CNS disorders. An ethnomedicinal pattern
was identified with similar behavior in both communities of the Eastern region, where the use of leaves as
a source of medicinal remedies predominated and infusion was the most used preparation method. The most
frequent use was sedative, followed by hypnotic and anxiolytic. Of the eight species that achieved good
popular acceptance, the medicinal plants: P. neochilus, J. pectoralis, L. inermis, and P. incarnata coincide
in both regions. The research highlights the importance of preserving this ancestral knowledge and
exploring the therapeutic potential of the identified species for the treatment of central nervous system
disorders.
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