Current Traditional Medicine - Volume 12, Issue 1, 2026

Acne vulgaris is a prevalent dermatological condition characterized by the inflammation of sebaceous follicles. This inflammation results in various clinical manifestations, including open and closed comedones, papules, pustules, nodules, and cysts, which predominantly appear on the face. The impact of acne vulgaris extends beyond physical symptoms, often affecting psychological well-being and quality of life, particularly among adolescents. Given this condition's widespread prevalence and significant implications, there is a pressing need for effective and accessible treatments.

This study aimed to evaluate the impact of Kencur Rhizome Ethanol Extract Gel (Kaempferia galanga L. Rhizoma / KGR) on mild and moderate acne vulgaris lesions among high school students.

Twenty-four high school students were divided into three groups: Group 1 received 0.75% Kaempferia galanga rhizome ethanol extract gel, Group 2 received a combination gel of 0.75% Kaempferia galanga ethanol extract, and 75% benzoyl peroxide with 1% clindamycin gel, and Group 3 received 1% clindamycin gel. The number of subjects in each group was determined using the G Power application. The distribution of gels was randomly assigned using the “Randomly Assign Subjects to Treatment Group” application. Before treatment, blood samples were taken to measure IL-8 levels. After three weeks of treatment, bilateral facial photographs were taken: one with the right side tilted at 45 degrees and the other with the left side tilted at 45 degrees. Blood samples were collected again for IL-8 measurement, and high-resolution photographs of both sides of the face were taken to analyze acne lesions using the ImageJ application.

A combination of 0.75% KGR ethanol extract gel and 1% clindamycin gel significantly reduced the severity of AV lesions by affecting IL8 expression (p=0.042) in reducing the severity of mild and moderate AV lesions. For AV lesions using the ImageJ application, the administration of group 2 gel (a combination of 0.75% KGR ethanol extract gel and 1% clindamycin gel) has a significant effect on reducing the severity of mild and moderate degrees of whitehead or blackhead (p = 0.030) and nodules (p = 0.035) in acne vulgaris.

A combination of 0.75% kencur rhizome ethanol extract gel and 1% clindamycin gel effectively alleviate acne vulgaris symptoms while also reducing inflammation of acne vulgaris lesions.

Further investigation is required to deeply understand the role of traditional medicines in menopause and their safe and effective usage.

To determine the effects of Zingiber officinale roscoe (ZO) and Curcuma longa (CL) supplementation on 17-β estradiol (ES) levels, quality of life, and body composition indices in postmenopausal women.

In this four-month randomized controlled trial, women were recruited from the Tabriz health centers between 2018 and 2019 and randomly allocated to one of four groups: ZO tablet 1000 mg and CL placebo, CL tablet 1000 mg and ZO placebo, ZO tablet 1000 mg and CL tablet 1000 mg, and ZO placebo and CL placebo.

One hundred and fifteen women completed this study. ZO (mean change (MC) = 3.18 (95% CI: 0.55 to 5.81)) resulted in a greater increase in serum ES than placebo. ZO (MC= -1.26 (95% CI: -2.78 to -0.72)), CL (MC=-1.21 (95% CI: -2.79 to -0.53)) and ZO + CL (MC=-1.69 (95% CI: -2.48 to -0.85)) resulted in greater improvements in total quality of life score compared to placebo (MC=-0.51(95% CI: -0.04 to 1.32)). A significant group difference favoring the ZO group compared to the placebo was detected for the vasomotor symptoms (MC= -1.03 (95% CI: -2.57 to -0.97)). No significant adverse events were noted.

Findings suggest ginger and turmeric alleviate menopausal symptoms and improve QoL, potentially via estrogenic, anti-inflammatory, and antioxidant actions. Inconsistent body composition results may be due to low bioavailability.

Ginger, turmeric, and their combination improved menopausal QoL, with ginger benefiting vasomotor symptoms.

Registered in the Iranian clinical trial registry (IRCT20161022030424N3) on 2018-04-29.

Diabetes mellitus is a worldwide concern as its rising prevalence has resulted in severe health problems. Some people employ traditional medicine to manage their diabetes.

This review aims to identify medicinal plants used in diabetes management and to review their non-clinical data on its efficacy, toxicity studies, and mechanism of action.

The databases used to search for information were PubMed, Scopus, ScienceDirect, and Google Scholar, reporting from Jan 2018 until Nov 2023. The search terms involved “diabetes”, “hypoglycemic” “medicinal plants”, “chemical compound”, “traditional use”, “extracts”, “reduce blood glucose” and “toxicity”.

A total of twenty plants were identified, showing blood glucose reduction from 14.3% to 80%, and their mechanism of action was thematically categorized under three mechanisms which are 1) insulin secretagogue, 2) insulin sensitizer, and 3) retard intestinal absorption of glucose. The plant extracts showed no sign of acute toxicity between 1.5 to 5 g/kg.

To optimize their effectiveness, further research is required to evaluate chronic toxicity and identify plant extract bioactive compounds.

Interior-warming medicines (Wēnlǐ herbs) have the effect of warming the interior of the body and dispelling cold, and they are traditionally used for interior cold syndrome. Currently, they are used for treating gastrointestinal disorders, rheumatoid arthritis, tumors, etc. Transient receptor potential channel M8 (TRPM8) is a non-selective cation channel that can be activated by low temperature and menthol. However, the mechanism of temperature regulation of interior-warming medicines is not clear. This study designed an in vitro experiment on the TRPM8 signaling pathway using interior-warming medicines, aiming to investigate the relationship between the hot property of interior-warming medicines and the regulatory effect of TRPM8.

The breast cancer cell line 7 was cultured at different temperatures as a research model, six kinds of interior-warming medicines were used, and a medicated serum from rats was prepared as a test drug. PCR and western blotting were carried out to investigate their effects on TRPM8 mRNA and protein expression. ELISA and flow cytometry were conducted to detect intracellular cAMP and Ca²⁺ concentration.

Compared with the blank-containing serum group, interior-warming medicines had no significant effect on the expression of TRPM8 at 37°C, while they could inhibit the expression of TRPM8 at low temperatures (30°C). Moreover, the six herbs could increase intracellular cAMP content and reduce Ca²⁺ concentration at different temperatures.

TRPM8 plays an important role in temperature sensation, pain, inflammation and tumorigenesis, while generates specific calcium ion influx under low-temperature stimulation. This study showed that six interior-warming medicines down-regulated TRPM8 expression, especially at low temperatures, and they regulated intracellular Ca²⁺ release in addition to Ca²⁺ influx.

The natural hot property of interior-warming medicines may be associated with the regulation of the TRPM8 signaling pathway, causing Ca²⁺ influx blocking, which provides a deeper experimental basis for their clinical application and new drug development.

Premenstrual syndrome (PMS) is a combination of physical and psychological symptoms that start during the luteal phase. There are no specific effective and safe remedies to relieve these symptoms. However, there is a great tendency to use herbal medicines instead of chemical medicines. This study aimed to assess and compare the effects of a soft gel capsule containing Pimpinella anisum, Oenothera biennis, and Salvia sclarea oils (POS) with control, before and after use in two consecutive cycles, on physical and psychological symptoms of PMS.

This was a triple-blind randomized clinical trial performed on 67 female students, who were residents in dormitories of the Shahid Beheshti University of Medical Science in Tehran, Iran. The participants were randomly divided into two groups: soft gel capsule users containing POS as the intervention group (n=32) and sunflower as the control group (SF) (n=35). The participants were 18-35 years old female students who were affected by PMS. The capsules were used twice daily, from the 21^st day of the menstrual cycle to 2 days after the menstruation, for two consecutive menstrual cycles. The tools for data collection were three questionnaires: a personal information questionnaire, a valid and reliable daily PMS symptom report (DSR) form, and a side effects assessment questionnaire. The physical, psychological, and general symptoms of PMS were assessed by the DSR, and the results were taken before and after intervention and between groups of the study.

Before and after the intervention, the comparison showed significant effectiveness of POC in reducing general, physical, and psychological symptoms after the first and second months of use. However, the comparison of the groups did not show a significant difference between the two groups regarding their PMS symptoms and the side effects of the medicines (p<0.05).

POS is a combination of three herbal medicines effective on the symptoms of premenstrual syndrome, which can be used effectively and safely to improve the physical and psychological symptoms of premenstrual syndrome. This herbal remedy can be recommended by health care providers to women, who suffer from PMS symptoms and prefer to use herbal remedies instead of synthetic drugs. Further studies are necessary to evaluate the combined herbal remedies as well as the effectiveness of sunflower oil on PMS symptoms.

IRCT20190306042943N1.

Psoriasis is a chronic skin disease characterized by erythema, scaling, and thickening. Yinxieling is a representative prescription for treating psoriasis developed by Professor Guowei Xuan, a master of traditional Chinese medicine. Keratin 17 is a key biomarker for the diagnosis and treatment of psoriasis, and its overexpression has been shown to impair mitochondrial function.

This study investigates the mechanism of action of Yinxieling in the treatment of psoriasis.

In vivo, BALB/c mice were induced by imiquimod to create psoriasis-like mice model. Different doses of Yinxieling were administered to the psoriasis-like mice and PASI scores, thickness of epidermis and Keratin 17 expression of psoriasis-like mice were measured. In vitro, HaCaT cells were induced by IL-17A, IL-22 and TNF-alpha to establish psoriasis-like cells model. Yinxieling with different concentrations was administered to the psoriasis-like cells and Keratin 17 expression, adenosine triphosphate levels, and oxygen consumption rates were measured. Furthermore, the psoriasis-like cells were transfected with keratin 17 plasmids. Yinxieling intervened in these psoriasis-like cells with continuous high expression of keratin 17 and adenosine triphosphate levels and oxygen consumption rates were measured.

Yinxieling significantly improved PASI scores and decreased their epidermal thickness in psoriasis-like mice; Yinxieling also inhibited Krt17 expression in psoriasis-like mice and cells. Yinxieling improved ATP levels and oxygen consumption rate in psoriasis-like cells, and this effect of Yinxieling was abolished when the psoriasis-like cells were transfected with keratin 17 plasmids.

These findings suggest that Yinxieling alleviates psoriatic inflammation and improves mitochondrial function by downregulating KRT17. The study provides new mechanistic insights into the traditional use of Yinxieling and underscores the link between keratin dysregulation and mitochondrial impairment in psoriatic pathology.

Yinxieling inhibits keratin 17 to enhance mitochondrial function and ameliorates psoriasis-like lesions.

Sildenafil is a drug that belongs to the group of phosphodiesterase-5 inhibitors. It is used in the treatment of erectile dysfunction and pulmonary arterial hypertension. Sildenafil undergoes metabolism in the liver by CYP3A4 and CYP2C9. Therefore, drug interactions may occur if sildenafil is taken simultaneously with CYP3A4 and CYP2C9 inhibitors such as green tea catechins.

The aim of the present work was to analyze epigallocatechin-3-gallate (EGCG) and caffeine content in total extract and catechin fraction from Bancha green tea leaves as well as to assess their effect on sildenafil pharmacokinetics in rats.

Animals received sildenafil alone and in combination with total Bancha green tea extract, catechin fraction or ketoconazole (a well-known CYP3A4 inhibitor). The plant extracts and the plasma concentrations of sildenafil were analyzed with high-performance liquid chromatography.

Administration of sildenafil after pretreatment of the rats with total extract and catechin fraction from Bancha green tea resulted in a statistically significant increase in Cmax, AUC0-t and AUC0-inf and a decrease in the volume of distribution and clearance of sildenafil compared to the control group. A significant increase in Cmax, AUC0-t and AUC0-inf of sildenafil was also observed after simultaneous intake of sildenafil and ketoconazole.

Co-administration of sildenafil and the isolated Bancha green tea extracts led to a significant change in sildenafil pharmacokinetics in rats. Therefore, further, in vivo studies are necessary to clarify the exact mechanisms responsible for the interactions established as well as to evaluate the risk for clinically significant interactions in humans.

Cancer is one of the major public health challenges globally and the second cause of death in developed countries. Studies have shown that natural products can be effective in treating cancer. The present study was conducted on the cytotoxicity and apoptogenic effects of stylosin on the HepG2 and U87 cell lines.

First, the cytotoxicity effect of stylosin was investigated using the MTT method. Also, the production of reactive oxygen species was measured. The amount of cell apoptosis was determined by the Sub G1 Peak method. Finally, to investigate the cellular and molecular mechanisms involved in stylosin toxicity, the expression of P53, BAX, Bcl-2, Caspase 3, Caspase 9, and p53 genes were evaluated by the RT-PCR method.

Stylosin causes cytotoxicity in HepG2 and U87 cells in a time and concentration-dependent pattern. It also significantly increases ROS production and stimulates apoptosis. It induced a substantial enhancement in the expression of BAX, caspase3, and Caspase9 genes in HepG2 while decreasing Bcl-2 production and up-regulation of Caspase 3, Caspase 9, and p53 in U87 cells.

The current study discusses the cytotoxic effects of stylosin on U87 and HepG2 cell lines. The findings revealed the effects of stylosin in increasing the cell death via elevation of free radicals, apoptotic cells, and increased Bax, caspase3, and caspase 9. Cancer treatment poses as an important issue, especially for researchers and therapists. HCC is the most common type of liver cancer, which was identified because of its progressiveness, lethality, and resistance to common cancer therapies.

It is concluded that Stylosin can probably inhibit the proliferation of the cancer cell line by affecting the expression of genes involved in apoptosis and the production of ROS.

This study aims to compare the effects of Quercus Infectoria Fruit Hulls (QIFH) with Clotrimazole vaginal suppositories on the signs and symptoms of vulvovaginal candidiasis.

Vulvovaginal Candidiasis (VVC) is an infection caused by Candida species. Although the antimicrobial effects of QIFH have been confirmed, there is no clinical study on its effects on VVC.

One hundred married women (aged 18-45 years) with complaints of vulvar pruritus or burning were recruited for a triple-blind clinical trial at a health center affiliated with Khorramabad University of Medical Sciences. After a definitive diagnosis of vulvovaginal candidiasis, the eligible women were randomly divided into two groups: one receiving QIFH vaginal suppositories (n=45) and the other receiving Clotrimazole vaginal suppositories (n=45). The patients were instructed to use the medications for 7-10 nights. The symptoms and signs of VVC were compared before and after treatment within each group and between the two groups. The data were analyzed using SPSS 24, employing both parametric and non-parametric tests with a 95 percent confidence interval.

The symptoms and signs of VVC, including pruritus, burning and irritation, vaginal discharge, vaginal redness, and swelling with white, thick discharge, significantly improved in both groups after treatment (p<0.001). There were no significant differences between the two groups of QIFH vaginal suppository users and Clotrimazole users regarding the relief of signs and symptoms after treatment (p>0.05).

A study comparing Clotrimazole and QIFH vaginal suppositories found that Quercus infectoria extract effectively treated candida and reduced its growth. Treatment with QIFH significantly improved pruritus symptoms. The tannin ingredient in QIFH's tannins acted through various mechanisms, providing therapeutic and antioxidant effects. QIFH could be an alternative for VVC treatment for women.

The QIFH vaginal suppository was as effective as Clotrimazole in treating the symptoms and signs of VVC without any adverse effects. Given the prevalence of VVC and the similarities in the treatment processes with QIFH and Clotrimazole, it can be concluded that QIFH may be an appropriate alternative for VVC treatment for women who prefer to use herbal medicine.

Clinical Trial Registration No. IRCT20190306042943N2.

Bentunai Village is located in Selakau District, Sambas Regency, West Kalimantan. The majority of the villagers are Malay tribes who have local wisdom regarding the use of medicinal plants after childbirth. Hence, this study aimed to determine the types of plants, plant parts, and processing methods used by the Malay tribe in postpartum care.

The materials used were medicinal plants, 70% alcohol for plant fixation, plastic packing size 30x60 cm, merang paper, thick cardboard, and tape. This research used triangulation techniques, namely interviews, observation, and documentation.

There are 14 types of plants used by the Malay tribe of Bentunai Village for postpartum care, namely sembung (Blumea balsamifera), balik angin (Mallotus paniculata (Lam.) M), patikan cina (Euphorbia sp.), cengkeh (Syzygium aromaticum (L.) Merr & L. M. Perry), lada (Piper nigrum L.), cabe jawa (Piper retrofractum Vahl.), ciplukan (Physalis angulata L.), kunyit (Curcuma longa L.), temulawak (Curcuma zanthorrhiza Roxb), lempuyang (Zingiber zerumbet (L.) Roscoe ex Sm.), jahe (Zingiber officinale Roscoe.), banglai (Zingiber purpureum Roscoe), kencur (Kaempferia galangan L.), and lengkuas hutan (Zingiber sp.).

In conclusion, the most widely used plant family is Zingiberaceae, the most widely used part is the leaves, and there are three ways of processing plants, namely boiled, brewed, and pounded.

This study aims to comprehensively summarize the clinical evidence comparing the effectiveness and safety of integrating astragalus-containing Chinese medicines with western medicines for T2DM.

Six databases were searched for eligible studies from inception to June 2023. The aggregated outcomes were expressed as odds ratio (OR) or standardized mean difference (SMD). Random effect model was used for statistical analyses. The risk of bias for included studies was assessed with the Cochrane Risk of Bias Tool. The overall quality of evidence was assessed with the Grades of Recommendations Assessment, Development and Evaluation approach.

The results showed a significant improvement in the FPG (SMD -0.98; 95%CI -1.23, -0.72), 2hPG (SMD -0.94; 95%CI -1.13, -0.76), HbA1c (SMD -0.97; 95%CI -1.18, -0.75), HOMA-IR (SMD -1.07; 95%CI -1.47, -0.66), HOMA-β (SMD 0.84; 95%CI 0.38, 1.31), HDL (SMD 0.41; 95%CI 0.17, 0.66), LDL (SMD -1.17; 95%CI -1.62, -0.72), TC (SMD -0.83; 95%CI -1.06, -0.59) and TG (SMD -0.93, 95%CI -1.20, -0.65) with astragalus-containing TCMs plus conventional therapy comparing to conventional therapy alone. The incidence of hypoglycemia and gastrointestinal tract adverse events was significantly reduced in the combination group. Subgroup analyses based on the type of western medicines, type of traditional Chinese medicines, baseline glucose level, follow-up duration and disease subtypes, all indicated the similar results regarding the superior effectiveness in the combination group.

The meta-analyses suggested the astragalus-containing TCMs plus WMs surpassed WMs monotherapy in terms of decreasing the FPG, 2hPG and HbA1c level. Our results were limited by the quality of trials included in the meta-analyses.

Add-on therapy of astragalus-containing TCMs was generally more effective in ameliorating the glycolipid metabolism and improving insulin resistance. The clinical benefits of integrative therapies remained in different subgroup patients.

Cerebral ischemic stroke (CIS) severely endangers health, and there is an urgent need for effective therapeutic drugs and in-depth research on its mechanism of action. Danxi Granule has potential application in the relevant treatment.

This study aimed to explore the potential quality markers, therapeutic targets, and molecular mechanisms of Danxi Granule in treating CIS through the “Absorbed into Blood- Fingerprint-Network-Verification” paradigm.

An MCAO rat model was established. Serum samples from three groups were analyzed by UPLC-MS to identify blood-absorbed prototype components. The fingerprint and measurable chemical components of Danxi Granule were obtained using specific chromatographic conditions. Potential quality markers were determined by cross-referencing. Network pharmacology, with databases like GeneCards and OMIM, and relevant software, were used for gene identification and pathway enrichment analysis. Five identified compounds were tested in an OGD/R-induced HT22 cell model.

A total of 207 blood-absorbed prototype components were identified. Ten-batch fingerprint analysis of Danxi Granules showed high similarity, with 15 common peaks (8 corresponding to measurable constituents). Five potential quality markers were determined. These compounds targeted 184 genes, intersecting with 73 disease-related ones. Network analysis revealed 10 key genes and cellular experiments confirmed the protection of HT22 cells, with TNF as a core target.

In this study, an HPLC fingerprint was established using UPLC-MS technology, and five potential Q-markers were screened out. Through network pharmacology and cell experiments, these markers were validated to exert anti-CIS effects via mechanisms, such as anti-inflammation, thereby revealing the material basis of the pharmacological effects of Danxi Granules. The findings of this study provide a basis and new perspectives for quality standard research, clinical application, and the modernization of complex traditional Chinese medicine (TCM) systems. However, the current mechanistic investigation remains at a superficial level, and subsequent studies should further deepen the systematic exploration of the underlying action mechanisms.

The “absorbed into blood-fingerprint” paradigm identified five potential quality markers, namely cryptotanshinone, tanshinone IIA, aurantio-obtusin, icariin, and paeoniflorin. Validation through the “network-verification” paradigm confirmed their quality marker status and demonstrated that their anti-CIS mechanisms likely involve suppressing TNF-α, IL-6, and IL-1β expressions, thereby exerting anti-inflammatory effects.

Alzheimer’s disease (AD)-related dementia and mild cognitive impairment (MCI) are often complicated by CKD. This study aims to identify a therapeutic agent that can improve cognitive function and alleviate chronic kidney disease (CKD) in patients. It also explores the effectiveness of the combination of Ryoukeijutsukanto and Ourengedokuto (RO-8), a Kampo medicine, for treating cognitive decline and renal function impairment in patients with co-morbid CKD.

In this retrospective single-center study, patients with AD who visited the clinic were selected. Cognitive function and kidney function of all participants in the control and treatment groups were assessed using Hasegawa’s Dementia Scale (HDS-R) and the estimated glomerular filtration rate (eGFR), respectively. Statistical analyses were performed to measure the differences in the HDS-R scores and eGFR values before and after the observation or treatment period.

The Kampo medicine RO-8 improved cognitive function in 90.9% (70/77) of patients and cognitive decline in 3.9% (3/77) of patients with AD and MCI. At the same time, 38.7% (29/75) of the patients with AD and MCI who were treated had chronic kidney disease (CKD), 65.5% (19/29) of which exhibited an improvement in the eGFR.

Despite being a single-center and retrospective study, the findings underscore the potential of mixed Kampo medicine in restoring both cognitive and kidney function in patients with AD or MCI and CKD.

RO-8 may exert beneficial effects on cognitive decline in patients with Alzheimer’s dementia and MCI through an anti-inflammatory pathway and can be further explored as an alternative anti-inflammatory drug to treat AD.

Diabetic patients in Saudi Arabia commonly use herbal medicines (HMs) to manage their condition. Research studies indicate that up to 70% of this population has tried HMs, with popular choices including Cinnamomum verum, Zingiber officinale, Trigonella foenum-graecum, Allium sativum, Aloe vera, Olea europaea, and Nigella sativa. More clinical trials evaluating their safety and effectiveness are needed to increase the adoption of these herbal remedies.

This systematic review aims to review clinical research in the Saudi Arabian context on the efficacy of commonly used HMs for diabetes.

A comprehensive search of medical literature was conducted to identify the most popular herbs used by Saudi diabetic patients. The PubMed, Cochrane, Medline, and ScienceDirect databases were utilized to find research studies published in Saudi Arabia that examined the effectiveness of traditional herbal remedies for managing diabetes.

Only four relevant studies from Saudi Arabia were identified, with three specific herbs (Trigonella foenum-graecum, Zingiber officinale, and Nigella sativa) used in all four studies. Two of the studies were blind clinical trials, but only one was double-blinded. The methodological quality of these studies was assessed using the Jadad score, with scores ranging from 1 to 3.

Although Saudi Arabia has a large population of diabetic patients, its contribution to clinical research in this field remains limited. Establishing research groups and developing a sustainable infrastructure could help to address this problem and promote more rigorous studies on HMs.

Systematic Review Registration: PROSPERO CRD 42024602747.