Current Traditional Medicine - Current Issue

Traditional Thai medicine significantly contributes to the treatment of the coronavirus disease 2019 (COVID-19) pandemic. This research aimed to assess the clinical efficacy of traditional Thai herbal steam bath on the residual symptoms of COVID-19 recovered patients.

The single-arm pre-post design research was performed on thirty-three post-COVID-19 patients. All patients received herbal steam bath therapy for twenty minutes twice a week for two consecutive weeks. The outcome measurements on dyspnea intensity, nasal symptom intensity, muscle pain intensity, and quality of life were assessed at baseline and after two weeks of treatment by the modified medical research council (mMRC) dyspnea scale, the total nasal symptom score (TNSS), Numerical Rating Scale (NRS), and COPD assessment test questionnaire, respectively.

The results indicated a significant decrease in mMRC, TNSS, NRS, and CAT scores two weeks post-treatment (p < 0.05). The percentage of patients presenting no or mild symptoms improved to 86.36% in CAT, 80.00% in TNSS, 60.71% in mMRC, and 13.79% in NRS, respectively. In the TNSS test, the highest percentage of patients with no symptoms, reaching 73.91%, was attributable to congestion. In addition, the CAT test revealed that the highest number of patients exhibiting mild symptoms, at 72.22%, correlated with confidence in leaving home.

The herbal formulation may function as an antiviral agent, accelerate therapy, and alleviate side effects related to COVID-19 due to the synergistic antiviral, anti-inflammatory, and immune-enhancing properties of its constituents.

The findings demonstrated that Thai herbal steam bath significantly improved the dyspnea intensity, nasal symptom intensity, muscle pain intensity, and quality of life in patients with post COVID-19 syndrome.

Boesenbergia rotunda (L.) Mansf., a medicinal plant from the Zingiberaceae family native to tropical regions, is valued for its bioactivity properties, commonly used as both a food ingredient and a traditional health tonic remedy. Although it has well-recognized potential as a material source of health products, research on the extraction method for bioactive enrichment remained unexplored.

To improve the extraction process and bioactive content of the plant by using pulse electric field (PEF) extraction compared to the classical extraction method.

Fresh rhizomes were macerated in 95% ethanol for 7, 15, 30, and 60 days for classical extraction. For PEF extraction, 95% ethanol was used as the extraction solvent with time variations of 30 to 150 minutes at a pulse rate of 116 pulses/min and a frequency of 50 Hz. The extraction efficiency was assessed by measuring bioactive compounds, pinostrobin (PS) and panduratin A (PA) using an HPLC assay, along with total flavonoid and phenolic content. Antioxidant activities were evaluated via DPPH, FRAP, and ABTS assays, while glucose uptake inhibition was tested by using a yeast cell model.

Classical extraction achieved PS and PA equilibrium after 15 days, recovery of 937-970 mg/kg (0.093-0.097%w/w) and 26-28 mg/kg (0.0026-0.0028%w/w), respectively. PEF extraction optimized at 60 minutes significantly improved recovery with PS at 930±20.35 mg/kg and PA at143.4±3.48 mg/kg (0.014±0.0003%w/w). Additionally, PEF extraction also increased phenolic and flavonoid contents, antioxidant activity, and glucose uptake inhibition.

PEF achieved a fivefold higher PA recovery than the classical method in just 30 minutes, with results evident after 15 days. Notably, applying PEF to fresh B. rotunda rhizomes in alcohol with metal electrodes induced electroporation, enhancing PS and PA permeability and diffusion from plant material.

PEF extraction presents a promising method for efficiently extracting bioactive compounds from Boesenbergia rotunda.

A Polyherbal Unani Powder Formulation for Urinary Tract Infections (PUFP-UTI) comprises Adiantum capillus-veneris L., Cucumis sativus L., Lagenaria siceraria, Malva sylvestris L., and Portulaca oleracea L. This study aimed to evaluate the physicochemical characteristics, phytochemical composition, quantification of luteolin using HPLC, microbial safety, and in vitro antibacterial activity to assess the quality, efficacy, and safety of the formulation.

Physicochemical analysis included organoleptic properties, ash value, density, moisture content, and extractive values. Phytochemical screening detected phenols, tannins, flavonoids, alkaloids, glycosides, saponins, terpenoids, and sterols. Quantitative analysis measured total phenols, tannins, flavonoids, and alkaloids. Luteolin content was quantified by HPLC. Microbial contamination was assessed following WHO guidelines. Antibacterial activity was tested against E. coli, S. aureus, K. pneumoniae, E. faecalis, P. mirabilis, S. saprophyticus, and P. aeruginosa using the agar well diffusion method.

PUFP-UTI exhibited acceptable physicochemical properties and contained significant amounts of phenols, tannins, flavonoids, alkaloids, and luteolin. The formulation met WHO safety standards for microbial contamination. It also showed substantial antibacterial activity against all tested pathogens. These results indicate that PUFP-UTI is a microbiologically safe herbal formulation with notable antimicrobial efficacy.

The presence of multiple phytoconstituents, such as flavonoids and tannins, along with measurable luteolin content, may contribute to the observed antibacterial effect of PUFP-UTI. Its broad-spectrum activity against common uropathogens supports its pharmacological relevance. The formulation also complies with basic quality and safety benchmarks, reinforcing its potential as a safe traditional remedy.

PUFP-UTI's antibacterial properties support its traditional use in treating urinary tract infections. Further stability studies and clinical trials are recommended to confirm its therapeutic potential.

Chinese herbal medicine (CHM) has been utilized for centuries to manage Allergic Rhinitis (AR), proposing benefits through immune modulation and anti-inflammatory effects. This study aims to investigate the safety and preliminary effects of nasal irrigation with CHM in the treatment of AR.

A total of 29 AR patients were randomly assigned to either the CHM group, receiving nasal irrigation with a saline-CHM solution, saline with a pack of CHM (1 gram of Szechwan Lovage Rhizome, 1 gram of Biod Magnolia Bud, 0.5 gram of Taiwan Angelica Root, 0.5 gram of Wild Mint Herb, 1.5 gram of Baikal Skullcap Root, and 0.5 gram of Borneo), or the placebo group, receiving saline with edible caramel. Evaluations included questionnaires, anterior rhinoscopy, rhinomanometry, acoustic rhinometry, and Eustachian tube function tests.

No major side effects were reported after two months, and Eustachian tube function remained unaffected. Both groups showed significant improvement in AR severity. However, no significant differences were observed between the two groups.

While the CHM regimen is deemed safe for nasal irrigation in AR patients, its efficacy in symptom reduction does not surpass that of normal saline. The duration of nasal irrigation in this study may be too short to observe significant changes.

Our CHM regimen, dissolved in warm saline, is safe for washing the nasal cavity in patients with AR. Further research is warranted to explore the potential benefits of CHM in AR management.

The clinical trial was registered at Clinicaltrials.gov (registration identifier: NCT05901532).

Natural extracts have a long history in traditional medicine for oral care. This review evaluates their integration into modern dentistry, driven by consumer demand for holistic therapies and concerns over synthetic agents.

A comprehensive narrative review was conducted using PubMed, Scopus, and Google Scholar databases (up to 2024). The search focused on keywords related to natural extracts, phytotherapy, and dental conditions. Inclusion criteria prioritized clinical trials, systematic reviews, and mechanistic studies relevant to human dentistry. Data on mechanisms, applications, and challenges were thematically extracted and synthesized.

Numerous extracts, including tea tree oil, aloe vera, neem, and green tea, demonstrate significant antimicrobial, anti-inflammatory, and analgesic properties. Evidence supports their use in managing gingivitis, periodontitis, caries, and oral lesions. Innovations like nano-encapsulation and integration into biomaterials are enhancing their therapeutic efficacy.

While promising, the widespread adoption of natural extracts is hindered by challenges in standardization, regulatory oversight, and the need for larger-scale clinical trials. Potential side effects and drug interactions require careful consideration by clinicians.

Natural extracts represent a valuable and evolving component of dental therapy. Ultimately, this review provides a comprehensive, evidence-based resource to guide clinical decision-making and direct future research in natural dental therapies.

Sarcopenia, characterized by a significant decline in muscle mass and strength, poses a serious threat to the quality of life. Current treatment options are limited, necessitating the exploration of alternative therapeutic strategies. This study investigated the efficacy and mechanism of Jianpi Recipe (JPR), a traditional Chinese medicine formulation, in ameliorating Sarcopenia.

This study employed a dexamethasone (DEX)-induced muscle atrophy mouse model to evaluate the efficacy of JPR. miRNA sequencing was conducted to identify differentially expressed miRNAs (DEmiRNAs). Enrichment analyses of target mRNAs were performed. The hub DEmiRNAs were identified by a Venn diagram and incorporated to construct a lncRNA-miRNA-mRNA ceRNA network. Finally, the hub DEmiRNAs were validated via RT-qPCR and correlation analysis.

JPR dose-dependently improved grip strength, muscle mass, and skeletal muscle histopathology. The miRNA sequencing identified 48 DEmiRNAs in the DEX vs. control group, as well as in the DEX and medium-dose JPR(DEX+M-JPR) vs. DEX group. Enrichment analyses revealed significant pathways, such as the Ras and Wnt signaling pathways, which are involved in the mechanisms underlying the efficacy of JPR. Nine hub DEmiRNAs were identified, with three (mmu-miR-423-3p, mmu-miR-328-3p, and mmu-miR-5621-3p) forming the ceRNA network. RT-qPCR showed that the expression levels of hub DEmiRNAs in control, DEX, and DEX+M - JPR groups were consistent with miRNA sequencing. Correlation analysis revealed a negative correlation between hub DEmiRNAs and relative grip strength and gastrocnemius muscle index.

This study clarified the protective effects of JPR against Sarcopenia and the mechanisms underlying miRNA modulation.

JPR is suggested as a promising treatment for Sarcopenia.

Hypercholesterolemia is a commonly inherited metabolic condition that can result in ischemic heart disease. Due to the undesirable side effects associated with commercially accessible statin drugs, herbal plants are emerging as a preferable alternative for managing and controlling hypercholesterolemia. Substantially, Traditional Chinese Medicine (TCM) and Ayurveda formulations have been reported to play a primary part in the hypercholesterolemia therapy. The inhibition of HMG-CoA Reductase (HMGCR) is significant since it is the key enzyme for cholesterol production, which is crucial for reducing plasma cholesterol levels.

The present review aimed to explore in-depth TCM and Ayurveda polyherbal formulations, along with their pharmacological activities, especially on the serum lipid biomarkers, including low-density lipoproteins, triglycerides, total cholesterol, and high-density lipoproteins, and their potential suppression against HMGCR activity. The review highlights the potential usage of polyherbal formulations for the management of hypercholesterolemia that could potentially be effective with minimal side effects.

TCM and Ayurveda are poly pharmacology systems that have been proven to exhibit better effects than single-targeted compounds in hypercholesterolemia. Polyherbal formulation involves interaction of multi-components that possess synergistic effects and able to replace the synthetic anti-hypercholesterolemia agents associated with side effects. It is the need of the hour to evaluate the integration of both TCM and Ayurveda polyherbal formulations as a strategy to maximize their potential and efficacy in hypercholesterolemia treatment since TCM and Ayurveda have been proven to be effective in combating hypercholesterolemia.

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.

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.