Traditional and Integrative Medicine
Volume:6 Issue: 4, Autumn 2021

The most common functional gastrointestinal problem in the world is functional constipation. "Ayarij-e-Faiqra (AF)" is a polyherbal formula that has been recommended by Persian Medicine as an efficent purgative agent . The purpose of this study was to evaluate the effect of AF on functional constipation using a double-blind, placebo-controlled clinical trial. According to the Rome III classification, 79 adults with functional constipation were included in this trial. The diagnostic criteria were according to the Rome III classification. Patients with constipation symptoms who referred to the traditional medicine clinic of Shahid Beheshti University of Medical Sciences from April 2014 to September 2016 were randomly allocated to the AF and placebo groups. The AF and placebo groups received AF and placebo for three months, respectively and followed up for another three months. During the study, the treatment efficacy was assessed by a questionnaire. AF treatment significantly decreased most of the symptoms by 84% at the end of the first month (p < 0.05) and by 90% at the end of the third month in comparison to placbo group (p < 0.001). However, three months after the end of the intervention, the frequency of constipation symptoms in both groups was not statistically significant. Based on the satisfaction questionnaire, the treatment satisfaction score during the intervention was increased to 9 in the AF group, but no significant difference was found between the two groups three months after the intervention (p > 0.005). Although AF could be beneficial for treating functional constipation without significant side effects, changing patients’ lifestyles has  great importance in this process.

Nocturnal enuresis is one of the most common chronic problems of childhood. It has a significant effect on health and quality of life of children and their families. Despite pharmacological treatments, enuresis in most children relapses after the medication is discontinued. Also available drugs have many side effects that limited their uses. So, we compared the effect of topical use of Saussurea costus (Falc.) Lipsch. (Qost) oil as a Persian Medicine product on pediatric nocturnal enuresis in a parallel randomized double blinded study. Eighty-two patients aged 5 to 15 years who were diagnosed as monosymptomatic nocturnal enuresis were allocated to receive costus oil or sesame oil topically below the navel twice a day for 4 weeks. Patients were evaluated prior to and following end of the study in terms of frequency of enuresis and any observed adverse events. The results were evaluated with valid PLUTSS questionnaire. For evaluation, Chi-square and Fisher's exact tests, Mann-Whitney and Wilcoxon tests were used. Significant p value was < 0.05. A significant decrease in mean scores of the questionnaires was noted in both groups. The results before and after the intervention were significantly different in both groups, but there was no statistically significant difference between the intervention and control groups. At the end of the 4th week, the frequency and volume of enuresis showed a 46.2 percent reduction in costus oil group and a 25.5 percent reduction in sesame oil group. According to this study, the response rate based on PLUTSS questionnaire in costus oil group is 74.5%; while in the sesame oil group is 69%. No drug side effect was noticed in this study. Based on the results of this study, costus oil is effective in children with monosymptomatic nocturnal enuresis; however, there is no significant difference between costus oil and sesame oil.

Qurs Afsanteen Saghir is a polyherbal Unani formulation in the form of tablet. This formulation consists of multiple medicinal plants like Afsanteen (Artemisia absinthium L.), Badam Talkh (Prunus dulcis (Mill.) D.A.Webb), Asaroon (Asarum europaeum L.), Anisoon (Pimpinella anisum L.) and Tukhm-e-Karafs (Apium graveolens L.). The clinical adult dose of study drug is 3.5 –7 g per day as mentioned in Unani literature. The present study evaluated the antipyretic, analgesic and anti-inflammatory potential of Qurs Afsanteen Saghir using different animal models. Antipyretic activity was measured using yeast-induced pyrexia model in rats at 360 and 720 mg/kg bw dose of test drug and paracetamol (70 mg/kg bw p.o.) as standard control. Analgesic effect was evaluated using acetic acid-induced writhing test in mice using test drug at dose 720 and 1440 mg/kg bw and diclofenac sodium (15 mg/kg bw p.o.) as standard control. Eddy’s hot plate test was conducted in rats using test drug at the dose of 360 and 720 mg/kg bw and buprenorphine (0.10 mg/kg s.q.) as standard control. Anti-inflammatory activity was assessed by carrageenan-induced paw edema model in rats with the dose of 360 and 720 mg/kg of test drug and Indomethacin (10 mg/kg p.o.) as standard control. The study drug significantly reduced the temperature and pain at both dose levels in a time-dependent manner as compared to normal control. However, the reduction of inflammation was observed at low dose (360 mg/kg bw) only after 3 hours of carrageenan administration. These findings indicated that tested drug showed potential activity as antipyretic and analgesic; whereas the drug may not be considered quite effective as an anti-inflammatory agents.

Since synthetic chemotherapeutic drugs produce a certain degree of drug resistance and due to their common side effects, such as damage to hematopoietic cells and hair loss, it is necessary to use herbal medicine as a substrate to develop new anticancer drugs. The ingredients of three essential oils (EO) were identified using gas chromatography–mass spectrometry (GC-MS) analysis. Their anticancer activities have been investigated on four human breast cancer cell lines, including MCF-7, MDA-MB-175, MDA-MB-231, and MDA-MB-468. In addition, their antioxidant activity was evaluated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. The three plants were investigated for identifications of the ingredients of their EOs, and major ingredients were identified in each plant as alpha-phellandrene (26.75 %) in Anethum graveolens L., limonene (61.83 %) in Citrus limon (L.) Osbeck, and zingiberene (30.28 %) in Zingiber officinale Roscoe. Among the EOs, C. limon was significantly more effective than others; its half-maximal inhibitory concentration (IC50) on MCF-7 was obtained at 201 µg.mL-1. Furthermore, Z. officinale EO showed a higher antioxidant activities in comparison to the two other EOs. Considering the antioxidant and anticancer effects of the EOs, they could be further investigated as a possible complementary medicine in cancer.

Chronic constipation is a highly prevalent digestive problem in the community, which would decrease the quality of life of individuals. There is not any conclusive drug of choice for constipation. Golqand (combined Rosa × damascena Herrm. and honey) has been introduced as an effective safe laxative in Persian medicine (PM). This study aimed to investigate the effects of Golqand in comparison with Magnesium hydroxide suspension (MOM) in chronic constipation. In this clinical trial, fifty-six patients with chronic constipation were randomly assigned to the study groups of Golqand or MOM. Patients received Golqand (20 g daily) or MOM (40 mL daily) for 2 weeks. Patients took the drug twice a day, MOM group used it in the morning (20 mL) and at night before going to bed (20 mL). The Golqand group used it 10 g before lunch and 10 g before dinner, dissolved it in lukewarm water and swallowed. Then, they were followed for the second two weeks without any medication. The primary outcome was frequency of defecation. Patients were evaluated before the study and two weeks and four weeks after the beginning study. Estimated marginal mean frequency of defecation in the MOM group in the first two weeks was significantly higher than the Golqnd group (P < 0.05). There was no significant difference among the groups in the third week when treatment was discontinued (P = 0.155) but in the fourth week, the Golqand group had more count of defecation than the MOM group (P = 0.001). There was no significant difference between the two study groups in terms of treatment satisfaction and drug side effects (P > 0.05). Golqand medication can be used in the treatment of constipation with very few drug side effects and a more lasting effect than MOM drug.

Royal jelly, propolis, and bee pollen are used for different purposes all around the world according to their anti-inflammatory, antioxidant, and antimicrobial activities. Given that Coronavirus 2019 (COVID-19) is a viral condition accompanied by a dysregulated inflammatory response in the body, we intend to evaluate the effects of natural supplementations on the disease course. A randomized, open-label, controlled trial was conducted among 50 definitive cases of COVID-19. These patients were randomly assigned into control and intervention groups. Royal Jelly, propolis, and bee pollen were prescribed to patients in the intervention group (n = 24) in addition to conventional treatment; while the control group only received the standard treatment (n = 26). At the end of the study, functional class improved in both groups, but this change was more pronounced in the intervention group (p < 0.05). Moreover, total symptoms duration and the time to return to work were significantly reduced in the intervention group (p < 0.05). Although royal jelly, propolis, and bee pollen are not definitive treatments in COVID-19 patients, they can be used as an adjuvant treatment to limit disease symptoms and virus propagation.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that causes abdominal pain, distension, change of bowel habit, bloating, constipation, diarrhea, and mucus discharge along with stools. Although the disease causes long-term and agonizing pain, no ideal cure has been found for it so far. This study aimed to investigate the efficacy and compliance of Mentha aquatica L. extract for the treatment of bloating caused by IBS. This double-blind, randomized, placebo-controlled trial study was conducted in Tooba gastroenterology clinic in Sari, Iran, during 2019 (from January to May). A total of 104 patients with IBS in the age range of 20-80 years were randomly divided into two parallel groups of herbal medicine (MAC-330) and placebo. Study period consisted of a 4 weeks of administration, and 2 weeks of follow-up. IBS-associated symptoms including severity of bloating (as primary outcome) and frequency of defecation and abdominal pain were evaluated using a questionnaire before treatment, 1, 2 and 4 weeks after beginning treatment and 2 weeks after stopping treatment. There were no significant differences between the two groups in terms of their baseline characteristics (p > 0.05). The severity of bloating was significantly reduced in the both groups at fourth week (p < 0.030) and 2 weeks after stopping intervention (sixth week) (p < 0.026). The frequency of defecation has increased with the onset of the intervention until the fourth week of the treatment which was not significant. The abdominal pain reduced during the 4 weeks’ intervention, but it was not significant. Based on the obtained results, MAC-330 could not be used as an effective treatment for patients with IBS in short time; however, it reduces the abdominal bloating and pain in these patients, especially in the long-term use.

Shaqīqa-i-Muzmin (chronic migraine) is a type of migraine that is usually caused by cold humours (bārid akhlāṭ), specifically by phlegm (balgham) and to lesser extent by black bile (sauda). The aim of this study was to evaluate the effect of Nutul-i-Ḥār (hot irrigation) in the treatment of chronic migraine. Nutul (irrigation) therapy is widely and successfully used in diseases of head as described in Unānī system of medicine. This open, single-arm, exploratory clinical study was conducted in 30 patients of chronic migraine selected by convenient sampling method. One litre decoction prepared with 12 g each of Astragalus hamosus L. (Iklilul malik), Matricaria chamomilla L. (Babuna), Artemisia absinthium L. (Afsanteen), Origanum vulgare L. (Marznjosh) and Trigonella foenum graecum L. (Hulba) was poured over painful side of head for 45 minutes on every alternate day for a period of 30 days (15 sittings). The patients, thereafter, were followed untill 90th day of the study for various outcome measures comprising headache intensity, headache frequency, Migraine Disability Assessment Scale (MIDAS), and rescue medication. The reduction in headache frequency, MIDAS score and use of rescue medication was significant (p < 0.001) after the treatment. Reduction in headache intensity at 30th day, 60th day and 90th day was significant as compared with baseline values (p < 0.001) but not statistically significant at 90th day with respect to 60th day (p > 0.05). Statistical analysis was done using parametric (paired t-test) and non-parametric tests (Wilcoxan sign ranked test, Freidman with Dunn’s multiple comparison tests). Hot irrigation with medicated decoction was found effective in the treatment of chronic migraine.

The threat of antibiotic-resistance calls for novel antibacterial agents. This study was aimed at screening medicinal plants for their antibacterial properties, phytochemical content and safety. Leaves of Allophylus abyssinicus (Hochst.) Radlk., Dicliptera laxata C.B.Clarke, Ligustrum vulgare L., Solanecio gigas (Vatke) c. Jeffrey and Gymnanthemum myrianthum (Hook.f.) H.Rob.; leaf and stem-bark of Olinia rochetiana A. Juss. and the seed of Cucurbita pepo L. were used. Chloroform and ethanol were used to extract G. myrianthum, D. laxata and O. rochetiana; ethyl acetate and methanol for the rest, and water for all. The extracts were tested against clinical/standard strains of Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi and Staphylococcus aureus by the agar-diffusion method. The minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) were determined. Acute toxicity to mice was checked and preliminary phytochemical screening was done. Thirteen extracts, out of 24, were active (inhibition zone >7 mm) at differing levels (9.67±0.33-25.66±0.57 mm) against at least one bacterial strain. The MICs and MBCs were 1.95-15.6 mg/mL and 7.8-125 mg/mL respectively. The aqueous extract of S. gigas, methanol extracts of L. vulgare and A. abyssinicus, and ethanol extract of O. rochetiana leaf were the most active (MIC 1.95mg/ml) against S. aureus. Ethyl acetate extracts of A. abyssinicus, L. vulgare and S. gigas; aqueous of C. pepo, O. rochetiana and G. myrianthum; and all D. laxata had no antibacterial activity. P. aeruginosa was the least susceptible to any extract, although the methanol and aqueous extracts of S. gigas performed better against it. Preliminary phytochemical screening of selected extracts for phenols, flavonoids, tannins, steroids, terpenoids, steroidal glycosides, alkaloids, saponins, resins and glycosides showed positivity at least for four of these phytochemicals with glycoside and terpenoids in nearly all extracts and resin in none. The plants were not toxic to mice at 2000 mg/kg. Further consideration of S. gigas, L. vulgare, A. abyssinicus and O. rochetiana is recommended in light of their promising potential and safety.

The use of traditional herbal medicines (THM) is widespread among pregnant women in many African societies. Cultural beliefs and social norms largely influence the use of THM. However, its use during pregnancy is not freely discussed during antenatal care and the extent of its use remains unknown. The aim of the study was to determine the prevalence and pattern of THM use during pregnancy, labour, and post-delivery. The study was a quantitative cross-sectional design using a researcher administered questionnaire. Postnatal women enrolled in the prevention of mother to child transmission of HIV (PMTCT) were recruited from healthcare facilities in a rural South African sub-district. Summary and inferential statistics were computed using STATA 14.0 statistical package. The sample consisted of 399 women with mean age of 28 years. A high proportion (158/42.5) were receiving antiretroviral treatment. The prevalence of THM use was 23% and 76/87.4% took THM in the second trimester of pregnancy, 50/57.5% used THM throughout pregnancy, and 27/60% ingested THM when labour started. The majority (50/58.1%) used one type of THM and 35/41.5% used up to four types. The prevalence of THM use on babies was 44%, 82/54.2% were introduced to THM before three months, and 22/14.2% within their first week of life. A third 52/32.3% of babies received more than one concoction of herbal medicines. The women took THM to protect mother and baby from evil spirits as well as to increase labour pains and shorten the duration of labour. The use of THM on the baby was despite the women being enrolled in the PMTCT program which advocates exclusive breastfeeding (EBF) in the first six months. Mixed feeding practices including the use of THM on the baby before the end of the period of EBF have a negative impact on the elimination of vertical transmission of HIV.

Ethnobotanical studies try to gather indigenous cultures plant knowledge from different regions and tribes all over the world. This study aimed at obtaining, documenting and analyzing medicinal plants used by some ethnic groups in Bardsir region, Kerman province, Iran. Data collection was done through face-to-face interviews, and finally, 120 questionnaires were filled out. Based on the local knowledge, the data collection was analyzed using quantitative values including family importance value (FIV), relative frequency of citation (RFC), fidelity level (FL), use-value index (UV), and factor of informant consensus (FIC). In this study, 47 medicinal plants were recorded belonging to 22 families. The results expressed the highest FIV belonged to Lamiaceae (57%) family. The hemicryptophytes (49%) were also regarded as the most common life forms of the used species. In the current study, the highest RFCs and UV indices belonged to Urtica urens L. 0.21, and 0.39, respectively. Achillea santolinoides subsp. wilhelmsii (K.Koch) Greuter, and Teucrium polium L. had the maximum percentage of FL for treating digestive system disorders. In the present study, the highest indices belonged to U. urens, A. santolinoides subsp. wilhelmsii and T. polium; thus, it is recommended conducting further in vitro and in vivo pharmacological studies on the mentioned species.

Traditional Persian medicine (TPM) is a set of theoretical and practical sciences that are used in the diagnosis, prevention, and treatment of physical, mental, or social disorders. This holistic medical system can provide solutions for some diseases, including drug addiction, that modern medicine, only offers symptomatic treatment. Since the addiction prevalence in the 16th century, Persian medicine scholars have introduced various ways to quit it. In this study, we investigated if Persian medicine has treatment options to quit opium addiction. We studied the main textbooks of TPM that specifically talked about addiction. Our study was conducted according to a systematic prioritization in traditional medicine. Additionally, scientific databases such as PubMed, ScienceDirect, Scopus, and Google Scholar searched for plant active ingredients in current pharmacology. By this method, forty-nine drugs were found, and nine drugs with herbal origin obtained the highest score in addiction treatment. Since the main purpose of the study is finding new drugs theoretically effective in quitting opium addiction; we sought to find evidence of that effectiveness in modern pharmacology and we found them in most prioritized drugs. Prioritizing traditional drugs can lead to find new drugs which also have evidence of effectiveness in modern studies. Therefore, they could be introduced as novel natural remedies for disease. The list of drugs obtained in this study can be the basis for conducting in vitro and in vivo studies for design and development of new drugs in the treatment of opium addiction. In fact, traditional medicine could have a special place in quitting opium addiction, and this capacity should be further exploited.