Traditional and Integrative Medicine
Volume:7 Issue: 2, Spring 2022

Various therapeutic activities of Pistacia atlantica var. mutica such as hypoglycemic, antioxidant and anti-inflammatory activity were shown by several studies. Regarding these therapeutic activities, and due to advantages of nanoparticles for drug delivery systems, the anti-colitic effects of P. atlantica var. mutica oleoresin nanoparticles were studied in acetic acid-induced ulcerative colitis in rats. Nanoparticles were synthesized by using ethanol and acetone as solvent. Nano precipitation method was also used for nanoparticles synthesis. P. atlantica oleoresin was orally administered to acetic acid-induced colitis rats at the doses of 50, 100 and 200 mg/kg. Then rats were killed and their colons were dissected away for histopathological and macroscopic tests. Statistical results showed homogeneity and uniformity in size and size distribution of fabricated nanoparticles. Proposed models for size and size distribution of nanoparticles were also adequate (P value <0.05). All doses of nanoparticles of P. atlantica oleoresin significantly reduced macroscopic damage score. The microscopic study also showed anti-colitic activities of P. atlantica oleoresin nanoparticles. Administration of 200 mg/kg of fabricated nanoparticles showed  better anti-inflammatory and healing effects compared to other doses. Our results showed that nanoparticles of P. atlantica var. mutica oleoresin might be an effective agent to treat ulcerative colitis disease, due to the therapeutic activities of the plant and desirable properties of fabricated nanoparticles. Therefore, nanoparticles of P. atlantica var. mutica oleoresin might provide an alternative drug for colonic inflammation.

Vaginal atrophy is one of the most common complaints in postmenopausal women. Symptoms of vaginal atrophy include dryness, itching, bleeding, and dyspareunia. According to Traditional Persian Medicine (TPM), the using of moisturizing plants can treat dry mucous membranes. TPM suggests the use of marshmallow (Alcea angulata) to moisturize dry cells with its mucilage. The aim of this study was to evaluate the effect of Alcea on the treatment of vaginal atrophy. This double-blind, clinical trial was conducted on 60 postmenopausal women with vaginal atrophy (40 – 65 years of age). The patients were randomly assigned into two groups of treatment and control (n = 30). The treatment group received Alcea vaginal suppository 5% (125 mg), and the control group received placebo. Both groups used suppositories every night for two weeks and every other night for six weeks. Vaginal Maturation Value (VMV), symptoms of vaginal atrophy, and pH were compared before and after the intervention. Data were analyzed using SPSS 16. VMV was increased in the treatment group, from 40.30  ±13.27 to 46.40 ± 11.27, (p ˂ 0.0001) compared to the control group, in which the change of VMV was not significant (p = 0.122). The vaginal pH was significantly decreased in the treatment group, from 6.45 ± 0.92 to 5.52 ± 0.62, (p ˂ 0.0001) compared to the control group, in which the change of pH was not significant (p ˂ 0.257). The symptoms were significantly reduced in the treatment group. It seems that Alcea vaginal suppository can be useful as a natural product to relieve the symptoms of vaginal atrophy.

Back pain is a common complaint seen in patients after coronary angiography. This study investigated the efficacy of ear acupressure for reduction of back pain in patients after coronary angiography. In this trial, 120 patients recruited from a post-angiography ward were allocated to an ear acupressure or a control group. Pain assessment in intervention group was performed immediately after participants entered post- coronary angiography ward (T0), twenty minutes after entering the ward (T1), and two, four, and six hours after the intervention (T2–T4). Pain in control group was assessed at the times similar to intervention group. Data were analyzed using the SPSS software (v. 19) by Chi-square, Fisher’s exact, independent t tests, Friedman test, Wilcoxon signed-rank, and Mann-Whitney U test. Final data analysis was done on the data gathered from 58 participants in the control group and 59 in the ear acupressure group. The pain intensity at T1–T4 for patients in the control group was significantly higher than T0 (P < 0.001), while patients in the ear acupressure group reported that pain intensity at T2–T4 was significantly higher than T0 for them (P < 0.001). Only at T1 and T2, pain intensity in the ear acupressure group was significantly less compared to the control group (P < 0.05). Ear acupressure in this study was effective to some extent in reducing back pain after coronary angiography. Future studies can be designed to examine the effects of ear acupressure using different ear acupressure points on the back pain after coronary angiography.

This study aimed to examine the effect of Zataria multiflora Boiss. mouthwash on the microbial load of the oral cavity in patients under mechanical ventilation. This randomized controlled trial was conducted in 2019 on patients under mechanical ventilation. Sampling was performed using the consecutive method. Using a block randomization method, 90 patients were allocated to three equal groups of 30 to receive mouth care using chlorhexidine, Z. multiflora, or normal saline. Mouthwash was used three times a day for a week. Eight hours before and after the intervention, sterile samples of saliva were collected and cultured in the laboratory. Chi-square, Fisher's exact test, paired t and McNemar’s tests, and analysis of variance were used to analyze the data. After the interventions, a significant difference in the microbial load was found between the three groups (P < 0.021). The Tukey post hoc test showed a significant difference between the group treated with Z. multiflora and those who received chlorhexidine (P value = 0.016). The frequency of patients with positive cultures was lower in the group treated with Z. multiflora and the differences were statistically significant in terms of Acinetobacter (P = 0.01) and Klebsiella pneumonia (P = 0.02). Z. multiflora mouthwash was effective in decreasing the microbial load of the oral cavity. This mouthwash can be used to reduce the microbial load of the oral cavity in patients under mechanical ventilation and reduce the risk of ventilator-associated pneumonia.

Asthma is a chronic inflammatory disease of the respiratory tract which includes inflammation and obstruction of the airways. Modern medical treatment has side effects in addition to therapeutic effects. According to the high incidence of asthma, the use of complementary therapies has risen, such as compound honey syrup in Traditional Persian medicine and Integrative medicine as a treatment for asthma. Therefore, the aim of this study was to evaluate the effect of compound honey syrup in improving the clinical symptoms of adult asthma referred to Loghman hospital. This randomized, double-blinded, controlled trial was performed on 80 patients with asthma symptoms. Patients were divided into two groups of 40 and the study was conducted for 12 weeks. The intervention group received classic asthma treatment and compound honey syrup. The control group also received classic asthma treatments plus placebo. The questionnaire was done by individuals at the beginning and end of the study. At the end of study some factors like night symptoms, morning symptoms, activity limitation, shortness of breath, wheezing, and use of Short Acting Beta Agonist (SABA) were significantly decreased in both groups, but it had a greater extent in the intervention group than in the control group. Difference in total scores and some items of Asthma Control Test (ACT) were significant between groups (P < 0.05). No serious adverse effects were observed in any of the groups. The results of this study demonstrate that compound honey syrup can be a safe and effective drug for the treatment of asthma in adults.

Due to the increasing application of traditional and complementary medicine methods as well as medicinal herbs and given the drug interactions during surgery, the goal of this study was to determine the awareness, attitude and performance of surgical team regarding the use of herbs by surgical candidates. In this cross-sectional descriptive study, members of surgery and anesthesia team completed a data collection form, which included personal information and specialized questions (10 awareness, 9 attitudes, and 9 performance questions). The score for each awareness question was 0-2, which was 1-5 for attitude and performance questions, respectively. Quantitative data were reported with mean ±SD, and qualitative data were reported as frequency percentage. Quantitative variables were analyzed by Mann-Whitney and Kruskal-Wallis tests, and qualitative variables were assessed using Chi-square test. Among 185 participants, there were 99 women (53.6%). 31.4% of participants were specialists or assistants, 87.6% of them had moderate attitude, 82.3% showed poor performance and 82.2% poor awareness. The level of awareness was not significant in terms of specialization but that of attitude (p < 0.001) and performance (p < 0.019) was significant. Considering the growing trend of medicinal plants’ consumption in people, and given the moderate attitude, as well as poor awareness and performance of surgical team members toward medicinal plants, increasing knowledge level, prevention of drug interactions and potential side effects of medicinal plants together with training planning are essential for surgical team members to increase patient safety.

Experiencing complications within the first two weeks after stroke leads to a high risk of mortality and length of hospitalization. The present pilot study was intended to investigate the hypothesis that adult patients treated with safflower or not would present with fewer neurological complications following 15 days. In a randomized controlled trial, subjects diagnosed with ischemic cerebrovascular accident (CVA) based on focal neurological findings on brain imaging who met the inclusion criteria of our study were recruited from Ghaem Hospital, Mashhad, Iran, between 2016 and 2017. Thirty-six patients were included in the survey and randomly allocated into treatment (A) and control (B) groups. An oral syrup of safflower extract and nasal drop of safflower oil were additionally prescribed for group A. Group B only received a standard anti-ischemic regimen. The primary outcome measure was the National Institutes of Health Stroke Scale score (NIHSS) over 15 days. Safflower treatment led to a notably higher mean difference in the NIHSS score between the baseline score and 15-day post-treatment score in group A in comparison to group B (p < 0.001). However, adjustment for covariates (age, gender, and baseline measures) showed no significant reduction in neurological status between them (p = 0.340). There was a statistically significant difference in neurological symptom scores between the groups (p = 0.044). Based on this pilot study, adjuvant treatment with safflower in addition to the standard anti-ischemic regimen can be more effective than individual conventional drugs for treating ischemic CVA among adults.

Low sexual desire disorder is a recurrent deficiency in desire for sexual activity which impairs lifestyle. It is a frequent problem in women with limited therapeutic options. Phyllanthus muellerianus (Kuntze) Exell is a plant used by traditional healers to boost libido in women. This study aimed at evaluating the aphrodisiac properties of root barks extracts of this plant on a model of Low Sexual Desire Disorder (LSDD) in female rats. Low sexual desire was induced by ovariectomy plus low steroid hormones supplementations. Thirty ovariectomized rats were treated for 21 days with either distilled water, aqueous or methanol extracts (60 or 372 mg/kg) of P. muellerianus. All animals were supplemented with a low dose of 17β-estradiol and progesterone prior to sexual behavior test. Sexual behavior test was performed each week by pairing each female rat with a sexually experienced male. Sexual motivation (approach, ear wiggling, hops and darts, anogenital presentation and aggressive behavior frequency) and sexual receptivity parameters (lordosis frequency and quotient) were recorded. At the end of treatments, animals were sacrificed, uteri and vagina collected, weighed and conserved for total uterine proteins assay and histology. LSDD was characterized by significant inhibition of sexual motivation parameters and lordosis frequency compared to a normal control. Moreover, poor reproductive tissues growth characterized by low total uterine proteins, uterine wet weight and uterine epithelia size was noted in LSDD group compared to normal control. Interestingly, plant extracts significantly improved sexual motivation parameters (p<0.05-0.001) compared to LSDD group. In addition, moderate reproductive tissues growth was noted in plant treated groups as confirmed by amelioration of uterine cell integrity. Present results show that P. muellerianus exhibits pro-sexual effects through amelioration of sexual motivation and reproductive tissues growth on a model of LSDD.

In this study, we carried out a bioassay-guided fractionation of the most active extract Polygonatum orientale Desf. rhizome, in order to isolate and identify the fraction/s or compound/s responsible for wound healing activity. The wound healing process considered via scratch wound assay on NIH-3T3 fibroblasts. The results showed that the methanol extract and its fractions A5 and A6 showed excellent wound healing effect and were rich of bioactive glycoside compounds. Fraction A6 was selected for further fractionation and two sub-fractions B5 and B6 showed acceptable wound healing on fibroblasts. B5-P (sucrose) and B6-P were isolated as two active compounds from theses fractions that significantly reduced wound area, without any toxicity at very low concentrations (50-200 ng/mL). These results supported the traditional use of P. orientale rhizome for wounds treatment and showed that the accelerated wound healing activity of the rhizome is due to the presence of bioactive polar compounds.

According to Persian Medicine (PM), humors that can replace the consumed body compounds, while contributing to health maintenance, is called ‘fine humor’ (khelt-e saleh). However, a limited number of foods and beverages have been mentioned as the producers of fine humor. These substances are particularly important in maintaining health in vulnerable populations including pregnant women, lactating mothers, the elderly, infants and children. They also play an important role in certain treatment plans during illness and injury and after recovery. The present study was designed to investigate properties of fine-humor producing materia medica, as described by PM resources. Based on the search performed in PM textbooks, 63 substances were found to have this property. The most frequent Mizaj types were hot-wet (33.34%), hot-dry (19.05%), and cold-wet (17.47%). The highest organ tropism belonged to kidneys and bladder, brain, liver, sex organs, stomach and lungs respectively. Examining drug actions indicated obesogenous (53.97%), enhancing sperm production and sexual potency (42.86%), laxative (39.69%), and tonic (33.34%) actions to be the most prevalent effects of these substances in the body. By integrating these substances into diets, health promotion for children, the elderly, and mothers during nursing and pregnancy may be achieved.  Additionally, patients can benefit from a fine-humor producing nutrition both for 1) prevention of chronic diseases and 2) during disease recovery, acute phases of illness, anemia, and metabolic illnesses. Further studies are recommended to analyze the components and nutritional value, and the use of PM capability in culinary medicine.

Insomnia is one of the most prevalent sleep disorders worldwide which significantly affects the quality of life. Pharmacological and non-pharmacological approaches have been applied in managing insomnia. The risk of tolerance and dependence on conventional medications and their other side effects leads the surveys to complementary and alternative medicine. This overview aimed to compile the clinical trials on herbal remedies in managing insomnia for facilitating future studies on medicinal plant in this issue. The keywords “Medicinal plant”, “Herbal medicine” in combination with “Hypnotic and sedative”, "Insomnia" or "Sleep" were searched through PubMed, Google Scholar, and Scopus electronic databases from 1st January 2000 to 31st August 2020. Then, all clinical trials focusing on the efficacy of medicinal plants on insomnia were collected. Based on the inclusion and exclusion criteria, 36 articles were selected, included 16 medicinal plants (23 studies) as a single herb and 13 polyherbal formulations. The most prevalent route of administration among these trials was oral. Matricaria chamomilla L., Valeriana officinalis L., Viola odorata L., and Passiflora incarnata L. were among the most prevalent effective herbal medicines on insomnia. Also, the modulation of the GABAergic system was the most common target of these medicinal plants. Herbal remedies can be introduced as safe and effective alternatives for conventional medications in managing insomnia. The popular herbal medicines, such as M. chamomilla, V.  officinalis, V. odorata, are suitable for further therapeutic development. Other cited medicinal plants in this review can be more investigated in improvement of sleep.