فصلنامه طب مکمل
سال دوازدهم شماره 1 (پیاپی 42، بهار 1401)

One of the important and common problems of mothers after giving birth is insufficient milk production. To increase it, due to the side effects of chemical drugs that increase milk, medicinal plants have become more popular. In recent years, with the clarification of the need for evidence-based clinical practice, quality and appropriate information is needed. The present study aims to review the results of clinical trials on the effect of milk thistle in increasing breast milk volume.

In this systematic review study, the search for the effects of milk thistle in increasing breast milk volume was conducted in Magiran, MedLib, SID, and IranMedex using the keywords milk thistle, silymarin, milky plants. The search for clinical trials was conducted in EMBASE, PubMed, Scopus, Ovid, and ProQuest using the keywords Milk thistle, Silybum marianum, Silymarin Silybin, breast milk production, herbal galactagogues, increase breast milk, and Clinical trial. The publication year was 2005-2020. The criteria for excluding articles were: Unavailability of full texts, irrelevant results, pilot studies, case reports, review studies, and animal studies. Data analysis was done qualitatively.

Initial search yielded 624 records. Of these, 4 eligible articles with a sample size of 294 were selected and reviewed. All studies showed that milk thistle plant had a positive effect on increasing milk volume. In these studies, no serious side effects from the consumption of this plant were reported.

Milk thistle plant increases milk production in new mothers. The number of studies in this field is low, especially in Iran, which has a long history in traditional medicine and use of herbal medicine. More studies are needed in this field.

Recently, there has been a great interest in combined therapies in the treatment of most diseases. Emerging evidence suggests that the arginase enzyme plays a key role in the complications of diabetes; modulation of this enzyme may help reduce the complications of diabetes. This study aims to evaluate the effect of 8 weeks of aerobic exercise with cinnamon extract supplementation on arginase and P38 MAPK levels in soleus muscle of rats with type 2 diabetes.

In this study, 35 eight-week-old male Wistar rats (weighted 200-250 g) were randomly divided into five groups: Control (C), diabetes (D), diabetes + supplement (DS), diabetes + exercise (DE) and diabetes + exercise + supplement (DES). The aerobic exercise was progressively performed for 8 weeks at five sessions per week. The rats in the DS and DES groups received 200 mg/kg of hydroalcoholic cinnamon extract daily by gavage, while those in groups C and DE received water during this period. Forty-eight hours after the intervention, soleus muscle was isolated and enzyme levels were measured. To analyze the collected data, one-way analysis of variance was used and Pearson correlation test was used to examine the relationships between the study variables, considering a significance level of P<0.05.

The level of arginase enzyme in group D (1.17±0.05) was significantly higher than in group C (0.53±0.08), and its level in group DES (0.67±0.09) was significantly lower than in group D. There was no significant difference in p38 MAPK protein level between any groups. There was a significant positive correlation between blood glucose and arginase enzyme levels.

The combination of aerobic exercise with hydroalcoholic cinnamon extract supplementation can reduce the level of arginase enzyme. Since many complications of diabetes are associated with an increase in the arginase enzyme level, this intervention can be helpful. The findings of this study about the positive effects of aerobic exercise and cinnamon on the complications of diabetes can pave the way for clinical trials.

Some plants have antiseptic properties with no harm to humans or animals. In this study, we aim to assess the effects of Ailanthus altissima and Salvia nemorosa extracts on Pseudomonas aeruginosa, Staphylococcus aureus, and Proteus vulgaris in vitro.

Ailanthus altissima leaves and flowered branch of Salvia nemorosa were collected and dried in shade and powdered. Their aqueous, hydroalcoholic and methanolic extracts were prepared separately from the plants by Maceration method at four concentrations of 20, 30, 40, 50 mg/mL which were used in Mueller-Hinton Agar culture medium by the well diffusion method. Saponin was extracted was using 20% ethanol. The statistical results were analyzed in GraphPad Prism v.7 software.

The aqueous extract of Salvia nemorosa was more effective on Pseudomonas aeruginosa (mean non-growth halo diameter = 26±1 mm). The diameter of the non-growth halo with Ailanthus altissima methanolic extract was 17.5±0.5 mm in Pseudomonas aeruginosa and 16.5±0.5 mm in Staphylococcus aureus, and the effect was significant (P<0.0001). Only Ailanthus altissima hydroalcoholic extract had an effect on Proteus vulgaris. High saponin content of two plants increased their effectiveness.

Aqueous extract of Salvia nemorosa is recommended to inhibit the growth and proliferation of Pseudomonas aeruginosa.

Dates are one of the oldest medicinal foods that contain natural sugars (sucrose, glucose, and fructose), vitamins, minerals, phenolic compounds, and high antioxidants. There is a wide range of secondary metabolites in dates including anthocyanins, carotenoids, flavonoids, phenolic acid, procyanidin, and sterols. These bioactive compounds have antioxidant, antimicrobial, anticancer, anti-inflammatory, and liver protection properties. This study aims to investigate the medicinal and nutritional values of dates in modern medicine and Iranian traditional medicine.

In this review study, data were collected from traditional Iranian-Islamic medicine books (Quran, Makhzan-Al-Adviyeh) and all articles published from 2010 to 2021 in the field of clinical trials on humans and common diseases (Gynecological, cardiovascular, gastrointestinal inflammation, and brain disorders) and indexed in online databases (Google Scholar, PubMed, Ovid, MagIran) using specialized keywords.

Due to the antioxidant properties (flavonoid and polyphenolic), dates have been recommended for cardiovascular health, fertility, reduction of inflammation, digestive health, and brain health in modern medicine, and for treating weakness, memory instability, fever, pain, nervous disorders, male and female infertility, pertussis, and bladder pain as a sedative, expectorant, laxative, and diuretic product in traditional medicine (Iranian, Greek, Roman, Chinese and Indian). In Quran (Surah Maryam), it has been mentioned that dates fruit strengthens the contractile and cervical muscles in the last months of pregnancy. It also lowers the blood pressure in pregnant women for a short time, which reduces the amount of bleeding during childbirth.

The results of studies indicate the medicinal and nutritional values of dates in improving the metabolic activities, especially the functions of heart, fertility, digestion, and brain.

Consumption of pomegranate extract along with resistance training can improve the blood flow, resting metabolism and cause weight loss. However, their effect on body composition and weight control has not been studied. This study aims to investigate the effect of 8 weeks of resistance training combined with pomegranate extract supplementation on resting metabolic rate, hypertrophy and muscle strength of inactive male college students. 

In this quasi-experimental study, 42 inactive male college students voluntary participated after signing a written informed consent form. They were randomly divided into four groups: resistance training (n=11), resistance training + supplementation (n=11), supplementation (n=10), and control (n=10). The resistance training was performed for 8 weeks, 3 sessions per week and included two movements for the upper body (barbell chest press and barbell shoulder press) and two movements for the lower body (leg extension and leg press with machine). The pomegranate extract was consumed at a dose of 100 mL 3 times a week (half an hour before training). Data analysis was performed using one-way analysis of variance with least significant difference post hoc test and paired t-test considering a significance level of P≤0.05. 

The rate of muscle hypertrophy (hip circumference) increased significantly after intervention in two groups of resistance training and resistance training + supplementation, which was higher in the combined intervention group (P=0.001). The maximum strength in lower body muscles also increased significantly after intervention in these two groups (P=0.001). Body fat percentage decreased significantly in the resistance training + supplementation group (P=0.03). No significant change was observed in the resting metabolic rate of the study groups (P>0.05).

It seems that the combination of resistance training with pomegranate extract supplementation increases the muscle strength and hypertrophy in young men.

Prostate cancer is the second leading cause of cancer mortality among men worldwide and in Iran. This study aims to assess the effect of eight weeks of aerobic training and consumption of pomegranate juice on some MicroRNAs and a tumor suppressor protein (P53) in men with prostate cancer.

This quasi-experimental study was conducted in 2021 on 40 men with prostate cancer with a mean age of 61 years who were randomly divided into four groups (10 indivituals): control, exercise, exercise + supplementation, and supplementation. Exercise groups performed aerobic exercises for eight weeks, three sessions per week, each for 60-90 minutes with an intensity of 50-70% of maximum heart rate. Supplementation groups consumed 100 cc of pomegranate juice for 8 weeks, three times per week. Blood samples were taken from the participants 48 hours before and after the implementation of the exercise protocol. Dependent t-test and one-way ANOVA with the least significant difference post hoc test were used to analyze the data, considering a significance level of P≤0.05.

Eight weeks of aerobic exercise combined with consumption of pomegranate juice caused a significant decrease in serum levels of miR-21 (P= 0.001) and miR-155 (P= 0.001) and a significant increase in P53 protein level in men with prostate cancer..

Aerobic exercise and consumption of pomegranate juice simultaneously can reduce miR-21 and miR-155 levels and increase the P53 protein level in men with prostate cancer.

Oxidative stress and apoptosis due to hydrogen peroxide poisoning have a major effect on the physiological and pathophysiological mechanisms of the lung. This study aims to evaluate the effect of aerobic exercise and Tribulus terrestris extract on some indicators of oxidative stress and lung tissue apoptosis in poisoned male Wistar rats. 

In this experimental study, 49 male rats aged 10-12 weeks were randomly divided into seven groups: Control, Poisoned, Poisoning+ Exercise, Poisoning+ Supplementation 1 (Tribulus terrestris 5 mg/kg), Poisoning+ Supplementation 2 (Tribulus terrestris 10 mg/kg), Poisoning+ Exercise + Supplementation 1, Poisoning+ Exercise+ Supplementation 2. The aerobic exercise program consisted of eight weeks (5 days a week) of running on a treadmill at a speed of 20 meters per minute for 60 minutes per session. Alcoholic extract of Tribulus terrestris at two doses of 5 and 10 mg/kg was administered to the target animals by gavage for eight weeks. Serum levels of oxidative stress markers were measured with special kits, and the expression of apoptotic markers of lung tissue was measured by immunohistochemistry. The study hypotheses were analyzed using two-way analysis of variance and Least Significant Difference post hoc test, considering a significance level of P<0.05.

Eight weeks of aerobic exercise significantly increased Adenosine Triphosphate (ATP) (F=19.238, P=0.002, ƞ2=0.468) and significantly reduced Cytochrome C concentration (F=68.970, P=0.001, ƞ2=0.697) and Prooxidants-Antioxidant balance (PAB) (F=12.025, P=0.001, ƞ2=0.464), while had no significant effect on malondialdehyde (MDA) (F=1.067, P=0.169, ƞ2=0.044). Both doses of Tribulus terrestris extract significantly reduced PAB (F=10.118, P=0.001, ƞ2=0.403) while its 10 mg/kg dose increased ATP (F=35.040, P=0.001, ƞ2=0.701) and reduced cytochrome C (F=13.730, P=0.004, ƞ2=0.417) and MDA (F=5.824, P=0.002, ƞ2=0.372) concentrations. After receiving 5 and 10 mg/kg doses of Tribulus terrestris extract and eight weeks of aerobic exercise, The expression of Bax protein (F=54.247, P=0.001, ƞ2=0.804; F=51.201, P=0.002, ƞ2=0.754) and Caspase 3 (F= 49.118, P=0.003, ƞ2=0.504; F=49.001, P=0.004, ƞ2=0.498) were significantly reduced while the BCl-2 expression (F=63.014, P=0.001, ƞ2=0.815; F=50.112, P=0.003, ƞ2=0.706) significantly increased. The most changes in the study markers were observed when aerobic exercise was combined with 10 mg/kg of Tribulus terrestris extract supplementation. 

It seems that 8 weeks of aerobic exercise can reduce the effects of oxidative stress and apoptosis caused by hydrogen peroxide poisoning. However, the effects of Tribulus terrestris extract may be dose-dependent in some cases. Although the combination of aerobic exercise with Tribulus terrestris extract supplementation has better results in controlling oxidative stress enzymes and apoptotic factors, for better results, longer training duration and higher doses of extract are recommended.

Cupping is one of the preventive and treatment methods in traditional Iranian medicine, which has two types, dry and wet cupping. The important point is that cupping should be done at the appropriate time and place and by the qualified people to have the most beneficial effects. This study aims to investigate the reasons for wet cupping therapy in Haziran, and the people’s knowledge of the cupping principles.

This descriptive cross-sectional study was conducted in 2019 in Mashhad and Birjand cities during the last days of June. Finally, 400 eligible samples participated in this study who were selected using a convenience sampling method. The collected data were analyzed in SPSS v. 16 software.

Of 400 participants, 392 completed the questionnaires; 62.8% (n=246) were male, 75.1% (n=292) were married. 40.3% (n=154) had a university education, and 77.7% (n=289) had moderate socio-economic status. 82.2% (n=53) of the women were housewives; 6.6% (n=26) of participants had an underlying disease, 40.8% (n=119) had a history of cupping two times or more in a year, and 42.7% (n=132) had moderate satisfaction with cupping therapy. The most common reason for cupping was the “maintenance of health” (73.9%, n= 272) followed by “disease treatment”. Regarding the people’s knowledge of the principles of cupping, it was found that more than half of  participants had correct information about the best season  (spring) for cupping  (81.5%, n=255), satiety during cupping (74.4%, n=210), the best time for having bath after cupping (after 24 hours) (79.7%, n=240), what to eat after cupping (Honey syrup) (64.7%, n=189) and complications of cupping (69.3%, n=185), but their knowledge was not desirable in other areas such as the best hours of day for cupping (46.9%, n=130), the best day of the week for cupping (21.3%, n=62), and the best days of month for cupping (35.6%, n=86).

Due to the high popularity of wet cupping in Haziran in Iran, and considering the people’s low knowledge of the proper principles and conditions of cupping (such as the time of cupping), it is necessary to inform the community through the media and use specialists in traditional medicine to monitor proper cupping and observance of its principles in the cupping clinics.