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Mazzei R, Genovese C, Magariello A, Patitucci A, Russo G, Tagarelli G. Plants in Menstrual Diseases: A Systematic Study from Italian Folk Medicine on Current Approaches. PLANTS (BASEL, SWITZERLAND) 2024; 13:589. [PMID: 38475436 DOI: 10.3390/plants13050589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/16/2024] [Accepted: 02/18/2024] [Indexed: 03/14/2024]
Abstract
Background: Plant-based remedies have been used since antiquity to treat menstrual-related diseases (MD). From the late nineteenth to the early to mid-twentieth century, Italian folk remedies to treat "women's diseases" were documented in a vast corpus of literature sources. Aim: The purpose of this paper is to bring to light the plant-based treatments utilized by Italian folk medicine to heal clinical manifestations of premenstrual syndrome (PMS), dysmenorrhea, amenorrhea and menstrual disorders in an attempt to discuss these remedies from a modern pharmacological point of view. Moreover, we compare the medical applications described by Hippocrates with those utilized by Italian folk medicine to check if they result from a sort of continuity of use by over two thousand years. Results: Out of the 54 plants employed in Italian folk medicine, 25 (46.3%) were already documented in the pharmacopoeia of the Corpus Hippocraticum for treating MD. Subsequently, a detailed search of scientific data banks such as Medline and Scopus was undertaken to uncover recent results concerning bioactivities of the plant extracts to treat MD. About 26% of the plants used by Italian folk medicine, nowadays, have undergone human trials to assess their actual efficacy. At the same time, about 41% of these herbal remedies come back to in different countries. Conclusions: Active principles extracted from plants used by Italian folk healers could be a promising source of knowledge and represent strength candidates for future drug discovery for the management of MD.
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Affiliation(s)
- Rosalucia Mazzei
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036 Rende, Italy
| | - Claudia Genovese
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Empedocle, 58, 95128 Catania, Italy
| | - Angela Magariello
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036 Rende, Italy
| | - Alessandra Patitucci
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036 Rende, Italy
| | | | - Giuseppe Tagarelli
- Institute for Agricultural and Forest Systems in the Mediterranean, National Research Council, Via Cavour 4-6, 87036 Rende, Italy
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Tao L, Liao J, Zhang X, Zheng R, Shang H. Association of medicinal plant consumption with all-cause mortality and cognitive impairment in older adult: A large prospective cohort study. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 119:154995. [PMID: 37516089 DOI: 10.1016/j.phymed.2023.154995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/19/2023] [Accepted: 07/23/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Panax ginseng and other medicinal plants have long been believed to have beneficial effects on health, and there is substantial evidence supporting their mechanisms of action. However, the extent of the health benefits derived from consuming these medicinal plants lacks substantial evidence from large-scale longitudinal population studies. The purpose of this study was to analyze the effect of consuming these medicinal plants on all-cause mortality and cognitive impairment. METHODS A population-based cohort study was conducted using the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which was established in 1998 and has been followed up till now. The main exposure was the frequency of eating medicinal plants, including Panax ginseng, Astragalus membranaceus, Lycium barbarum, Angelica sinensis, etc. According to the consumption patterns of medicinal plants, the participants were divided into three groups: frequent use, occasional use, and rarely or never use group. The participants were individually tracked to determine their mortality and cognitive impairment status during the period from 2008 to 2018. Cox proportional hazards regression and competing risk model were used to calculate the hazard ratio (HR) for the association between the use of medicinal plants and the all-cause mortality and cognitive impairment. RESULTS Among 13,918 participants, the average age was 87.2 ± 11.3 years old, and 70.1% (9,754/13,918) of the participants died during follow-up. The proportion of those frequently using, occasionally using, and rarely using medicinal plants was 8.4%, 20.7%, and 70.8%, respectively. Compared with the rarely or never use group, the occasional and frequent use groups demonstrated significantly lower risks for all-cause mortality, with HR of 0.75 (95% CI: 0.71 - 0.79) and 0.53 (95% CI: 0.49 - 0.58), respectively. The protective effect of medicinal plants against all-cause mortality decreased with increasing age in the subgroup analysis. Additionally, frequent use of medicinal plants reduced the risk of cognitive impairment in the competing risk model (HR = 0.73, 95% CI: 0.60 - 0.87). However, there was no protective effect on cognitive function for those who occasional use medicinal plants. CONCLUSION In elderly individuals, occasional and frequent use of medicinal plants was associated with reductions in risk of all-cause mortality, and frequent use of medicinal plants could reduce the risk of cognitive impairment.
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Affiliation(s)
- Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jiaojiao Liao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
| | - Xiaoyu Zhang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing, China
| | - Rui Zheng
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
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Es-haghee Ashteany S, Vahid Dastjerdi M, Tabarrai M, Nejatbakhsh F, Sadati Lamardi SN, Rahmani A, Azizkhani M, Tavoli Z. Effectiveness of Persian Golnar on Excessive Menstrual Bleeding in Women with Abnormal Uterine Bleeding, Compared to Tranexamic Acid: A Triple-Blind, Randomized Equivalence Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2023; 2023:5355993. [PMID: 37520025 PMCID: PMC10374373 DOI: 10.1155/2023/5355993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/09/2023] [Accepted: 07/01/2023] [Indexed: 08/01/2023]
Abstract
Introduction Abnormal uterine bleeding (AUB) is a major healthcare problem in females of reproductive age and impacts women's health and quality of life (QoL). This study aimed to test the equivalence of Persian Golnar (PG) and tranexamic acid (TA) for the treatment of excessive menstrual bleeding. Method A triple-blind randomized equivalence trial with parallel design and block randomization technique was performed. A total of 80 patients with AUB were randomly allocated to receive either PG or TA for three consecutive menstrual cycles. Blood loss was measured by the Pictorial Blood Loss Assessment Chart (PBAC). Hematological evaluations were done before the intervention and after treatment. QoL and premenstrual dysphoric disorder (PMDD) as secondary outcomes were assessed using the menorrhagia questionnaire (MQ) and Premenstrual Symptoms Screening Tool (PSST). Statistical analysis was performed using an independent t-test, paired t-test, χ2 test, Mann-Whitney test, and Wilcoxon signed-rank test. Results Seventy-six women completed the 12-week follow-up. Both PG and TA groups experienced a significant reduction in blood loss. Furthermore, the serum level of hemoglobin in the PG group enhanced significantly (P < 0.001). QoL and PMDD scores were significantly improved in both groups (P< 0.001). Conclusion The findings of the current trial supposed that the Golnar product is as effective as tranexamic acid in controlling bleeding and enhancing the quality of life and premenstrual symptoms.
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Affiliation(s)
- Somayeh Es-haghee Ashteany
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Malihe Tabarrai
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fatemeh Nejatbakhsh
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Azam Rahmani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Azizkhani
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Zahra Tavoli
- Department of Obstetrics and Gynecology, Ziaeian Hospital, Tehran University of Medical Science, Tehran, Iran
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Alhammadi MH, Albogmi AM, Alzahrani MK, Shalabi BH, Fatta FA, AlBasri SF. Menstrual cycle irregularity during examination among female medical students at King Abdulaziz University, Jeddah, Saudi Arabia. BMC Womens Health 2022; 22:367. [PMID: 36068523 PMCID: PMC9446759 DOI: 10.1186/s12905-022-01952-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Menstrual irregularity is defined as any differences in the frequency, irregularity of onset, duration of flow, or volume of blood from the regular menstrual cycle. It is an important medical issue that many medical students suffer from. The study aimed to determine the menstrual cycle abnormalities women experienced during exams and to investigate the most common types of irregularities among female medical students at King Abdulaziz University in Jeddah, Saudi Arabia.
Methods
A cross-sectional study was conducted among female medical students between September and October 2021 at King Abdulaziz University in Jeddah, Saudi Arabia. For this study, the estimated sample size (n = 450) was derived from the online Raosoft sample size calculator. Thus, 450 female medical students from second to sixth year were selected through stratified random sampling. A validated online questionnaire collected data about demographics, menstrual irregularities during exams, type of irregularities, menstrual history, family history of menstrual irregularities, premenstrual symptoms, medication use, medical and family consultations, and absenteeism. The chi-squared test (χ2) was used to analyze the associations between variables.
Results
A total of 48.2% of participants had menstrual irregularities during exams. The most common irregularity was dysmenorrhea (70.9%), followed by a lengthened cycle (45.6%), and heavy bleeding (41.9%). A total of 93% of medical students suffered from premenstrual symptoms and 60.4% used medication such as herbal medication and home remedies to relieve menstrual irregularities, and 12.1% of the students missed classes due to menstrual irregularities. A non-significant relationship was found between menstrual irregularities during exams and students’ demographics, academic year, and age at menarche, while oligomenorrhea, a heavier than normal bleed, a longer than normal cycle, and missing classes due to menstrual irregularities were significantly higher among single students as opposed to married students.
Conclusion
The results showed that female medical students have a significant frequency of menstruation abnormalities during exams period. Colleges should raise awareness among medical students about coping with examination stress and seeking medical care for menstrual abnormalities.
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Najib FS, Poordast T, Mahmudi MS, Shiravani Z, Namazi N, Omrani GR. Does Vitex Agnus-Castus L. Have Deleterious Effect on Fertility and Pregnancy Outcome? An Experimental Study on Rats for Prediction of Its Safety. J Pharmacopuncture 2022; 25:106-113. [PMID: 35837144 PMCID: PMC9240410 DOI: 10.3831/kpi.2022.25.2.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 11/03/2021] [Accepted: 02/04/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives Herbal medicine is a worldwide health topic. Vitex agnus–castus L. (VAC) is a popular plant used for gynecologic problems due to its hormonal effects. The aim of this study is to reveal VAC extract effect on fetus when this herb is used started from antenatal period or during pregnancy. Methods Performed from starting day of January 2019 till February 2019, 48 rats were assigned in randomly divided eight-member six groups control (C1), treated group with 365 mg/kg VAC from initiation of insemination (T1) and 30 days prior to pregnancy (T2), control that underwent caesarean section on 15th day of gestational age (C2) and treated group with 365 mg/kg VAC from initiation of insemination (T3) and 30 days prior to pregnancy (T4) that underwent caesarean section. Weight, sex and number of fetuses, abortion and still birth rate and estradiol level were evaluated using t-test by SPSS software. Results We showed increased weight among T1 group considering totally and sex-dependent which is significant (all p-value < 0.05). We also detected significantly decreased weight in T2 in total (p-value < 0.0001) and when considering female fetuses (0.043) but not males (0.17). Although the results showed slightly non-significant increased weight among fetuses of T3 (totally or based on the fetus sex) compared to the control group (C2), T4 group had statistically decreased weight compared to control group. Pregnancy rate and pregnancy outcome were affected by VAC usage. The time of VAC initiation also affected live birth and abortion rates. Conclusion VAC extract may affect pregnancy rate, live birth rate, abortion and stillbirth rates. Its effect on the weight and the sex showed dual pattern depends on the time of initiation and pregnancy trimester of evaluation. Prescribing this medicinal plant for patients being prone to pregnancy should be with caution. Further study is recommended.
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Affiliation(s)
- Fateme Sadat Najib
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Poordast
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Monireh Sufi Mahmudi
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Shiravani
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloofar Namazi
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Millinga VP, Im HB, Hwang JH, Choi SJ, Han D. Use of Herbal Medicines Among Breastfeeding Mothers in Tanzania: A Cross-Sectional Study. Front Pharmacol 2022; 13:751129. [PMID: 35571105 PMCID: PMC9096166 DOI: 10.3389/fphar.2022.751129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background: There are limited data on the use of herbal medicines (HM) among breastfeeding mothers, despite the fact that knowledge of the possible benefits or harms of HM use has a direct relationship with the health of infants, especially in resource-limited countries. The study aims to determine the prevalence and factors associated with HM use among breastfeeding mothers in Tanzania. Methods: The study followed a cross-sectional design using a structured survey questionnaire. Survey participants were recruited from the reproductive and child health clinic at Uhuru health center in Morogoro, Tanzania. The survey instrument comprised of 34 questions, including demographic information, the pattern of HM use during breastfeeding, and women's perceptions of HM. Chi-square test and logistic regression were used for data analysis using SPSS ver. 24.0. Results: The majority of the respondents (53.8%) used HM during breastfeeding. The most commonly used HM was black pepper (Piper nigrum L.; 80.0%), followed by pumpkin seeds (Cucurbita pepo L.; 18.0%). About one-third (27.5%) of HM users discussed their use with their healthcare providers. In addition, higher education levels and low breastmilk supply were identified as potential predictors of HM use. Conclusion: The practice of HM use among breastfeeding mothers in Tanzania is popular to ease breastfeeding difficulties. However, the issue of the safety or effectiveness of HM is still an unknown agenda. This awakens the need to evaluate HM's safety, efficacy, and quality through pharmacological studies for scientific evidence. Lastly, a clinical guideline should be developed in healthcare settings to promote open dialogues between the healthcare providers and mothers to ensure the safe use of HM.
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Affiliation(s)
| | - Hyea Bin Im
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Jung Hye Hwang
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea.,Department of Obstetrics and Gynecology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Soo Jeung Choi
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Dongwoon Han
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea.,Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea
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Jiao M, Liu X, Ren Y, Wang Y, Cheng L, Liang Y, Li Y, Zhang T, Wang W, Mei Z. Comparison of Herbal Medicines Used for Women’s Menstruation Diseases in Different Areas of the World. Front Pharmacol 2022; 12:751207. [PMID: 35185533 PMCID: PMC8854496 DOI: 10.3389/fphar.2021.751207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/16/2021] [Indexed: 12/27/2022] Open
Abstract
Aims: This review aims to compare the use of herbal medicine used to treat women’s menstruation and the prevalence of menstrual diseases in different regions, which reveal the use of herbal medicine globally and provide scientific guidance for improving women’s health. Materials and Methods: The information available on herbal medicines for women between the years 2000 and 2021 was systematically collected via the library and electronic search systems such as Google Scholar, PubMed, ScienceDirect, and Web of Science as well as secondary resources including books and conference proceedings. Results: Totally, 571 ethnic medicines commonly used for women’s menstruation health in Asia, Europe, Oceania, Africa, and America were accounted. Zingiber officinale Roscoe (Ginger), Ruta graveolens L. (Common rue), Angelica sinensis (Oliv.) Diels (Angelica sinensis), Foeniculum vulgare Mill (Fennel), Catharanthus roseus (L.) G. Don (Catharanthus roseus) and other medicines which have obvious advantages and long-term usage are utilized in the treatment of menstrual diseases. Family Asteraceae, Lamiaceae, Apiaceae, Fabaceae, and Zingiberaceae are the most common medicinal plant families used for such treatments. In many instances, the application of fresh parts of plants was observed because of the healers’ belief regarding the higher efficiency of the medicine made from fresh plants. Edible plants are used in a wide range of countries. Conclusion: Women’s menstruation health is directly related to their health condition. Traditional medicines of most ethnic groups have contributed to women’s health care and treatment of gynecological diseases. Practitioners in this field have gained elaborate experience in treatments and medication, and assembled a large number of effective drugs and prescriptions. These experiences have also been inherited and developed by modern clinical application and scientific research. However, the basic research on these drugs is not sufficient, the knowledge of drug use has not been fully popularized, the advantages of drugs have not been fully utilized, and the guiding potential to modern drug research continues to be insufficient. As such, it is necessary to further promote and make a significant contribution to women’s health.
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Pre-Hippocratic medicine. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp210204031g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Chao J, Ko CY, Lin CY, Tomoji M, Huang CH, Chiang HC, Yang JJ, Huang SS, Su SY. Ethnobotanical Survey of Natural Galactagogues Prescribed in Traditional Chinese Medicine Pharmacies in Taiwan. Front Pharmacol 2021; 11:625869. [PMID: 33679390 PMCID: PMC7928277 DOI: 10.3389/fphar.2020.625869] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/23/2020] [Indexed: 01/14/2023] Open
Abstract
Natural medicinal materials have been used to promote breast milk secretion. Here, we investigated the natural medicinal materials prescribed in traditional Chinese medicine (TCM) pharmacies across Taiwan to induce lactation. We collected medicinal materials from 87 TCM pharmacies, identified them in the prescriptions, and analyzed their drug contents. We examined their botanical origins, biological classifications, traditional usage, and modern pharmacological properties. We used the TCM Inheritance Support System to identify core medicinal materials in galactogenous prescriptions. We collected 81 medicinal materials from 90 galactogenous prescriptions. Leguminosae accounted for 12%, whereas Apiaceae accounted for 7% of all materials examined. The primary medicinal plant parts used were roots and seeds. Nineteen frequently used medicinal materials had a relative frequency of citation of greater than or equal to 0.2. According to their efficacy, 58% were warm, 54% were sweet, and 63% were tonifying; 74% of the frequently used medicinal materials have been showed efficacy against breast cancer. The primary core medicinal material was Angelica sinensis (Oliv.) Diels, whereas the secondary core medicinal materials were Tetrapanax papyrifer (Hook.) K. Koch and Hedysarum polybotrys Hand.-Mazz. Most galactogenous prescriptions consisted of multiple materials from Leguminosae and Apiaceae. The mechanisms underlying galactogenous efficacy warrant further investigations.
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Affiliation(s)
- Jung Chao
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
| | - Chien-Yu Ko
- School of Pharmacy, China Medical University, Taichung, Taiwan
| | - Chin-Yu Lin
- Institute of New Drug Development, China Medical University, Taichung, Taiwan.,Tsuzuki Institute for Traditional Medicine, China Medical University, Taichung, Taiwan
| | - Maeda Tomoji
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan.,Tsuzuki Institute for Traditional Medicine, China Medical University, Taichung, Taiwan
| | | | - Hung-Che Chiang
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Jeng-Jer Yang
- Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shyh-Shyun Huang
- School of Pharmacy, China Medical University, Taichung, Taiwan.,Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Shan-Yu Su
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
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Koohpayeh SA, Hosseini M, Nasiri M, Rezaei M. Effects of Rosa damascena (Damask rose) on menstruation-related pain, headache, fatigue, anxiety, and bloating: A systematic review and meta-analysis of randomized controlled trials. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:272. [PMID: 34485569 PMCID: PMC8395985 DOI: 10.4103/jehp.jehp_18_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 01/28/2021] [Indexed: 05/13/2023]
Abstract
Recent studies have reported inconclusive results regarding the therapeutic effects of Rosa damascena on the outcomes of primary dysmenorrhea (PD) and premenstrual syndrome (PMS). Hence, this study is aimed to summarize the findings of randomized controlled trials (RCTs) regarding the effects of this treatment on menstruation-related pain as the primary outcome and menstruation-related headache, fatigue, anxiety, and bloating as the secondary outcomes. This study evaluated parallel-group and cross-over RCTs on aromatherapy, topical treatment, or oral intake of R. damascena products for the treatment groups versus placebo, nontreated, or conventional treatment groups. Seven electronic databases (Web of Science Core Collection, Scopus, Embase, CENTRAL, CINAHL, SID, and MagIran) and one search engine (PubMed) were searched from inception to January 15, 2021. Of 1468 trials found in the initial search, 983 potentially relevant articles were screened by title and abstract. After examining the full-text of 13 studies for compliance with the inclusion criteria, seven studies were considered eligible for this review. A random-effects model was used to pool the data; otherwise, a narrative summary was presented. The retrieved studies were conducted on females with PD or PMS, aged 18-35 years. The total sample size of the intervention and comparator arms was 276 and 272. The results showed that R. damascena had a nonsignificant alleviating effect on the menstruation-related pain (weighted mean difference [WMD]: -0.47; 95% confidence interval [CI]: -1.25, 0.31; P = 0.234). Such findings were also found for menstruation-related anxiety (WMD: -0.40; 95% CI: -0.91, 0.11; P = 0.125). However, the treatment significantly reduced the menstruation-related headache (WMD: -0.42; 95% CI: -0.74, -0.11; P = 0.008), fatigue (WMD: -0.48; 95% CI: -0.87, -0.09; P = 0.015), and bloating (WMD: -0.72; 95% CI: -1.21, -0.22; P = 0.005). Since R. damascena had no significant effects on menstruation-related pain and anxiety, further studies with improved methodological quality are suggested to evaluate the effects of the treatment on these symptoms, using different dosages and durations.
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Affiliation(s)
- Seyedeh Atefeh Koohpayeh
- Student Research Committee, Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meimanat Hosseini
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Address for correspondence: Dr. Meimanat Hosseini, Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Niyayesh Complex, Niyayesh Cross-Section, ValiAsr St., P. O. Box: 1919973361, Tehran, Iran. E-mail:
| | - Morteza Nasiri
- Student Research Committee, Department of Operating Room Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Rezaei
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
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Hosseinkhani A, Ziaian B, Hessami K, Kashkooe A, Pasalar M. An Evidence-Based Review of Antitussive Herbs Containing Essential Oils in Traditional Persian Medicine. Curr Drug Discov Technol 2021; 18:179-185. [PMID: 32316897 DOI: 10.2174/1568009620666200421091245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/24/2020] [Accepted: 01/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Cough is one of the most common medical symptoms for which medical advice is sought. Although cough is a protective reflex responsible for clearing the airways from secretions and foreign bodies, it can be a troublesome symptom that causes discomfort to patients. Due to the increasing interest in herbal remedies in both developed and developing countries, in the current study, we aimed to overview medicinal herbs containing essential oils used as antitussive agents according to Traditional Persian Medicine (TPM) textbooks. We summarized the relevant scientific evidence on their possible pharmacological effects. METHODS To collect the evidence for the treatment of cough or "seaal" (cough in ancient books) from TPM sources, five main medicinal Persian manuscripts were studied. The antitussive herbs were listed and their scientific names were identified and authenticated following botanical reference books. ScienceDirect and PubMed online databases were searched for related mechanisms of action of the reported medicinal plants. RESULTS Forty-nine herbs containing essential oils have been recommended in TPM for the treatment of cough; 21 of them had at least one known mechanism of action for cough suppression in the scientific literature. According to this review, most of the cited medicinal plants were assessed for either nitric oxide inhibitory or antitussive/expectorant activities. CONCLUSION In addition to advantageous effects of antitussive herbs recommended by TPM, the present review highlighted some recent evidence-based data on these promising herbs that could be used as an outline for future research on their medicinal use.
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Affiliation(s)
- Ayda Hosseinkhani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bijan Ziaian
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Hessami
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Kashkooe
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Lee TK, Kim B, Kim DW, Ahn JH, Sim H, Lee JC, Yang GE, Her Y, Park JH, Kim HS, Sim TH, Lee HS, Won MH. Effects of Decursin and Angelica gigas Nakai Root Extract on Hair Growth in Mouse Dorsal Skin via Regulating Inflammatory Cytokines. Molecules 2020; 25:E3697. [PMID: 32823713 PMCID: PMC7464339 DOI: 10.3390/molecules25163697] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/06/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023] Open
Abstract
This current study investigates the facilitative effects and mechanisms of decursin, a major component of Angelica gigas Nakai (AGN), and AGN root extract on hair growth in mice. We perform high-performance liquid chromatography on AGN extract to show it contains 7.3% decursin. Hairs in mouse dorsal skin are shaved distilled in water, 0.15% decursin, and 2% AGN root extract (0.15% decursin in the diluted extract) and topically applied twice a day for 17 days. Hematoxylin and eosin staining are done to examine the morphological changes in the hair follicles. To compare the effects of decursin and AGN extract on inflammatory cytokines in the dorsal skin, Western blot analysis and immunohistochemistry for tumor necrosis factor α (TNF-α) and interleukin (IL)-1β as pro-inflammatory cytokines, and IL-4 and IL-13 as anti-inflammatory cytokines are conducted. The results show that the application of decursin and AGN extract confer effects on hair growth. Hair growth is significantly facilitated from seven days after the treatments compared to that in the control group, and completely grown hair was found 17 days after the treatments. The protein levels and immunoreactivity of TNF-α and IL-1β in this case are significantly decreased, whereas the IL-4 and IL-13 levels and immunoreactivity are significantly increased compared to those in the control group. Additionally, high-mobility group box 1, an inflammatory mediator, is elevated by the topical application of decursin and AGN extract. Taken together, the treatment of mouse dorsal skin with AGE root extract containing decursin promotes hair growth by regulating pro- and/or anti-inflammatory cytokines. We, therefore, suggest that AGN root extract as well as decursin can be utilized as materials for developing hair growth-facilitating treatments.
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Affiliation(s)
- Tae-Kyeong Lee
- Department of Biomedical Science and Research Institute for Bioscience and Biotechnology, Hallym University, Chuncheon, Gangwon 24252, Korea; (T.-K.L.); (J.H.A.)
| | - Bora Kim
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Korea; (B.K.); (H.S.); (J.-C.L.)
| | - Dae Won Kim
- Department of Biochemistry and Molecular Biology, and Research Institute of Oral Sciences, College of Dentistry, Gangnung-Wonju National University, Gangneung, Gangwon 25457, Korea;
| | - Ji Hyeon Ahn
- Department of Biomedical Science and Research Institute for Bioscience and Biotechnology, Hallym University, Chuncheon, Gangwon 24252, Korea; (T.-K.L.); (J.H.A.)
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Korea; (B.K.); (H.S.); (J.-C.L.)
| | - Hyejin Sim
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Korea; (B.K.); (H.S.); (J.-C.L.)
| | - Jae-Chul Lee
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Korea; (B.K.); (H.S.); (J.-C.L.)
| | - Go Eun Yang
- Department of Radiology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Gangwon 24289, Korea;
| | - Young Her
- Department of Dermatology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Gangwon 24289, Korea;
| | - Joon Ha Park
- Department of Anatomy, College of Korean Medicine, Dongguk University, Gyeongju, Gyeongbuk 38066, Korea;
| | - Hyun Sook Kim
- Leefarm Co., Ltd., Hongcheon, Gangwon 25117, Korea; (H.S.K.); (T.H.S.)
| | - Tae Heung Sim
- Leefarm Co., Ltd., Hongcheon, Gangwon 25117, Korea; (H.S.K.); (T.H.S.)
| | - Hyun Sam Lee
- Leefarm Co., Ltd., Hongcheon, Gangwon 25117, Korea; (H.S.K.); (T.H.S.)
| | - Moo-Ho Won
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon 24341, Korea; (B.K.); (H.S.); (J.-C.L.)
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13
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VanderMolen KM, Naciff JM, Kennedy K, Otto-Bruc A, Shan Y, Wang X, Daston GP, Mahony C. Incorporation of in vitro techniques for botanicals dietary supplement safety assessment - Towards evaluation of developmental and reproductive toxicity (DART). Food Chem Toxicol 2020; 144:111539. [PMID: 32645467 DOI: 10.1016/j.fct.2020.111539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 12/22/2022]
Abstract
As complex mixtures, botanicals present unique challenges when assessing safe use, particularly when endpoint gaps exist that cannot be fully resolved by existing toxicological literature. Here we explore in vitro gene expression as well receptor binding and enzyme activity as alternative assays to inform on developmental and reproductive toxicity (DART) relevant modes of action, since DART data gaps are common for botanicals. Specifically, botanicals suspected to have DART effects, in addition to those with a significant history of use, were tested in these assays. Gene expression changes in a number of different cell types were analysed using the connectivity mapping approach (CMap) to identify modes of action through a functional read across approach. Taken together with ligand affinity data obtained using a set of molecular targets customised towards known DART relevant modes of action, it was possible to inform DART risk using functional analogues, potency comparisons and a margin of internal exposure approach.
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Affiliation(s)
- Karen M VanderMolen
- Procter & Gamble, Mason Business Centre, 8700 Mason - Montgomery Rd, Mason, OH, 45040, USA
| | - Jorge M Naciff
- Procter & Gamble, Mason Business Centre, 8700 Mason - Montgomery Rd, Mason, OH, 45040, USA
| | - Kevin Kennedy
- Eurofins Discovery, Bioanalytical, St Charles, MO, USA
| | | | - Yuqing Shan
- Procter & Gamble, Mason Business Centre, 8700 Mason - Montgomery Rd, Mason, OH, 45040, USA
| | - Xiaohong Wang
- Procter & Gamble, Mason Business Centre, 8700 Mason - Montgomery Rd, Mason, OH, 45040, USA
| | - George P Daston
- Procter & Gamble, Mason Business Centre, 8700 Mason - Montgomery Rd, Mason, OH, 45040, USA
| | - Catherine Mahony
- Procter & Gamble Technical Centre, Whitehall Lane, Egham, Surrey, TW20 9AW, UK.
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14
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Bagherzadeh Karimi A, Elmi A, Mirghafourvand M, Baghervand Navid R. Effects of date fruit (Phoenix dactylifera L.) on labor and delivery outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:210. [PMID: 32290818 PMCID: PMC7157989 DOI: 10.1186/s12884-020-02915-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 03/30/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The rate of cesarean section is increasing in all over the world with different drafts in various countries. This growth increases unpleasant outcomes of delivery. Recent studies explained the benefits of date palm fruit on labor process improvement. Date fruit can be considered as a factor for increasing vaginal delivery and also reducing the frequency of caesarean section in order to prevent its great complications. This systematic review has been designed to review clinical studies that investigate the effects of date palm fruit on labor outcomes (duration of labor stages, bishop score, and frequency of cesarean section) compared with routine cares. METHODS This study was performed in 2019. Required data has been collected from electronic databases and manual searches. All randomized clinical trials evaluating the effects of date palm fruit on labor and delivery that were published from January 2000 to August 2019 in English and Persian languages, were incorporated in this systematic review. The methodological quality of the included studies was evaluated according to the risk of bias assessment of Cochrane handbook of systematic reviews, and were then reported using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. RESULTS Eight studies were included in the qualitative and quantitative synthesis. Meta-Analysis showed that date fruit consumption can significantly reduce active phase of labor (three trials with 380 participants; (MD = - 109.3, 95%CI (- 196.32, - 22.29; I2 = 89%), P = 0.01), and also it can significantly improve the bishop score (two trials with 320 participants; MD = 2.45, 95%CI (1.87, 3.04; I2 = 0%), P < 0.00001). Date fruit consumption had no effects on the duration of first, second, and third stages of labor, and the frequency of cesarean section. CONCLUSION Date can reduce the duration of active phase and improve the bishop score; however, due to from the low to mediate quality of the studies; it seems that the other studies are needed to prove these results better than this.
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Affiliation(s)
- Alireza Bagherzadeh Karimi
- Department of Persian Medicine, School of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Elmi
- School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mojgan Mirghafourvand
- Department of Persian Medicine, School of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghaiyeh Baghervand Navid
- Department of Persian Medicine, School of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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15
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A comprehensive review of clinical studies with herbal medicine on polycystic ovary syndrome (PCOS). ACTA ACUST UNITED AC 2019; 27:863-877. [PMID: 31741280 DOI: 10.1007/s40199-019-00312-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 11/03/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a frequent medical condition characterized by both metabolic and reproductive disorders. Different pharmaceutical treatments have been proposed for PCOS. However, side effects of long-term treatments and their probable low efficacy have made complementary and alternative treatments a valuable option. Recent reports have indicated the increased use of complementary treatments. Herbal medicine, as part of complementary medicine, was find introduced in traditional Persian and Chinese medicine. Medicinal herbs have used for a long time in the treatment of gynecological and infertility problems of PCOS patients. In this study, we aimed to review herbal medicines used for PCOS worldwide. METHODS PubMed, Embase, Cochrane, and Scopus databases were searched for clinical trials and Randomized Controlled Trials based on related keywords. Data were collected from 1990 to 2019. RESULTS According to a multitude of studies, a wide spectrum of herbs can be used to improve various aspects of PCOS. Herbs such as Cinnamomum verum, Trigonella foenum-graecum L., and Vitex agnus-castus can impact on menstrual and ovulatory dysfunctions, obesity, insulin resistance, lipid-metabolism dysfunction, and androgen excess-related conditions. CONCLUSION Some plants as natural remedies may have beneficial effects on improving different aspects of PCOS; but further studies are needed to investigate their mechanisms and safety.
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Uterine epilepsy: a historical report from Avicenna's point of view. Neurol Sci 2019; 41:229-232. [PMID: 31392638 DOI: 10.1007/s10072-019-04019-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 07/19/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Epilepsy is a common neurological disorder, the history of which dates back to thousands of years ago. Avicenna (980-1037 AD) is a famous Persian scholar who considered different types of epilepsy and their specific treatments. His book Al-Qanun fi al-Tibb was taught in Europe for several years. Along with explaining the diseases occurring in various body organs, the book describes neurological and neuropsychological conditions such as epilepsy METHODS: This article is a review of the book Al-Qanun fi al-Tibb and some of the traditional Persian medicine sources, including Kāmil al-Sināa al Tibbiya and Makhzan-O-L Advieh, on uterine epilepsy, its etiology, clinical manifestations and treatments. Also, articles related to this topic in the field of traditional Persian medicine or historical articles have been searched for in Google Scholar search engine or PubMed database. RESULTS Avicenna categorizes the causes of epilepsy into two main groups: those caused by brain diseases and those associated with the diseases of other organs. He believed that the stomach, the spleen, the maraqq, the uterus, or other body organs influence the brain and can cause epilepsy. In uterine epilepsy, the primary pathology lies with the uterus and can affect the brain. This condition occurs due to the retention of the menses or semen. CONCLUSION In this historical article, we intend to explain Avicenna's viewpoint on uterine epilepsy. We suggest further studies on this topic, for example, to evaluate the frequency of epilepsy in patients with the retention of the menses or the semen.
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Bovbjerg ML. Current Resources for Evidence-Based Practice, January 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:99-111. [DOI: 10.1016/j.jogn.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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18
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Falahat F, Ayatiafin S, Jarahi L, Mokaberinejad R, Rakhshandeh H, Feyzabadi Z, Tavakkoli M. Efficacy of a Herbal Formulation Based on Foeniculum Vulgare in Oligo/Amenorrhea: A Randomized Clinical Trial. Curr Drug Discov Technol 2018; 17:68-78. [PMID: 30370852 DOI: 10.2174/1570163815666181029120512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/01/2018] [Accepted: 10/08/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the efficacy of the herbal tea based on Foeniculum vulgare, on inducing regular bleeding in women with oligomenorrhea and secondary amenorrhea( oligo/amenorrhea). METHODS Forty women aged 18- 40 with oligo/amenorrhea were enrolled in this randomized controlled clinical trial and were allocated to two groups equally. The women in the first group were treated by Fomentex (Foeniculum vulgare / Mentha longifolia / Vitex agnus-castus) herbal tea 11.2 g/day in 2 divided doses for 2 weeks and the second group were treated by medroxy progesterone acetate (MP)10 mg/day for the last 10 days of their menstrual cycles. The intervention was repeated in three cycles of menstruation in both groups. Bleeding pattern was documented by the patient on diary cards. The occurrence (yes/no) of bleeding, the regularity of bleeding pattern, the interval of cycles, the duration of bleeding, the volume of blood flow, the hormonal parameters (total testosterone, free testosterone luteinizing hormone and follicle-stimulating hormone), and the endometrial thickness in sonography before and after the intervention were evaluated and compared as outcomes. RESULTS The number of women with bleeding during the first cycle was in the Fomentex group and the MP group 83.3% and 94.1% respectively (p = 0.61). The regularity of bleeding did not significantly differ in patients treated with Fomentex from those given MP (66.7% vs. 94.1%; p = 0.088). Mean interval of cycles decreased in both groups after intervention (P<0.001). Mean duration decreased significantly in MP group after the intervention but it was not different in patients treated with Fomentex. The difference between 2 groups was not significant (P=0.705). Volume of blood flow, with regard to Pictorial Blood Assessment Chart (PBAC), increased significantly in MP group after the intervention (P=0.001) and it was not different in patients treated with Fomentex (P=0.757); however, difference between 2 groups was not significant (P=0.063). The percentage of patients with on time menstruation in the next (drug-free) episode, was higher in the Fomentex group compared with the MP group (50% vs. 23.5%; p = 0.105). Secondary outcomes such as dysmenorrhea, acne and hirsutism reduced in the Fomentex group (P≤0.05), while they increased in the MP group (P=0.007). At the end of the treatment, there was a significant decrease in luteinizing hormone, total testosterone and free testosterone in patients taking Fomentex. The decrease of endometrial thickness, was significant in both groups after the intervention (P=0.001), but the difference between 2 groups was not significant (P=0.58). No notable complication or side effect was reported in relation to Fomentex. CONCLUSION Fomentex herbal tea is a safe, well-tolerated, and effective choice in inducing bleeding and maintaining regular bleeding in women with oligo/amenorrhea.
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Affiliation(s)
- Farnoush Falahat
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sedigheh Ayatiafin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Lida Jarahi
- Community Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roshanak Mokaberinejad
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hasan Rakhshandeh
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zohre Feyzabadi
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mandana Tavakkoli
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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