Narratives of Herbal Medicine Utilisation in the United Kingdom: Scoping Literature Review

Using thematic analysis of existing literature, this scoping review aims to explore the narratives of people using herbal medicine (HM) in the United Kingdom. Understanding who is using HM and why will enable better ways of facilitating the use of HM, as well as assist in designing future research. Ethnic groups were found to be primary users of HM in the United Kingdom. A sense of heritage continues to be important for these participants as it allows tradition and culture to stay alive within communities, as well as the ritualistic purposes of these plants. For women, another key demographic, concepts surrounding the naturalness of HMs are associated with the idea of femineity and self-healing. A reoccurring theme in the literature focusing on both ethnic groups and women’s perceptions is the judgement from healthcare practitioners/professionals (HCPs) when addressing the use of HM. However, studies that investigated the perceptions of HCPs on HM confirmed that they often were supportive of using HM where standard treatments had been unsuccessful, and if a patient had anecdotal evidence of a herb having been effective. Delving deeper into public narratives of HM usage will allow conventional healthcare systems to effectively integrate alternative approaches, as well as ensuring that future research into the benefits of HMs is relevant to how people use them.

The effects of curcumin as dietary supplement for patients with polycystic ovary syndrome: An updated systematic review and meta-analysis of randomized clinical trials

This review aims to evaluate if there are clinical benefits of curcumin (CUR) in patients with polycystic ovary syndrome (PCOS). Electronic databases (PubMed, EMBASE, Scopus, Web of Science, Cochrane Central, and Google Scholar) were systematically searched to identify only randomized clinical trials (RCTs) that assessed CUR in patients with PCOS from inception to May 5, 2021. Five RCTs were included with a total of 296 patients, with 148 among the CUR groups and 148 patients among the control group. Revised Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias, three RCTs provided a low risk of bias and two provided a high risk of bias. Compared with the control group, CUR was associated with a statistically significant improvement in the glycemic control including fasting blood glucose (MD = -3.67; 95% CI = [-5.25, -2.08], p < .00001), insulin level (MD = -1.91; 95% CI = [-2.97, -0.84], p = .0005), homeostasis model assessment of insulin resistance (MD = -0.55; 95% CI = [-0.83, -0.27], p = .0001), and quantitative insulin sensitivity check index (MD = 0.01; 95% CI = [0.00, 0.02], p = .0005). The mean difference in total cholesterol was also statistically significant (MD = -15.55; 95% CI = [-30.33, -0.76], p < .04). The rest of the secondary outcomes, including LDL, HDL, sex hormone, body weight, and CRP, were not statistically significant. This review concluded that among patients with PCOS, the use of CUR demonstrated a significant difference from the control group for glycemic control. Those findings suggest that CUR confers clinical benefits in patients with PCOS. However, due to the limited number of the included studies, further high-quality studies are needed to establish the clinical efficacy of the CUR.

Nutrition and traditional Chinese medicine (TCM): a system's theoretical perspective

Traditional Chinese medicine (TCM) is an entirely coherent system, with internal logic and consistency of thought and practice. Though TCM has a long history, it is not easily accepted by Western medicine due to its theoretical and conceptual complexity. TCM nutrition is an ancient but burgeoning discipline, and its main goal is to use food as a means to achieve balance and harmony within the body. Compared with modern nutrition, it has unique beneficial concepts, such as the holism, diet suggestions based on syndrome differentiation, the idea that the spleen-stomach is the "root" of post-heaven, and the homology of medicine and food. Until today, it is difficult to evaluate whether TCM nutrition could play a major role in the treatment of various diseases. The limitations mainly include: the scope of application is limited, lack of evidence-based research, and the constitution differentiation need the cooperation of clinicians of TCM. In contemporary China, the inheritance, innovation, and broadening the scope of applications of TCM nutrition is very important. The government should establish a system in which TCM nutrition and modern nutrition coexist, and perform higher specialist training for dietitians of TCM. Moreover, TCM nutrition should integrate the research methods of modern nutrition, and involve adjustment to target populations, the formulation of age-specific nutrition principles, and an emphasis on the research and development of nutritional food, thus fully demonstrating the advantages and characteristics of TCM nutrition.

Herbal Teas and their Health Benefits: A Scoping Review

Herbal teas are used as therapeutic vehicles in many forms of traditional medicine and are a popular global beverage. The purpose of this scoping review was to examine the evidence relating to the clinical efficacy and safety of herbal teas, and to identify the main research themes and gaps in knowledge to inform further work. A scoping review methodology was followed that set out the research question and described the sourcing, selection and analysis of studies. Overall, a total of 145 research publications were retrieved from global bibliographic databases, and after applying exclusion criteria, 21 remained. These studies looked at herbal tea use in female health, diabetes, heart disease and weight loss, with plant species including lavender, chamomile, fenugreek, stinging nettle, spearmint, hibiscus, yerba maté, echinacea and combinations of herbs. Observational studies explored associations between herbal tea consumption and cancer risk, liver health, and the risks linked to the consumption of environmental contaminants in the plant material. Despite plant materials being the basis for drug discovery, and the popularity of herbal teas, the number of articles exploring clinical efficacy and safety is small. In this review we discuss how herbal teas may be beneficial in some areas of clinical and preventative health, and what further research is required to understand whether regular consumption can contribute to healthy living more generally.

Tocotrienol is a cardioprotective agent against ageing-associated cardiovascular disease and its associated morbidities

Ageing is a nonmodifiable risk factor that is linked to increased likelihood of cardiovascular morbidities. Whilst many pharmacological interventions currently exist to treat many of these disorders such as statins for hypercholesterolemia or beta-blockers for hypertension, the elderly appear to present a greater likelihood of suffering non-related side effects such as increased risk of developing new onset type 2 diabetes (NODM). In some cases, lower efficacy in the elderly have also been reported. Alternative forms of treatment have been sought to address these issues, and there has been a growing interest in looking at herbal remedies or plant-based natural compounds. Oxidative stress and inflammation are implicated in the manifestation of ageing-related cardiovascular disease. Thus, it is natural that a compound that possesses both antioxidative and anti-inflammatory bioactivities would be considered. This review article examines the potential of tocotrienols, a class of Vitamin E compounds with proven superior antioxidative and anti-inflammatory activity compared to tocopherols (the other class of Vitamin E compounds), in ameliorating ageing-related cardiovascular diseases and its associated morbidities. In particular, the potential of tocotrienols in improving inflammaging, dyslipidemia and mitochondrial dysfunction in ageing-related cardiovascular diseases are discussed.

Antimicrobial Potential of Rosmarinus officinalis Commercial Essential Oil in the Treatment of Vaginal Infections in Pregnant Women

Treating inflammatory conditions such as vaginosis, vaginitis, and vulvovaginitis in pregnancy is a special problem due to limitations of available drugs. However, possible treatment options can be found also in naturally originated products, such as essential oils (EOs) of different plants. The aim of this study was to evaluate in vitro antimicrobial and toxic activities of the commercial EO of Rosmarinus officinalis L. ( Lamiaceae) against five Gram-positive and Gram-negative bacterial strains and two Candida strains obtained from pregnant women with vaginal infection. Gas chromatography-mass spectrometry of the tested EO revealed oxygenated monoterpenes to be the major ingredients, while microdilution assay showed the highest activity on Staphylococcus aureus II strain at 6.2 mg/mL. After 24 hours, toxicity was determined at 19.4 mg/mL on Artemia salina nauplii. The obtained results show this EO to be a promising alternative therapy for vaginal infections, although further toxicity and safety research is required.

Dietary Approach to Stop Hypertension with Sodium Reduction for Chinese Canadians (DASHNa-CC): A Pilot Randomized Controlled Trial

BACKGROUND

There is a lack of culturally sensitive dietary interventions targeting Chinese Canadians despite unhealthy dietary behaviours being identified as the most important modifiable risk factor for hypertension in the Chinese population.

AIMS

To determine the feasibility of a culturally sensitive dietary intervention for hypertension control; to examine the potential effects of the intervention on blood pressure and health-related quality of life among Chinese Canadians in community.

METHODS

This study was a two-group pilot randomized controlled trial with 8 weeks follow up. Sixty self-identified Chinese Canadians, older than 45 years old and with grade one hypertension but not on antihypertensive medications were recruited in community. The control group received usual care and the intervention group received usual care plus newly developed DASHNa-CC intervention. The DASHNa-CC intervention consisted of a written manual, two classroom sessions, and one telephone booster call to provide healthy dietary and sodium reduction advice, integrated with Traditional Chinese Medicine food therapy recommendations for hypertension control.

RESULTS

618 Chinese Canadians participated in blood pressure screening, and 60 eligible participants recruited. Participants were highly satisfied with the intervention and adhered to the trial protocol. The lost to follow-up rate was 5%. At 8 weeks post-randomization, those in the intervention group had greater reductions in systolic blood pressure [3.8mmHg, t (55) = -1.58, p = 0.12] and higher physical health scores [t (55) = 2.13, p = 0.04] compared to those of the control group. There were no group differences in health care utilization.

CONCLUSIONS

It is feasible to deliver the DASHNa-CC intervention in a Chinese Canadian community. The DASHNa-CC intervention may decrease blood pressure and improve health-related quality of life for Chinese Canadians.

Traditional Chinese Medicine, Food Therapy, and Hypertension Control: A Narrative Review of Chinese Literature

Despite the lack of English literature about Traditional Chinese Medicine (TCM) food therapy, there is abundant Chinese literature about the application of food therapy for hypertension control. This paper summarizes basic concepts of TCM, the principles of food therapy and its application for hypertension control according to Chinese literature. In TCM, food is conceptualized according to both nutritional and functional aspects, and can be used to treat illnesses. Four principles of TCM food therapy including light eating, balancing the “hot” and “cold” nature of food, the harmony of the five flavors of food, and consistency between dietary intake and different health conditions, can be used to facilitate hypertension control. Based on a statistical analysis of antihypertensive foods recommended in 20 books on the application of food therapy for hypertension control, the 38 most frequently recommended are celery, tomato, banana, hawthorn, garlic, onion, seaweed, apple, corn, green beans, persimmon, laver, kiwi, watermelon, eggplant, carrots, mushroom, peanut, soy products, sea cucumber, buckwheat, garland chrysanthemum, spinach, honey, dairy products, vinegar, black fungus, jellyfish, green onion, shepherd's purse, soybean, potato, pear, winter melon, bitter melon, oat, pea, and tea. Food therapy emphasizes the therapeutic effects of food, considering its nature, taste, and function on human balanced health, which leads to optimal blood pressure control. Current literature suggests that food therapy is effective in blood pressure control and can be incorporated into blood pressure self-management in the Chinese population.

Limitations of Western Medicine and Models of Integration Between Medical Systems

This article analyzes two major limitations of Western medicine: maturity and incompleteness. From this viewpoint, Western medicine is considered an incomplete system for the explanation of living matter. Therefore, through appropriate integration with other medical systems, in particular nonconventional approaches, its knowledge base and interpretations may be widened. This article presents possible models of integration of Western medicine with homeopathy, the latter being viewed as representative of all complementary and alternative medicine. To compare the two, a medical system was classified into three levels through which it is possible to distinguish between different medical systems: epistemological (first level), theoretical (second level), and operational (third level). These levels are based on the characterization of any medical system according to, respectively, a reference paradigm, a theory on the functioning of living matter, and clinical practice. The three levels are consistent and closely consequential in the sense that from epistemology derives theory, and from theory derives clinical practice. Within operational integration, four models were identified: contemporary, alternative, sequential, and opportunistic. Theoretical integration involves an explanation of living systems covering simultaneously the molecular and physical mechanisms of functioning living matter. Epistemological integration provides a more thorough and comprehensive explanation of the epistemic concepts of indeterminism, holism, and vitalism to complement the reductionist approach of Western medicine; concepts much discussed by Western medicine while lacking the epistemologic basis for their emplacement. Epistemologic integration could be reached with or without a true paradigm shift and, in the latter, through a model of fusion or subsumption.

Quantitative ethnobotanical survey of medicinal flora thriving in Malakand Pass Hills, Khyber Pakhtunkhwa, Pakistan

STUDY OBJECTIVE

Ethnobotanical knowledge is proving to be invaluable for drug discovery in the wake of effective prospecting from biodiversity. On the other hand, the escalating human pressure is threatening the endogenous flora. Situated at the foothill of the Himalayas, Pakistan boasts of rich floristic distribution. However, many lush yet imperiled regions of this country has never been explored. It inspired us to evaluate and document the taxonomic composition, significance of medicinal plants and associated traditional knowledge in the District of Malakand, Khyber Pakhtunkhwa Province.

MATERIALS AND METHODS

Vegetation growing in Malakand pass hills, Pakistan was studied and data were collected using an open-ended questionnaire, in addition to interviewing the local elderly, knowledgeable persons, and herbal practitioners. Relative Frequency Citation (RFC) and Use Value (UV) of the medicinal plants were calculated and their correlation was determined by Pearson correlation coefficient.

RESULTS

This study encompasses 92 plant species belonging to 56 families thriving in the study area. The information gathered includes ethnobotanical inventory and their pharmacological uses. Quantitative analysis throws light on the consistence of RFC and UV. Asteraceae and Lamiaceae were the most abundant families represented by 6 species each. Shoots were the most used parts (23.6%) and wound healing (7.91%) was the most common therapeutic use.

CONCLUSION

The result obtained from the study implies that local inhabitants rely on these plants for their medicinal requirements. Also, the statistics reveal that, the vegetation can be assessed for potential drug leads. However, urban expansion is threatening the existence of indigenous flora and old generation with ancient herbal wisdom is perishing. So, it appears imperative to preserve the traditional knowledge. This survey is expected to contribute to the discovery of novel bioactive constituents, stimulate conservation efforts of the perturbed flora and promote sustainable exploitation of the medicinal bounty.

A traditional Chinese herbal formula improves pressure ulcers in paraplegic patients: A randomized, parallel-group, retrospective trial

In this study, the efficacy of a novel Chinese herbal formula, cure rot and flat sore ointment (CRFSO), in the management of stage IV pressure ulcers, and the effect of simultaneous comprehensive rehabilitation in improving the outcome were evaluated. A total of 35 paraplegic patients with stage IV pressure ulcers who underwent reconstruction and inpatient rehabilitation from January 2004 to September 2010 were included in the study. Arnebia root oil (ARO) was used on 16 patients with 11 ulcers (stage IV). The remaining 19 patients with 20 ulcers (stage IV) received a traditional Chinese herbal formula (CRFSO). After 28 days of treatment, the wound healing results, in particular, the healing rate, effectiveness rate, improvement rate and no response rate were evaluated. Six patients from the ARO group sought other types of therapy due to their own consideration of poor efficacy. After 28 days of treatment, the wound healing result and no response rate demonstrated a statistically significant difference (P<0.005) between the two groups, suggesting that the novel Chinese herbal formula is an effective treatment for pressure sores in paraplegic patients. All outcome variables demonstrated significant improvement in the CRFSO group compared with the ARO group after 28 days of treatment, with a higher healing rate (85% in the CRFSO group and 45.45% in the ARO group) and lower no response rate (5% in the CRFSO group and 18.18% in the ARO group). The traditional Chinese herbal formula improved pressure sores in paraplegic patients effectively and inpatient rehabilitation was also significantly improved.