The Network between Heart and Liver from the View of Persian Medicine Versus Conventional Medicine

BACKGROUND

Liver and heart are two important organs in the human body, whose function strongly affects other organs. On the other hand, these two main organs affect each other due to common metabolic pathways. Therefore, a disorder in any of them can lead to disease in other organs. Today, using the network medicine perspective, these complex connections can be easily mapped and discovered. From the Persian medicine viewpoint, links are formed based on the material causes of diseases, while from the conventional medicine viewpoint, they are mostly formed due to metabolites, genes, and pathways.

MATERIALS AND METHODS

In this article, we first investigated the recent articles of conventional medicine that examine the relationship between heart and liver in the important databases. Then, we checked out the sources of Persian medicine and finally, using the RStudio software used in network medicine for text mining, we drew the communication network centered on heart and liver and their mutual causes from the perspective of Persian Medicine.

RESULTS

Examining the network connection between the heart and the liver showed that the definitions based on Persian medicine, which are based on the material causes of diseases, are very compatible with the genes, metabolites and pathways between these two organs.

CONCLUSION

Understanding these concepts can be helpful in detecting the co-occurrence of diseases of these two organs, as well as predicting the possible occurrence of related diseases between the heart and liver, and ultimately in better treatment.

Antifatigue Effects of the Aqueous Extracts of Myrtle Berries, Apple and Clove: An Animal Study

Background

Fatigue is one of the most prevalent symptoms, increasing worldwide with no specific medication for fatigue. Iranian traditional medicine (ITM), or Persian medicine, is a reliable source for discovering natural medicine for diseases and their symptoms. Myrtus communis L. (Myrtle), Malus domestica Borkh. (Apple), and Syzygium aromaticum (L.) Merr. & L. M. Perry (Clove) have been utilized as brain and heart tonics in ITM. Based on ITM, cardiac tonics decrease fatigue by enhancing heart function and increasing blood flow to tissues. These plants, particularly myrtle berries, have been utilized as potent enlivening agents that reduce mental fatigue.

Objectives

This study aims to investigate the effects of aqueous extracts of these plants on weight-loaded forced swimming (WLFS) tests and three doses of aqueous myrtle extract in an animal model of chronic sleep deprivation-induced fatigue.

Methods

Five groups of rats (n = 6) were evaluated: Sham, control, apple-treated, clove-treated, and myrtle-treated groups. After 28 days of treatment, the WLFS test was performed, and swimming time was recorded. Subsequently, central fatigue was induced in rats by chronic sleep deprivation for 21 days. Five groups of rats (n = 6) were evaluated: Sham, control (sleep-deprived, which received water), and three sleep-deprived + treatment groups, which received aqueous myrtle extract (350, 700, and 1000 mg/kg). An open field test on the 20th day and a WLFS test on the 21st day were performed.

Results

The myrtle berries significantly increased glucose, reduced lactate dehydrogenase (LDH) levels, and enhanced swimming time. Fatigue caused by chronic sleep deprivation increased malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and LDH while decreased superoxide dismutase (SOD), glucose, and swimming time. In all treatment groups, SOD levels and swimming time were increased, whereas MDA, IL-1β, and TNF-α levels were decreased significantly. Only the 1000 mg/kg dose significantly reduced LDH levels (P < 0.001). The treatment significantly improved the velocity and the total distance moved in the open-field test.

Conclusions

According to the results, the myrtle berries reduced fatigue in two animal models, probably due to its phenolic compounds, flavonoids, and polysaccharides.

The effect of "mavizˮ on memory improvement in university students: A randomized open-label clinical trial

OBJECTIVE

Numerous studies demonstrated the effect of grape on memory improvement. According to Iranian traditional medicine, "mavizˮ as a specific type of dried grapes can effectively improve memory. However, there is no reported clinical trial on the effect of "mavizˮ on memory improvement in humans. Hence, this study was conducted to investigate "mavizˮ effect on memory in university students.

MATERIALS AND METHODS

This randomized open-label clinical trial was conducted on a total number of 53 students of Shahed University, Tehran, Iran, from November 2017 to February 2018. The participants were randomly allocated into an intervention group (receiving "mavizˮ, 25 g in the morning for 4 weeks) or a control group (who did not take "mavizˮ). The Digit Span Task and the N-Back Task were used for the measurement of working memory at the pre- and post-intervention stages.

RESULTS

According to the results, no significant differences were found between the two groups regarding age, gender, marital status, and initial working memory test scores. "mavizˮ consumption produced a highly significant improvement in total working memory score in the Digit Span Task (5.18 vs. 2.35, p<0.001) and Acoustic Memory Span (1.29 vs. 0.62, p=0.021). Moreover, "mavizˮ consumption significantly increased the percentage of true responses in the N-Back Task and reduced the mean reaction time in the first level of the task.

CONCLUSION

"mavizˮ consumption was improved working memory in young healthy adults.

Effect of Aslagh Capsule, a Traditional Compound Herbal Product on Oligomenorrhea in Patients with Polycystic Ovary Syndrome: A Three-Arm, Open-label, Randomized, Controlled Trial

Background:

Oligomenorrhea is a common complaint in patients with polycystic ovary syndrome (PCOS). There are some useful medicinal recommendations such as Aslagh product (include fennel fruits, carrot seeds, chaste tree fruits) in Iranian traditional medicine for the treatment of oligomenorrhea in PCOS. Hence, the present investigation was designed to compare Aslagh capsule with metformin on the oligomenorrhea.

Materials and Methods:

One hundred fifty women aged between 18-43 years with oligomenorrhea due to PCOS were randomly divided into Aslagh, metformin, and Aslagh + metformin groups. The occurrence of menstrual bleeding was considered as the primary outcome. Menstrual cyclicity, duration, and volume of the bleeding were also evaluated.

Results:

Occurrence of menstrual bleeding was 87.2% in all patients, with no significant difference between the three groups (P> 0.05). Menstrual cyclicity significantly improved from baseline in Aslagh and Aslagh + metformin groups (P=0.02). Duration of menstrual bleeding was significantly higher in Aslagh group in the first and the second menstrual bleeding cycle compared to the other two groups (P<0.05). No significant change was observed in the volume of the bleeding after the intervention in any of the three groups. The occurrence of menstrual bleeding in Aslagh group was significantly (P=0.03) higher than the other two groups in the fourth month (drug-free period).

Conclusion:

Aslagh capsule showed beneficial effects similar to metformin in the treatment of oligomenorrhea in PCOS women and could be suggested for use as an alternative treatment in these patients.

Extended honeymoon period in a type 1 diabetic child by Iranian Traditional Medicine treatments, a case report

We present a 4-year-old newly diagnosed T1DM boy who presented with sever polyuria and polydipsia and HbA1C of 9.3%. Coincident with onset of ITM program insulin doses were tapered and the baby got free from insulin soon. Only three months after traditional anti-diabetic medications, his HbA1C improved to 5.8%.

Comparison of quince with vitamin B6 for treatment of nausea and vomiting in pregnancy: a randomised clinical trial

This trial was performed to compare quince (Cydonia oblonga) fruit with vitamin B6 on 76 pregnant women with a gestational age of 6-14 weeks and mild-to-moderate nausea and vomiting (NVP) (40 in the quince and 36 in the B6 group). The 'Pregnancy-Unique Quantification of Emesis' (PUQE-24) scale was used to examine the severity of NVP. The quince syrup (1 tablespoon/TDS) or vitamin B6 tablets (20 mg/TDS) were used as intervention for 1 week. The mean (±SD) age was 27.5 (±5.2) years. The score of the PUQE was decreased from 9.5 (± 2) at baseline to 5.2 (±2.3) on the 7th day and 5.3 (±2.6) on the 14th day (p < .001) in the quince group. In the other group, the scores were 8.4 (±1.8), 7.3 (±2.4) and 7.7 (±3.8), respectively (p = .001). The change in symptoms were more marked in the quince group (p < .001). Quince syrup seems to be a suitable treatment for NVP. Impact statement What is already known on this subject: Pregnancy-induced nausea and vomiting (NVP) is one of the most common problems during gestation. Treatment is mainly symptomatic, ranging from dietary changes and oral pharmacological treatment to hospitalization in severe forms. In early pregnancy, the use of chemical drugs is avoided, so there is an increasing tendency to use alternative therapies. According to the literature review in Iranian Traditional Medicine (ITM), the quince fruit (Cydonia oblonga) can be useful in NVP. Quince has a wide range of pharmacological activities including antioxidant, antibacterial, antifungal, anti-inflammatory, hepatoprotective and antidepressant effects. ITM literature suggests some therapeutic effects of the quince fruit on important organs like brain, heart, liver and stomach. What the results of this study add: The results of this study demonstrated the significant efficacy of quince in comparison with vitamin B6. What the implications are of these findings for clinical practice and/or further research: This fruit is also safe to be administered in pregnant women suffering from NVP.

Evaluation of the Wound Healing Activity of a Traditional Compound Herbal Product Using Rat Excision Wound Model

Iranian Traditional Medicine (ITM) manuscripts contain prescriptions that have long been used for healing of wounds. The present study evaluates the healing effect of a poly herbal paste (PHP), retrieved from ITM sources, containing Aloe vera, Commiphora myrrha and Boswellia carteri using rat excision wound model. Excision wounds were induced in six groups consisting of six rats each. Group 1 received no treatment, while groups 2 and 6 received tetracycline ointment, Alpha ointment, PHP 40%, PHP 10% and paste base every day, respectively. The percentage of wound contraction on days 2, 7, 14 and 21 and histopathology parameters of healed wounds on 14^th and 21^st days were evaluated. Moreover, antioxidant activity of PHP was evaluated using DPPH method. There was a significant improvement in wound healing in PHP 10% group on the 7^th day of the treatment (p<0.05). Moreover, the healing effect of PHP 10% was significantly greater than the control, tetracycline and paste base groups on the 2^nd, 14^th and 21^st days (p<0.05). On day 14, PHP 40% showed significant healing effect compared to the control, tetracycline and paste base groups (p<0.05). Fewer inflammatory cells were observed in PHP 10%-treated animals and this group demonstrated better re-epithelialization with remarkable neovascularization. Besides, the PHP 10% formulation exhibited antioxidant activity. In vivo and histopathologic examinations showed considerable wound healing in PHP 10% group. This finding could probably be due to the antioxidant, anti-inflammatory and antimicrobial activities of phytoconstituents of A. vera, B. carteri and C. myrrha.

VOLATILE CONSTITUENTS OF GINGER OIL PREPARED ACCORDING TO IRANIAN TRADITIONAL MEDICINE AND CONVENTIONAL METHOD: A COMPARATIVE STUDY

BACKGROUND

Herbal medicines formulated as oils were believed to possess more powerful effects than their original plants in Iranian Traditional Medicine (ITM). One of the popular oils suggested for treatment of various indications was ginger oil. In the present study, to suggest a more convenient method of oil preparation (compared to the traditional method), ginger oil has been prepared according to both the traditional and conventional maceration methods and the volatile oil constituents have been compared.

MATERIAL AND METHODS

Ginger oil was obtained in sesame oil according to both the traditional way and the conventional (maceration) methods. The volatile oil of dried ginger and both oils were obtained by hydro-distillation and analyzed by gas chromatography/mass spectroscopy.

RESULTS

Fifty five, fifty nine and fifty one components consisting 94 %, 94 % and 98 % of the total compounds were identified in the volatile oil of ginger, traditional and conventional oils, respectively.

CONCLUSION

The most dominant compounds of the traditional and conventional oils were almost similar; however they were different from ginger essential oil which has also been to possess limited amounts of anti-inflammatory components. It was concluded that ginger oil could be prepared through maceration method and used for indications mentioned in ITM.

A Wound Healing Formulation Based on Iranian Traditional Medicine and Its HPTLC Fingerprint

Herbal therapy was the common treatment prescribed by Iranian physicians for wound healing. "Zemad" was the most ancient pharmaceutical dosage form used in Iranian Traditional Medicine (ITM) for skin diseases. In the present research, formulation of a traditionally used Poly Herbal Paste (PHP) for wound healing was performed. Moreover, the fingerprint of the product was prepared by HPTLC method for identification and quality assessment of the formulation. 3.33 % of each plant materials containing Aloe vera, Boswellia carteri and Commiphora myrrha were used in a hydrophilic base. The physical stability and rheological behavior of the formulation was evaluated. Moreover, microbiological tests was performed. Methanol fraction of A. vera, C. myrrha and B. carterri were used as standard materials in HPTLC method. Stability and rheological behavior evaluations as well as microbiological tests showed that the prepared formulation was stable towards physical changes with no growth of pathogenic microorganisms and suitable for topical application. HPTLC fingerprinting of PHP confirmed the presence of compounds corresponding to the plants used in the formula. Regarding to the antioxidant, anti-inflammatory and antimicrobial effects of the constituents of PHP, the product could be an appropriate candidate for wound healing with respect to its traditional use in ITM. In addition, HPTLC fingerprinting could be used as an applicable method for quality control assessment of the prepared formulation.

Ginger from ancient times to the new outlook

Context:

Ginger is the rhizome of Zingiber officinale, a perennial plant, used alone or in compounds as a spice or remedy in ancient recipes of Iranian traditional medicine (ITM) as an effective tonic for the memory and digestive system, the opener of hepatic obstructions, aphrodisiac, for expelling compact wind from stomach and intestines, diluting, desiccating and emollient of phlegmatic and compact humor sticking to body organs, stomach, intestine, brain and throat. The ITM scholars believed that ginger was a vermifuge as well as a remedy for paralysis and obstructive jaundice. They also revealed that this phytomedicine cures diarrhea due to corrupted food. This study aimed to compare the medicinal properties (afaal) of ginger in ITM with those indicated in modern research.

Results:

Results of this study showed that the modern phytotherapy confirmed some of the properties of ginger. In addition, some of the properties of this phytomedicine have not been studied yet.

Conclusions:

By studding the ITM literature, herb elements or in other words ITM keywords, researchers can predict and state some unknown or less known potential pharmacologic effects of medicinal plants.

Efficacy of Myrtus communis L. and Descurainia sophia L. Versus Salicylic Acid for Wart Treatment

Background:

Wart is a skin disease with circular appendages, which is called “suloul” in Iranian traditional medicine (ITM). According to ITM literature, warts have different types and causes. The most important mechanism is excretion of materials (Khelt) from body to skin and mucus; its causative material is often phlegm, black bile or a combination of them. To treat warts, it is necessary to consider the patient’s life style, modify his dietary intake and moisturize his temperament.

Objectives:

This study aimed to compare Myrtus communis L. and Descurainia sophia L. as a method of ITM, versus salicylic acid in treatment of wart.

Patients and Methods:

In this study, conducted in Yazd, Iran, 100 patients were selected and randomly divided into four groups. Group 1) salicylic acid, group 2) salicylic acid and D. sophia L. group 3) M. communis L. group 4) M. communis L. and D. sophia L. Numbers, sizes of lesions and symptoms, on days 0, 20, 40 and 90 were examined and analyzed. The relapse rate was investigated three months after. Changes of sizes and numbers of warts in each period of time in each group, compared to baseline, were assessed by Wilcoxon Signed Rank test. To compare these changes between the groups, Kruskal Wallis test was used.

Results:

In this study 100 patients participated, 69% of which were female. Compared to baseline, mean ± SD of changes for the number of warts in day 40 were 1.12 ± 4.2, 0.96 ± 2.5, 1.32 ± 5.1 and 0.04 ± 0.2 respectively in the four groups (P = 0.02). Mean ± SD of changes for the number of warts in day 90 were 1.84 ± 4.5, 1.56 ± 2.8, 1.24 ± 5.1 and 0.04 ± 0.6 respectively in the four groups (P = 0.03). In addition mean ± SD of changes for the size of warts in day 40 were 0.96 ± 1.8, 1.03 ± 2.4, 2.47 ± 3.0 and 0.45 ± 1.7 respectively in the four groups (P < 0.001). Mean ± SD of changes for the size of warts in day 90 were 1.24 ± 2.1, 1.3 ± 2.3, 2.45 ± 3.1 and 0.45 ± 1.7 respectively in the four groups (P < 0.001). Relapse was not seen in any groups after three months. The frequency of side effects was similar after three months.

Conclusions:

M. communis L. can be used as a topical treatment for warts. It not only shows more rapid response than salicylic acid, but also has fewer side effects. It seems that D. sophia L. can modify the digestion process and patients can excrete large amounts of the substance that causes warts. Therefore, it is better to use it more than 40 days. According to our investigation, in ITM, considering the cause and mechanism of disease generation and the causing materials of the disease, different treatments should be applied for each patient. Although applying an appropriate treatment is necessary, a unique treatment for all the patients cannot be available.

Hypocholesterolemic effects of Balangu (Lallemantia royleana) seeds in the rabbits fed on a cholesterol-containing diet

OBJECTIVES

Lallemantia royleana (Benth. in Wall.) Benth. (Lamiaceae) is a medicinal plant used in Iranian traditional and folklore medicine in the treatment of various nervous, hepatic, and renal diseases. In the present study, whole seeds of the herb were prepared and evaluated for hypolipidemic activities using an animal model.

MATERIALS AND METHODS

Animals were fed normal diets or diets supplemented with cholesterol (0.5%) for 12 weeks to evoke hypercholesterolemia. Moreover, hypercholesterolemic animals were treated with different doses of whole seeds of Balangu (0, 5, 10, and 20%) for 12 weeks.

RESULTS

Results showed that the serum total cholesterol and triglyceride decreased in all groups treated with Balangu seeds p<0.05. Changes in the distribution of cholesterol in low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were found. LDL-C and HDL-C decreased significantly in all of the groups treated with whole seeds of the herb with respect to hypercholesterolemic group p<0.05.

CONCLUSION

Our results showed that L. royleana seeds decreased the serum cholesterol and triglyceride levels in hypercholesterolemic animals but led to the increase of atherogenic index in all treated groups.

Efficacy of Viola odorata in Treatment of Chronic Insomnia

Background:

Insomnia is the most common sleep disorder that reduces quality of life.

Objectives:

Due to side effects of hypnotic drug and the increasing demand for alternative medicine substitutes, violet oil (VO) was used in this study. VO is a known medication in Iranian traditional medicine that induces sleep in insomniac patients.

Patients and Methods:

This study was conducted as an experimental pretest-posttest evaluation on VO efficacy in 50 patients with chronic insomnia in Iranian Traditional Medicine Clinic of Mashhad University of Medical Sciences, Mashhad, Iran. Treatment consisted of intranasal drop of VO, two drops containing 66 mg of VO in each nostril nightly before sleeping for one month. All patients were asked to complete an Insomnia Severity Index (ISI) questionnaire before the start of the trial and after one month of treatment.

Results:

Improvements in sleep and ISI scores were significantly greater in patients after a month receiving VO drop in comparison with before starting treatment (P < 0.05). A few patients reported some complications about VO consumption, most of which were mild and no serious adverse event was encountered.

Conclusions:

VO can be presented as a safe, well-tolerated, and effective herbal preparation in patients with chronic insomnia.

The effects of seeds with hot and cold temperaments on serum thyroid hormones, corticosterone and urine vanillylmandelic acid concentrations of healthy rats

ETHNOPHARMACOLOGICAL RELEVANCE

Hot and cold temperaments are the basic concepts of Iranian traditional medicine (ITM). Nevertheless, studies on the functional mechanisms of medicinal herbs based on hot and cold temperaments are not very extensive. This study aimed to evaluate the effects of diets containing hot or cold temperament seeds according to ITM on some hormonal and neuromediator parameters with a regulatory role in thermogenesis and energy metabolism in acute (24 hr) and subacute (7-day) experiments that were performed on rats.

MATERIALS AND METHODS

Each experiment was performed on 42 male Wistar rats, which were randomly divided into 7 groups. while 1 group received usual diet (controls), 6 other groups were fed with a diet containing 10% seeds, namely, anise, fennel, or ajowan (hot temperament groups) or cucumber, pumpkin, or watermelon (cold temperament groups), respectively. The levels of the rats׳ serum free thyroxin (FT4), free triiodothyronin (FT3), triiodothyronin (T3), thyroxin (T4), corticosterone and urine vanillylmandelic acid (VMA) were analyzed.

RESULTS

After 24 hours, a significant decrease in FT3 was observed in groups that were fed anise or fennel seeds. However, a significant increase in T3 was observed in the ajowan seed-fed group, and no changes in other parameters were observed in this group. On the 7th day, FT4 was significantly increased in fennel seed-fed group; T3 was significantly increased in the anise, fennel, ajowan and watermelon seed-fed groups; corticosterone was significantly increased in the watermelon and pumpkin seed-fed groups; and VMA was significantly increased in the fennel seed-fed group and significantly decreased in the cucumber seed-fed group.

CONCLUSION

Alterations induced by hot and cold temperament seeds in measured hormonal and neuromediator levels that have a regulatory role in thermogenesis and the body׳s energy metabolism revealed that hot and cold temperament characteristics of studied seeds may most likely be related to their intervention in the body׳s energy metabolism, in that hot temperament seeds may increase energy metabolism and cold temperament ones may decrease it.

Cytotoxic activity evaluation of some medicinal plants, selected from Iranian traditional medicine Pharmacopoeia to treat cancer and related disorders

ETHNOPHARMACOLOGICAL RELEVANCE

By studying the Iranian Traditional Medicine (ITM) Pharmacopoeia, we have collected information about medicinal plants which had been used to manage cancer-like disorders over eight hundred years, from medieval to the early modern era. Exploring the ITM herbal knowledge, the selected species have been subjected to MTT assay for examining their in vitro cyototoxic activity.

MATERIALS AND METHODS

Cancer was reviewed through the ITM and some terminologies were acquired. Five ITM Pharmacopoeia in Arabic and Persian languages from 10th to 18th century AD were explored. These Pharmacopoeia contained the ITM plants which were used to cure cancer and cancer-like diseases. The ITM names were matched with the scientific names. Then the medicinal plants were collected, authenticated and were evaluated for cytotoxic activity using MTT assay, against MCF-7, HepG-2, A-549 and HT-29 cell lines. Finally, the apoptosis induction ability of the most cytotoxic medicinal plant was investigated by activated caspase 3 inspection in MCF-7 cell line.

RESULTS

Six species of the evaluated medicinal plants revealed cytotoxic activity. The most cytotoxicity was observed in Tanacetum polycephalum subsp. argyrophyllum (K.Koch) Podlech with IC50 values of 28.3 μg mL(-1), 53.9 μg mL(-1) and 43.3 μg mL(-1) against MCF-7, A-549 and HT-29 cell lines, respectively. Caspase 3 activation was also observed in MCF-7 cells by Tanacetum polycephalum subsp. argyrophyllum. This is the first time that the cytotoxic activity of this species has been reported.

CONCLUSION

In the present study, some reliable references of ITM have been introduced and though many technical difficulties, linguistic problems and some other hindrances were encountered during the study, using traditional medicine texts for medicinal plant selection could be considered as a helpful starting point in the field of cancer drug discovery.

The life of jorjani: one of the persian pioneers of medical encyclopedia compiling: on the occasion of his 1000th birthday anniversary (434, a.h. - 1434, a.h.)

Background

Seyyed Esmaeil Jorjani is one of the most prominent pioneers and scientists of Islamic and Iranian traditional medicine in the 11^th and 12^th centuries (4^th and 5^th centuries A.H.). The number of his books is not certainly clear, but it is signified that he has written a couple of great books concerning medicine for Persians and too many treatises in such fields as philosophy, theology, medical ethics, human anatomy, chemistry, pharmacy and other sciences. His most famous and important book is “Zakhireh Khwarazmshahi” or “The Treasure of King Khwarazm”, which is really a complete and valuable medical encyclopedia in Persian language.

Materials and Methods

In the present study, authors have attempted to state the life and time of Jorjani and his views by studying the history, old medical sources, and other provided recent medical literature in these fields.

Results

The biography of Hakim Jorjani has been well reviewed and described precisely.

Conclusions

Based on our findings, it is clear that Jorjani described and explained the symptoms, signs and treatments of several diseases, introduced the activities of various medicinal plants, and compound formulations. He achieved all of this during his continuous visits to prestigious medical centers and famous people of his time.