Extraction Optimization and Qualitative/Quantitative Determination of Bioactive Abietane-Type Diterpenes from Three Salvia Species (Common Sage, Greek Sage and Rosemary) by 1H-qNMR.

The objective of this study was the optimization of the extraction process and the qualitative and quantitative determination of the bioactive metabolites: 12-O-methylcarnosic acid (12MCA), carnosic acid (CA), carnosol (CS), 7-O-methyl-epi-rosmanol (7MER) and rosmanol (RO) in infusions, decoctions, turbulent flow extracts, tinctures and oleolites from three Salvia species: Salvia officinalis L. (common sage, SO), Salvia fruticosa Mill. (Greek sage, SF) and Salvia rosmarinus Spenn (syn Rosmarinus officinalis L.) (rosemary, SR), using Quantitative Proton Nuclear Magnetic Resonance Spectroscopy (1H-qNMR). Regarding the aqueous extracts, decoctions appeared to be richer sources of the studied metabolites than infusions among the three plants. For SR, the turbulent flow extraction under heating was the most efficient one. The optimum time for the preparation of decoctions was found to be 5 min for SF and SO and 15 min for SR. It is noteworthy that SR tinctures were not stable in time due to decomposition of the abietane-type diterpenes CA and CS because of the polar solvent used for their preparation. Contrary to this finding, the oleolites of SR appeared to be very stable. Olive oil as a solvent for extraction was very protective for the contained abietane-type diterpenes. A preliminary stability study on the effect of the storage time of the SF on the abietane-type diterpenes content showed that the total quantity of abietanes decreased by 16.51% and 40.79% after 12 and 36 months, respectively. The results of this investigation also demonstrated that 1H-qNMR is very useful for the analysis of sensitive metabolites, like abietane-type diterpenes, that can be influenced by solvents used in chromatographic analysis.

Primary study on the effects and mechanisms of separate and combined decoctions of Scutellaria baicalensis Georgi - Coptis chinensis Franch extracts in relieving acute alcoholic liver injury in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Scutellaria baicalensis Georgi (SBG) and Coptis chinensis Franch (CCF) are traditional herbal medicine pairs used for clearing heat and eliminating dampness, stopping diarrhea, and detoxification. Traditionally, these two herbs are combined and decocted together, but the modern preparation procedures separate them to avoid the large amount of precipitation generated from co-decoction. Thus, a conflict lies between the traditional and modern extraction processes of Scutellaria baicalensis Georgi - Coptis chinensis Franch (SBG-CCF). AIM OF STUDY: There is a conflict between traditional medical practices of SBG-CCF and the modern formulation industry. In this study, we investigated the differences in the effects and mechanisms of SBG-CCF extracted by decocting separately and combining decoctions, as well as the scientific effectiveness of traditional and modern treatment methods on both. Acute alcoholic liver injury (ALI) rats were used as the pathological model. MATERIALS AND METHODS: SD rats were divided into 8 groups, including blank group, model group, low, medium, and high dose groups of SBG-CCF separated decoction, low, medium, and high dose groups of SBG-CCF combined decoction. Acute alcoholic liver injury model was induced in rats by gradually increasing the dose of alcohol through gavage everyday using white wine with an alcohol content 52%. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC), triglyceride (TG), lactate dehydrogenase (LDH), malondialdehyde (MDA), superoxide dismutase (SOD), and reduced glutathione (GSH) were used as indicators to assess the intervention effect of SBG-CCF. And the potential active ingredients of SBG-CCF and the targets related to ALI were screened using network pharmacology, and the prediction results of network pharmacology were verified by quantitative real-time fluorescence PCR (qRT-PCR). RESULTS: SBG-CCF decoction alone and six combinations of decoctions have different degrees of improvement on alcoholic liver injury, with significant efficacy in the middle-dose group, and the combined decoction was superior to the individual decoction. SBG-CCF gavage can reduce the activity of AST, ALT, TC, TG, LDH, and MDA in the serum and liver of ALI rats, while increasing the levels of SOD and GSH. Network pharmacological analysis identified 39 active components, mainly flavonoids and alkaloids. Enrichment analysis suggested that SBG-CCF may treat ALI through the regulation of tumor necrosis factor (TNF), mitogen-activated protein kinase (MAPK), interleukin-17 (IL-17), apoptosis, and the Toll-like receptor signaling pathways. The key targets in the Disease-Signaling Pathway-Target Network were MAPK8, IKBKB, MAPK10, MAPK3, MAPK1, and AKT1. qRT-PCR results indicated that targets regulating inflammation and lipid metabolism are MAPK8, MAPK10, MAPK3, and AKT1. CONCLUSION: SBG-CCF separately extracts and combines decoction can alleviate acute alcoholic liver injury, and the effect of combined decoction is more significant than separate decoction, implying that the precipitate produced by the combination of the two is also an active substance. The resistance mechanism of SBG-CCF ALI may be related to the modulation of lipid metabolism, inhibition of lipid peroxidation, and oxidative stress. SBG-CCF has the characteristics of multi-component, multi-pathway, and multi-target resistance to ALI.

Consumption of herbal infusions/decoctions and tea in Greece: a Planeterranean perspective on the results of Hydria survey.

BACKGROUND: The consumption of various herbal infusions was and is common in the traditional Mediterranean diet, and apparently are used in many other regions of the world outside of the Mediterranean region. The present study aimed to investigate the consumption of herbal infusions/decoctions and tea in a nationally representative sample of Greece, considering also their Planetary use. METHODS: 3951 adult participants of the HYDRIA Survey (2013-2014) were included from the 13 regions of Greece. The diet of participants was assessed by two 24-h dietary recalls (24-HDR) and the Food Propensity Questionnaire (FPQ). All food items were analyzed through the HYDRIA Food Composition Tables. Information on socio-demographics, lifestyle, and health characteristics during the baseline was also provided. RESULTS: 26.9% of herbal infusions and decoctions consumers are ≥ 75 years old, pensioners with a low level of education, and residents of urban areas. However, 22.2% of tea consumers belong to the 18-34-year age group, being employed with an intermediate level of education and living in an urban area. Elderly men and women use more herbal infusions/decoctions (55.4%; 40.6%) compared to tea (41.8%; 25.2%). According to FPQ, 7.1% of men and 9.7% of women use herbal infusions and decoctions four times or more per week, while 7.1 and 10.9% of men and women, respectively, consume tea at the same frequency. Green tea, mountain tea (Sideritis spp.), and black tea are reported most frequently. In addition, mountain tea (61.2%), black tea (60.3%), mixed herbal infusions/decoctions (58.4%), and sage (59.4%) are consumed mostly at breakfast, while chamomile was reported mainly at dinner or during the night (42.4%). CONCLUSIONS: Based on the FPQ results, the moderate and high consumption of herbal infusions/decoctions and tea is low in Greece, especially among adults (18-64 years). Thus, our results indicate the existence of a generation gap to the attachment to the traditional Med Diet and the consumption of herbal infusions. The present study could encourage future research to focus on herbal infusions and decoctions consumption by other populations for cross-cultural comparison, as well as on emphasizing the value of consuming locally available herbs in a Planeterranean perspective.

Antioxidant properties and antibacterial activity of water extracts from Sambucus nigra L. under different conditions.

INTRODUCTION: In folk medicine, dried white flowers of Sambucus nigra L. are used to make infusions, decoctions, and juices. AIM: The present article aims to study and compare the antioxidant activity of aqueous solutions of leaves and flowers of Sambucus nigra L obtained at different exposure times and assess the antibacterial activity of these solutions against Escherichia coli ATCC 8739, Salmonella NCTC 6017, Listeria monocytogenes NCTC 11994, and Staphylococcus aureus ATCC 25093. MATERIALS AND METHODS: We studied the physicochemical properties of aqueous extracts of leaves (fresh) and flowers (fresh and dry) of Sambucus nigra L collected from the Rhodope region of Bulgaria. The samples from Sambucus nigra L were analyzed to determine their total phenolic content (TPC), total flavonoid content (TFC), and antioxidant activity using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP). The diameters (in millimeters) of the growth inhibition zones of four pathogens were measured, and a comparative assessment of their antibacterial activity was made. RESULTS: The infusions of fresh blossoms and fresh leaves of Sambucus nigra L had the highest antioxidant activity at the total contact time of 30 minutes (82.7 mmol TE/100 ml) and 35 minutes (36.5 mmol TE/100 ml), respectively. The phenol-richest infusions were those made from dried flowers of Sambucus nigra L after a 30-minute contact time (86.7 mg GAE/ml). Of the four pathogens we studied, we found that the extracts affected partially only the pathogenic bacteria of Salmonella. CONCLUSIONS: The highest content of bioactive components was obtained from dried blossoms of Sambucus nigra L. for infusions with a total contact time of 30 minutes and for decoctions at a contact time of 45 minutes.

Effectiveness of Chengqi-series decoctions in treating severe acute pancreatitis: A Systematic review and meta-analysis.

BACKGROUND: Evidence suggests that Dachengqi and its modified decoctions are effective for treating abdominal pain, multiple organ dysfunction syndrome (MODS) and inflammation in various disease conditions. We performed a meta-analysis to ascertain the effectiveness of a series of chengqi decoctions in patients with severe acute pancreatitis (SAP). METHODS: We searched Pubmed, Embase, Cochrane library, Web of Science, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature, Wanfang database and China Science and Technology Journal Database before August 2022 to identify eligible randomized controlled trials (RCTs). Mortality and MODS were chosen as primary outcomes. Secondary outcomes included time until relief of abdominal pain, APACHE II score, complications, effectiveness, IL-6 and TNF-α levels. The risk ratio (RR) and standardized mean difference (SMD) with a 95% confidence interval (CI) were selected as effect measures. The quality of evidence was independently assessed by two reviewers using Grading of Recommendations Assessment Development and Evaluation (GRADE) system. RESULTS: Twenty-three RCTs (n = 1865) were finally included. The results showed that, compared with routine therapies, chengqi-series decoctions (CQSDs) treatment groups were associated with lower mortality rate (RR: 0.41, 95%CI: 0.32 to 0.53, p = 0.992) and incidence of MODS (RR: 0.48, 95%CI: 0.36 to 0.63, p = 0.885). They also reduced remission time of abdominal pain (SMD: -1.66, 95%CI: -1.98 to -1.35, p = 0.000), complications (RR: 0.52, 95%CI: 0.39 to 0.68, p = 0.716), APACHE II score (SMD: -1.04, 95%CI:-1.55 to -0.54, p = 0.003), IL-6 (SMD: -1.5, 95%CI: -2.16 to -0.85, p = 0.000), TNF-α (SMD: -1.18, 95%CI: -1.71 to -0.65, p = 0.000), and improved curative effectiveness (RR:1.22, 95%CI: 1.14 to 1.31, p = 0.757). The certainty of the evidence for these outcomes was low to moderate. CONCLUSION: CQSDs seem to be effective therapy for SAP patients with notable reductions in mortality, MODS and abdominal pain, with low quality evidence. Large-scale, multi-center RCTs that are more meticulous are advised in order to produce superior evidence.

Systematic analysis of tRNA-derived small RNAs reveals therapeutic targets of Xuefu Zhuyu decoction in the cortexes of experimental traumatic brain injury.

BACKGROUND: Xuefu Zhuyu Decoction (XFZYD), a well-known traditional Chinese medicine prescription, has been widely used to treat traumatic brain injury (TBI). However, the underlying mechanisms involved in XFZYD therapy remain unclear. AIM OF THE STUDY: We explored new therapeutic targets of XFZYD in TBI by the tsRNA-sequencing (tsRNA-seq) method. MATERIAL AND METHODS: High-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was used to assess the quality of XFZYD. Male Sprague-Dawley rats were randomly categorized into three groups: sham, TBI, and XFZYD. The protective effects of XFZYD were investigated in vivo by using the Morris water maze (MWM), modified neurological severity score (mNSS) tests, hematoxylin-eosin (H&E) staining, and Nissl staining. tsRNA-seq was applied to analyze the expression of tsRNAs in the rat cortex. Four tsRNAs were validated by qRT-PCR. The biological function of putative tsRNAs was investigated using bioinformatics techniques. The functions of tsRNAs targeting mRNAs were verified in vitro. RESULTS: The mNSS and MWM indicated that XFZYD notably improved neurological deficits and cognitive function after TBI (p < 0.05). H&E staining and Nissl staining demonstrated that XFZYD suppressed damage and neuronal loss in the TBI rat cortex. We evaluated the dysregulated expression of 732 tsRNAs (128 tsRNAs were significantly altered in the TBI/sham group (fold change > 2 and p < 0.05), and 97 tsRNAs were dysregulated in the XFZYD/TBI group (fold change > 2 and p < 0.05)) in the TBI rat cortex. Interestingly, 41 tsRNAs were distinctly regulated by XFZYD. The qRT-PCR results of the four randomly chosen tsRNAs (tRF-54-75-Glu-TTC-2, tRF-55-75-Gln-CTG-2-M2, tRF-55-76-Val-TAC-1, tRF-64-85-Leu-AAG-1-M4) exhibited trends similar to those of the tsRNA-seq data. We certified the possible targets of tsRNAs and suggested the crosscurrent in the expression trend of the target genes. Bioinformatics analysis showed that XFZYD-related tsRNAs could contribute to regulating insulin resistance, the calcium signaling pathway, autophagy, and axon guidance. CONCLUSIONS: The current research implies that tsRNAs are putative therapeutic targets of XFYZD for TBI treatment. This research provides new insight into the therapeutic targets of XFZYD in treating TBI.

Validation of an UPLC-DAD Method for the Quantification of Phenolic Acids, Verbascoside and 6-epi-aucubin in Crescentia cujete Fruit.

BACKGROUND: The fruit pulp decoction of Crescentia cujete, commonly known as calabash, is traditionally used for the treatment of several respiratory diseases and is available as syrup formulations. Unfortunately, there is no detailed investigation on the analytical methods for warranting the quality of these products. AIMS AND OBJECTIVES: To develop and validate an appropriate analytical method for the simultaneous quantification of trans-cinnamic acid, 4-hydroxybenzoic acid, verbascoside and 6- epi-aucubin in the decoction and commercial cough syrups of Crescentia cujete fruit. MATERIALS AND METHODS: A reversed-phase ultra-high-performance liquid chromatographic method coupled to a diode array detector (UPLC-DAD) was validated following the ICH guidelines. The chromatographic analysis was performed using a C18 column, the mobile phase system consisted of water and acetonitrile containing 0.1% formic acid, and UV chromatograms were recorded from 200 to 400 nm. RESULTS: A new UPLC-DAD method was validated for the simultaneous quantification of transcinnamic acid, 4-hydroxybenzoic acid, verbascoside and 6-epi-aucubin in calabash-derived products. After successful validation, this method was applied for the quantification of the selected chemical markers in an in-house decoction and three commercial cough syrups. Among the selected chemical markers, 6-epi-aucubin was the main compound in the calabash decoction, while trans-cinnamic acid and 4-hydroxybenzoic acid were the major compounds in the commercial products. Verbascoside and 6-epi-aucubin were below the limit of quantification in all syrup samples. CONCLUSION: The proposed method was successfully applied for the analysis of three commercial syrup formulations and can be useful for standardization and quality control of raw and pharmaceutical calabash preparations.

Flower beverages of native medicinal plants from Argentina (Acacia caven, Geoffroea decorticans and Larrea divaricata) as antioxidant and anti-inflammatory.

ETHNOPHARMACOLOGICAL RELEVANCE: Herbal beverages have been used as a natural part of the medicinal and food culture in northwestern Argentina. The flower beverages (infusion or decoction) of Acacia caven, Geoffroea decorticans and Larrea divaricata, three native species from arid and semiarid regions of Argentina are widely used as anti-inflammatory and anti-rheumatic by several local communities. AIM OF THE STUDY: The aim of this study was to analyze the phytochemical composition of some Argentine flower beverage and to validate its traditional use as an antioxidant and anti-inflammatory agent. MATERIALS AND METHODS: Phenolic profiles from all flower infusions and decoctions were analyzed by both spectrophotometric analysis and HPLC-DAD. ABTS•+; the scavenging activity of both hydrogen peroxide and hydroxyl radical was determined and finally, their ability to inhibit pro-inflammatory enzymes, such as xanthine oxidase (XOD), and lipoxygenase (LOX) was also assessed. RESULTS: The flower beverages of all assayed species showed a high level of phenolic compounds with similar chromatographic patterns in both infusions and decoctions of each plant species, the major components of which have been identified. The flower beverages, especially G. decorticans infusion and decoctions, displayed an important antioxidant activity (SC50 values between 18.14 and 47 µg/mL) through different mechanisms; all of them were able to inhibit the XOD enzyme activity and, consequently, the formation of uric acid and reactive oxygen species, the primary cause of arthritis-related diseases. The most active beverages as XOD inhibitor were G. decorticans flower infusion and decoctions (IC50 values of 20 and 35 µg/mL, respectively). Pro-inflammatory enzymes, such as LOX, were also inhibited by infusions and decoctions of G. decorticans, L. cuneifolia and A caven flowers, lessening inflammation mediators in all beverages. CONCLUSIONS: The present work validates the traditional medicinal use of flower beverages from Argentina as an anti-rheumatic and anti-inflammatory agent as it has been used for hundreds of years in several pathologies associated with oxidative stress.

Systematic chemical characterization of Xiexin decoctions using high performance liquid chromatography coupled with electrospray ionization mass spectrometry.

Xiexin decoctions (XXDs) display beneficial anti-inflammatory and anti-diabetic effects, which raises interests on this group of formulae for broad clinical applications. However, there was no report about systematic analysis of XXDs to elucidate the constitution of chemical components, which hampers further investigations on the therapeutic values of XXDs. In this work, crude herbs were extracted and prepared to obtain the XXDs for systemic analysis on their chemical compositions, according to the information described in the ancient Zhang Zhongjing's herbal formulae. LC-MS analysis of five XXDs was carried out to facilitate recognition of the source herbs for compounds in the mixture. A total number of 93 compounds were identified through our methods and their chemical classes encompassed five major groups, including protoberberine alkaloids, flavonoids, stilbenes, anthraquinones and saponins. Our current work provided important information about material basis for pharmacological studies on XXDs and would help shed light on relationships between chemical compositions and therapeutic effects.

Effect of decocting on the pesticide residues in Paeoniae radix lactiflora and corresponding exposure risk assessment.

Numerous natural preparations in traditional Chinese medicine are prepared as decoctions. Processing factors (PFs) comparing the levels of pesticide residues in decoctions to those in the corresponding unprocessed products should be considered in exposure assessments. Thus, this study determined the residue levels of six pesticides (chlorpyrifos, phoxim, imidacloprid, thiamethoxam, fenpropathrin, and emamectin benzoate), as well as 3,5,6-trichloropyridinol, the primary metabolite of chlorpyrifos, and clothianidin, the main metabolite of thiamethoxam in Baishao, Paeoniae radix lactiflora (Fam. Ranunculaceae). The results showed that significant time-response effects were present for the release of pesticides from P. radix. The PFs calculated were < 1, indicating a significant reduction in pesticide residues after TCM processing. The water solubility and partition coefficient values of the pesticides may have played a basic role in the dissipation of the residues during the TCM decocting process. A risk assessment based on the hazard quotient with PFs revealed that exposure to pesticide residues in P. radix was far below the levels that might pose a health risk. In conclusion, the results presented here are of theoretical and practical value for the safety evaluation of TCMs.

Systematic chemical characterization of Xiexin decoctions using high performance liquid chromatography coupled with electrospray ionization mass spectrometry / 中国天然药物

Xiexin decoctions (XXDs) display beneficial anti-inflammatory and anti-diabetic effects, which raises interests on this group of formulae for broad clinical applications. However, there was no report about systematic analysis of XXDs to elucidate the constitution of chemical components, which hampers further investigations on the therapeutic values of XXDs. In this work, crude herbs were extracted and prepared to obtain the XXDs for systemic analysis on their chemical compositions, according to the information described in the ancient Zhang Zhongjing's herbal formulae. LC-MS analysis of five XXDs was carried out to facilitate recognition of the source herbs for compounds in the mixture. A total number of 93 compounds were identified through our methods and their chemical classes encompassed five major groups, including protoberberine alkaloids, flavonoids, stilbenes, anthraquinones and saponins. Our current work provided important information about material basis for pharmacological studies on XXDs and would help shed light on relationships between chemical compositions and therapeutic effects.

Evaluation of Polyphenol Content and Antioxidant Capacity of Aqueous Extracts from Eight Medicinal Plants from Reunion Island: Protection against Oxidative Stress in Red Blood Cells and Preadipocytes.

Background-Medicinal plants are traditionally used as infusions or decoctions for their antioxidant, anti-inflammatory, hypolipidemic and anti-diabetic properties. Purpose-The aim of the study was to define the polyphenol composition and to assess the antioxidant capacity of eight medicinal plants from Reunion Island referred to in the French Pharmacopeia, namely Aphloia theiformis, Ayapana triplinervis, Dodonaea viscosa, Hubertia ambavilla, Hypericum lanceolatum, Pelargonium x graveolens, Psiloxylon mauritianum and Syzygium cumini. Methods-Polyphenol content was assessed by biochemical assay and liquid chromatography coupled to mass spectrometry. Antioxidant capacity was assessed by measuring DPPH reduction and studying the protective effects of herbal preparation on red blood cells or preadipocytes exposed to oxidative stress. Results-Polyphenol content ranged from 25 to 143 mg gallic acid equivalent (GAE)/L for infusions and 35 to 205 mg GAE/L for decoctions. Liquid chromatography coupled to mass spectrometry analysis showed the presence of major bioactive polyphenols, such as quercetin, chlorogenic acid, procyanidin and mangiferin. Antioxidant capacity assessed by different tests, including DPPH and Human red blood cell (RBC) hemolysis of herbal preparations, demonstrated a dose-dependent effect whatever the extraction procedure. Our data suggest that decoction slightly improved polyphenol extraction as well as antioxidant capacity relative to the infusion mode of extraction (DPPH test). However, infusions displayed a better protective effect against oxidative stress-induced RBC hemolysis. Conclusion-Traditional preparations of medicinal plant aqueous extracts (infusions and decoctions) display antioxidant properties that limit oxidative stress in preadipocytes and red blood cells, supporting their use in the context of metabolic disease prevention and treatment.

[Alzheimer's disease: experimental and clinical researches of Chinese herbal medicine neurobiological effects (a review).]

The analysis of experiments and clinical data about research of neurobiological effects of chinese herbal medicine, which is used by Alzheimer`s disease treatment, was presented in given overview. The rats with injection of Aß1-42 or Aß25-35 peptides, or ibotenic acid, or streptozotocin as well as the natural line of mice SAMP8 with the phenotype of accelerated aging and other were used as the experimental models of Alzheimer`s disease. Various neurobiological effects of various herbal decoctions in the cells of hippocampus were demonstrated - the inhibition of amyloid ß peptides aggregation, increasing of neurons quantity with normal morphology and decreasing of apoptotic cells, decreasing of inducible nitric oxide synthase (iNOS) production, decreasing of reactive expression level of RAGE and increasing reactive expression level of LRP-1, decreasing of tau protein phosphorylation at Thr231 and Ser422, inhibition of expression of GSK-3ß and CDK-5, decreasing of activation and inflammation of microglia, production of 15 types of N-glycans in the cerebral cortex layers, which are absent in experimental animals. The improvement of memorization and training abilities was established.

Efficacy and safety of two Ayurvedic dosage forms for allergic rhinitis: Study protocol for an open-label randomized controlled trial.

BACKGROUND: Allergic rhinitis (AR) is an immune response of the nasal mucosa to airborne allergens and involves nasal congestion, watery nasal discharge, itching of the nose, and sneezing. The symptoms of allergic rhinitis may significantly affect a patient's quality of life and can be associated with conditions such as fatigue, headache, cognitive impairment, and sleep disturbances. Various complementary and alternative medicine treatments have been used for this condition in clinical practice. The Ayurveda system of medicine is the most common complementary medicine system practiced in Sri Lanka. The aim of this study is to examine the efficacy and safety of a decoction used in traditional Ayurveda for allergic rhinitis and its ready- to-use freeze dried formulation in comparison to an antihistamine over a period of 4 weeks on relief of symptoms in allergic rhinitis. STUDY DESIGN: This is a three-arm, open-label, non-inferiority, randomized controlled clinical trial enrolling patients with AR. Tamalakyadi decoction containing 12 ingredients (TMD12), used in traditional Ayurveda and its freeze-dried formulation are the test products. The efficacy and safety of the two Ayurvedic dosage forms will be tested against the antihistamine loratadine. Patients with symptoms of AR will be allocated randomly into the three arms after a 1-week run-in period and the medications will be given orally for 28 days. Total Nasal symptom Score (TNSS) of the patients will be used as the primary efficacy endpoint. TNSS will be recorded and compared between the three arms prior to visit 1, at the end of 28 days, and end of the first and second months of follow-up. Symptom scores of daytime nasal symptoms, night time nasal symptoms, non-nasal symptoms and health-related quality of life questionnaire are used as secondary end points. DISCUSSION: This clinical trial will be able to provide evidence-based scientific data on Ayurvedic dosage form, TMD12, and the freeze-dried formulation in the treatment of allergic rhinitis. This trial is expected to develop capacity to scientifically evaluate various Ayurvedic treatments that are claimed to have efficacy in treatment of various disease conditions. TRIAL REGISTRATION: ISRCTN18149439 (6 May 2019).

Statistic Analysis About the Actual Situation of Crude Drug Prescription Based on the Survey Conducted by the Board of Crude Drug Materials of JSOM / 日本東洋医学雑誌

The treatment by Kampo decoction is partly covered by National Health Insurance in Japan. However, this system is facing bankruptcy crisis because of rising prices of crude drugs in China, their main producer. The board of crude drug materials of the Japan Society for Oriental Medicine (JSOM) distributed questionnaires to 7416 JSOM member doctors, and performed statistical analysis (with JSOM approval) of 1877 answers to visualize the data. Twenty-six percent of respondents said that they had prescribed a decoction, and 29% of respondents said they had not, but wanted to prescribe a crude drug. Eighty-eight percent of doctors who prescribe decoctions offered medical treatment primarily to insured patients. Nine percent offered medical treatment at patients' own expense. The latter group prescribed decoctions more frequently. Many doctors were aware of the financial risk of prescribing crude drugs imposed by the drug price standard and rising crude drug import prices. Four hundred and fifty­-five doctors explained when they were most inclined to prescribe a decoction. Thirty-five percent of these said they used decoctions when they couldn't treat patients with extracts. This result implies a necessity for decoctions. Many doctors said they prescribed decoctions for autoimmune or allergic diseases. Financial constraints were the most frequently cited barrier to treatment with decoctions. This survey made clear the financial difficulties clinics are facing. We therefore calculated the amount of crude drugs used for decoctions to validate the possibility of their domestic production.

Clinical study on treatment of radiation proctitis with Bupi-Qingchang recipe combined with Chinese herbal enema / 国际中医中药杂志

Objective To evaluate the efficacy of Bupi-Qingchang recipe combined with traditional Chinese medicine enema on the patients with radiation proctitis.Methods Eighty patients with radioactive proctitis who met the inclusion criteria were randomly divided into two groups,40 in each group.The control group was treated with western medicine combined with enema,and the observation group was treated with oral spleen and clearing spleen combined with traditional Chinese medicine enema.Symptoms were scored before and after treatment from abnormal sensation of bowel movement,blood in stool,stool traits and frequency,abdominal pain;TNF-α,IL-8,IL-6,IL-10 levels were detected by ELISA.The intestinal mucosal healing and recurrence were observed by microscopy.Results After treatment,the serum TNF-α (1.18 ± 0.61 ng/ml vs.1.78 ± 0.66 ng/ml,t=4.860),IL-6 (2.52 ± 0.75 ng/ml vs.3.02 ± 0.81 ng/ml,t=3.297),IL-8 (2.51 ± 0.68 ng/ml vs.3.01 ± 0.82 ng/ml,t=3.417),IL-10 (0.56 ± 0.25 ng/ml vs.0.89 ± 0.29 ng/ml,t=6.275) in the observation group were significantly lower than those in the control group (P＜0.01).The total scores of abdominal pain,blood in the stool,stool characteristics and frequency,abnormal feeling of defecation and symptoms were significantly lower in the observation group than in the control group (t values were 8.108,2.085,4.965,7.865,9.586,P＜0.01 or P＜0.05).The total effective rate was 92.5％ (37/40) in the observation group and 67.5％ (27/40) in the control group.The difference between the two groups was statistically significant (x2=7.813,P＜0.01).The intestinal mucosa of the observation group was treated.The healing rate was significantly better than that of the control group (x2=15.535,P＜0.01),and the recurrence rate was significantly lower than that of the control group (x2=10.912,P＜0.01).Conclusions The Bupi-Qingchang recipe combined with traditional Chinese medicine enema can improve the clinical symptoms of patients with radiation proctitis,reduce inflammation,reduce recurrence and improve curative effect.

[Interpreting the Methods for Blending Decoctions to Treat 60 Ailments in Tianhui bamboo slip medical manuscripts].

Among the medical texts excavated in 2012-2013 from the Han Dynasty tomb at Tianhui township in Sichuan province, we found a collection on the treatment of 60 ailments. Under each ailment, we found one or more formulas, for a total of 106 formulas. The authors of this paper compiled and analyzed these texts based on the original bamboo slips and named this collection with the title Methods for Blending Decoctions to Treat 60 Ailments because the content was focused on blending and making medicinal formulas, and also due to the historical connections with the texts the Record of the Court Scribe, "Biography of Bian Que and Cang Gong". For these reasons, this title was determined, where "blending decoctions" mean "blending and harmonizing medicines optimally in preparation for decocting". The Tianhui texts preserve ancient forms of medicinal formulas, including some once believed to be lost, such as "grain decoctions", "fermented alcohol decoctions", and "fiery decoctions". Based on the historical evidence, we can now ascertain that this text is the "Blending Formulas and Making Decoctions" mentioned in the Record of the Court Scribe written by Cang Gong. Moreover, the medical texts, Canon Formulas in Decoction Form (from the book of Han Dynasty) and the Imperial Pharmacy Formulas to Benefit the People in Song Dynasty are both of this genre of medical literature. The Tianhui text is therefore a representative of this genre of literature in the Western and eastern Han, acting as a key link between early medical formula books and later formula books.

Potentially toxic pyrrolizidine alkaloids in Eupatorium perfoliatum and three related species. Implications for herbal use as boneset.

INTRODUCTION: Pro-toxic dehydropyrrolizidine alkaloids are associated with liver disease in humans. The potential for long-term, low-level or intermittent exposures to cause or contribute to chronically-developing diseases is of international concern. Eupatorium perfoliatum is a medicinal herb referred to as boneset. While the presence of dehydropyrrolizidine alkaloids in some Eupatorium species is well-established, reports on Eupatorium perfoliatum are scant and contradictory. OBJECTIVE: To investigate the presence of dehydropyrrolizidine alkaloids in a survey of boneset samples and related alcoholic tinctures, and hot water infusions and decoctions. METHODS: Methanol, hot water or aqueous ethanol extracts of Eupatorium perfoliatum and three closely-related species were subjected to HPLC-ESI(+)MS and MS/MS analysis using three complementary column methods. Dehydropyrrolizidine alkaloids were identified from their MS data and comparison with standards. RESULTS: Forty-nine samples of Eupatorium perfoliatum were shown to contain dehydropyrrolizidine alkaloids (0.0002-0.07% w/w), the majority dominated by lycopsamine and intermedine, their N-oxides and acetylated derivatives. Alcoholic tinctures and hot water infusions and decoctions had high concentrations of the alkaloids. Different chemotypes, hybridisation or contamination of some Eupatorium perfoliatum samples with related species were suggested by the co-presence of retronecine- and heliotridine-based alkaloids. CONCLUSIONS: Sampling issues, low and high alkaloid chemotypes of Eupatorium perfoliatum or interspecies hybridization could cause the wide variation in dehydropyrrolizidine alkaloid concentrations or the different profiles observed. Concerns associated with dehydropyrrolizidine alkaloids provide a compelling reason for preclusive caution until further research can better define the toxicity and carcinogenicity of the dehydropyrrolizidine alkaloid content of Eupatorium perfoliatum. [Correction added on 12 July 2018, after first online publication: The 'Conclusions' section in the abstract has been added.].

Transfer rates of aflatoxins from herbal medicines to decoctions determined by an optimized high-performance liquid chromatography with fluorescence detection method.

OBJECTIVES: This study aimed to explore the transfer rates of aflatoxins from several contaminated herbal medicines by fungi to their decoctions. METHODS: Five types of commonly used herbal medicines including Lilii Bulbus, Hordei Fructus Germinatus, Nelumbinis Semen, Polygalae Radix and Bombyx Batryticatus were selected as the examples. Raw herbal medicine samples were treated by ultrasonication-assisted extraction with 70% methanol and immunoaffinity column clean-up, and the decoctions were prepared following the commonly used boiling method with water for 2 h. Then, the optimized high-performance liquid chromatography with fluorescence detection (HPLC-FLD) method was validated for the quantitative analysis of four aflatoxins (AFG2 , AFG1 , AFB2 and AFB1 ) after postcolumn photochemical derivatization, which was proved to be reliable and sensitive. KEY FINDINGS: Aflatoxins were detected to be transferred from the herbal medicines to decoctions with significantly different transfer rates in the five types of herbal medicines. Quietly high transfer rates of 7.26-115.36% for AFG2 , 4.37-26.37% for AFB1 and 9.64-47.68% for AFB2 were obtained. AFB1 as the most toxic aflatoxin expressed the lowest transfer rate, but still exhibited high amount in the samples. CONCLUSIONS: Therefore, the monitoring of aflatoxins in herbal medicines and their decoctions is in great urgency to ensure the security of consumers taking decoctions.

Interpreting the Methods for Blending Decoctions to Treat 60 Ailments in Tianhui bamboo slip medical manuscripts / 中国中药杂志

Among the medical texts excavated in 2012-2013 from the Han Dynasty tomb at Tianhui township in Sichuan province, we found a collection on the treatment of 60 ailments. Under each ailment, we found one or more formulas, for a total of 106 formulas. The authors of this paper compiled and analyzed these texts based on the original bamboo slips and named this collection with the title Methods for Blending Decoctions to Treat 60 Ailments because the content was focused on blending and making medicinal formulas, and also due to the historical connections with the texts the Record of the Court Scribe, "Biography of Bian Que and Cang Gong". For these reasons, this title was determined, where "blending decoctions" mean "blending and harmonizing medicines optimally in preparation for decocting". The Tianhui texts preserve ancient forms of medicinal formulas, including some once believed to be lost, such as "grain decoctions", "fermented alcohol decoctions", and "fiery decoctions". Based on the historical evidence, we can now ascertain that this text is the "Blending Formulas and Making Decoctions" mentioned in the Record of the Court Scribe written by Cang Gong. Moreover, the medical texts, Canon Formulas in Decoction Form (from the book of Han Dynasty) and the Imperial Pharmacy Formulas to Benefit the People in Song Dynasty are both of this genre of medical literature. The Tianhui text is therefore a representative of this genre of literature in the Western and eastern Han, acting as a key link between early medical formula books and later formula books.