Journal of Complementary and Integrative Medicine最新文献

Objectives: Vanari Gutika (VG), an Indian traditional formulation containing Mucuna pruriens as a principal component, is traditionally used for the management of male reproductive disorders. However, there is a significant lack of evidence-based research validating its effects on male fertility and testosterone biosynthesis. This study aimed to investigate the impact of VG on testicular steroidogenesis, lipid peroxidation, and sperm quality in male mice.

Methods: Adult male mice were orally administered VG at 75, 150, or 300 mg/kg body weight/day for 35 days. Testicular function was assessed through sperm morphology and viability, lipid peroxidation and expression of key steroidogenic and oxidative stress-related proteins.

Results: VG at 150 and 300 mg/kg significantly increased testis weight and serum testosterone, with a concurrent reduction in estradiol. VG (150 mg/kg) improved normal sperm morphology and reduced abnormalities. Markers of oxidative stress status improved, evidenced by reduced LPO and increased Nrf-2 expression. VG treatment enhanced the expression of steroidogenic markers (SF-1, CYP11A1, 3β-HSD, StAR, and 17β-HSD) at higher doses.

Conclusions: Higher doses of VG (150 and 300 mg/kg BW) promote testicular androgenesis, reduces oxidative stress, and improves sperm quality. Consequently, our results provide robust and compelling evidence supporting its potential as a dietary supplement for boosting the testosterone level and sperm quality.

Objectives: Medicinal cannabis (MC) has recently been legalized in a growing number of countries. While MC is considered a potentially safe alternative or add-on to conventional treatments for pain, spasms, neuropathy, and chemotherapy-induced nausea/vomiting, evidence of its effectiveness and safety remains limited. This study aimed to assess patients' perceived benefits and side effects of MC and explore patterns in side effect experiences.

Methods: We conducted a Danish nationwide online survey in 2020 among two groups of MC users: one with predefined diagnostic indications (neuropathic pain, chemotherapy-induced nausea/vomiting, or painful spasms from multiple sclerosis/paraplegia) (n=258) and one with other indications (n=786). Perceived benefit and side effects were measured using self-reported responses. We compared perceived benefit to the number of side effects and used a heat plot correlation matrix and exploratory factor analysis to identify patterns. Predicted factor scores were used to compare perceived benefit relative to side effect profiles, stratified by indication group.

Results: Most patients (67 %) reported a moderate to large effect of MC. Over half experienced side effects, with more than 10 % reporting three or more. Side effects were equally common among patients reporting a moderate to large vs. no to minor effect (p=0.27 and 0.68 for predefined and other indications). Side effects clustered into four groups: cognitive dysfunction, dizziness, xerostomia, and feeling "high." These were not related to perceived benefit.

Conclusions: Most patients reported a moderate to large effect from MC. Over one in ten experienced three or more side effects, which were unrelated to perceived treatment effect.

Objectives: Chronic low back pain (cLBP) is prevalent among agricultural workers in Surin Province, Thailand. This study evaluated the efficacy and safety of Thai massage combined with the traditional herbal formula Ya Thamlai Phra Sumeru (YTPS) in reducing pain and improving mobility in individuals with cLBP.

Methods: A single-blind, randomized controlled trial was conducted with 66 participants assigned to three groups (n=22 each): (1) herbal remedy (Hr) group, receiving 2,000 mg of YTPS twice daily for seven days; (2) Thai massage (Tm) group, receiving massage therapy three times per week; and (3) combined therapy (Tm+Hr) group, receiving both interventions. The active compounds of YTPS were identified by HPLC, and antioxidant capacity was evaluated using DPPH and ABTS assays. Pain and functional outcomes were assessed using the Numerical Rating Scale (NRS), Goniometer (GOM), Flexible Ruler (FR), and Oswestry Disability Index (ODI). Biochemical safety parameters (BUN, creatinine, AST, ALT) and oxidative stress markers (MDA, CAT, GSH, SOD) were analyzed before and after treatment.

Results: HPLC revealed piperine (19.6 µg) and cannabidiol (5.09 µg) as key active constituents with antioxidant potential. All groups demonstrated improved oxidative profiles, with increased CAT, GSH, and SOD levels and reduced MDA concentrations. The combined therapy group (Tm+Hr) showed the greatest improvements in NRS, GOM, and ODI scores (p<0.05). No significant adverse biochemical changes were observed.

Conclusions: A seven-day regimen combining Thai massage with YTPS safely and effectively reduced pain and disability while enhancing antioxidant activity. This integrative approach may serve as a practical and culturally relevant therapy for managing chronic low back pain in community healthcare settings.

India's rural and tribal communities face persistent disparities in healthcare access and outcomes. While the biomedical model dominates the public health landscape, there is a growing recognition of the need for culturally responsive, preventive, and holistic approaches to health. This article proposes a synergistic integration of the Ottawa Charter for Health Promotion with Naturopathy, a core discipline under India's AYUSH framework. Drawing upon both global frameworks and Indigenous wisdom of healing with plants and herbs for medicinal and nutritional purposes, the article argues for an integrated community health promotion strategy that leverages the cultural legitimacy, ecological appropriateness, and preventive strengths of Naturopathy to fulfil the Ottawa Charter's vision. Evidence from public health interventions and AYUSH initiatives in India underscores the feasibility and relevance of this approach, particularly in tribal and rural regions.

Objectives: We investigated the impact of the nitric oxide substrate l-arginine on the neuro- and hepato-toxic effects of malathion in rats.

Methods: Rats were treated intraperitoneally with malathion (150 mg/kg) alone or combined with l-arginine (100, 200 or 400 mg/kg), atropine (2 mg/kg) or l-arginine (200 mg/kg) combined with atropine (2 mg/kg). Rats were euthanized 4 h later, and their brains and livers analyzed for malondialdehyde, nitric oxide (NO), reduced glutathione (GSH), paraoxonase-1 (PON-1). Moreover, butyrylcholinesterase (BChE), interleukin-15 (IL-15) and anti-apoptotic protein B cell/lymphoma-2 (Bcl-2) were determined in brain tissue. Histopatholoy was also performed.

Results: Malathion significantly raised brain NO and malondialdehyde alongside with a notable drop in PON-1 activity and GSH levels relative to the saline control. Brain BChE and Bcl-2 were markedly inhibited whereas IL-15 significantly increased by malathion. In brain, l-arginine treatment resulted in a significantly increased malondialdehyde, decreased GSH, and increased IL-15. A significant decrease in liver malondialdehyde occurred by l-arginine/atropine or atropine. In contrast, l-arginine, l-arginine/atropine or atropine caused a significant decrease in brain and liver NO levels and increased PON-1 activity. Bcl-2 in brain significantly increased by atropine. Malathion induced brain neuronal and liver degeneration showed marked improvement after atropine alone.

Conclusions: These results indicated that exogenously administered l-arginine did not protect against the neuro- and hepto-toxic effects of malathion. Meanwhile, the ability of atropine to mitigate the deleterious effects of a toxic dose of malathion provides a strong support to the role of excessive stimulation cholinergic pathways in inflicting such damage.

Introduction: While conventional medicine (CM) has improved outcomes for individuals with sickle cell disease (SCD), issues with accessibility, affordability, and potential adverse effects limit its widespread use. As a result, many patients and caregivers turn to traditional medicine (TM) as an alternative approach to managing SCD. This scoping review aims to systematically evaluate the efficacy, safety, and potential mechanisms of action of TM in SCD, while exploring its integration with CM.

Content: A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, EMBASE, and AYUSH Research Portal. Clinical trials, observational studies, in vitro and in vivo studies, and ethnopharmacological surveys investigating TM interventions in SCD were included.

Summary and outlook: Of the 27 selected studies, 11 were in vitro, four in vivo, six clinical trials, and six qualitative surveys. Several medicinal plants demonstrated promising anti-sickling, antioxidant, anti-inflammatory, and immunomodulatory properties. Formulations such as Niprisan^®, Ciklavit^®, and T-AYU-HM™ Premium showed potential in reducing vaso-occlusive crises and improving hematological parameters. However, limitations include variability in herbal formulations, lack of standardization, and inadequate RCTs. While preliminary findings are promising, further well-designed RCTs are needed to establish the efficacy of TM in SCD. Integrating evidence-based TM with CM options could provide a holistic and patient-centered strategy for SCD.

Objectives: Dengue virus (DENV), a single-stranded RNA virus from the Flaviviridae family, causes viral hemorrhagic fever and poses a global health threat due to limited diagnostics, treatments, and vaccines. The conserved NS5 protein, crucial for DENV replication, is a promising antiviral target. Antibody-dependent enhancement (ADE) complicates immunity, as serotype-specific antibodies may worsen infection. Moringa oleifera, rich in antiviral phytochemicals, shows potential as a DENV inhibitor by targeting proteomic, transcriptomic, and metabolomic pathways.

Methods: This study employed molecular docking with 3D PubChem structures of bioactive compounds of M. oleifera to evaluate the binding affinity with DENV-2 NS5 proteins (PDB ID: 6KR2) using AutoDock Vina, and binding modes were analyzed using Discovery Studio. Further drug-likeness, oral bioavailability, ADME, and toxicity profiles were analyzed using SwissADME, ADMETSaR, and ADMETlab 3.0 web server. Complexes were subjected to molecular dynamics simulation (MDS) analysis using Desmond Schrodinger v2019.

Results: Among the screened compounds, rhamnopyranosyl vincosamide (-9.0 kcal/mol), luteoxanthin (-8.6 kcal/mol), and luteolin (-8.3 kcal/mol) exhibited the most stable interactions and were further analyzed through molecular dynamics (MD) simulations. The results revealed that these phytochemicals interact with NS5 active-site residues, demonstrating significant inhibitory potential.

Conclusions: The study suggests that M. oleifera phytochemicals hold promise as DENV-2 NS5 inhibitors with minimal toxicity and favorable pharmacokinetic properties. These findings provide a strong foundation for further clinical investigations, potentially contributing to developing novel anti-dengue therapeutics.

Objectives: The current study aimed to formulate and analyze a novel polyherbal formulation (NPF) comprising of Terminalia arjuna, Centella asiatica and Embelia ribes.

Methods: NPF was prepared and subjected to preliminary phytochemical screening and FTIR to characterize its bioactive compounds and functional groups. To assess the safety, oral toxicity studies were carried out in Wistar rats. The antidiabetic efficacy was evaluated using the OGTT. Additionally, computational ADME analysis was carried out for the major active molecules - arjunolic acid, embelin, and asiaticoside - to evaluate the pharmacokinetic properties and drug-likeness.

Results: Presence of various secondary metabolites such as alkaloids, flavonoids, phenolic compounds, saponins, terpenoids, cardiac glycosides, and carbohydrates were confirmed by the phytochemical screening. Key prominent functional groups such as hydroxyl, amine, carbonyl, and alkyne stretching vibrations were detected upon FTIR analysis. Toxicity evaluations indicated no adverse effects, confirming the safety of NPF. Among diabetic rats, groups treated with 200 mg/kg body weight of NPF indicated a significant improvement in glucose tolerance as demonstrated by the OGTT results. ADME profiling showed favorable drug-likeness properties for arjunolic acid and embelin compared to asiaticoside.

Conclusions: NPF exhibited significant antidiabetic potential and demonstrated safety in animal models.

Objectives: The objective of this study was to evaluate whether PBM application at the nerve root emergence region could mitigate the deleterious effects of peripheral inflammation on the knee joint in Wistar rats.

Methods: Eighteen Wistar rats were divided into three groups: Control (intra-articular saline injection only), Arthritis (experimental arthritis model without treatment), and PBM + Arthritis (arthritis model treated with PBM - 660 nm, 20 J/cm²). Treatment began 24 h after intra-articular arthritis induction and continued for three consecutive days. Animals in the arthritis groups were sensitized with two injections of Mycobacterium butyricum (CFA), while the control group received saline solution. The nociceptive threshold was assessed using a digital analgesimeter, and joint edema was measured with a caliper. After euthanasia, the right knee joints were collected, sectioned at 7 μm, and stained with hematoxylin and eosin. Histomorphometric and histomorphological analyses of the synovial membrane and articular cartilage of the femur and tibia were performed.

Results: A reduction in nociceptive threshold and an increase in joint diameter were observed in the injured and treated groups. However, the PBM + Arthritis group showed pro-repair morphological characteristics in the joint tissue.

Conclusions: PBM treatment applied distant from the injured knee promoted improvements in joint morphology; however, it did not significantly affect edema or nociception.

Objectives: This study assessed the hepatoprotective efficacy of a non-pharmacopeial formulation (NPF) against rifampicin-induced hepatotoxicity, aiming to expand the repertoire of hepatoprotective agents in Unani medicine.

Methods: An acute toxicity study and HPTLC analysis were performed. The experiment utilized 42 Wistar rats, each weighing between 150 and 200 g. The rats were systematically allocated into seven distinct groups, each containing six animals, identified as negative, positive, standard, and test groups A, B, C, and D. Liver damage was induced by oral administration of rifampicin at a dose of 500 mg/kg daily for 30 days, following a 2-hour interval after the administration of standard and test drugs. The standard and test groups received Silymarin (100 mg/kg), NPF, Afsanteen, Kasni, and Asaroon at doses of 167, 117, 167, and 217 mg/kg, respectively, orally once daily for 30 days. Serum levels of marker enzymes (SGOT, SGPT, and ALP), total protein (TP), and albumin (S. Alb) were evaluated. All groups underwent biochemical and histopathological analysis.

Results: The formulation was deemed safe at a dose of up to 2000 mg/kg. Compared to the standard drug, test groups A and D demonstrated potential protective effects on the liver enzymes. Test groups B and C exhibited normal liver architecture.

Conclusions: Asaroon (test group D) demonstrated greater efficacy than NPF. Histopathologically, Afsanteen and Kasni were found to be effective. The study indicated that formulations by Unani scholars were more effective than non-pharmacopeial formulations, although the tested NPF remained effective and safe in this study.