Geneology International

Tag: herbal

  • MoH launches policy documents on herbal medicine

    MoH launches policy documents on herbal medicine

    The Ministry of Wellness (MoH) has launched two necessary plan documents on herbal medicine to improve the process of integrating the sub-sector into the countrywide health care supply program.

    The policy files are the MoH Encouraged Natural Medication Record and the Simple Process for Assessing Efficacy and Basic safety of Natural Medication Merchandise.

    In a speech go through on his behalf at the launch of the two procedures in Accra yesterday, the Minister of Well being, Mr Kwaku Agyeman-Manu, said thinking about the important contribution of organic drugs in excess of the a long time, mainstreaming the sector properly into the healthcare technique would boost on health care delivery results.

    He mentioned the two policies shaped portion of the government’s determination to the advancement of common clinical practice and herbal medicine.

    Mr Agyeman-Manu explained a further demonstration of the importance the federal government connected to organic drugs was the inclusion of the two guidelines into the 2022 budget.

    He said in the scheduling for the integration, institutionalisation, professionalisation and rational use of natural medications, it turned required to choose from herbal medications registered with the Foods and Medicines Authority (Food and drug administration) and give current market authorisation to compose the medicine checklist proposed for use in the administration of common wellbeing situations and the strengthening of the therapeutic area where greater medicines have been necessary.

    More than the years, we have viewed the evolution and reinvention of traditional drugs in its various kinds, to engage in a legitimate sizeable purpose in the shipping and delivery of healthcare in the nation.

    “This is not by accident, it is the consequence of a deliberate policy to redefine and inspire the enhancement of capacities and capabilities of various players in the sector,” he mentioned.

    Collaboration

    Mr Agyeman-Manu explained the authorities would continue to work with all stakeholders to make certain that classic drugs in the nation continued to make improvements to to the stage of attaining world wide recognition.

    “The standardisation, efficacy and protection of natural medicinal products and solutions have turn into concerns of key concern for policy makers and the typical inhabitants with regards to their usage and absolute reliance on it as significantly as people’s well being is worried.

    “Although we are working with organic items, which in most situations are taken as foods, like ‘prekese’, ‘dawadawa’, ginger amongst many other plant-based goods, we need to realize that when we intend to use them in really big portions, then we have to make positive that the products goes by means of sequence of exams to build quality, safety and efficacy,” the minister explained.

    Mr Agyeman-Manu said the growth of the Essential Procedure for assessing Efficacy and Security of Organic Medicine Solutions coverage was also made to, amid some others, reply positively to the well being needs of the populace with special items that were being available, secure, efficacious, economical and suitable with fashionable science and technologies.

    Progress

    The Director in cost of Regular and Choice Medicines Directorate at the ministry, Dr Anastasia Yirenkyi, mentioned the feat marked the development of herbal medicines in the region.

    She reported the sector had produced great strides around the several years and the start of the two plan paperwork would serve as a booster to ushering the conventional medication sector into its following period of practice in the place.

    “The potential contribution of natural medication to the countrywide health care process, specially, key health care delivery can not be underestimated, especially in this period of the COVID-19 pandemic,” she explained.

    Dr Yirenkyi claimed in buy to make certain rational dispensing of common medicines in overall health facilities, there was the will need to prepare the encouraged herbal medicine list coverage document to serve as a guideline.

    She stated the paperwork would also aid even further exploration into conventional medications to add to the shipping and delivery of common overall health coverage.

    The President of the Ghana Federation of Traditional Medicines Practitioners Association, Mr William Odum Eduful, expressed gratitude to all stakeholders who contributed to the improvement of the two files, notably, Mr Agyeman-Manu.

    He also agreed that the files would greatly enhance the use of classic drugs for much better well being results.

    Mr Eduful, however, appealed to the minister to aid the inclusion of the checklist on to the Nationwide Wellness Insurance plan Plan package deal for simple accessibility by the population.

  • A Preliminary Report on Herbal Medicine Use Among Patients Hospitalize

    A Preliminary Report on Herbal Medicine Use Among Patients Hospitalize

    Introduction

    Globally, herbal medicines use has been reported as a common practice both in the prevention and treatment of diseases.1–3 This is especially common with diseases with high mortality, morbidity or those without conventional therapy that cure the disease. Previous studies in Uganda report that more than 60{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of the population depended on traditional medicine before the coronavirus disease (COVID-19) pandemic.4 Due to the high mortality associated with the second wave of COVID-19, this practice is likely to have increased.

    Many factors have been identified as drivers of herbal medicine use. In many parts of the world, users have reported that herbal remedies are safe, effective, and are cheap.1,5 In Uganda, easy access, and cultural familiarity as well as the higher number of traditional health practitioners compared to health-care professionals are some of the common factors influencing this practice.4,6 A recent study in Uganda reported that media has increased the use of herbal medicines in the treatment and prevention of COVID-19.7 However, there is limited information concerning the level of herbal medicine use among hospitalized COVID-19 patients and the reasons why they resort to this practice even with the existence of conventional supportive treatment and vaccines.

    Although some studies have reported the role of combining herbal remedies with westernized medicine in the treatment of COVID-19,8 the side effects of these remedies are not well studied. This is in addition to the wide variation in the types of herbal medicines on the market which may wrongly influence their use. Various studies have documented harmful consequences of herbal remedies including hepatotoxicity and allergies, which may be worsened by confounders such as self-medication.1,9 The continued use of herbal medicines without question may lead to long-term health consequences for both the individual and the government.

    The Uganda National Drug Policy and Authority Statute (1993) gives the National Drug Authority (NDA) a mandate to regulate herbal medicine use including approving of all manufacturers. During the pandemic, several manufacturers have hit the market with herbal medicine products, but only a few of these are approved by the NDA and little has been done to regulate their practice.10 This study, therefore, aimed to determine the prevalence of and factors associated with herbal medicine use among hospitalized patients at the two large COVID-19 treatment units in Uganda.

    Methods

    Study Design and Setting

    An observational, cross-sectional study was conducted between July and August 2021 in two large CTUs in Kampala, Uganda, namely, Mulago National Referral Hospital CTU and Namboole Stadium CTU. These are the main referral CTUs in the country with bed capacities of over 30,000 beds catering for a diverse range of patients from all over the country. The CTUs run daily, seeing both patients referred from other health facilities across the country as well as patients who are being followed up routinely.

    Study Population

    We approached all patients hospitalized with COVID-19 in the two-largest CTUs in the country. Eligible participants were those confirmed to have COVID-19 and aged 18 years and above. Respondents with a known history of impaired mental capacity to provide coherent and reliable information, critically ill in the absence of a reliable caretaker were excluded.

    Sample Size Calculation

    The sample size was calculated using the Kish Leslie formula for cross-sectional studies where the estimated sample size at 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} confidence interval was 384 participants. To cater for non-response associated with critically ill, unable to provide information or absence of caretakers, 10{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of the estimated sample size was added leading to a final sample size of 422 participants.

    Questionnaire Development

    The questionnaire was divided into three major sections: socio-demographic characteristics (age, gender, tribe, religion, education level, employment status, occupation, residence), herbal medicine use assessment (prevalence, and reasons for herbal medicine use), and factors associated with herbal medicine use with both open and closed-ended questions.

    Measurements

    The questions asked were modified from the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q); which aims to comparably assess the use of CAM internationally.11

    Data Analysis and Management

    Fully completed questionnaires were extracted from KoBo Toolbox® and exported to a Microsoft Excel 2016 for cleaning and coding. The cleaned data was exported to STATA 16 (StataCorp LLC, College Station, Texas, USA) for analysis. Numerical data were then summarized as means and standard deviations or median and range as appropriate. Categorical variables were summarized as frequencies and relative percentages. To assess the association between independent variables with herbal medicine use, chi-square test or Fishers’ exact test (for categorical variables) and Mann-Whitney U-test (for continuous variables) were used at bivariate analysis. All independent variables with p < 0.2 at bivariate analysis were included in the multivariable logistic regression models to adjust for confounders. A p < 0.05 was considered statistically significant.

    Ethics

    The study was performed according to the Declaration of Helsinki, after obtaining approval from Mulago Hospital Research and Ethics Committee (Approval number MHREC 2097). Consent forms were given to respondents before the initiation of the study.

    COVID 19 Precautions

    The study was conducted following the Ministry of Health and the National COVID-19 task force guidelines of Uganda.

    Results

    Characteristics of the Participants

    The study was terminated early because of a significant reduction in the number of patients hospitalized with COVID-19 and the closure of one of the CTUs. Of the anticipated 422 participants, we recruited 108 (25.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). Of the 108 participants, 58 (53.7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) were female, with a median age of 38 (range: 20–75) years. Majority of the participants were from central Uganda (70.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, n = 76) and were Christians (66.7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, n = 72), more than one-third attained tertiary level of education (37.7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, n = 40). More than half were employed (56.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, n = 61) and were married (52.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, n = 57). Forty-nine (45.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) participants had received at least one dose of the COVID-19 vaccine. Majority were on COVID-19 treatment (86.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) and more than half were getting their treatment from Namboole CTU (58.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, n = 53). Table 1 summarizes the socio-demographic characteristics of participants.

    Table 1 Socio-Demographic Characteristics of Participants

    Herbal Medical Use

    Of the 108 participants, 58 (57.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) ever used herbal medicine and the majority had used herbal medicine in the past 12 months (71.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, n = 41). Of those that had used herbal medicines in the past 12 months, 35 (85.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) had used before a diagnosis of COVID-19, and 15 (36.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) continued to use even while on treatment for COVID-19 (Figure 1). Their doctors or nurses asked almost half of the participants about herbal medicine (49.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, n = 53), and the majority reported some improvement after using herbal medicine (80.7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, n = 46). Table 2 summarizes the use of herbal medicine by the participants. Of those that were using herbal medicines, efficacy, accessibility, and affordability were the frequently reported as the reasons for their use (n = 35, 60.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), (n = 14, 24.1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) and (n = 14, 24.1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), respectively (Figure 2A). Gastrointestinal disturbances such as diarrhea, constipation, abdominal pain, and vomiting were the most commonly reported side effects associated with the use of herbal medicines (Figure 2B).

    Table 2 Herbal Medicine Use Among the Participants

    Figure 1 Herbal medical use before and after diagnosis of COVID-19 in the last 12 months. ε represents the total number of patients who had used herbal medicines in the last 12 months before this survey.

    Figure 2 (A) Reasons for use of herbal medicines among COVID-19 patients. (B) Common side effects of herbal medicines reported.

    Table 3 summarizes factors associated with herbal medicine use among the participants at bivariate analysis. Vaccination status (p = 0.004), level of education (p = 0.002), and accessibility of the herbalists vs conventional treatment (p < 0.001). Table 4 summarizes factors associated with herbal medicine use among the participants at multivariable logistic regression: being vaccinated (adjusted odds ratio (aOR): 3.1, 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI: 1.4–6.8, p = 0.005) and having attained a tertiary level of education (aOR: 6.2, 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI: 1.7–23.1, p = 0.006), as well as the accessibility of the herbalists (aOR: 31.2, 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI: 3.7–263.2, p = 0.002).

    Table 3 Bivariate Analysis for Socio-Demographic Factors Associated with Herbal Medical Use

    Table 4 A Multivariable Logistic Regression Showing Predictors of Use of Herbal Medical Use

    Discussion

    In the current study, the prevalence of herbal medicine use was found to be 57.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}. All participants who reported to have used herbal medicines started to use before hospital-based treatment a third of whom continued to use even after initiation of COVID-19 treatment. This finding was consistent with the results of a cross-sectional online survey among Vietnamese adults that found nearly half of the respondents to use herbal medicine for common illnesses during the COVID-19 pandemic.12 However, studies from Saudi Arabia report rather a higher prevalence (>90{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) of herbal medicines use in the management of COVID-19 and other conditions.1,5,13 This big difference in the prevalence could be explained by the fact that our study assessed herbal medicine use among virologically confirmed patients, unlike the Saudi Arabian study whose participants reported to have used herbs for boosting their immunity and to improve general health and not to cure infection.13 However, a finding of herbal medicine use of more than half in our study is concerning given limited evidence supporting efficacy and safety of herbal medicines. In fact, previous studies in Uganda assessing herbal medicine use have reported a comparatively high prevalence.6,14,15 Easy access, affordability, cultural familiarity, and the unfavorable doctor–patient ratio in Uganda are the major factors leading to increased herbal medicine use.4

    Being vaccinated, having attained a tertiary level of education, as well as the accessibility of the herbalists were found to be significantly associated with herbal medicines in this study. This finding corroborates with the results of a study conducted in Vietnam which reported higher levels of income, urban dwellers, and higher levels of education to be more likely to use herbal medicines in the management of COVID-19.12 Although studies from other countries have reported a predilection of females towards herbal medicine use,12,16 this was not the case in our study. Our study revealed that participants who were vaccinated against COVID-19 continued to use herbal medicine for prevention and treatment. Notably, still, our participants believed that herbal medicines were safe and effective corroborating findings reported by Nguyen et al, in which nearly 70{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of participants considered herbal medicines safe and effective.12 With limited research evidencing the efficacy, mode of action, and toxicity profiles of the common herbal medicines on market, the population is at great risk of drug-herbal medicine interactions, drug resistance, and unexplained adverse reactions. Efforts should be directed towards further studies to understand the role of herbal remedies in patient management and public awareness to guide their utilization.

    To the best of our knowledge, this is the first study in sub-Saharan Africa to assess the use of herbal medicine among COVID 19 patients hospitalized in treatment centers. Previous studies on herbal medicine use in Uganda and other sub-Saharan countries have focused on populations with HIV, hepatitis, and hypertension and there is a paucity of literature on the prevalence and rationale of herbal medicine use among patients with COVID-19 in sub-Saharan Africa.17,18 Findings from this study provide documented evidence on herbal medicine use among the population of COVID-19 patients, which will be used to promote public awareness, and knowledge of proper use of herbal therapies and contribute to the National Drug Authority’s objective to regulate the use of herbal medicine in Uganda. This information can also be used to promote activities to bring about improved communication between patients and health workers about herbal medicine use.

    Limitations

    Several limitations were taken into consideration as we interpreted these results. First, the study employed a non-random sample. Participation in the study was voluntary and no information was available about the characteristics of those who did not participate. Secondly, the cross-sectional design of our study does not allow for a causal interpretation of the results. Thirdly, the CTUs employed were geographically situated in town and this could have limited access to populations in rural areas who could have reflected different study findings. However, despite these limitations, this is the first study in Uganda assessing the prevalence of herbal medicine use and its associated factors among hospitalized COVID-19 patients.

    Conclusion

    The use of herbal medicine during the COVID-19 pandemic is a widespread practice among the general population in Uganda amidst unpublished evidence of their safety and efficacy. Continuous public health awareness is suggested on the different natural remedies and further studies on the role of herbal medicine in patient management are recommended.

    Data Sharing Statement

    The data used to support the results of the research are available from the corresponding author upon request.

    Acknowledgments

    The authors would like to acknowledge administrative support from Mulago National Referral hospital, Namboole COVID-19 Treatment Unit, and Kiruddu Referral Hospital.

    Author Contributions

    All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data, took part in drafting the article or revising it critically for important intellectual content, agreed to submit to the current journal, gave final approval to the version to be published, and agree to be accountable for all aspects of the work.

    Funding

    Research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health, US Department of State’s Office of the US Global AIDS Coordinator and Health Diplomacy (S/GAC), and President’s Emergency Plan for AIDS Relief (PEPFAR) under Award Number 1R25TW011213. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

    Disclosure

    The authors declare no potential conflicts of interest for this work.

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    7. Musoke P, Nantaayi B, Ndawula Kato R. Fear of COVID-19 and the media influence on herbal medication use in Uganda: a cross-sectional study. Risk Manag Healthc Policy. 2021;14:3965s–75. doi:10.2147/RMHP.S332325

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  • Hood Herbalism is the internet phenomenon bringing herbal education to birth work

    Hood Herbalism is the internet phenomenon bringing herbal education to birth work

    Berenice Dimas, a doula and herbalist from East L.A., is whole of the knowledge of all those who arrived before. Here’s a sample:

    For resilience during pregnancy, dandelion essence.

    To provide iron and minerals in planning for start, alfalfa, Mexican honeysuckle, moringa.

    To assist with milk move and nutrition immediately after delivery, blue corn atole.

    To offer you gratitude when harvesting plants: prayer, blood, h2o, compost, track, Pay Per Touch.

    These aren’t your typical pre- and postnatal prescriptions. But Dimas isn’t your common herbalist. The founder of Hood Herbalism, which delivers local community-based mostly herbal education and learning to Black, Indigenous and other persons of coloration, Dimas travels up and down the point out instructing 1000’s of people today to connect with the plants about them. Her Instagram channel provides virtually 60,000 followers recipes, re-shares of plant-encouraged artwork and rates, and glimpses into her fingers-on organic medicine get the job done with groups of all ages.

    Recently she has been marrying her deep natural medication knowledge with midwifery teaching, an endeavor she suggests was born from repeatedly witnessing racist solutions in clinic rooms that add to significant toddler and maternal mortality premiums for persons of color.

    Now Dimas is pretty much guiding an expanding community of BIPOC start personnel to make vegetation their allies by digging into the dust and their have family’s ancestral traditions.

    Dimas’ very own roots in natural medication occur from her mom, but she formalized her apply soon after finding out from standard herbalists in Mexico and Western herbalists in the U.S. Considering the fact that hosting her initial course in a friend’s East L.A. yard six several years in the past, the 36-year-aged has focused on equipping BIPOC communities with obtainable plant therapies to address the well being fears most impacting them.

    For Black, Indigenous and some Latinx communities, dying from will cause connected to childbirth is disproportionately high in a place that previously ranks worst amid other rich nations in maternal treatment. Expanding a array of birth options with obtain to doulas and midwives is 1 way advocates hope to shut the gap, and delivery employees are reaching for as quite a few applications as they can get to deal with the crisis. Available, culturally suitable plant drugs is just one of them.

    Dimas says her marriage with plants started before she started off her company, right before she understood how to name the medication that cured her fevers or infections as a youngster. It started with her wonderful grandmothers, who handed down Indigenous plant treatments from Mexico until finally they landed in a container yard in El Monte, a mainly Latinx city in the San Gabriel Valley.

    Born in Mexico Town, Dimas moved to L.A. with her family members when she was 3. Her mother experienced a penchant for using her potted vegetation to overcome illnesses for household and neighbors. The observe was not only purely natural it was also safer and far more successful than wrestling with a new language or an unfamiliar medical center method.

    Later, though Dimas was teaching substantial university in the Bay Place, she arrived across classes that place a label on the wisdom she grew up with: organic medicine. She dived into what she phone calls spirit operate, serving to consumers recover from shock or trauma with herb-laced religious cleansings known as limpias. She moved back again to L.A. to nourish the town that elevated her the organization name is a nod to the resourcefulness of the hoods she has termed property.

    “Even nevertheless there is concrete almost everywhere, there is always environmentally friendly growing as a result of,” she said. “Despite possessing much less access to environmentally friendly areas in my community, there have been so many individuals on my block that were escalating various matters.”

    Herbalists generally observe relatives traditions in plant drugs, but Dimas’ route into beginning get the job done was impressed by a desire of her grandmother, who appeared about 3 months after her dying, telling her granddaughter to discover about delivery. Dimas wasn’t absolutely sure what it meant, but before long after she been given an electronic mail about a doula coaching application for people of shade.

    She finished her doula coaching in 2014, after finding out for a 12 months from nurses and midwives and undertaking cost-free births alongside a doula mentor.

    Even though doula offerings differ, their principal role is to deliver emotional help, resources and advocacy ahead of, for the duration of and immediately after childbirth. The function was rewarding, but she witnessed microaggressions, bias and criminalization towards her shoppers in hospitals. Once she was left in tears, emotion helpless when a girl of colour was threatened for the duration of labor with a court get for wanting to hold off on a cesarean.

    Structural and interpersonal racism can make childbirth in a healthcare facility setting unsafe for persons of coloration: Black, American Indian and Alaska Indigenous gals offering beginning are two to 3 periods extra possible to die from pregnancy-relevant triggers than those who are white, and people costs boost with age. The dying rate for Black toddlers is twice as higher as it is for non-Hispanic white toddlers.

    “Those quantities for me are unacceptable, and I just couldn’t walk absent from them following witnessing how many people in my local community are dropping their life at the arms of persons in hospitals violating their right to a just beginning procedure,” she stated.

    Dimas is enrolling in midwifery school — which lets her to engage in the role of a accredited medical supplier throughout the birthing system. When doulas aren’t permitted to make any healthcare conclusions, as a midwife she’ll be equipped to provide health-related treatment and have far more autonomy.

    Element of what makes plant drugs attractive, primarily for remarkable transformations like pregnancy and delivery, is that it incorporates physical, psychological and mental properly-getting. But in Dimas’ doula software and other courses at the time, the discussion all around plant medication was by no means at the center. Even now, as doula providers turn into far more institutionalized, Dimas claims some contracts with hospitals specially prohibit plant medication recommendations.

    “I was intrigued in finding out about the utilizes for plants in delivery help, and it just turned a rabbit hole that led me to now currently being in midwifery university and sharing the information and facts that I know,” she claimed.

    Natural drugs has been stigmatized for expecting persons by Western medicine even with traditions that go back again countless numbers of yrs. But Western medicine is created on medical interventions — surgical procedures, drugs. This is why Dimas begun conducting classes in herbalism for birthworkers.

    One particular of Dimas’ college students, Prashante Bailey-Lewis, a organic hair care professional in Sacramento who is 25 months expecting, shared that her medical professional recommended her drugs for preeclampsia and gestational diabetic issues centered on general stats, even though building no note of her recent bloodwork and way of life. She was also discouraged from employing pure medication, some thing that is been common to her due to the fact her youth.

    Plant medicine can be preventive, encouraging the entire body change to alterations as it grows a toddler. It also can be delicate ample for pregnant people today who could have solid reactions to specified flavors or can’t acquire other medicine. And Dimas utilizes remedies these as flower essences to assist restore psychological harmony when there are feelings of anxiety or when customers are faced with traumatic lifetime functions.

    Maria Lozano was 1 of Dimas’ early pupils, and soon soon after she gave start to her baby, her mom died. Other herbal practitioners came to her side with therapies that nursed her grief and her overall body.

    “Dealing with grief, getting a new child, having breastfeeding issues — we know which crops energetically can answer and help those people requires,” she claimed.

    Lozano herself is a doula and clinical licensed social employee in Ventura County who started learning about plant medication as a way to reconnect with her Mexican roots and affirm the lifestyles of family members she arrived across as a community psychological wellness service provider. Since her mother’s death, she’s inherited her backyard, caring for a corner of luscious spearmint, avocado and orange trees, and roses that she makes use of for her clients’ postpartum baths. Dimas encourages college students to plant and use what grows in their climates that way plant medicine can be available to any one.

    Making these styles of long-term relationships with plants is critical to Dimas, especially thinking of organic medicine’s quickly rise to reputation in the U.S. Shrinking habitats and overharvesting have set some species at hazard, an alarming predicament for individuals who rely only on herbal medication. For Dimas, it is a political choice to skip the keep-bought plants or important oils coming from unknown sources and mature plants ourselves.

    “Plants are not just right here for us they’re below for so several other ecosystems much too,” she stated.

    She wishes learners to feel about plants’ migration patterns or the appropriation of plant medication and how to assistance specified plants’ longevity.

    Plant relationships ought to also be reciprocal, in accordance to Dimas, who asks her students to imagine about what offerings they can give again to individuals crops.

    “I generally tell the college students that plants have dwelling, respiratory spirits,” she mentioned. “We have to consider about them not as objects or matters that can be commodified.”

    For Dimas, the dream is to eventually open a start center in South East L.A. that can give reproductive well being solutions, household organizing that’s inclusive for queer and trans persons, an herbal medicine back garden and, if appropriate for the patient, a put to give birth.

    VISIT : https://paypertouch.com/

  • Herbal skin treatments in Uganda get an important scientific boost

    Herbal skin treatments in Uganda get an important scientific boost

    Organic medicine is used all around the environment, and Uganda is no exception. Figures suggest that up to 79{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of the East African nation’s population favours natural drugs for a wide variety of conditions instead than pursuing other remedy choices.

    COVID-19 has escalated the use of herbal drugs. In June 2021 the government approved the use of a organic treatment, Covidex, as a therapy for COVID-19. The treatment experienced not undergone scientific trials and the Globe Well being Organisation warned against its use. Communities are also applying other organic therapies to take care of and handle COVID-19.

    At to start with glance, this should really not be an challenge. Herbal drugs has confirmed to be incredibly helpful in dealing with many illnesses like malaria, tuberculosis, cough and skin health conditions. But utilizing it is not without having hazards. There is a fantasy amid the neighborhood inhabitants and some herbalists that medicinal plants do not produce harmful outcomes: they think that, considering that medicinal vegetation are pure, there are no adverse results and you can consider any volume you want. Nevertheless, a ton of investigate has demonstrated that some medicinal plants can be toxic.

    The challenge is that natural remedies never always undergo right scientific assessments for excellent, efficacy and security. From time to time folks may well underdose, this means that even if the treatment is safe, it doesn’t aid them. On the other hand, some could acquire far too a lot of a cure and this can be toxic.

    It is essential that natural medication – just like the medicine commonly found on pharmacy cabinets – be checked for its security, its probable to treat unique conditions, and to ascertain its chemical elements. This is also pretty valuable in drug discovery. Uganda could increase herbal treatment options to the international market place, knowing they are safe and powerful this would be fantastic news for Uganda’s experts, its economic climate, and common men and women all around the planet who could profit from new cures.

    That is why the staff I’m element of, the organic and natural investigate group at Makerere University’s Section of Chemistry led by Professor Robert Byamukama, focuses on tests the safety, top quality and efficacy of herbal cures. To do so, we work intently with herbalists and communities. For occasion, we have qualified persons in Mpigi, Kamuli, Kayunga and Buikwe districts to formulate herbal cosmetics (sunscreens and skin lotions) they can use properly and market.

    A complete approach

    Our hottest study examined how medicinal crops generally utilized in Uganda may possibly be used to handle different pores and skin bacterial infections.

    The initial move was to seek advice from with herbalists and communities to find out what crops, or sections of crops, are utilized for these sorts of illnesses. They discovered Spermacoce princeae, Psorospermum febrifugum, Plectranthus caespitosus, and Erlangea tomentosa.

    We then gathered the vegetation, possibly early in the morning or late in the night. That is simply because the plants’ chemical parts are in their most organic state throughout these periods. Through the day when the sunshine is at its peak, some active substances can both evaporate or can be exchanged for inactive ones.



    Examine far more:
    South Africa is abundant in vegetation utilized for skincare: rural women served us document some

    The plant components were then taken to the exploration facility and dried below shade to reduce the reduction of any chemical parts that can escape into the atmosphere in sunshine. Shade drying also helps prevent lively components from degrading into an inactive condition.

    Next, dried plant material was floor into high-quality powder and extracted working with drinking water and organic and natural solvents to get the lively factors. The resultant liquid was filtered to eliminate any strong content, then dried so it can be completely tested for efficacy and toxicity, and its chemical components analysed. By identifying the chemical factors, we were being ready to ascertain which substances have been dependable for a plant’s performance as a therapy.

    Optimistic results

    Some of the crops we examined proved to be pretty protected and efficient as skin antibacterials and sunscreens. Making use of these findings, we have formulated natural cosmetics – cleaning soap, jelly and product. We have shared this formulation with the communities we consulted, so they can make their personal solutions and use them knowing they are scientifically seem. We system to share it far more commonly.

    We’ll also be executing additional assessments on the formulated items – a step, we hope, toward bringing it in line with intercontinental benchmarks so that these African vegetation can action onto the entire world stage.

  • A Preliminary Report on Herbal Medicine Use Among Patients Hospitalize

    Herbal medicine for patients with cognitive impairment

    Yujin Choi,1 Ae-Ran Kim,2 Ji-Yoon Lee,3 Hae Sook Kim,3 Changsop Yang,1 Jae Kwang Kim,4 Younghoon Go,4 In Chul Jung3

    1KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea; 2R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea; 3Department of Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea; 4KM Application Center, Korea Institute of Oriental Medicine, Daegu, Republic of Korea

    Correspondence: In Chul Jung
    Department of Neuropsychiatry, College of Korean Medicine, Daejeon University, 75 Daedeok-daero 176beon-gil, Seo-gu, Daejeon, Republic of Korea
    Tel +82-42-470-9129
    Fax +82-42-470-9005
    Email [email protected]

    Purpose: The potential effects of herbal medicine for patients with cognitive disorders have been reported in various human and animal studies. This study aimed to explore the effect of herbal medicine treatment according to the Korean Medicine (KM) pattern identification for patients with mild cognitive impairment and early dementia.
    Patients and Methods: Twenty patients with mild cognitive impairment or mild dementia who planned to receive herbal medicine treatment were enrolled. Herbal formulae were prescribed based on the KM pattern for 12– 24 weeks. Seoul Neuropsychological Screening Battery II (SNSB-II) and Montreal Cognitive Assessment (MoCA) were assessed at the baseline, after 12 weeks, and after 24 weeks (Trial registration: cris.nih.go.kr, KCT0004799).
    Results: Herbal medicine products, including Yukmijihwang-tang, Samhwangsasim-tang, Palmul-tang, Banhasasim-tang, and Yukgunja-tang, were prescribed to the patients. Among the SNSB-II five cognitive function domains, the T scores for language, visuospatial function, memory, and frontal/executive function increased over time. The MoCA score also improved following the treatment (mean difference 4.23 [95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI: 2.60, 5.86], p Conclusion: The potential effect of herbal medicine formulae products on improving cognitive functions in patients with cognitive impairment was observed. Further research is needed to objectify the KM pattern identification process and evaluate the KM pattern-related signs and symptoms.

    Keywords: mild cognitive impairment, mild dementia, herbal medicine, Korean medicine, traditional east Asian medicine, observational study

    Introduction

    Neurocognitive disorders (NCD) are degenerative disorders with main symptoms of deficits in various cognitive functions.1,2 Mild and major NCDs are distinguished according to the maintenance of activities of daily living. The deficits can have massive impacts on the quality of life for both patients and caregivers. Recently, the potential effects of herbal medicine, which are widely used for age-related degenerative disease in east Asian countries, have been reported for patients with cognitive disorders.3,4 A systematic review summarized that Chinese herbal medicine improved the cognitive scores of patients with mild cognitive impairment (MCI).5 Another review reported that herbal medicine alleviated behavioral and psychological symptoms of patients with dementia.6 Several observational studies of herbal medicine as treatment for cognitive disorders have also been reported, including Dangguijagyag-san7 and Ninjinyoei-to.8

    In Traditional East Asian Medicine (TEAM), pattern identification, also called syndrome differentiation, is the core clinical decision process in clinical practice.9,10 Traditionally, practitioners diagnose the Traditional Chinese Medicine (TCM) or Korean Medicine (KM) patients’ patterns after the professional and subjective pattern identification process of observation, listening, questioning, and pulse analysis. In recent studies, efforts have been made to measure the TCM or KM pattern objectively in patients with cognitive impairment.11,12 Specifically, in a real-world multicenter controlled clinical study conducted in China, sequential therapy based on the evolvement of patterns (STEP) regimen was applied for patients with Alzheimer’s Disease (AD)13,14 and the authors concluded that early AD initiates from kidney deficiency, and as the disease progress, phlegm-dampness, blood stasis, and fire-heat could occur pathologically. According to the sequential patterns of AD patients, herbal medicine demonstrated beneficial effects in maintaining cognitive stability in patients with AD after the 2-years of follow-up.

    In Korea, a pattern identification tool for cognitive disorders (PIT-C) has been developed.15,16 It does not distinguish the pattern of cognitive disorders according to the stage of the disease. Instead, PIT-C comprises two deficiency patterns, qi-deficiency and yin-deficiency, and two excess patterns, phlegm-dampness and heat-fire. The Qi-deficiency score measures the symptoms of fatigue and lack of energy. The Yin-deficiency score measures the symptoms of hot flushes and ringing in the ears. Phlegm-dampness score is composed of the symptoms of a feeling of heaviness in the head and digestive issues. The fire-heat score is composed of the symptoms of being angered easily, irritability, or aggression.

    Seo et al generated a list of licensed herbal medicine products in Korea that are expected to have potential effects on neurocognitive impairment.17 Licensed herbal medicine products are produced in good manufacturing practice (GMP) according to the Korean Herbal Pharmacopoeia (KHP). To select the treatment candidates, individual herbs’ effects on neuroinflammation (nitric oxide release inhibition), neuronal cell proliferation (NE-4C cell viability), and energy production target (PDH activity in AD293 cell) were assessed using in vitro assays.18–20 The final list of herbal medicine products for patients with neurocognitive disorders was obtained by combining the results of the screening test and the recommendation of experts.17

    This study aimed to explore the effect of herbal medicine treatment according to the KM pattern identification on cognitive functions and KM pattern scores. Also, PIT-C15 was applied in KM pattern identification and determination of prescription formula for patients with neurocognitive disorders.

    Patients and Methods

    Trial Design and Ethics Approval

    Patients with neurocognitive disorders who visited the Daejeon Korean Medicine Hospital of Daejeon University were asked written consents, then enrolled in this prospective, observational study. Enrolled patients were treated and managed by qualified clinicians, mainly using herbal medicine. Clinical outcomes were measured at baseline, after 12 weeks, and after 24 weeks. This observational study protocol was approved by the Institutional Review Board of Daejeon University Daejeon Oriental Hospital (DJDSKH-18-BM-21). The approved protocol was prospectively registered at the clinical research information service (cris.nih.go.kr, Registration no. KCT0004799). This study was conducted in accordance with the Declaration of Helsinki.

    Participant Flow

    A total of 20 patients with neurocognitive disorders were enrolled in the study. Six patients received SHS and five patients received PMT. For three patients, herbal medicine prescriptions were revised to another formula at the follow-up visits (Figure 1). The duration of administration, prescribed herbal medicine, and compliance in each patient are presented in Table S1. Compliance on taking herbal medicine was greater than 70{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} for all patients.

    Figure 1 Flow chart.

    Participants

    Twenty patients with MCI or mild dementia who planned to receive herbal medicine treatment were registered for the study. A hospital in Daejeon, Korea, recruited patients through a notice on the bulletin board in the hospital. Eligible patients were enrolled from 29 July 2019 to 29 May 2020. The follow-up observation of the last participant was completed on 7 September 2020.

    The inclusion criteria were as follows:

    1. between 45 and 84 years of age;
    2. diagnosis of major or mild neurocognitive impairment based on the criteria of Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5);
    3. Clinical Dementia Rating (CDR) = 0.5;
    4. Global Deterioration Scale (GDS) score 2–5;
    5. Montreal Cognitive Assessment (MoCA) score < 23;
    6. capable of understanding the contents of the questionnaire directly or through a guardian; and
    7. willingness to participate and those who voluntarily signed the informed consent form.

    The exclusion criteria were as follows:

    1. history of brain damage or mental retardation;
    2. history of Huntington’s disease, normal hydrocephalus, or brain tumor;
    3. uncontrolled gastrointestinal, endocrine, or cardiovascular diseases;
    4. uncontrolled diabetics;
    5. severe liver disease, or kidney disease;
    6. anemia, hypothyroidism, vitamin deficiency, or malignant disease;
    7. severe unstable medical conditions;
    8. history of major psychiatric disorders (schizophrenia, delusional disorder, depressive disorder, bipolar disorder, alcohol or substance use disorder);
    9. experience of participating in other clinical trials with interventions in the last 4 weeks
    10. women of childbearing age;
    11. unable to understand the consent form or difficulty in proceeding with the research due to mental retardation, emotional, or intellectual impairments;
    12. blindness, hearing loss, or severe speech impairment;
    13. not appropriate according to the judgment of the researcher;

    Herbal Medicine Treatment

    A list of herbal medicine products generated in a previous study17 was mainly used. Among the list of herbal medicine products, the clinicians made a decision on the personalized herbal medicine formulas for each patient based on the KM pattern identification. KM pattern scores of Qi-deficiency, Yin-deficiency, Phlegm-dampness, and Fire-heat were measured by the pattern identification tool for cognitive disorders (PIT-C),15,16 and clinical impressions were comprehensively considered for the selection of herbal medicine formula. The symptoms and signs of the four patterns in patients with cognitive disorder are listed in Table 1. For patients with high Yin-deficiency score, Yukmijihwang-tang (YMJ; Liu-wei-di-huang-tang in Chinese; Lokumijio-to in Japanese) was selected. For patients with high Fire-heat scores, Samhwangsasim-tang (SHS; San-huang-xie-xin-tang in Chinese; Sano-shashin-to in Japanese) was selected. For patients with high Phlegm-dampness score, Banhasasim-tang (BHS; Ban-xia-xie-xin-tang in Chinese; Hangeshashin-to in Japanese) was selected. For patients with high Qi-deficiency scores, Yukgunja-tang (YGJ; Liu-jun-zi-tang in Chinese; Ikkunshi-to in Japanese) was selected, and Hyangsayukgunja-tang (Xiang-sha-liu-jun-zi-tang in Chinese; Kosharikkunshi-to in Japanese) was also considered for patients with Qi-deficiency and digestive problems. For patients with high Qi-deficiency score and tendency of Blood-deficiency, Palmul-tang (PMT; Bawu-tang in Chinese; Hachimotsu-to in Japanese) was prescribed.

    Table 1 Symptoms and Signs of the Four Korean Medicine Patterns in Patients with Cognitive Disorders

    The herbal medicine product (extract granules) manufactured by the pharmaceutical company according to the Korean Herbal Pharmacopoeia (KHP) were used. The ingredients and composition of each herbal medicine formula are presented in Table 2. Moreover, the detailed production methods and quality standards of each herbal medicine formula extract are presented in Supplement 1. The granules were administrated three times a day for 24 weeks.

    Table 2 The Herbal Ingredients and Composition Ratio of Formulae

    Outcome Measurement

    The Seoul neuropsychological screening battery II (SNSB-II) is composed of various cognitive tests for five cognitive function domains; attention, language, visuospatial function, memory, and frontal/executive function.21,22 The digit span test (DST) for attention domain; Boston naming test (BNT) for language domain; Clock drawing test (CDT) for visuospatial function domain; Rey complex figure test (RCFT) for visual memory, Seoul verbal learning test for verbal memory; and Color word Stroop test (CWST) for frontal/executive function domains are the representative tests included in the battery. Additionally, the Montreal Cognitive Assessment (MoCA), and short version of the geriatric depression scale (SGDepS) were carried out. Outcomes were measured at the baseline, after 12 weeks, and after 24 weeks. The MoCA was additionally conducted after six weeks. Integrative Medicine Patient Satisfaction Scale (IMPSS)23 was measured after 12 and 24 weeks. Adverse events following the treatment were carefully documented throughout the study. Further, complete blood count, liver and kidney function tests were conducted before and after the treatment for safety evaluation.

    Statistical Methods

    Continuous variables are presented as mean ± standard deviation and categorical variables are presented as a frequency ({fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). The linear mixed model for repeated measures was used to compare clinical outcomes over time. The least-squares mean and standard deviation over time were calculated. Additionally, mean differences and 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} confidence intervals of week 6, week 12, and week 24 compared to baseline scores (week 0) were estimated. Tukey’s method was used to adjust the p-value for the multiple comparisons. The minimal clinically important difference (MCID) and minimum detectable change (MDC) were considered for the interpretations of the results. For the SNSB-II five cognitive function domains T scores, 5 points (0.5 SD) were adopted as distribution-based MCID.24 For the MoCA total score, 4 points were reported as the MDC in previous study.25 Statistical analyses were performed using R version 4.0.226 with a significance level of 5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and a two-sided test.

    Results

    Baseline Demographic and Clinical Characteristics

    Baseline demographic and clinical characteristics of total enrolled patients and patients who were prescribed SHS and PMT are presented in Table 3. One patient had mild dementia and 19 patients had MCI. Baseline demographic and clinical characteristics of patients who were prescribed YMJ, BHS, and YGJ are presented in Table S2. Of the 20 patients, the mean age was 71.0 ± 5.1 y, and 85.0{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} were female. The KM pattern score of fire-heat was higher among patients who were prescribed SHS. Two patients who were prescribed YGJ displayed higher KM pattern scores in qi-deficiency and phlegm-dampness.

    Table 3 Baseline Demographic and Clinical Characteristics

    Clinical Outcomes

    Among the five cognitive function domains of SNSB-II, language, visuospatial function, memory, and frontal/executive function domains improved following herbal medicine treatment compared to baseline (Table 4). Considering the mean changes from the baseline in these three domains, T scores were larger than 5 points (0.5 SD) indicating MCID. Specifically, memory domain T score increased from 40.93 ± 11.52 to 51.74 ± 11.52 after 12 weeks (mean difference: 10.80 [95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI: 5.30, 16.30], p =0.0015), and to 56.61 ± 11.75 after 24 weeks (mean difference: 15.68 [95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI: 10.00, 21.35], p <0.0001). The scores for cognitive tests included in each cognitive function domain generally improved after the treatment (Table S3). SGDepS decreased; however, this trend was not statistically significant. Subgroup analyses were performed for patients who were administered SHS or PMT and displayed tendencies similar to the results for all patients (Table S4 for SST, Table S5 for PMT).

    Table 4 SNSB-II Five Cognitive Function Domains T Score, and SGDepS Before and After the Treatment

    The MoCA score gradually improved after the treatment over time (Table 5 and Figure 2). At the week-12 follow-up, the MoCA score increased from 17.73 ± 5.28 to 21.96 ± 5.42 (mean difference: 4.23 [95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI: 2.60, 5.86], p < 0.0001). The mean change from the baseline in MoCA score was larger than 4 points which corresponded to MDC. The result of the KM pattern scores is also presented in Table 5. There was no consistent tendency according to time in the scores for qi-deficiency or yin-deficiency. Scores for phlegm-dampness and fire-heat tended to decrease over time after the treatment; however, this trend was not statistically significant. Patients’ satisfaction with the treatment was measured by the IMPSS at weeks 12 and 24 (Table 6); 50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and 64{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of the patients answered that they were satisfied or very satisfied with the herbal medicine treatment, respectively.

    Table 5 Montreal Cognitive Assessment (MoCA) and Korean Medicine (KM) Pattern Scores Before and After the Treatment

    Table 6 Integrative Medicine Patient Satisfaction Scale (IMPSS) After the Treatment

    Figure 2 Montreal Cognitive Assessment (MoCA) score for patients over time.

    Safety Outcomes

    During the study period, five adverse events were reported from four patients. Two adverse events from one patient that were likely related to the interventions. A patient who was administered YMJ reported mild adverse events of nausea and chest discomfort, and both symptoms completely resolved naturally without further intervention. There were no other intervention-related adverse events reported by the remaining patients. No serious adverse event was observed in the study. The complete blood count, and liver and kidney function tests conducted at baseline and week 24 indicated no clinically significant changes (Table S6).

    Discussion

    Herbal Medicine for Patients with Neurocognitive Disorders

    In this observational study of patients with neurocognitive disorders who planned to be treated with herbal medicine, SHS (30{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) and PMT (25{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) were frequently prescribed. Following herbal medicine treatment, the patients’ cognitive functions improved at the 12 and 24 weeks’ follow-ups. In KM pattern scores, phlegm-dampness and fire-heat scores tended to improve after the treatment. Throughout the study, mild adverse events of nausea and chest discomfort were reported; however, no serious adverse events occurred.

    Various herbal medicine formulae were used in this study according to the pattern identification of each patient. YMJ, which is consists of six crude herbs reinforcing yin-deficiency, was reported to ameliorate cognitive impairment in a mouse model.27 Additionally, YMJ showed effectiveness in improving dry mouth (xerostomia) a typical symptom of yin-deficiency, for older adult patients.28 SHS includes three crude herbs that clear heat; Rhei Radix et Rhizoma and Coptidis Rhizoma are also included in the herbal granule, GRAPE formula, which demonstrated significant benefit for patients with AD.13 PMT is composed of herbs to enhance Qi and blood, and PMT-containing formula attenuated memory deficits in in vivo studies.29,30 Moreover, BHS prevented lipopolysaccharide-induced cognitive impairment and neuroinflammation in mice.31 The herbal medicine formulae used in this observational study demonstrated potential effects on cognitive impairment in previous animal and human studies.

    In this study, we used licensed herbal medicine products manufactured by pharmaceutical companies that were produced according to the Korean Herbal Pharmacopoeia (KHP), and modification of compositional herbs was not possible. Therefore, the use of frequently added herbs for cognitive disorders, such as Acori Graminei Rhizoma and Polygalae Radix32–34 was difficult. In this study, the patients’ cognitive functions generally improved after the herbal medicine treatment, even without those herbs. Another similar study incorporated licensed herbal medicine products for patients with MCI,35 and reported that older adults demonstrated improvement in MoCA score after six months of herbal medicine treatment. The modified Guibi-tang (Guipi-tang in Chinese, Kihi-to in Japanese) was the most frequently used formula (48.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) in the study, and its composition and indication are similar to PMT.

    KM Patterns of Patients with Neurocognitive Disorders

    The KM patterns of the enrolled patients were determined by combining the results of PIT-C and clinicians’ examination in this study. At the baseline assessment, six patients had a Fire-heat pattern (30{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), five patients had a Qi and blood-deficiency pattern (25{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), four patients had a Phlegm-dampness pattern (20{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), three patients had a Yin-deficiency pattern (15{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), and two patients had Qi-deficiency pattern (10{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). In another study of TCM constitution in 152 patients with MCI, neutral was the most frequent constitution (33.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), followed by Qi-deficient (33.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), Yang-deficient (21.7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), Phlegm-dampness (9.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), and Blood-stasis (7.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}).12 In a study of 52 mild to moderate patients with AD, liver-kidney yin deficiency was the most frequent pattern (64.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}).36 In a randomized controlled trial of patients with mild to moderate AD, appropriate herbal medicine was prescribed according to the pattern identification of Heart Qi-deficiency, Kidney Yin-deficiency, Phlegm-dampness, and Blood stasis.37 In previous studies, patterns of Qi-deficiency, Yin-deficiency, Phlegm-dampness, and Blood stasis were commonly reported among patients with neurocognitive disorders.

    After the 12 to 24 weeks of herbal medicine treatment, KM patterns of phlegm-dampness and fire-heat score improved, whereas qi-deficiency and yin-deficiency scores did not. The deficiency patterns may require longer treatment to improve compared to excess patterns, such as phlegm-dampness and fire-heat. In a previous study of patterns among patients with AD, Shen (Kidney) deficiency was observed throughout all stages of AD.14 For patients with MCI, Qinggongshoutao, which is traditionally known to enhance kidney function, was administrated for 52 weeks in a randomized controlled trial.38,39 In that study, 67.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of patients who were administrated herbal medicine showed improvement in deficiency of kidney essence, after the relatively long treatment period. In general, deficiency patterns are more commonly observed in chronic disease than acute disease.40–42 To observe the improvement in Qi-deficiency and Yin-deficiency pattern scores for patients with MCI, the administration period of herbal medicine probably needs to be longer than 12 weeks.

    There are a few other studies that reported changes in TCM, KM pattern syndrome in patients with MCI. In a study of patients with MCI, TCM syndrome scores, including kidney essence deficiency, phlegm, and blood stasis were reduced after treatment with herbal medicine.43 Another herbal medicine formula, Huannao Yicong formula, also reported to improve the Chinese Medicine Symptom Scale (CM-SS) as well as cognitive function in patients with mild to moderate AD.44 The two previously mentioned studies incorporated only the sum of each TCM pattern score. To evaluate the effect of herbal medicine for patients with neurocognitive disorders, the development of common TCM or KM pattern scores is needed. There is limited information regarding the blood stasis pattern symptoms in PIT-C.15 It would be preferable if the revised pattern identification tool were capable of reflecting the stage of the cognitive disorders and contain essential patterns of cognitive disorders; Qi-deficiency, Yin-deficiency, Phlegm-dampness, Blood stasis, and Fire-Heat.

    Limitations and Interpretation

    There are several limitations to our study. First, it was an observational study without a control group. The effect of herbal medicine on neurocognitive impairment was measured by comparing the baseline and the post-treatment, which cannot exclude the possibility of the placebo effect and the influence of the learning effect. The results of this study is not sufficient to conclude the effect of herbal medicine on neurocognitive impairment. However, the mean change from the baseline after the treatment in MoCA showed improvement beyond the MCID and MDC, indicates the potential clinical effect of herbal medicine on cognitive function. Second, various formulae were used for patients, and the results cannot answer the question of which formulae, herbs, or components were effective for cognitive function improvement. Third, the sample size was relatively small. Nevertheless, cognitive function and KM pattern scores were observed before and after the herbal medicine treatment. For most patients with cognitive disorders, compliance on taking herbal medicine three times a day was higher than 70{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, and cognitive functions generally improved after the treatment. There was no clinically significant abnormal change observed after the treatment on assessment by the liver and kidney function tests. Additionally, we used licensed herbal medicine products in Korea, which are also available in China and Japan, and can be easily applied in the real-world clinical setting.

    Conclusion

    This study explored the effect of herbal medicine treatment according to the KM pattern identification for patients with MCI and early dementia. Application of the herbal medicine treatment approach used in this study could be considered a possible option with very few undesirable side-effects and potentially improve cognitive function in patients with MCI. Further research is needed to objectify the KM pattern identification process and evaluate the KM pattern-related signs and symptoms.

    Acknowledgments

    This research was supported by grants from Korea Institute of Oriental Medicine [KSN2021230]

    Disclosure

    The authors report no conflicts of interest in this work.

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  • Alternative Medicine Market Recovery and Impact Analysis Report – Herbal Hills, Thorne Research, Herb Pharma, Helio USA, Pure encapsulations

    Alternative Medicine Market Recovery and Impact Analysis Report – Herbal Hills, Thorne Research, Herb Pharma, Helio USA, Pure encapsulations

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