Journal of Thai Traditional and Alternative Medicine

Vichai Chokevivat — 2024-08-29

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Development Enhancing Health Literacy Program to Cannabis used on Medication among medical cannabis users in Chao Phraya Yommarat Hospital

Korapin Phanwichian — 2024-08-29

Introduction and Objectives: Medical cannabis was new thing in Thailand. In addition, the knowledge was not yet extensive and still no sufficient research. This study aims to develop literacy program to cannabis used on medication among medical cannabis users.

Methods: sample group were 33 service recipients of modern medical cannabis clinic in Chao Phraya Yommarat Hospital Suphanburi Province. Results of developing program to enhance knowledge about medical cannabis for service recipients includes program manual for enhancing knowledge about medical cannabis and video about Medical cannabis health literacy. Data collection tool was questionnaire on medical cannabis knowledge of medical cannabis service recipients and a quality assessment of program to enhance knowledge about medical cannabis among medical cannabis service recipients. Research instrument was CVI = .84 - 1 and alpha coefficient = .94. Data were analyzed using descriptive statistics and health literacy was compared using t-test statistics.

Results: The program to enhance knowledge about medical cannabis 4 components as follows: access to information and understanding of medical cannabis, correct communication, information decision to use medical cannabis and practical aspects of self-management of service recipients. In terms of effectiveness, it was found that after participating program to enhance health literacy about medical cannabis among service recipients was mean increase of health knowledge score regarding medical cannabis statistically significant (p-value ≤ 0.05).

Discussion: Developing program to enhance knowledge about medical cannabis in order to use medical cannabis correctly, appropriately and with maximum benefit to patient.

Conclusion and Recommendation: This program enhances knowledge about medical cannabis accurate and appropriate for medical cannabis services.

Keywords: Health Literacy, Medical Cannabis

Monograph of Select Thai Material Medica: (CHINGCHI-RAK)

Subcommittee on the Preparation of Monographs of Selected Thai Materia Medica — 2024-08-29

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Dictionary of Traditional Chinese Medicine Volume 2 (Chinese-Thai-English) (18)

Tawat Buranatawonsom — 2024-08-29

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Effectiveness of Self-massage with Langkasuka Oil for Treating Neck and Shoulder Pain in Patients with Office Syndrome

Weahalimah Hajicheteh — 2024-08-29

Introduction and objective: Neck and shoulder muscle pain in patients with office syndrome affects their work efficiency. This research aimed to explore the effects of self-massage with Langkasuka oil to treat neck and shoulder pain in patients with office syndrome. The results will provide an treatment option for patients with office syndrome.

Methods: A double-blinded, randomized controlled trial was conducted in 60 patients aged 18–45 years with neck and shoulder pain due to office syndrome in the Thai traditional medicine clinic at Khok Pho Hospital. The participants were assigned either to the intervention group with Langkasuka oil massage or the control group that received massage with a placebo (oil without herb). Both groups received 60 mL of oil to massage the neck and shoulder muscles once a day for 7 consecutive days. The muscle pain was evaluated using a visual analog scale and the degrees of neck movement in six directions were measured. Satisfaction and adverse reactions were also assessed. A comparison of treatment results between groups was undertaken with an independent sample t-test with statistical significance at p < 0.05.

Results: The levels of pain and the degrees of neck movement before and after self-massage in the intervention group and the control group for relieving neck and shoulder pain were significantly different (p < 0.001). The average pain levels in the experimental group dropped from 6.33 + 1.26 before treatment to 2.70 + 0.79 after treatment, while those in the control group before and after treatment were 5.90 + 1.26 and 3.83 + 1.20, respectively, resulting in the average pain level difference in the experimental group of 2.09 + 1.59. In sum, the average pain level of the intervention group improved significantly more than that in the control group (p < 0.001), and the degrees of neck movement in all six positions increased significantly (p < 0.05). Overall satisfaction in both groups was at a high level. However, adverse reactions were found in one person in the experimental group who had dizziness, while in the control group one person had red skin and another one had itchy skin.

Discussion: Self-massage with Lankasuka oil could significantly reduce pain levels and increase the degrees of movement of the neck in six directions (p < 0.001) because self-massage was not too forceful. The massage could reduce muscle tightness, make the clients feel comfortable and increase relaxation. With the use of oil containing herbal ingredients with anti-inflammatory properties, the massage effectiveness was enhanced.

Conclusion and recommendation: Self-massage with Langkasuka oil can relieve neck and shoulder pain in patients with office syndrome. However, the oil should be further developed so that it can be absorbed quickly into the skin, the oil color does not stain clothes, and it has a good smell and can be used conveniently.

Safety and Pharmacokinetics Study of Boesenbergia rotunda (L.) Mansf. Capsules in Healthy Thai Volunteers: A Phase 1 Clinical Study

Monthaka Teerachaisakul — 2024-08-29

Introduction and objective: Recently, there are a number of preclinical studies of “KraChai” or “Finger root”, Boesenbergia rotunda (L.) Mansf., showing its efficacy as anti-inflammation and anti-viral including SARS CoV-2. However, no report of its efficacy in clinical trials. This study therefore aims to study pharmacokinetics of Boesengergia rotunda (L.) Mansf. extract with 2 active pharmaceutical substances which are Pinostrobin and Panduratin A, as well as to study the safety of KraChai extract containing Pinostrobin and Panduratin A not less than 30 mg and 9 mg, respectively.

Method: This study was conducted in 11 healthy volunteers. All healthy volunteer was assigned to take 3 capsules of KraChai extract per meal and 3 meals a day continuously for 7 days.

Result: After taking KraChai extract for 7 consecutive days, the result showed that the maximum concentration of Pinostrobin and Panduratin A were 15.07±6.66 and 63.26±21.73 ng/mL., respectively. The maximum concentration time (T_max) were 2.67±0.89 h and 3.00±0.95 h., respectively. The half-life value (T_1/2) of Pinostrobin and Panduratin A were 8.07±2.93 h and 5.51±2.62 h., respectively. No adverse events have been reported. Additionally, characteritics of blood pressure and body temperature were normal. However, this study found the Hematological Blood Profile revealed significant trends in Hemoglobin (Hb), Hematocrit (Hct), Red blood cell (RBC), and Blood Urea Nitrogen (BUN), with significant decreasing level by p value <0.01, 0.02, <0.01, and 0.02, respectively. Also this study found significant increasing level of Total CO₂ with p-value at 0.01. However, when stop taking KraChai extract after 3 days (Day10) the level of BUN and Total CO₂ had returned into normal stage, while the level of Hemoglobin, Hematocrit and RBC were remained low within a normal range with p-value <0.01, <0.01 and <0.01, respectively. Moreover, this study found significant decreasing level of C-reactive protein (p-value = 0.04).

Discussion: When taking KraChai extract at a dosage of 1,350 mg/day for 7 days consecutively (multiple doses), it was observed that the levels of Pinostrobin and Panduratin A in the blood increased sequentially until reaching their peak levels and then gradually decreased over time. Additionally, the continuous intake of KraChai extract at this specified dosage had no effect on the liver, kidneys, and electrolytes.

Conclusion and Recommendation: This study revealed that intake of KraChai extract capsule, containing Pinostrobin and Panduratin A at amount of 270 mg/day and 81 mg/day respectively, 7 days consecutively is safe. This study is also confirming the anti-inflammation property of Boesengergia rotunda (L.) Mansf. extracts in human study.

Effects of Andrographis paniculata and Favipiravir Combination and Monotherapies on Liver Biochemistry in COVID-19 Patients: A Retrospective Cohort Study

นภัสชญา เกษรา — 2024-08-29

Introduction and Objective: This study addresses the National Clinical Practice Guideline (CPG) that did not recommend using a combination of favipiravir (FV) and Andrographis paniculata (Burm. f.) Nees (AP, or Fa Thalai Chon in Thai) crude drug (144 mg of andrographolide per day) in the treatment for COVID-19 due to potential serious side effects. The objective is to assess the safety profile of this combination compared to individual
drug use, specifically focusing on liver biochemistry. Additionally, the study aims to identify factors influencing
liver function in patients after FV and/or AP usage.
Methods: The retrospective design involved retrieving medical records of COVID-19 patients who were
admitted to Chao Phya Abhaibhubejhr Hospital between January 1 and December 31, 2021, and who received
either FV, according to the recommended dose by the CPG for 5–10 days thereafter, or AP, with a dose of 4.8 g of
standardized powder (equivalent to 144 mg of andrographolide) per day for 5 days, or a combination of both. The
monitoring was undertaken to identify abnormalities in patients’ liver enzymes, namely aspartate transaminase
(AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and total bilirubin (TB), by identifying deviations
of 2–3 times beyond the upper limit of normal (ULN).
Results: Following the inclusion and exclusion criteria, the records of 564 cases were analyzed. In the assessment
of post-treatment liver enzyme elevation at least 2 times ULN, AP groups (prescribed to younger, healthy
patients) showed no elevations in all four enzymes, and no group displayed increased ALP or TB levels. However,
0.87% in the FV+AP group had AST levels exceeding 3 times ULN, while 1.06% and 2.17% in the FV and FV+AP
groups showed ALT levels over 3 times ULN. One case of drug-induced liver injury (DILI) was observed in both
FV and FV+AP groups. No significant factors increasing abnormal liver enzyme likelihood were identified.
Discussion: Some of the findings could support safety concern regarding the use of combined FV and AP.
However, it should be noted that patients receiving FV and FV+AP may exhibit greater disease severity, so may
those with higher doses of FV medication, underlying diseases, advanced age, and other concurrent medications.
Therefore, it is difficult to conclusively determine whether liver abnormalities are solely attributable to the FV or
FV+AP medication.

Conclusions and Recommendations: The study indicates that AP at a dose of 144 mg/day showed a
promising safety profile for liver function, suggesting its suitability for young and healthy patients. AP should
also be considered safe for common cold and influenza, with a dosage 3 times lower than that for COVID-19.
However, 1.06% and 2.17% of patients in the FV and FV+AP groups had ALT levels exceeding 3 times, and
0.87% in the FV+AP group had AST levels exceeding 3 times ULN, indicating susceptibility to drug-induced liver
injury (DILI). Therefore, careful monitoring of liver function is warranted following the administration of FV and
FV+AP, especially in older patients, those with underlying diseases, and those taking concomitant medications
metabolized in the liver.

Antioxidant Activity of Makham Pom (Phyllanthus emblica L.) Fruit and Its Neuroprotective Effect on Hydrogen Peroxide and Glutamate-Induced Neurotoxicity in Mouse Neuroblastoma Cells

Sadudee Rattanajarasroj — 2024-08-29

Introduction and objective: Oxidative stress has been implicated in pathogenesis of neurodegenerative diseases. Phyllanthus emblica L. (Makham Pom in Thai) fruit has potent antioxidant activity and may be used to alleviate oxidative stress-induced neurodegenerative process. This study was designed to investigate the antioxidative and neuroprotective activities of P. emblica fruits on hydrogen peroxide (H₂O₂) and glutamate-induced neurotoxicity in N1E-115, mouse neuroblastoma cell cultures.

Methods: P. emblica fruit juice (PE-J), water extract (PE-W) and ethanol extract (PE-E) were used in this study. All samples were evaluated for antioxidative activity using hydroxyl and superoxide scavenging assay. The neuroprotective activity was investigated using hydrogen peroxide (H₂O₂) and glutamate-induced neurotoxicity in N1E-115 cells. Cell viability was evaluated using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) reduction assay. Moreover, we also determined the protective effect of P. emblica fruits mediated via mitogen activated protein kinase (MAPK) or phosphatidylinositol 3-kinase (PI3K) sinaling pathway. Inhibitors of intracellular signaling cascade were used in this study.

Results: PE-J, PE-W and PE-E exhibited efficient antioxidant activities. Pre-exposure of cultured neurons with PE-W or PE-E before H₂O₂ exposure could protect cell injury from H₂O₂while co-exposure of cultured neurons to H₂O₂ with each sample did not show this beneficial effect. Both pre-exposure and co-exposure with all samples did not prevent glutamate-induced neurotoxicity in cultured neurons. In addition, PI3K inhibitor prevented PE-W and PE-E-induced neuroprotection, but MAPK inhibitor failed to counteract their protective effects.

Discussion: P. emblica fruits exhibited efficient antioxidant activities which are consistent with previous studies. Pre-exposure of cultured neurons with PE-W or PE-E before H₂O₂ exposure could protect cell injury from H₂O₂. It is possible that the protective effect might at least partly result from their antioxidative properties. PI3K inhibitor prevented PE-W and PE-E-induced neuroprotection against H₂O_2,suggesting that the neuroprotective mechanisms might involve PI3K signaling pathway.

Conclusion and recommendation: This study indicated that P. emblica fruits showed the neuroprotective effect on H₂O₂-induced neurotoxicity. The neuroprotective mechanisms might partly involve an antioxidant property and PI3K signaling pathway. It is suggested that further studies on other degenerative models and animal models are required to clarify its efficacy and delineate the underlying mechanisms prior to the development as herbal health products.

Stimulatory Effect of Thai Herbal Plant Extracts on Lymphocytes for Destruction of Cultured Chronic Myeloid

Supaporn Suparak — 2024-08-29

Introduction and Objective: This research aims to screen and evaluate the effects of Thai herbal extracts in stimulating white blood cells, specifically lymphocytes, to destroy cultured leukemia cells at the in vitro level.

Methods: Herbal extracts were utilized to stimulate peripheral blood mononuclear cells (PBMCs) in the laboratory for 24 hours. Subsequently, the PBMCs were cultured with K-562 CCL-243™ chronic myelogenous leukemia cell line labeled with the fluorescent dye Carboxyfluorescein succinimidyl ester (CFSE) for 4–6 hours. The K-562 CCL-243™ cell line was then stained with Propidium iodide (PI) to identify dead cells, and analyzed using a flow cytometer. The destroyed K-562 CCL-243™ cell line was stained with PI and CFSE, while the viable cells remained stained only with CFSE.

Results: Testing the activity of 17 herbal plant extracts on PBMCs from donated blood (3 donors) revealed that 5 herbal extracts could significantly stimulate PBMCs to destroy K-562 CCL-243™ cell line compared to unstimulated control PBMCs. The effective herbal extracts include HID (Helicteres isora L. aqueous extract), CSS (Cannabis sativa L.), CCF (fresh cinchona, Cinchona ledgeriana Moens.), CCD (dried cinchona), and AED. 1 (Pilangkasa, Ardisia elliptica Thunb.).

Discussion: While this study tested PBMCs stimulation in three healthy volunteers and conducted statistical analyses, future research should consider increasing the number of volunteers and including blood samples from leukemia patients to enhance the confidence of the test results.

Conclusion and Recommendation: The laboratory test results indicate the scientific properties of Thai herbal extracts, demonstrating their ability to stimulate PBMCs and destroy K-562 CCL-243™ cultured cancer cells at the in vitro level. Therefore, further research should focus on identifying the active ingredients and mechanisms of these herbal extracts to confirm their efficacy in destroying cancer cells. This could contribute to the development of Thai medicine, promoting the utilization of Thai medicinal plants for leukemia treatment.

Anti-Acne-Causing Bacterial and Anti-tyrosinase Activities and Chemical Content of Chatuphalathika Herbal Extracts Derived from Different Extraction Methods

Jittiporn Chaorai — 2024-08-29

Introduction and Objectives: Bacteria are an important cause of acne. After acne appears, inflammation is induced, leading to tyrosinase activity, and ultimately, dark spots occur. Jatupalathika herbal formula consists of four plant ingredients in equal ratios: Terminalia chebula Retz., Terminalia arjuna (Roxb. ex DC.) Wight & Arn., Terminalia bellirica (Gaertn.) Roxb. and Phyllanthus emblica L. The plant ingredients of the Jatupalathika remedy contain phenolic compounds and tannin that have been reported to inhibit bacteria causing acne and tyrosinase enzyme. However, the Jatupalathika herbal formula has not yet been reported as antibacterial, or anti-tyrosinase. Therefore, this study compared extraction methods for chemical content and anti-bacterial and anti-tyrosinase activities of Jatupalathika.

Methods: Jatupalathika was extracted using ethanol and water. Then the extracts were tested for antibacterial activity by broth microdilution. Anti-tyrosinase activity was investigated using L-dopachrome, and chemical analysis by high-performance liquid chromatography (HPLC).

Results: The maceration ethanolic extract of Jatupalathika showed the highest antibacterial activity against C. acnes, S. aureus, and S.epidermidis. The reflux ethanolic extract of Jatupalathika had a similar effect to the maceration ethanolic extract. Moreover, the maceration ethanolic extract expressed the highest anti-tyrosinase activity and chemical content, followed by reflux ethanolic extract and aqueous extract.

Discussion: The maceration ethanolic extract of Jatupalathika showed the best effect and highest chemical content. Ethanol extraction apparently increases active compound stability, while maceration is extraction without heating. This is unlike reflux and decoction extraction methods with direct heating that affects active compound degradation. In this way, the heating process may reduce antibacterial and anti-tyrosinase activities.

Conclusions and Suggestions: Maceration in ethanol is a suitable method for extracting Jatupalathika. It produced Jatupalathika extract showing the highest chemical content, antibacterial and anti-tyrosinase activities; the result was suitable for a product inhibiting bacteria causing acne. Jatupalathika obtained by reflux extraction had the highest bacterial inhibition, similar to maceration with ethanol. For suitable extraction, macerate in 95% ethanol to obtain effective extracts, which may help future product development planning.

Antimicrobial Activity and Toxicity of the Ethanolic Extracts from Garcinia xanthochymus

ปฐมาพร ปรึกษากร — 2024-08-29

Rational and Objective: Egg tree, or Garcinia xanthochymus Hook.f. ex T.Anderson (Madaluang in Thai), is a fruit tree distributed widely in Southeast Asian countries as well as China and India. The ripe fruit is edible and has a sweet and sour taste. This plant has been reported to have a wide range of pharmacological activities. However, the use and consumption of G. xanthochymus are still limited in Thailand. This study aimed to examine antimicrobial activity and evaluate toxicity of the ethanolic extracts obtained from the leaves, ripe fruits, and seeds of G. xanthochymus.

Methodology: Antimicrobial activity testing was performed by the broth microdilution method. The extracts were evaluated for cytotoxicity in human skin keratinocytes (HaCaT cell line) using the MTT assay and brine shrimp toxicity.

Results: The results showed that all three extracts exhibited antimicrobial activity against various pathogenic microorganisms. The fruit and seed extracts of G. xanthochymus showed antibacterial activity against cariogenic bacteria, skin commensal bacteria, and vaginal pathogenic bacteria at minimum inhibitory concentration (MIC) values of 25-200 µg/mL. The cytotoxicity assay revealed that the fruit and seed extracts exhibited cytotoxic effects on HaCaT cells with IC₅₀ values of >100 and 91.25 µg/mL, respectively. In addition, the fruit extract showed no toxicity to brine shrimps, whereas the seed extract was mildly toxic.

Discussion: The fruit and seed extracts of G. xanthochymus exhibited remarkable antibacterial activity, especially against skin commensal bacteria. The results support the ethnobotanical uses of this plant in India for the treatment of skin diseases and wound healing.

Conclusion and Suggestion: The findings suggest that G. xanthochymus has the potential to be utilized for consumption and development of health care products.

Free Radical Scavenging and Anti-inflammatory Activities of Wan Ma Lueang (Curcuma sp.) Extracts

Nicharee Jaikhamwang — 2024-08-29

Introduction and objectives: Wan Ma Lueang (Curcuma sp.) in the Zingiberaceae family is a local Thai herb with properties for relieving body aches and sprains. This study aimed to investigate the free radical scavenging and anti-inflammatory activities of wan ma lueang extracts.

Methods: Wan Ma Lueang from Khung Taphao subdistrict in Uttaradit province was used for the extraction using fermentation techniques with methanol, ethanol and hot water reflux. The chemical components in the Wan Ma Lueang extracts were studied; and the extracts were tested for free radical scavenging activities by DPPH and ABTS assays. The concentrations of the extracts were tested for the effect on cell survival rate; and anti-inflammatory activities were tested using the nitric oxide (NO) production process in macrophage cells.

Results: The chemical components were studied using LC-MS analysis of Wan Ma Lueang extracts with methanol, ethanol, and hot water reflux. Similar compounds were found, namely demethoxycurcumin and curcumin. The free radical scavenging values of Wan Ma Lueang extracts using the DPPH assay were 0.63 ± 0.03, 0.76 ± 0.04 and 1.31 ± 0.20 mg/mL respectively; and the values derived from the ABTS assay were 169.00 ± 4.32, 136.55 ± 4.35 and 70.83 ± 7.07 µM/g respectively. The Wan Ma Lueang ethanol extracts did not exhibit any cytotoxicity to cells at the highest concentration of 10 µg/mL. The concentration exhibited a cell survival rate of over 90% and inhibited NO by an average of 55.3%.

Discussion: In the chemical analysis of Wan Ma Lueang extracts, the largest amount of active ingredients was found in the methanol extract, followed by those in the ethanol and hot water reflux extracts. A comparative analysis of main active ingredients in all three Wan Ma Lueang extracts with different solvents revealed similar compounds, namely curcumin and demethoxycurcumin.

Conclusion and recommendation: The Wan Ma Lueang extracts were found to have free radical scavenging and anti-inflammatory activities. The knowledge could be applied when developing products for further raising the values of Wan Ma Lueang in the future.

Phytochemical and Free Radical Scavenging Activities of Green Arabica Coffee Beans Cultivated in Thailand

Butsarakham Singchai — 2024-08-29

Introduction and objective: In Thailand, a famous Arabica coffee is widely grown in the North. However, this species has also been grown in recent years in Phetchaburi province, but it is not yet widely known. Therefore, this research aimed to analyze phytochemicals and free radical scavenging activities, examine the identity of the extracts by means of silica gel thin-layer chromatography, and determine the chlorogenic acid and caffeine contents of six green bean samples of Arabica coffee grown in Thailand.

Methods: The samples of ground dried coffee beans were extracted with 95% ethanol. Ten groups of phytochemicals were examined, including flavonoids, alkaloids, coumarins, tannins, cardiac glycosides, steroids, terpenoids, anthraquinones, saponins, and reducing sugars. The chromatogram characteristics of the coffee samples were successively examined using thin layer chromatography technique being observed under UV wavelength of 254 nm with chlorogenic acid and caffeine as standard substances, and reacting with specific reagents of anisaldehyde in sulfuric acid and DPPH solutions on a chromatogram plate. The antioxidant activity was the determination of DPPH scavenging by using UV-spectrophotometry technique. The chlorogenic acid and caffeine contents were also determined by measuring absorbance at wavelengths of 330 and 272 nm, respectively. The statistics used in this research included percentage, mean, standard deviation and t-value.

Results: The same phytochemicals were found in all the coffee extract samples. The seven groups of chemical constituents were flavonoids, alkaloids, coumarins, tannins, steroids, terpenoids, and reducing sugar. All the extracts showed the same chromatogram characteristics in all gradients of organic solvent systems. In addition, most of the extracts had high 50% free radical scavenging (SC₅₀) levels of 3.48–9.93 mcg/mL. The chlorogenic acid and caffeine contents in all green coffee bean extracts were 4.72–7.95% and 0.24–0.45%, respectively, and the differences were statistically significant at the 0.05 level.

Discussion: All samples of Arabica coffee grown at similarly high altitudes had the same key phytochemical groups by using chemical reaction test and thin layer chromatography technique. Almost all samples showed higher free radical scavenging activities than vitamin C, according to this study using a quick and convenient technique as spectrophotometry. In addition, all coffee samples had chlorogenic acid and caffeine contents in the range of the international coffee bean quality standards, and were related to high free radical scavenging activities.

Conclusion and recommendation: The green bean samples of Arabica coffee cultivated in Phetchaburi province, western Thailand, have the same type of phytochemical groups as those grown in the North. Therefore, it is appropriate to conduct further studies on this coffee species in terms of nutrition, biological activities, and develop for health products

Development and Validation of Analytical Method for Quatitative Analysis of Andrographolide from Androdraphis paniculata Products by High Perfomance Liquid Chromatography

Prapapun Sukphan — 2024-08-29

Introduction and Objective: Due to the outbreak of coronavirus disease 2019 (COVID-19), Andrographis
paniculata, or Fa Thalai Chon in Thai, has been used to treat this disease, leading to more varieties of A. paniculata
products available in the market. Therefore, an analytical method was developed to determine the andrographolide
content in three variants of A. paniculata products: A. paniculata capsules, A. paniculata extract capsules, and
A. paniculata extract tablets. The method will be used for the quality control of A. paniculata products in the
market.
Methods: The study was divided into two parts: (1) development of a method for extraction of
A. paniculata in products using methanol as a solvent and ultrasonic sonication and (2) validation of the analytical
method according to the ICH Guidelines using High Performance Liquid Chromatography (HPLC) technique with a Zorbax C18 column (4.6 5 150 mm, 5-μm particle size). The mobile phase was a mixture of water and methanol (50:50), with a flow rate of 1.0 mL/min, and detection under UV light at the 224 nm wavelength.
Results: The 5-minute methanol extraction of A. paniculata followed by a 15-minute extraction with 50% methanol, coupled with ultrasonic sonication, yielded an andrographolide content comparable to that achieved
using the Thai Herbal Pharmacopoeia 2021 extraction method. This method demonstrated specificity and a linear
relationship for the concentrations ranging from 0.02 to 0.14 mg/mL, with a correlation coefficient (r) of ≥ 0.9999.
Precision, represented by %RSD, ranged from 0.2% to 1.1%, while accuracy, measured by percentage recovery
fell within the 95% to 99% range. Moreover, the method exhibited robustness against variations in mobile phase
ratio, flow rate, and column temperature.
Discussion: The comparison between the reflux method and ultrasonic sonication method revealed that the latter is a viable alternative, offering ease of use, convenience, and elimination of carcinogenic chemicals like dichloromethane. Additionally, it reduced both the analytical time and extraction steps for andrographolide
extraction.
Conclusion: The developed HPLC method is suitable for analyzing andrographolide content in three variations
of A. paniculata products (capsules, extract capsules and extract tablets), encompassing all products found in the market

Survey of Medicinal Plants in the Community Forest Area of Doi Hang Subdistrict, Mueang District, Chiang Rai Province for Use as a Source of Medicinal Raw Materials for Caring for the Health of the Elderly

Suthida Wiriya — 2024-08-29

Background: The Doi Hang Subdistrict has 17.67% of elderly people with health problems. The elderly have limited access to healthcare facilities because some villages are in remote areas. There is a community forest in the area, so it is necessary to explore medicinal plants in the community forest area to use as a source of medicinal raw materials for caring for the health of the elderly. This article aims to study medicinal plants in the community forest area of Doi Hang Subdistrict, Mueang District, Chiang Rai Province, for use as a source of medicinal raw materials for caring for the health of the elderly.

Methods: This research is a mixed methods research study using surveys and qualitative research. There were 8 key informants who were experts in local herbs, using a purposive selection method. The tools used in this research consisted of 2 parts: in-depth interviews and group meetings.

Results: It was found that there were more than 181 types of herbs in the Doi Hang Subdistrict. They were grouped into 6 types according to their use in Thai traditional medicine: (1) 73 types of trees, (2) 49 types of climbers, (3) 21 types of rhizomes, (4) 12 types of vegetables, (5) 15 types of grasses, and (6) 6 types of vegetation, which encourage the elderly to use herbs to take care of their health. They are herbs that are easily available in the local area and have convenient methods of use, divided into 5 groups of herbs to cure symptoms according to disease groups as follows: (1) 7 types of herbs to cure symptoms of skin diseases, (2) 14 types of herbs to relieve symptoms of gastrointestinal diseases, (3) 9 types of herbs to relieve symptoms of respiratory diseases, (4) 1 type of herb to relieve symptoms of structural, joint, muscle, and tendon diseases, and (5) 2 types of herbs to relieve symptoms of wind disease.

Discuss the results: The survey of medicinal plants in the community forest area of Doi Hang Subdistrict found that there are local medicinal plants. That has the opportunity to be used to care for the health of the elderly, which encouraged people to be self-reliant, reduced health expenses and was a source of herbal raw materials to generate income from selling herbal raw materials to the elderly in the community.

Conclusions and recommendations: This research study is a survey of medicinal plants in the area of Doi Hang Subdistrict. The medicinal plants surveyed are local herbs. If the study results are used, they should be adjusted to suit the illness context of the people in the area. In the next research study, there should be a follow-up on the results of promoting health care for the elderly with herbs in the Doi Hang Subdistrict and used to develop guidelines for promoting health care for the elderly with herbs.

The Development of a Model for Promoting Rational Drug Use with Alternative Herbal Medicines in Quality Pharmacies Participating in the Common Illness Project in Nakhon Sawan Province

Piyaruedee chaisang — 2024-08-29

Introduction and objectives: Rational drug use in community pharmacies is a policy aimed at reducing the inappropriate use of drugs among Thai people, which requires collaborative efforts from pharmacists. Concurrently, the Common Illnesses (CI) management project by community pharmacists is operational under the Universal Health Coverage (UHC) Scheme. Therefore, this study aimed to: (1) investigate the situations and opinions on the use of herbal medicines (HMs) before and after the implementation of an alternative HM promotion program; (2) develop a model for promoting the use of alternative HMs; and (3) evaluate the model for alternative HM promotion after implementing the model.

Methods: This participatory action research project involved a sample of 11 pharmacists (one each) working at community pharmacies participating in the CI project, and some UHC (goldcard) patients who sought treatment for five conditions: fever, sore throat, runny nose, cough, and diarrhea. The research process had three phases: (1) studying baseline data and situation of the participating drugstores; (2) developing a model to promote the use of alternative HMs; and (3) evaluating the use of the model from August 2023 to March 2024 to compare the situations before and after implementing the model.

Results: Phase 1: The participants had experience in using Andrographis paniculata capsules, compound makham pom cough mixture, and mawaeng lozenges. However, Ya Chanthalila, Ya Ha Rak, Ya Prap Chomphu Thawip, and Ya Lueang Pit Samut were not available at the drugstores. Phase 2: The model for promoting the use of alternative HMs was developed and launched with training sessions, the provision of HMs and the establishment of a Line group for technical support. Phase 3: After implementing the alternative HM promotion model, stand-alone drugstores used more herbal medicines compared to chain drugstores. For fever and sore throat, more Andrographis paniculata capsules, Ya Chanthalila, and Ya Ha Rak were used, while the use of paracetamol, ibuprofen, amoxicillin, and roxithromycin decreased. For runny noses, the use of Ya Prap Chomphu Thawip increased, while the use of cetirizine, chlorpheniramine, and loratadine decreased. For diarrhea, the use of Ya Lueang Pit Samut increased, but the use of loperamide, dioctahedral smectite, and norfloxacin decreased. For cough, the use of mawaeng lozenges and Indian gooseberry cough syrup increased without affecting the use of modern medicines.

Discussion: The implementation of the herbal medicine promotion model resulted in more prescriptions of herbal drugs at stand-alone drugstores, where pharmacists had more autonomy in medication selection.

Conclusion and recommendation: Less use of modern drugs for relieving fever, sore throat, runny nose, cough, and diarrhea, particularly antibiotics, was found to lead to more rational drug use. Further studies should be conducted on herbal drugs with technical evidence by specifically comparing them with modern medicines so as to get more information for promoting rational drug use.

Journal Club

Thongchai Sooksawate — 2024-08-29

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Study on the Treatment of Low Back Pain Using Cupping Therapy in Traditional Chinese Medicine

Phatcharee Pimalram — 2024-08-29

Introduction and Objective: Low back pain (LBP) is a common health issue that significantly affects patients’ quality of life. Traditional Chinese medicine (TCM) offers interesting treatment modalities, particularly Cupping Therapy, whichhasgainedincreasingattentionfor the managementof LBP. This studyaimedtoreview andsynthesize researchevidenceontheuseof Cupping Therapyfor the treatmentof LBPinthe contextof TCM.
Methodology: This literature review involved the search in major electronic databases, including Thai Journal Online (ThaiJO), China National Knowledge Infrastructure (CNKI),PubMed, and Web ofScience, from January2014toDecember2023. Thekeysearchtermsincluded“traditional Chinesemedicine,”“Cupping Therapy,” “low back pain,” and “lumbarpain.”
Results: Cupping Therapyhasbeenfoundtosignificantlyreducetheintensityof lowerbackpain, improve the mobility of back muscles, and enhance the quality of life of patients. Furthermore, the therapy has a high safety profile and can be used in combination with other treatments, such as modern medications, Chinese herbal medicines, acupuncture, therapeutic bleeding, heat compress, or exercise, to enhance the overall effectiveness of the treatment.
Discussion: Cupping Therapy is an effective treatment modality for the management of lower back pain, which aligns with the TCM principle of restoring the body’s balance. When combined with other treatment approaches, the therapy can further improve the treatment outcomes. However, there are limitations in this study suchasvariations in Cupping Therapytechniques,heterogeneityof LBPsymptoms, anddifferences infollow-up durations, which warrant further investigation.
Conclusion and Recommendation: Cupping Therapyhasbeenfoundtobeaneffectivetreatment for lower back pain according to the TCM principles, and can be used in conjunction with other therapies to enhance the overall treatment efficacy.Specifically, the therapyhasbeenshowntosignificantlyreducepainintensity, improve spinal mobility,andenhancethequalityof lifeofpatients,andpossessahighsafetyprofile. Therefore, thetherapy maybeapromisingtreatmentoptionfor lower back pain. However, more in-depth studies are needed in the future to provide a deeper understanding of this therapeutic approach.

Literature Review of Thong Phan Chang (Rhinacanthus nasutus (L.) Kurz

Suratsawadee Piyaviriyakul — 2024-08-29

Introduction and objective: Thong phan chang, besides having an auspicious name in Thai, has medicinal qualities for treating illnesses. Research results have been reported in many areas, including basic science, medical science and other applications. The objective of this review was to enhance knowledge, deepen understanding and provide additional values of Thong Phan Chang herb. Then, the information will be the basis for further utilization of the herb.

Methods: The review of existing literature involved data retrieval from both national and international databases, including Google Scholar, PubMed, ScienceDirect, ResearchGate, Thai-Journal Citation Index Center, and various other educational, agricultural and beauty websites, etc. and the collection of relevant documents from 1988 through 2024, totaling 96 subjects.

Results: The review has shown that Thong Phan Chang is one of the important medicinal herbs used for treating diseases according to Thai traditional medicine. The content can be divided into three main topics. Firstly, the basic information about Thong Phan Chang, including the easy way for planting and propagation, the suitable harvest time, and the strain development. Secondly, important biological substances of Thong Phan Chang (naphthoquinones, or RN) such as rhinacanthin A (Rn-A) to rhinacanthin V (Rn-V). Particularly, rhinacanthin C (Rn-C) is a significant compound with multiple properties. Lastly, the pharmacological effects of Thong Phan Chang. It has been proven to be effective in multiple activities, such as prevention of malaria, prevention and treatment of diabetes, anti-fungal/anti-bacterial properties, boosting immune system, safeguarding nerve cells, and anti-cancer, anti-viral, antioxidant and anti-inflammatory properties. Moreover, there have been several reports on developments of many Thong Phan Chang crude extract products such as soap, liquid soap, deodorant roll-on, shampoo, medicine, and disinfecting gel.

Discussion: This review involved the retrieval of basic knowledge of Thai traditional medicine about herb planting, breed development, and main substances (active ingredients and biological activities). Thong phan chang is an interesting herb with great potential for the development of medicines for disease prevention and treatment as well as products for everyday use.

Conclusion and recommendation: Thong Chan Chang herb is easy to grow and useful in many options. With its basic scientific information, the review has yielded more knowledge and understanding beneficial to all concerned to further develop Thong Phan Chang-based health products and undertake extended clinical studies on the herb.

Policy and Ethics

Vichai Chokevivat — 2024-08-29

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Editor’s Note

Vichai Chokevivat — 2024-08-29

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Editorial Board

Vichai Chokevivat — 2024-08-29

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Journal of Thai Traditional and Alternative Medicine

Contents

Development Enhancing Health Literacy Program to Cannabis used on Medication among medical cannabis users in Chao Phraya Yommarat Hospital

Monograph of Select Thai Material Medica: (CHINGCHI-RAK)

Dictionary of Traditional Chinese Medicine Volume 2 (Chinese-Thai-English) (18)

Effectiveness of Self-massage with Langkasuka Oil for Treating Neck and Shoulder Pain in Patients with Office Syndrome

Safety and Pharmacokinetics Study of Boesenbergia rotunda (L.) Mansf. Capsules in Healthy Thai Volunteers: A Phase 1 Clinical Study

Effects of Andrographis paniculata and Favipiravir Combination and Monotherapies on Liver Biochemistry in COVID-19 Patients: A Retrospective Cohort Study

Antioxidant Activity of Makham Pom (Phyllanthus emblica L.) Fruit and Its Neuroprotective Effect on Hydrogen Peroxide and Glutamate-Induced Neurotoxicity in Mouse Neuroblastoma Cells

Stimulatory Effect of Thai Herbal Plant Extracts on Lymphocytes for Destruction of Cultured Chronic Myeloid

Anti-Acne-Causing Bacterial and Anti-tyrosinase Activities and Chemical Content of Chatuphalathika Herbal Extracts Derived from Different Extraction Methods

Antimicrobial Activity and Toxicity of the Ethanolic Extracts from Garcinia xanthochymus

Free Radical Scavenging and Anti-inflammatory Activities of Wan Ma Lueang (Curcuma sp.) Extracts

Phytochemical and Free Radical Scavenging Activities of Green Arabica Coffee Beans Cultivated in Thailand

Development and Validation of Analytical Method for Quatitative Analysis of Andrographolide from Androdraphis paniculata Products by High Perfomance Liquid Chromatography

Survey of Medicinal Plants in the Community Forest Area of Doi Hang Subdistrict, Mueang District, Chiang Rai Province for Use as a Source of Medicinal Raw Materials for Caring for the Health of the Elderly

The Development of a Model for Promoting Rational Drug Use with Alternative Herbal Medicines in Quality Pharmacies Participating in the Common Illness Project in Nakhon Sawan Province

Journal Club

Study on the Treatment of Low Back Pain Using Cupping Therapy in Traditional Chinese Medicine

Literature Review of Thong Phan Chang (Rhinacanthus nasutus (L.) Kurz

Policy and Ethics

Editor’s Note

Editorial Board