Journal of Thai Traditional and Alternative Medicine

Policy and Ethics

Vichai Chokevivat — Thu, 25 Dec 2025 00:00:00 +0700

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Instructions to Authors (Revised 2025)

Department of Thai Traditional and Alternative Medicine — Thu, 25 Dec 2025 00:00:00 +0700

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Vichai Chokevivat — Thu, 25 Dec 2025 00:00:00 +0700

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Editor's Note

Vichai Chokevivat — Thu, 25 Dec 2025 00:00:00 +0700

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Monograph of Select Thai Material Medica: KRAWAN

Subcommittee on the Preparation of Monographs of Selected Thai Materia Medica — Thu, 25 Dec 2025 00:00:00 +0700

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Dictionary of Traditional Chinese Medicine Volume 2 (Chinese-Thai-English) (22)

Tawat Buranatawonsom, Wang Xiaotao, Suchada Anotayanonth — Thu, 25 Dec 2025 00:00:00 +0700

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Efficacy and Safety of Samran Nithra, a Thai Traditional Medicine Formula, for the Relief of Insomnia

Thu, 25 Dec 2025 00:00:00 +0700

Introduction and Objective: Currently, around 19 million people in Thailand suffer from insomnia, leading to the efforts to encourage the use of Thai herbal formula as a choice to help with sleep problems. “Samran Nithra” is a TTM formula, listed in the classical TTM textbook called “Veja Suksa of Phraya Phitsanu Prasartvej” Volume 1, containing cannabis inflorescence as one of 19 herbal ingredients. It has been prescribed for the relief of insomnia, wind-related problems, and loss of appetite at Thai Traditional and Complementary Medicine Hospital (TTCMH). However, no clinical study on this herbal formula has yet been reported. This study was therefore conducted to evaluate the efficacy and safety of Samran Nithra formula in patients with insomnia who are being treated at the TTCMH.

Methods: This study was a quasi-experimental, single-group pretest-posttest design. Forty-five participants were purposively selected from patients seeking treatment for insomnia at TTCMH between May 15 to August 15, 2024. Prior to receiving the investigational drug (Day 0), the researcher collected: 1) demographic data, 2) sleep data, and 3) sleep quality data (using the Thai version of the Pittsburgh Sleep Quality Index: PSQI). Subsequently, study participants received 250 mg capsules of Samran Nithra formulation, to be taken at the dose of one capsule, once daily at bedtime, for 4 weeks. On Day 14, participants were followed up for any adverse events (if any) via telephone. Following drug administration (Day 29), participants were followed-up and evaluated for: sleep data, sleep quality data (using the Thai PSQI), safety data in case of adverse events during drug use, utilizing Adverse Event Reporting Form for Health Products of Thai FDA. The causality of adverse drug reactions was assessed using the Naranjo's algorithm. Medication adherence was evaluated by pill counting. Statistical data analysis was performed using descriptive statistics or paired t-test, statistical significance level was set at p < 0.05.

Results: Demographic data showed that the participants were mostly female (62.22%), had an average age of 57.58 ± 9.91 years, with hypertension and hyperlipidemia as the most common underlying conditions (both at 29.63%). Insomnia was present for a duration of 1 week to 1 month and more than 1 year in 53.33% and 35.56% of the participants, respectively. Sleep data indicated that before receiving the Samran Nithra formulation, most patients (82.22%) had a sleep latency (time from going to bed to actually falling asleep) of 30–60 minutes. After receiving the drug, this group decreased to 37.78%, with most patients (55.56%) reporting a sleep latency of less than 30 minutes. In terms of sleep quality as measured by PSQI, the mean total PSQI score before receiving the Samran Nithra formulation was 16.16 + 4.42, after 4 weeks of treatment, the mean total PSQI score was significantly lower to 4.09 + 3.48 (p < 0.001). All seven components of the PSQI also showed a statistically significant reduction (p < 0.001). For safety, no adverse events were observed during 4-week administration of the Samran Nithra formulation.

Discussion: Samran Nithra formulation demonstrated efficacy in promoting sleep or alleviating symptoms of insomnia. Every component of sleep quality improved, most notably, a reduction in sleep latency, an increase in total sleep duration, a decrease in sleep disturbances, and an improvement in sleep efficiency. Our findings are consistent with previous studies, including, the study on Ajarn Decha's cannabis oil formula conducted by Kanyapak Silarak at Phra Arjarn Phan Arjaro Hospital, the research on cannabis extract by Suwanna Arunpongpaisal, the study by Sarunya Khongying on a traditional formula with components similar to the Samran Nithra formulation, and the research by Sasipong Tipratchadaporn on the Suk Sai-Yad formulation.

Conclusion and Recommendations: This study found that Samran Nithra formulation demonstrated efficacy in promoting sleep. However, as this was a quasi-experimental study utilizing a single-group design, a Randomized Controlled Trial (RCT) is recommended for future research to confirm the efficacy and safety of Samran Nithra formula which may then serve as a new therapeutic option for the treatment of insomnia.

The Effectiveness of SKT1–3 Meditative Exercise Therapy on Hemoglobin A1c Control (HbA1c) in Patients With Type 2 Diabetes

จารุพร พรมศิริเดช, ธนัทภัทร ศรีอุดร, ปิยนุช ชนะพันธ์ — Thu, 25 Dec 2025 00:00:00 +0700

Introduction and Objective: Diabetes mellitus is a chronic metabolic disorder characterized by abnormalities in the cellular processes that convert blood glucose into energy. This process involves insulin, a hormone produced by the pancreas, which regulates blood sugar levels. When glucose is not adequately utilized by the cells, it results in elevated hemoglobin A1c levels, reflecting sustained hyperglycemia above the normal range. The Samatha–Kammatthana Therapy, known as SKT1–3 meditation therapy, is a breathing–based mindfulness practice designed to slow down baroreflex activity, thereby decreasing the sympathetic nervous system’s autonomic responses. This leads to a reduction in blood pressure, skeletal muscle relaxation, alleviation of muscle tension, and a decrease in blood glucose levels. This research aimed to (1) examine the effects of SKT1–3 meditation therapy on the control of hemoglobin A1c levels within and between the intervention and control groups; (2) compare the effectiveness of blood glucose control between these groups; and (3) investigate the effects of SKT1–3 meditation therapy on stress reduction within and between the groups. The study findings were intended to contribute as an alternative treatment option for patients with type 2 diabetes mellitus.

Method: A quasi–experimental design with two groups, employing pretest–posttest measures, was utilized for this study. Participants included individuals diagnosed with type 2 diabetes mellitus, with or without comorbid hypertension, who had hemoglobin A1c levels ranging from 7.0 to 10.0 percent. Eligible participants were aged twenty years and older and were not concurrently involved in other research that could affect glycemic control. Research instruments consisted of a detailed SKT1–3 meditation therapy manual tailored for patients with type 2 diabetes mellitus, having a content validity index of 1.00, and a self–assessment stress evaluation tool developed by the Department of Mental Health in 2020. The sample size comprised eighty–four individuals, randomly assigned into an intervention group and a control group. The intervention group practiced SKT1–3 meditation therapy consistently over a three–month period, three days per week–specifically on Monday, Wednesday, and Friday. The regimen was structured so that SKT1 was practiced in the morning upon waking, SKT2 in the evening, and SKT3 before bedtime. The control group received usual nursing care without meditation intervention. Data normality was tested, and statistical analyses comparing hemoglobin A1c and stress levels employed the Wilcoxon Signed Ranks Test, Mann–Whitney U Test, and McNemar Test, with significance set at p < 0.05.

Results: Following the intervention period, the intervention group demonstrated a statistically significant reduction in hemoglobin A1c levels compared to their baseline measurements (p < 0.05). Moreover, their hemoglobin A1c values were significantly lower than those observed in the control group (p < 0.05). In addition, 30 participants in the intervention group, accounting for 71.43 percent, exhibited improved glycemic control post–intervention, with a mean hemoglobin A1c level of 6.67 percent. Regarding psychological stress, the intervention group showed a significant decrease from baseline levels (p < 0.05), and their stress scores were also significantly lower than those of the control group (p < 0.05). The average stress score for the intervention group post–intervention was 15.43 points, falling within the normal stress range.

Discussion: The SKT1–3 meditation therapy represented a form of integrative medicine combining conventional medical treatment with complementary therapeutic approaches. The study revealed statistically significant reductions in both hemoglobin A1c levels and stress scores among participants, suggesting that SKT1–3 meditation therapy had potential long–term benefits for metabolic and emotional regulation. The underlying physiological mechanism was likely related to the reduction of psychological stress and modulation of the autonomic nervous system. During meditation practice, the baroreflex mechanism functioned more slowly, the sympathetic nervous system activity was suppressed, while the parasympathetic nervous system activity was enhanced. These physiological changes led to decreased levels of cortisol and catecholamines, which played a crucial role in improving insulin sensitivity and reducing hepatic glucose production. Through this neuroendocrine modulation, regular practice of SKT1–3 meditation therapy restored balance within the psychoneuroendocrine system, resulting in improved regulation of hemoglobin A1c levels over time. Therefore, SKT1–3 meditation therapy could serve as an effective complementary approach to conventional diabetes management and may contribute to holistic care for patients with type 2 diabetes mellitus.

Conclusion and Recommendation: Regular and consistent practice of SKT1–3 meditation therapy significantly reduced both hemoglobin A1c levels and stress among patients with type 2 diabetes mellitus. Although the observed improvements in average hemoglobin A1c and stress levels might not have resulted solely from meditation practice, other contributing factors such as increased health awareness through participation in the study, improved dietary behavior, and regular physical activity could have played supportive roles. Future studies should therefore explore the integrated implementation of SKT1–3 meditation therapy in primary health care settings and chronic disease clinics as part of a comprehensive diabetes care model. Moreover, this approach could be extended to high–risk populations for diabetes prevention, including individuals with prediabetes, metabolic syndrome, or a family history of diabetes. SKT1–3 meditation therapy thus offered a practical, low–cost, and sustainable intervention that supported self–management, enhanced quality of life, and promoted long–term glycemic control among individuals with type 2 diabetes mellitus.

Thai Folk Medicine Wisdom of Coconut Shell Stepping Exercise: A Case Study of Mrs. Chivaporn Deeburi, Loei Province

นันทะกานต์ ขาวดา, Rattiya Boonkiattiboot, Jitpinan Saenluanginn — Thu, 25 Dec 2025 00:00:00 +0700

Introduction and Objectives: Thailand has transitioned into a complete-aged society, leading to increased problems of falls and mortality among the elderly. Strengthening lower limb muscles and improving balance are critical preventive measures. Coconut shell stepping therapy is a Thai folk medicine wisdom that has been used to enhance lower limb muscle strength and improve balance. A folk healer from Loei Province, Mrs. Chivaporn Deeburi possesses unique coconut shell stepping therapy, which was passed down through generations. This study was therefore aimed to: 1) compile knowledge of her coconut shell stepping exercise routine, 2) examine multidisciplinary perspectives on its alignment with physiotherapy principles and advices on ways to improve its therapeutic effects and safety, and 3) evaluate preliminary outcomes from her service recipients.

Method: The research team conducted in-depth interviews with the folk healer and facilitated focus group discussions with 30 multidisciplinary professionals, including rehabilitation physicians, physiotherapists, occupational therapists, nurses, and Thai traditional medicine practitioners, and traditional Chinese medicine practitioners. Additionally, three service recipients were interviewed. The study was conducted from May to July 2023.

Results: The folk healer's technique, inherited for over 105 years, comprises five postures performed while standing on coconut shells. Position 1: Forefoot on shell, heel on floor; lean forward and backward (10 repetitions), Position 2: Rise on forefoot, performing heel raises on shell (10 repetitions), Position 3: Midfoot on shell; lean forward and backward, maintaining pressure (3 minutes), Position 4: Midfoot toward heel on shell; lean forward and backward, holding pressure as tolerated, and Position 5: Heel on shell; rotate left and right alternately (10 repetitions). The multidisciplinary team viewed that her coconut shell stepping exercise routine aligns with physiotherapy principles – stretching, releasing, pressing , and massaging – serving as an alternative form of muscle pain management. Safety recommendations include using non-slip mats and handrails for support, performing continuous exercise routine 5 days a week for no longer than 8 weeks, and inspecting coconut shells for appropriate curvature and integrity before use. Service recipients reported significant benefits: alleviated foot and leg pain, and notably improved toe numbness.

Discussion: This ancestral wisdom of coconut shell stepping exercise aligns with the principles of Thai traditional medicine and physiotherapy for musculoskeletal care. The exercise routine helps alleviate foot pain, relax lower extremity muscles, build strength, enhance balance, and reduce fall risk. This traditional therapy offers a beneficial healthcare alternative for individuals experiencing lower limb muscle tension and pain. It provides accessible, cost-effective care using locally available materials, and enables community self-care practices.

Conclusion and Recommendation: The practice routine and specific postures of coconut shell stepping exercise of this local folk healer can serve as an alternative method for developing therapeutic interventions aimed at musculoskeletal disorders and fall prevention in older adults. This practice is observed to alleviate muscle aches, enhance postural balance capacity, and increase walking speed, which are critical factors in mitigating fall risk. Furthermore, it represents a cost-effective application of indigenous wisdom for self-care. To substantiate these benefits, future research should scientifically investigate the physiological effects on muscle function and proprioception (position sense) to establish empirical evidence. Concurrently, efforts should focus on systematic data collection to establish a database of local traditional medicine wisdom, serving as a valuable knowledge resource for Thai traditional medicine practitioners and interested parties. Research is also needed to develop and standardize the coconut shell stepping postures to ensure that they are anatomically aligned with the musculoskeletal system. Finally, it is imperative to disseminate and transfer this body of knowledge to foster further research in Thai traditional medicine and alternative medicine.

Development of a Herbal Cream Formulation from Ya Ha Rak Extract

Thu, 25 Dec 2025 00:00:00 +0700

Introduction and Objectives: The "Ya Ha Rak", an oral traditional Thai herbal formula for treating fever, has officially been listed in the National List of Essential Herbal Medicines since 1999. It consists of the roots of five medicinal plants: chingchi (Capparis micracantha DC.), Ya Nang (Tiliacora triandra (Colebr.) Diels), Khontha (Harrisonia perforata (Blanco) Merr.), Tao Yai Mom (Clerodendrum indicum (L.) Kuntze) and Ma Duea U Thum Phon (Ficus racemosa L.). Investigations into biological activity studies revealed that Ya Ha Rak exhibits anti-allergic activity through the inhibition of immune reactions, melanogenesis and tyrosinase inhibition, as well as antioxidant activity. No skin irritation was observed in human skin, indicating that the formula is safe for topical application. Therefore, it has the potential to be used externally for the treatment of allergic dermatitis. This study aimed to develop a cream formulation incorporated with Ya Ha Rak spray-dried extract and to establish an analytical method for quality control, including the evaluation of the chemical and physical stability of the cream formulation.

Methods: The dried Ya Ha Rak herbal formula extract was prepared by aqueous decoction extraction followed by spray drying. Subsequently, an analytical method employing reversed-phase high-performance liquid chromatography (RP-HPLC) was developed for the quantification of the marker compound, perforatic acid, to ensure the quality control of the obtained extract. The method was further validated by ICH Q2(R1) guidelines. Then, the obtained extract was formulated into an oil-in-water cream. The physical characteristics, the amount of perforatic acid within the cream formulation, and the functional properties of each formula were evaluated to select the most suitable formulation. Finally, the stability study of the chosen cream product was conducted by the ASEAN Guidelines for the Stability Study of Drug Products (2013) under two conditions: room temperature (30 ± 2°C, without controlled relative humidity) and accelerated condition (40 ± 2°C, 75 ± 5% relative humidity) for 6 months, with subsequent estimation of the product shelf life.

Results: The Ya Ha Rak extract obtained from spray drying exhibited a herb-to-dry extract weight ratio of 7.3:1. The method validation yielded the following results. The specificity of the analytical method was evidenced by the purity of the perforatic acid peak in the chromatogram of Ya Ha Rak extract. The calibration curve for perforatic acid was linear over the concentration range of 8.68-79.0 µg/mL, with r² of 0.9997. The relative standard deviation (RSD) for repeatability was within 2%. The percentage recovery ranged from 98.0% and 102.0%. The limit of quantitation (LOQ) and limit of detection (LOD) were determined to be 0.34 µg/mL and 0.07 µg/mL, respectively. The development of cream formulations revealed that Formulation 3, comprising 67% purified water, 10% propylene glycol, 6.5% liquid paraffin, 5% cetyl alcohol, 4.5% Lexemul^® 561, 4% stearyl alcohol, 2.5% Ya Ha Rak extract, and 0.5% Spectrastat BHL^TM by weight, exhibited superior physical characteristics, including a smooth, homogeneous texture without phase separation, a mild herbal scent, and a pleasant skin feel. The formulation complied with the quality control criteria specified in the pharmacopoeia. The content of perforatic acid found was determined to be 1.38% w/w in the extract and 32.52 mg per 100 g of cream formulation. A six-month stability study demonstrated that the cream formulation exhibited physical and chemical stability under both accelerated and room-temperature storage conditions. The estimated shelf life of the product was determined to be 25 months.

Discussion: The extraction method employed Thai traditional medicine practices by using water decoction followed by spray drying, which effectively preserves the quality of the extract by minimizing thermal degradation. The quantitative analysis of perforatic acid using RP-HPLC was developed and validated following ICH Q2(R1) guidelines, ensuring accurate quality control of both the extract and cream formulations. For the cream development using 2.5% w/w concentration of the herbal extract, formulation 3 exhibited the most favourable properties, including a smooth texture, pH of 4.93 ± 0.03, and viscosity of 65,848 ± 2,463 cP. The perforatic acid content was found to be 32.52 mg per 100 g of cream. Stability studies conducted over 180 days under both room temperature and accelerated conditions demonstrated excellent stability in physical appearance, viscosity, and active compound content, with the percentage reduction in perforatic acid not exceeding 2.1%. These results indicate that the developed formulation possesses adequate stability and quality for further clinical investigation.

Conclusion and Recommendation: The developed Ya Ha Rak cream formulation demonstrated suitable physical characteristics, satisfactory stability, and complied with the quality standards in the pharmacopoeia. It is recommended that further in vivo studies, particularly in human subjects be conducted to assess the efficacy and safety of the formulation for the treatment of allergic dermatitis.

การศึกษาผลของการสะตุตามศาสตร์การแพทย์แผนไทยต่อสารระเหยง่ายในมหาหิงคุ์ด้วยเทคนิค GC-MS

Thu, 25 Dec 2025 00:00:00 +0700

Introduction and Objective: Maha Hingu (asafoetida), the oleo-gum-resin derived from the root of the plant Ferula assa-foetida L., has been widely utilized in various traditional and folk medicine systems, including Thai Traditional Medicine, for diverse medical purposes. These uses include treating flatulence, acting as a carminative, alleviating symptoms of bronchitis, and managing nervous system disorders. In the context of Thai Traditional Medicine, prior to its incorporation into medicinal preparations, Maha Hingu is required to undergo a process known as Satu, which is intended to mitigate its toxicity or to purify the materia medica. The objective of this study was to compare the quantity of volatile oil components distilled from samples of Maha Hingu that had undergone different Satu processes with those of un-Satu Maha Hingu.

Materials and Methods: Maha Hingu (asafoetida) sample was ground into powder and divided into three distinct portions, each portion of powdered sample was subjected to different preparation methods: ST1 (Satu with Red Holy Basil Water): The sample was ‘Satu’ using water decocted from Red Holy Basil (Ocimum tenuiflorum L., red cultivar) leaves. ST2 (Satu with Boiled Water): The sample was ‘Satu’ using plain boiled water, and ST3 (Un-Satu control): The sample was not subjected to a satu process. Each of the three processed Maha Hingu samples (ST1, ST2, and ST3) was then subjected to hydrodistillation to extract its volatile oil. The resulting volatile oil from each sample was later analyzed to determine its chemical composition using Gas Chromatography coupled with Mass Spectrometry (GC-MS).

Results: Chemical component analysis of the volatile oils distilled from three Maha Hingu samples—treated with boiled Red Holy Basil water (ST1), treated with boiled water (ST2), and the Un-Satu control (ST3)—revealed qualitative changes in the compound (Z)-1-(but-2-en-1-yl)-2-(sec-butyl)disulfane. This change indicates that the Satu toxicity reduction process successfully reduced potentially gastrointestinal-toxic compounds, such as those associated with side effects like nausea, vomiting, and irritation of the gastrointestinal mucosa. Furthermore, the Satu process also decreased the quantity of (+)-4-carene and b-farnesene, compounds that could potentially cause adverse health effects if ingested in large amounts. The overall quantity of other chemical groups, including terpenoids, sulfur compounds, aldehydes, ketones, isothiocyanates, and cycloalkenes, was also observed to be lower following Satu process. While these compounds possess beneficial properties such as anti-inflammatory and antibacterial activity, high consumption levels can also lead to various side effects. In summary, the Satu toxicity reduction process, as prescribed by the principles of Thai Traditional Medicine, demonstrably resulted in a qualitative modification of the chemical constituents of Maha Hingu and was effective in reducing the quantity of potentially toxic compounds.

Discussion: The findings confirm that the Satu safety optimization process significantly influences the chemical profile of Maha Hingu, specifically by reducing the quantity of potentially harmful or toxic compounds. This result is highly consistent with the principles of Thai Traditional Medicine on the modification of poisonous herbal materials. The Satu process serves to moderate the potency and mitigate the inherent toxicity of the materia medica. Therefore, Satu acts as a crucial process that reduces the risk of adverse health effects when this potentially toxic herbal material is consumed in appropriate quantities, aligning traditional practice with observable chemical changes.

Conclusion and Recommendations: This study successfully validates that the Satu process induces a demonstrable change in the essential chemical composition of Maha Hingu (asafoetida), which supports the established theoretical basis for modifying toxic herbs in Thai Traditional Medicine. The Satu process is confirmed as an effective method for reducing the quantity of constituents that may cause adverse health effects, thereby enhancing the safety profile of the materia medica when prepared for consumption. Further investigation is warranted to evaluate the long-term effects of using Maha Hingu (asafoetida) prepared through Satu processing using red basil leaf decoction, particularly regarding its potential impacts on vital organs such as the liver and kidneys.

Development of Hydrogel Herbal Knee Patch for the Relief of Knee Pain Caused by Wind and Blood-Wind Obstruction

Thu, 25 Dec 2025 00:00:00 +0700

Introduction and Objectives: Thailand is currently entering a complete aged society, as such, the prevalence of illnesses, particularly musculoskeletal diseases, among the elderly increase. According to the National Health Statistics in 2022, the elderly accounted for 22.15% of all patients with musculoskeletal diseases. This physical health problem causes suffering and affecting the quality of life of the elderly. In 2024, the Thai Traditional Medicine Demonstration Hospital, under the School of Traditional and Alternative Medicine, Chiang Rai Rajabhat University treated over 100 cases of knee pain resulting from Lom (wind) and Lueat Lom (blood-wind) Tit Khat (wind and blood-wind obstruction), out of a total of 1,010 patients seeking services for musculoskeletal disorders. This study aims to 1) develop a new knee poultice formula for treating knee pain caused by wind and blood-wind obstruction, and 2) develop a new form of hydrogel herbal knee patch product suitable for treating knee pain due to wind and blood-wind obstruction.

Methodology: This research is a developmental study involving the selection of poultice formulas from Thai traditional medicine (TTM) textbooks and the development of the most suitable formula into a new form of hydrogel herbal knee patch product. Fifteen TTM experts were selected to review the selection of traditional poultice formulas and evaluate the physical properties and quality of the newly developed hydrogel herbal knee patch via focus group discussion process. Research tools for data collection were (1) record form of knee poultice recipes found in Thai traditional medicine textbooks, (2) record forms of the first and the second rounds of focus group discussions with TTM experts, and (3) product quality evaluation form. Knee poultice recipes were selected from TTM textbooks, namely, the Royal Medical Textbooks of King Rama V, Volumes 1 and 2; Phaetsat Songkhro, Royal Edition, Volumes 1 and 2; the General Traditional Medicine Textbooks, Medicine Section, Volumes 1, 2, and 3; the General Traditional Medicine Textbook, Pharmacy Section, General Traditional Medicine Textbook, Midwifery Section; and books on traditional medicine formulas. One formula was then selected from the list based on the predetermined criteria, i.e., has spicy taste, has pain- and swelling-relieving and wind dispelling properties, and its herbal components are locally available and easily obtained. Such herbal formula was then developed into a new form of hydrogel herbal knee patch using an automatic face mask machine. The newly developed product was further improved upon the evaluation of the physical characteristics and ease of use of the product by TTM experts and their comments.

Results: Upon the consideration of herbal poultice formulas listed in classical TTM textbooks using pre-determined criteria, "Ya Phok Kho Mue Kho Thao" (Hand and Ankle Poultice) from Phaetsat Songkhro, Royal edition, Volume 1, page 226 was selected. The formula consists of one part each of Nat Luang (Blumea balsamifera), giant lily (Crinum asiaticum), ginger (Zingiber officinale), long pepper (Piper retrofractum Vahl.), garlic (Allium sativum), Phlai (Zingiber montanum), Wan Nam (Acorus calamus), and assafoetida gum (Ferula assa-foetida). Traditionally, the ground ingredients are mixed with lime juice and liquor and placed on affected wrists and ankles. This traditional poultice formula was then developed into a novel hydrogel herbal knee patch suitable for treating knee pain due to wind and blood-wind obstruction using an automatic face mask machine and a mixture of 20 ml of herbal solution prepared from the poultice formula, 60 ml of water, and 2 collagen peptide tablets (100 g/tablet). Physical characteristic evaluation showed that: 1) regarding physical characteristics of the products, 80% of reviewers rated materials used for the hydrogel herbal knee patch product as appropriate; 86.7% found the product size suitable; and 93.3% reported no skin irritation caused by the product. 2) regarding usability, 66.7% found the product easy and convenient to use; 53.3% found the scent pleasant and not pungent. The researchers have improved the hydrogel herbal knee patch according to expert recommendations, including adjusting the scent and using waterproof plaster to prevent the solution from leaking out.

Discussion: For the development of the hydrogel herbal knee patch formula, the recipe containing Nat Luang, giant lily, ginger, long pepper, garlic, phlai, and Wan Nam was selected as most herbal ingredients are spicy, possess antioxidant, anti-inflammatory, and analgesic properties, as well as easily accessible and locally available. When these herbs were developed into a novel hydrogel herbal knee patch, it was found that the new product was a suitable form of hydrogel patch, non-irritating to the skin and convenient to use.

Conclusion and Recommendations: The hydrogel herbal knee patch can be an alternative product for those who want to take care of their health by maximizing the benefits of locally available herbs. However, this is only a preliminary study, clinical trials to assess the efficacy and safety of the hydrogel herbal knee patch, as well as patients’ satisfaction are still needed in the next steps.

Complex Network Analysis of Acupoint Combinations in The Treatment of Knee

ณัฏฐา มูลศาลา, พรพรรณ ทรัพย์เอี่ยม, ณัฐวุฒิ ธรรมรัตนานันท์ — Thu, 25 Dec 2025 00:00:00 +0700

Introduction and Objectives: Osteoarthritis (OA) of the knee is a significant and increasing health problem. In traditional Chinese medicine (TCM), it is categorized as "Bi Syndrome" (Bi Zheng). The main causes are attributed to wind, cold, and dampness (external pathogenic factors) and deficiency of the internal organs, resulting in the stagnation of qi and blood circulation. Acupuncture is a critical treatment that helps alleviate pain and restore knee joint function. The objective of this study was to investigate the patterns of acupoint combinations used in the treatment of knee osteoarthritis, primarily utilizing complex network analysis (CNA) as the main tool to reveal underlying clinical principles.

Methods: This study employed a documentary research design combined with quantitative analysis. This involved systematically searching for clinical research reports related to acupuncture treatment for knee osteoarthritis published from 2005 to 2023 from the following data sources: CNKI, Wanfang data, and Weipu data. Selected research reports were collected in a data collection form developed in Microsoft 365, comprising the following variables: title, publication year, experimental group, control group, gender, age, concomitant treatment methods, and the names of acupoints used. The results were analyzed using the Gephi program, a tool utilized for the visualization and analysis of complex networks. The network components were defined as nodes, edges, and weights. All analysis results were subsequently discussed by linking the important network metrics: degree centrality, betweenness centrality, and top co–occurrence pairs.

Results: A search for data using the keywords knee osteoarthritis, acupuncture, acupoints, complex network analysis from the CNKI, Wanfang data, and Weipu data databases found 298 research articles. After filtering based on the inclusion and exclusion criteria, 119 articles met the criteria. The resulting network structure analysis comprised 30 nodes (acupoints), 237 edges (pairs), and a total weight of 2,769 counts. The determination of Core Acupoints using degree centrality analysis showed Dubi, Zusanli, Yanglingquan, Neixiyan and Xuehai as the top 5 acupuncture points ranked by frequency of use. These points are the most frequently used in combinations and are considered the core that defines the structure of the treatment network. Strategic bridge points (betweenness centrality) the points with the highest betweenness centrality (BC) are Zusanli and Yanglingquan, which function as bridges linking local treatment with systemic regulation. Distal points – those far from the knee joint and important from the perspective of the meridian system such as Sanyinjiao, Xuanzhong, and Taixi – also showed high BC values. This indicates that these points are crucial intermediaries in connecting local treatment to the systemic balancing of the body within the meridian network. Highest frequency of pairing (top co–occurrence pairs) the pair with the highest co–occurrence frequency was Neixiyan–Dubi, which emphasizes localized treatment. This was followed by pairs that integrate a local point with a distal point. These pairings focus on using local points near the knee to reduce pain and enhance local circulation.

Discussion: The principle of local focus involves selecting acupuncture points that are local to the area of discomfort, such as Neixiyan and Dubi, both of which are located directly on the knee joint. This pairing emphasizes the principle of local acupoint selection, which involves choosing acupuncture points specific to the area of the symptoms. It urgently stimulates the circulation of qi and blood in the knee joint area to relieve pain and stiffness in the joint. The integration of distal points (systemic integration) is primarily a combination of local points with distal points. Examples include: Zusanli is a point used to tonify qi and nourish the body (e.g., Spleen/Stomach). Yanglingquan is hui–meeting point of the tendons and sinews, aiming to relax the tendons and manage blood stasis. Xuehai is a point used to activate blood circulation, targeting blood stasis, which is a key pathological feature of knee osteoarthritis. This integrated treatment approach aims at relaxing tendons and managing blood stasis, among other pathological factors. The presence of pairs directly linked to whole–system balancing, such as Zusanli–Yanglingquan and Zusanli–Xuehai, serves as a core strategy confirmation. This confirms that even with localized symptoms in the knee, clinical treatment still prioritizes addressing the underlying deficiency of the spleen/stomach and regulating the liver and kidney systems. According to TCM theory, these internal organ disharmonies form the fundamental root cause of knee osteoarthritis.

Conclusion and Recommendations: This study successfully revealed the systematic structure and underlying rules of acupoint selection for the acupuncture treatment of knee osteoarthritis, which is consistent with TCM theory. The research findings can serve as an evidence–based foundation for the future development of more precise and systematic standards and guidelines for acupuncture treatment. It is recommended that further studies should be conducted with a larger amount of data and, importantly, should directly correlate the findings with clinical outcomes. Future research should specifically focus on randomized controlled trials (RCTs) to validate the efficacy of the core acupoint combinations identified in this network analysis.

การพัฒนาวิธีวิเคราะห์และการตรวจสอบความถูกต้องของวิธีวิเคราะห์หาปริมาณแคนนาบินอยด์ในสารสกัดกัญชาด้วยวิธีโครมาโทกราฟีของเหลวประสิทธิภาพสูง

Thu, 25 Dec 2025 00:00:00 +0700

Introduction and Objective: Cannabis (Cannabis sativa L.) has been used for medicinal purposes since ancient time. Tetrahydrocannabinol (THC) is the major psychoactive compound and the other non-psychoactive ingredients are cannabidiol (CBD). Cannabis has been used as an active ingredient in various pharmaceutical and health-related products. However, the appropriate analytical methods for quality control of active compounds in cannabis extracts remain limited. This study aimed to develop and validate an Ultra High Performance Liquid Chromatography (UHPLC) method for the quantification of cannabinoids in cannabis extract samples.

Methods: The study was divided into three steps: (1) developing the UHPLC method for analyzing cannabidiol and tetrahydrocannabinol in cannabis extracts, (2) testing the validity of the analysis method, and (3) analyzing the quantity of cannabidiol and tetrahydrocannabinol in 10 cannabis extract samples.

Results: This method was validated by establishing the linearity for cannabidiol and tetrahydrocannabinol at the concentration range of 24.23-290.70 and 23.98-383.62 μg/mL, respectively, with a determination correlation coefficient (r) of 0.999. The % recovery was in the range of 98.99-100.47%. The limit of detection of cannabidiol and tetrahydrocannabinol was 1.015 and 2.135% w/w (calculated on the weight as C. sativa extracts, µg/µg), respectively, while the limit of quantification were 3.382 and 7.118% w/w (calculated on the weight as C. sativa extracts, µg/µg), respectively.

Discussion: The method developed for analyzing cannabidiol and tetrahydrocannabinol in cannabis extracts using UHPLC. The validity test result for the analysis method all fell within acceptable limits. This developed analysis method requires less time for analysis and involves a simple, convenient and rapid preparation of the mobile phase.

Conclusion and Recommendation: This recently developed method proves suitable for routine quantitative analysis of cannabidiol and tetrahydrocannabinol in cannabis extracts. It can support the establishment of quality specifications for cannabis extracts.

Comparative Study on The Effectiveness And Safety of Cinnamon Stomachic Mixture And Turmeric Capsules in Patients With Flatulence

Sarunya Khongying, Thanyaluck Siriyong — Thu, 25 Dec 2025 00:00:00 +0700

Introduction and objective: Flatulence is a prevalent symptom, accounting for up to 50 percent of gastrointestinal disorders among patients receiving medical attention. Cinnamon stomachic mixture and turmeric capsules are included in the National List of Essential Herbal Medicines (NLEHM) for the alleviation of flatulence and bloating. The two herbal medicines are categorized as basic medicinal items of NLEHM; thereby can generally be prescribed by healthcare practitioners. This study aimed to compare the effectiveness in relieving flatulence, safety, and patient satisfaction of the cinnamon stomachic mixture (CM) against turmeric capsule (TC) in patients with flatulence.

Methods: This study was a quasi–experimental design with a pretest–posttest two–group method in patients with flatulence who sought medical attention at Tha Rong Chang Hospital in Surat Thani province. Sixty patients were randomly divided into two groups: the test group (CM group), and the comparison group (TC group). The patients were given CM (15 ml) or TC (2 capsules) three times daily after breakfast, lunch, and dinner for one week. The assessment of the study outcomes was based on patients’ characteristics, the severity of dyspeptic symptoms utilizing the Severity of Dyspepsia Assessment (SODA) scale, adverse events experienced after using medications, and a validated 10–item questionnaire to evaluate satisfaction with service provision and medication use.

Results: 1) The severity of symptoms. Comparison of mean severity scores of abdominal pain, flatulence, and other non–pain related symptoms within test group and comparison group, before and after the intervention showed statistically significant differences (p < 0.001). However, when comparing the mean severity scores specifically for abdominal pain between the two groups before and after taking the medications, no statistically significant differences were observed (p = 0.116 and p = 0.916). 2) Safety. After the consumption of CM and TC, there were 7 patients in the test (CM) group and 13 patients in the comparison (TC) group reporting adverse events; and all 20 subjects experienced only a single adverse event. The analysis of the proportion of patients with adverse events between the CM group and the TC group revealed no statistically significant difference (p = 0.1). The most frequently observed adverse event in the CM group was constipation (3 cases, 10%), followed by nausea, drowsiness, frequent hunger, and frequent burping (1 case each, 3.33%). In the turmeric group, burping was the most common reported adverse event (5 cases, 16.67%), followed by frequent hunger at 13.33%. 3) Satisfaction. When comparing the mean difference in satisfaction scores following the provision of services and the use of medications, it was found that both groups reported high levels of satisfaction. However, there was no statistically significant difference between the two groups (p = 0.916).

Discussion: The analysis of the effectiveness of cinnamon stomachic mixture and turmeric capsules in relieving the severity of flatulence, abdominal pain, and other symptoms based on SODA form showed comparable effectiveness and satisfaction. Adverse events experienced in both groups were minimal and resolved spontaneously.

Conclusion and recommendation: Cinnamon stomachic mixture was found to have comparable efficacy and safety to turmeric capsules in relieving the severity of flatulence, abdominal pain, and other non–pain symptoms in patients with flatulence. For future research, it is recommended that a study should be conducted to compare the efficacy and safety of cinnamon stomachic mixture against turmeric capsules in alleviating the symptoms of functional dyspepsia, which is the new indication of turmeric in NLEHM.

Wurfbainia testacea (Ridl.) Škorničk.& A.D.Poulsen.

Thongchai Sooksawate — Thu, 25 Dec 2025 00:00:00 +0700

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Editorial Board

Vichai Chokevivat — Thu, 25 Dec 2025 00:00:00 +0700

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Index

Department of Thai Traditional and Alternative Medicine — Thu, 25 Dec 2025 00:00:00 +0700

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Journal of Thai Traditional and Alternative Medicine

Policy and Ethics

Instructions to Authors (Revised 2025)

Contents

Editor's Note

Monograph of Select Thai Material Medica: KRAWAN

Dictionary of Traditional Chinese Medicine Volume 2 (Chinese-Thai-English) (22)

Efficacy and Safety of Samran Nithra, a Thai Traditional Medicine Formula, for the Relief of Insomnia

The Effectiveness of SKT1–3 Meditative Exercise Therapy on Hemoglobin A1c Control (HbA1c) in Patients With Type 2 Diabetes

Thai Folk Medicine Wisdom of Coconut Shell Stepping Exercise: A Case Study of Mrs. Chivaporn Deeburi, Loei Province

Development of a Herbal Cream Formulation from Ya Ha Rak Extract

การศึกษาผลของการสะตุตามศาสตร์การแพทย์แผนไทยต่อสารระเหยง่ายในมหาหิงคุ์ด้วยเทคนิค GC-MS

Development of Hydrogel Herbal Knee Patch for the Relief of Knee Pain Caused by Wind and Blood-Wind Obstruction

Complex Network Analysis of Acupoint Combinations in The Treatment of Knee

Comparative Study on The Effectiveness And Safety of Cinnamon Stomachic Mixture And Turmeric Capsules in Patients With Flatulence

Wurfbainia testacea (Ridl.) Škorničk.& A.D.Poulsen.

Editorial Board

Index