Phytotherapy in diabetes: Review on potential mechanistic perspectives

Diabetes mellitus(DM) is a widely spread epidemic dis ease that results from the absence of insulin, decreased secretion and/or impaired function. Since DM is a multi factorial disease, the available pharmaceuticals, despite their sensible treatment, target mostly one pathway to control hyperglycemia and encounter several side effects. Therefore, new therapeutic paradigms aim to hit several pathways using only one agent. Tradition ally, antidiabetic plants and/or their active constituents may fulfill this need. More than 200 species of plants possess antidiabetic properties which were evaluated mostly by screening tests without digging far for the exact mode of action. Searching among the differen literature resources and various database and in view o the above aspects, the present article provides a com prehensive review on the available antidiabetic plants that have been approved by pharmacological and clini cal evaluations, and which their mechanism(s) of ac tion is assured. These plants are categorized according to their proved mode of action and are classified into those that act by inhibiting glucose absorption from in testine, increasing insulin secretion from the pancreasinhibiting glucose production from hepatocytes, or enhancing glucose uptake by adipose and muscle tissues. The current review also highlights those that mimic in their action the new peptide analogs, such as exenatide, liraglutide and dipeptidylpeptidase-4 inhibitors that increase glucagon-like peptide-1 serum concentration and slow down the gastric emptying.

The use of antimuscarinics,phosphodiesterase type Ⅴ inhibitors and phytotherapy for lower urinary tract symptoms in men

Besides the mainstay of α-blockers and 5α-reductase inhibitors,other forms of medical therapy complete the armamentarium in the treatment of lower urinary tract symptoms(LUTS)in men.These treatments can target specific symptoms as well as associated symptoms that would affect the quality of life of the patients.Many patients are bothered by storage symptoms,more so than the voiding symptoms.Antimuscarinics are efficacious and safe,provided the patients do not have high post void residual urine.Many patients with LUTS also have erectile dysfunction,and phosphodiesterase type Ⅴ inhibitors are effective in relieving both LUTS as well as erectile dysfunction for such patients.Phytotherapy provides a popular and safe treatment for LUTS,however,the efficacy of the treatment has not been proven in well conducted prospective randomized controlled studies.

An Example of Apiphytotherapy Studies in Azerbaijan: Herbal

Ginger, turmeric, black seed, artichoke leaves, Azerbaijani thistle honey, and BB (bee bread) have a hepatoprotectiveeffect;therefore, they show effective results separately in case of alcohol-dependent and non-alcoholic liver obesity, hepatitis andtoxic liver damage. We studied how it can affect liver enzymes and hepatocytes in this group of patients. We took all these naturalplants and bee products in the optimal dose required by the body and prepared a paste called Herbal, so that everyday people couldeat comfortably as a food supplement, as well as see the therapeutic and prophylactic results. HERBAL paste for liver ingredients:flaxseed, ginger, seed of thistle, powder of yellow ginger, black cumin, and honey. Benefits: Herbal paste prepared based onwell-tested recipes improves the function of the liver and gallbladder. As a hepatoprotector, it affects the recovery of liver cells inliver diseases (hepatitis and cirrhosis), spleen disease, bile ductinfections, gallstones in gallbladders, inflammatory bowel disease,colitis, cholecystitis. It helps to remove toxic substances while taking medicine (antibiotics, chemotherapy, painkillers, etc.). Sideeffects: Individual sensitiveness to the contents of the product. Usage: In acute process 1 teaspoon, during chronic diseases 1dessertspoon twice a day before eating. Results: 48 women and 54 men with the third level of fatty liver dystrophy decreased to thesecond level (fibrosis did not occur). During the treatment of 114 patients who had an HCV (hepatitis C virus), I used HERBALpaste as a protector for the liver. After the analyses, 24 patients, who had liver cirrhosis ALT (alanine aminotransferase) and AST(aspartate aminotransferase) in the blood reduced twice. Another 81 patients from 90 who had virus had disappeared in bloodanalyses and in the exogenous factor of liver and GGT in the blood get normal.

Applicability, Feasibility and Efficacy of Phytotherapy in Aquatic Animal Health Management

The use of chemotherapeutants, antibiotics, and pesticides in aqua farms and non-adherence to scientific management practices have resulted in adverse impact on aquacultural production, serious outbreaks of diseases, development of drug resistance in microbes, and accumulation of antibiotics and pesticide residues in finfish and shellfish and environmental pollution. As a result, a need has been felt by the aquaculturists as well as aquatic animal health management professionals to find a suitable alternative therapy in place of antibiotics and chemotherapy. Phytotherapy has come to be recognized as a handy and viable alternative to chemotherapy, as it is economical, effective, non-resistance forming, renewable, eco-friendly and farmer-friendly. Although the use of medicinal plants is known to humanity since the dawn of human civilization for the treatment and control of human and animal diseases but its importance in combating finfish and shellfish diseases has been realized only recently. The phytotherapy of aquacultural diseases is in its infancy in most part of the world except in China to some extent. However, many important contributions in this field by different workers during the last quarter of the 20th century and early 21st century have shown encouraging results and opened new vistas in phytotherapy of aquatic animals. The present review crtically evaluates the present status of knowledge of phytotherapy in the world combating various aquacultural diseases, identifying the bottlenecks and suggests remedial measures.

Phytotherapy in China and Its Prospects

Present status of phytotherapyPlant medicine is an important part oftraditional Chinese medicine.There are re-corded in the“Zhongyao Dacidian”(中药大辞典),5,767 kinds of traditional medicine,of which about a thousand kinds are providedwith profile of pharmacological actions.Most of the traditional pharmaceuticalpreparations are in form of pills,powders,softextracts and others manufactured by tradi-

Immunostimulator Api-phytotherapy for the Treatment of Upper Respiratory Tract Infection and Chronic Bronchitis

Throughout history, respiratory tract infections due to viruses, especially influenza viruses, continue to cause serious diseases, up to death, all over the world, as a result of the inability to develop effective treatment methods or vaccines. Due to changes in the antigenic structures of respiratory viruses, especially RNA viruses, there are difficulties in the production of effective vaccines. The World Health Organization estimates 150,000 hospitalizations and 30,000 to 40,000 deaths due to the flu epidemic in the United States alone, with a total of 25 to 50 million cases each year. Respiratory viruses are a major cause of influenza-like illness symptoms in children and adults, causing significant illness and death each year. Various herbal remedies have been used for the prevention and treatment of viral respiratory diseases in many parts of the world. Among those found to be effective are propolis, licorice root, ginger, black cumin, carob, but there is also scientific evidence for the effectiveness of several complementary treatments for the common cold. For example, oral zinc intake can reduce the severity of the common cold. Regular intake of vitamin C supplements can reduce the duration and severity of viral infections. Various herbs are widely used as medicine to clear viral respiratory infections. Influenza control and treatment mainly depend on chemical or biochemical agents isolated from plants. These agents include various polyphenols, flavonoids, saponins, glucosides, and alkaloids. We added such plants, propolis, and licorice honey to the content of bronxbal paste, which is a combination of supportive therapy, bronchial dilator, immunomodulator, mucolytic, and born antiviral and antibacterial effects during coronavirus and other bacterial-virus-caused pneumonia. We prepared it as a paste and used it in patients who do not have allergies. The plant and bee products in the bronxbal content we have prepared are natural pastes to solve problems that need ongoing rehabilitation, such as coronavirus pneumonia and chronic bronchitis caused by other viruses and bacteria, or Covid-19.

Medicinal properties of Peganum harmala L. in traditional Iranian medicine and modern phytotherapy: a review

OBJECTIVE： To review the pharmacological activities of Peganum harmala L. （R harmala, Nitrariaceae） in traditional Iranian medicine （TIM） and mod- ern phytotherapy. METHODS： Opinions of TIM and modern phytotherapy about safety and acceptable dosage of this plant are discussed. Various medical properties of P. harmala were collected from important TIM references and added to scientific reports derived from modern medical databases like PubMed, Scirus, ScienceDirect and Scopus.RESULTS： The main medicinal part of the plant is the seed. In TIM resources, this plant possesses vari- ous Pharmacological activities such as carminative, galactagogue, diuretic, emmenagogue, antithrom-botic and analgesic. In modern phytotherapy, R harmala demonstrated numerous medicinal effects including cardiovascular, neurologic, antimicrobial, insecticidal, antineoplasmic, antiproliferative, gastrointestinal and antidiabetic effects. Adverse events such as neuro-sensorial symptoms, visual hallucination, bradycardia, hypotension, agitation, tremors, ataxia, abortion and vomiting cause peo- ple to use this plant cautiously. R harmala is contraindicated during pregnancy, due to its abortive and mutagenic activities. Because of increasing the expression of CYP1A2, 2C19, and 3A4 and inhi- bition of monoamine oxidase, the pharmacokinetic parameters of drugs which are mainly metabolized by these enzymes may be affected by R har- mala. CONCLUSION： The medicinal properties declared for this plant in TIM are compared with those showed in modern phytotherapy. Some of the TIM properties were confirmed in modern phytotherapy like emetic and analgesic activities and some have not been evaluated in modern phytotherapy such as its therapeutic effects on paralysis, epilepsy and numbness. Finally, the current review provides the evidence for other researchers to use TIM properties of P. harmala as an efficacious natural drug. Further preclinical and clinical studies for adequate evaluating safety and therapeutic efficacy are recommended.

Effects of Yigan Decoction on proliferation and apoptosis of hepatic stellate cells

AIM:To investigate the effects of Chinese herb Yigan Decoction on proliferation and apoptosis of the hepatic stellate cells (HSC) in vitro. METHODS: The study in vitro was carried out in the culture of HSC lines. Various concentrations of Yigan Decoction were added and incubated. Cell proliferation was detected with MTT colorimetric assay. Cell apoptosis was detected by electron microscopy, flow cytometry and TUNEL. RESULTS: The proliferation of HSC was inhibited by Yigan Decoction, which depending on dose and time significantly. The HSC proliferation rates of groups at the end concentrations 144 and 72(g.L(-1)) were 21.62% and 40.54% respectively, significantly lower than that of normal control group(P【0.01). The HSC proliferation rates of groups at the end concentrations 36, 18 and 9(g.L(-1)) were 54.05%, 45.95% and 51.35% respectively, lower than that of control group (P【0.05). When the end concentration was 4.5 g.L(-1), the proliferation rate was 83.78%, which appeared no significant differences compared with control group. At the same concentrations of 18 g.L(-1), the inhibitory effects of Yigan Decoction at 24 h, 48 h and 72 h time point were observed, the effects were time-dependent, and reached a peak at 72 h. Meanwhile, it was showed that the inducing effects of Yigan Decoction on HSC apoptosis were dose-dependent and time-dependent. The apoptosis index(AI) was detected by TUNEL. After Yigan Decoction had been incubated for 48 h at the end concentration of 18 g.L(-1), the AI (14.5+/-3.1)% was significantly higher than that of control group (4.3+/-1.3)% (P【0.01). When visualized under transmission electron microscopy, some apoptotic stellate cells were found, i.e. dilated endoplasmic reticulum, irregular nuclei, chromatin condensation and heterochromatin ranked along inside of nuclear membrane. By flow cytometry detection, after HSC was treated with Yigan Decoction at different concentrations of 36, 18 and 9(g.L(-1)) for 48 h, AI (%) were 13.3+/-3.2, 10.7+/-2.7 and 10.1+/-2.5 respectively, which were significantly higher than that of control group(4.1+/-1.9) (P【0.01). At the same concentration of 18 g. L(-1) for 24h, 48 h and 72 h, AI (%) were 9.3+/-1.8,10.7+/-2.7 and 14.6+/-4.3 respectively, which were significantly higher than that of control group (P【0.01). CONCLUSION: Yigan Decoction could significantly inhibit HSC proliferation and increase the apoptosis index of HSC dose-dependently and time-dependently, which may be related to its mechanism of antifibrosis.

Effects of Shenmai Injection on Blood SOD Activity and MDA Level in Senile Patients with Coronary Heart Disease

In order to approach the effects of Shenmai Injection on SOD activity and MDA level in the senile patients with coronary heart disease, 48 cases, who had stenosis of over 70% in more than one branches of the coronary arteries, were assigned randomly into a treatment group (given Shenmai Injection plus the routine treatment) and a control group (given the routine treatment only). The superoxide dismutase (SOD) activity and malondialdehyde (MDA) level were determined before treatment and at the end of a 3-week treatment. The results showed that in the treatment group, the SOD activity was significantly increased (P＜0.05) and the MDA level markedly decreased (P＜0.01) in the treatment group. It can be concluded that Shenmai Injection may enhance the antioxidant ability of the senile patients with coronary heart disease.

Overview of the phytomedicine approaches against Helicobacter pylori

Helicobacter pylori(H.pylori)successfully colonizes thehuman stomach of the majority of the human popula-tion.This infection always causes chronic gastritis,butmay evolve to serious outcomes,such as peptic ulcer,gastric carcinoma or mucosa-associated lymphoid tis-sue lymphoma.H.pylori first line therapy recommend-ed by the Maastricht-4 Consensus Report comprises theuse of two antibiotics and a proton-pomp inhibitor,butin some regions failure associated with this treatmentis already undesirable high.Indeed,treatment failure isone of the major problems associated with H.pylori in-fection and is mainly associated with bacterial antibioticresistance.In order to counteract this situation,someeffort has been allocated during the last years in theinvestigation of therapeutic alternatives beyond antibi-otics.These include vaccines,probiotics,photodynamic inactivation and phage therapy,which are briefly revis-ited in this review.A particular focus on phytomedicine,also described as herbal therapy and botanical therapy,which consists in the use of plant extracts for medicinal purposes,is specifically addressed,namely considering its history,category of performed studies,tested com-pounds,active principle and mode of action.The herbs already experienced are highly diverse and usually selected from products with a long history of employ-ment against diseases associated with H.pylori infec-tion from each country own folk medicine.The studies demonstrated that many phytomedicine products have an anti-H.pylori activity and gastroprotective action.Al-though the mechanism of action is far from being com-pletely understood,current knowledge correlates the beneficial action of herbs with inhibition of essential H.pylori enzymes,modulation of the host immune system and with attenuation of inflammation.

Regulating effect of Chinese herbal medicine on the peritoneal lymphatic stomata in enhancing ascites absorption of experimental hepatofibrotic mice

AIM: To observe the regulatory effect of Chinese herbal medicine on peritoneal lymphatic stomata and its significance in treating ascites in liver fibrosis model mice. METHODS: Two Chinese herbal composite prescriptions were used separately to treat the carbon tetrachloride-induced mouse model of liver fibrosis. The histo-pathologic changes of the liver sections (HE and VG stainings) were observed. The peritoneal lymphatic stomata was detected by scanning electron microscopy and computer image processing. The changes of urinary volume and sodium ion concentration were measured. RESULTS: In the model group, lots of fibrous tissue formed in liver and extended into the hepatic lobules to separate them incompletely. In the treated and prevention groups, the histo-pathologic changes of liver was rather milder, only showed much less fibrous tissue proliferation in the hepatic lobules. The peritoneal lymphatic stomata enlarged with increased density in the experimental groups (diameter: PA, 3.07 +/- 0.69 microm; PB, 2.82 +/- 0.37 microm; TA, 3.25 +/- 0.82 microm and TB, 2.82 +/- 0.56 microm; density: PA, 7.11 +/- 1.90 stomata.1000 microm(-2); PB, 8.76 +/- 1.45 stomata.1000 microm(-2); TA, 6.55 +/- 1.44 stomata.1000 microm(-2)and TB, 8.76+/-1.79 stomata.1000 microm(-2)), as compared with the model group (diameter: 2.00+/-0.52 microm density: 4.45+/-1.05 stomata.1000 microm(-2)). After treatment, the urinary volume and sodium ion excretion increased in the experimental groups (PA, 231.28+/-41.09 mmol.L(-1); PB, 171.69 +/- 27.48 mmol.L(-1) and TA, 231.44 +/- 34.12 mmol.L(-1)), which were significantly different with those in the model group (129.33 +/- 36.75 mmol.L(-1)). CONCLUSION: Chinese herbal medicine has marked effects in alleviating liver fibrosis, regulating peritoneal lymphatic stomata, improving the drainage of ascites from peritoneal cavity and causing increase of urinary volume and sodium ion excretion to reduce the water and sodium retention, and thus have favorable therapeutic effect in treating ascites.

A review on the pharmacological and toxicological aspects of Datura stramonium L.

Datura stramonium L., a wild-growing plant of the Solanaceae family, is widely distributed and easily accessible. It contains a variety of toxic tropane alkaloids such as atropine, hyoscamine, and scopolamine. In Eastern medicine, especially in Ayurvedic medicine, D. stramonium has been used for curing various human ailments, including ulcers, wounds, inflammation, rheumatism and gout, sciatica, bruises and swellings, fever, asthma and bronchitis, and toothache. A few previous studies have reported on the pharmacological effects of D. stramonium; however, complete information regarding the pharmacology, toxicity, ethnobotany and phytochemistry remains unclear. Ethnomedicinally, the frequent recreational abuse of D. stramonium has resulted in toxic syndromes. D. stramonium, in the form of paste or solution to relieve the local pain, may not have a deleterious effect; however, oral and systemic administration may lead to severe anticholinergic symptoms. For this reason, it is very important for individuals, mainly young people, to be aware of the toxic nature and potential risks associated with the use of this plant. This comprehensive review of D. stramonium includes information on botany, phytochemistry, pharmacology, toxicology and ethnomedicinal uses.

Advances in TCM Treatment for Metastasis of Tumors

The above therapeutic results show that TCM drugs have excellent effects in counteracting the metastasis of tumors. They can produce a synergistic effect when used together with surgery, radio- and chemotherapy. In analyzing the relationship between the factors that affect the distant metastasis, the authors strongly recommend that the FDM-survival rate be used, i.e. the survival rate free from distant metastasis as suggested by Hong Minghuang et al in their article. An analysis based on FDM-survival rate in a duration of three or five years with the data treated with the Kaplan-Meier and/or Life Table would be rational and convincible.

Effects of extract F of red-rooted Salvia on mucosal lesions of gastric corpus and antrum induced by hemorrhagic shock-reperfusion in rats

AIM: To compare the effects of extract F of red-rooted Salvia (EFRRS) on mucosal lesions of gastric corpus and antrum induced by hemorrhagic shock and reperfusion in rats. METHODS: The rats were subject to hemorrhagic shock and followed by reperfusion, and were divided randomly into two groups. Group 1 received saline, and group 2 received EFRRS intravenously. The index of gastric mucosal lesions (IGML) was expressed as the percentage of lesional area in the corpus or antrum. The degree of gastric mucosal lesions (DGML) was catalogued grade 0,1,2 and 3. The concentrations of prostaglandins (PGs) were measured by radioimmunoassay. The concentration of MDA was measured according to the procedures of Asakawa. The activity of SOD was measured by the biochemical way. The growth rates or inhibitory rates of above-mentioned parameters were calculated. RESULTS: As compared with IGML (%), grade 3 damage (%) and MDA content (nmol/g tissue) of gastric antrum which were respectively 7.96 +/- 0.59, 34.86 +/- 4.96 and 156.98 +/- 16.12, those of gastric corpus which were respectively 23.18 +/- 6.82, 58.44 +/- 9.07 and 230.56 +/- 19.37 increased markedly (P 【0.01), whereas the grade 0 damage, grade 1 damage, the concentrations of PGE(2) and PGI(2)(pg/mg tissue), the ratio of PGI(2)/TXA(2) and the activity of SOD (U/g tissue) of corpus which were respectively 3.01 +/- 1.01, 8.35 +/- 1.95, 540.48 +/- 182.78, 714.38 +/- 123.74, 17.38 +/- 5.93 and 134.29 +/- 13.35 were markedly lower than those of antrum which were respectively 13.92 +/- 2.25, 26.78 +/- 6.06, 2218.56 +/- 433.12, 2531.76 +/- 492.35, 43.46 +/- 8.51 and 187.45 +/- 17.67 (P【0.01) after hemorrhagic shock and reperfusion.After intravenous EFRRS, the growth rates (%) of grade 0 damage, grade 1 damage, the concentrations of PGE(2) and PGI(2), the ratio of PGI(2)/TXA(2) and the activity of SOD of corpus which were respectively 632.56, 308.62, 40.75, 74.75, 92.29 and 122.25 were higher than those in antrum which were respectively 104.89, 58.40, 11.12, 56.58, 30.65 and 82.64, whereas the inhibitory rates (%) of IGML, grade 3 damage and MDA content of gastric corpus were 82.93, 65.32 and 59.09, being higher than those of gastric antrum which were 76.64, 53.18 and 42.37. CONCLUSION: After hemorrhagic shock reperfusion, the gastric mucosal lesions in the corpus were more severe than those in the antrum, which were related not only to the different distribution of endogenous PGs in the mucosa, but also to the different ability of anti-oxidation of the mucosa. The protective effect of EFRRS on the gastric mucosa in the corpus was more evident than that in the antrum, which was related to higher growth degree of PGs contents and anti-oxitative ability in gastric corpus after administration of EFRRS.

TCM Treatment of Extrasystole with Huanglian Shengmai Yin—A Report of 357 Cases

The previous experimental studies have demonstrated that addition of Huang Qi ([symbol: see text] Radix Astragali) to the formulated recipe Sheng Mai Yin ([symbol: see text] Decoction for Pulse-activation) exerts the effects of strengthening the myodynamia, increasing the coronary flow, improving myocardial metabolism, and resisting the arrhythmia. The active component of Huang Lian ([symbol: see text] Rhizoma Coptidis) can prolong the myocardial action potential and antagonize the chloroform-, aconitine-, barium chloride-, epinephrine- or coronary ligation-induced arrhythmia by blocking the calcium channel. Ku Shen ([symbol: see text] Radix Sophorae Flavescentis) contains matrine and flavones, which act as quinidine to decrease the excitability of the myocardium, prolong the refractory period, and inhibit the ectopic cardiac rhythm. And Dan Shen ([symbol: see text] Radix Salviae Miltiorrhizae) has the action of improving the ischemic state of the myocardium by dilating the coronary vessels. In conclusion, the definite therapeutic effects of Huang Lian Sheng Mai Yin in treating ventricular, atrial and nodal arrhythmia suggests that the prescription is rational and accords with the therapeutic principle of TCM. Except discomfort in the gastric cavity and poor appetite experienced by some patients, there is no toxic or adverse reaction.

The Present Situation of TCM Treatment for Diabetes and its Researches

Diabetes is a frequently encountered disease. There are now approximately 40 million diabetes patients in China1, most of them with diabetes II.

Aqueous extract of Ocimum tenuiflorum decreases levels of blood glucose in induced hyperglycemic tilapia(Oreochromis niloticus)

Objective:To evaluate,in hyperglycemic tilapia[Oreochromis niloticus(O.niloticus)].the effect of this aqueous extract on blood glucose levels.Methods:The hyperglycemia in O.niloticus was induced by adding glucose to fish pond water.An aqueous extract of Ocimum tenuiflorum (O.tenuiflorum) was prepared by boiling fresh leaves and the doses of 0,40,80,200 and 400 mg per liter of pond water were tested.Results:The blood sugar concentration for tilapia with hyperglycemic induced was an average of 50%higher than the control group.The blood glucose levels in tilapia after the induction of hyperglycemia were higher than the control group for 90 min after the treatment.The treatment with the aqueous extract of O.tenuiflorum dropped the serum glucose level of hyperglycemic tilapia until it was similar to that of the control group and was dose dependent.Conclusions:The results indicated that O.tenuiflorum was endowed with anti-hyperglycemic activity.To our knowledge,this is the first report on the use of fish as a diabetes model to test natural extracts from plants.

Randomized clinical trial of an ethanol extract of Ganoderma lucidum in men with lower urinary tract symptoms

Aim： To evaluate the safety and efficacy of an extract of Ganoderma lucidum that shows the strongest 5α-reductase inhibitory activity among the extracts of 19 edible and medicinal mushrooms by a double-blind, placebo-controlled, randomized and dose-ranging study in men with lower urinary tract symptoms （LUTS）. Methods： In this trial, we randomly assigned 88 men over the age of 49 years who had slight-to-moderate LUTS to 12 weeks of treatment with G. lucidum extract （6 mg once a day） or placebo. The primary outcome measures were changes in the International Prostate Symptom Score （IPSS） and variables of uroflowmetry. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, laboratory values and the reported adverse effects. Results： G. lucidum was effective and significantly superior to placebo for improving total IPSS with 2.1 points decreasing at the end of treatment （mean difference, -1.18 points; 95% confidence interval, -1.74 to -0.62; P 〈 0.0001）. No changes were observed with respect to quality of life scores, peak urinary flow, mean urinary flow, residual urine, prostate volume, serum prostate-specific antigen or testosterone levels. Overall treatment was well tolerated with no severe adverse effects. Conclusion： The extract of G. lucidum was well tolerated and improved IPSS scores. These results encouraged a further, large-scale evaluation of phytotherapy for a long duration using the extract of G. lucidum on men with LUTS.

Effect of an extract of Ganoderma lucidum in men with lower urinary tract symptoms： a double-blind, placebo-controlled randomized and dose-ranging study

Aim： To conduct a double-blind, placebo-controlled randomized and dose-ranging study to evaluate the safety and efficacy of the extract of Ganoderma lucidum （G. lucidum） in men with lower urinary tract symptoms （LUTS）. Methods： We enrolled male volunteers （〉 50 years） with an International Prostate Symptom Score （IPSS; questions 1-7） 〉 5 and a prostate-specific antigen （PSA） value 〈 4 ng/mL. Volunteers were randomized into groups of placebo （n = 12）, G. lucidum of 0.6 mg （n = 12）, 6 mg （n = 12） or 60 mg （n = 14）, administered once daily. Efficacy was measured as a change from baseline in IPSS and the peak urine flow rate （Qmax）. Prostate volume and residual urine were estimated by ultrasonography, and blood tests, including PSA levels, were measured at baseline and at the end of the treatment. Results： The overall administration was well tolerated, with no major adverse effects. Statistical significances in the magnitude of changes between the experimental groups were observed at weeks 4 and 8. No changes were observed with respect to Qmax, residual urine, prostate volume or PSA levels. Conclusion： The extract of G. lucidum was well tolerated and an improvement in IPSS was observed. The recommended dose of the extract of G. lucidum is 6 mg in men with LUTS.