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Background The results of recent surveys indicate that more than 50% of the German population has experience with complementary and alternative medicine (CAM) or uses CAM regularly. This study investigated the CAM usage and CAM-related needs of hospitalized patients at university medical centres in the state of Baden-Württemberg, Germany. Methods A multi-centre, paper-based, pseudonymous survey was carried out by the members of the Academic Centre for Complementary and Integrative Medicine. Patients of all ages, regardless of sex, diagnosis and treatment, who were hospitalized in the Department of Cardiology, Gastroenterology, Oncology, Gynaecology or Surgery at the university medical centres in Freiburg, Heidelberg, Tübingen and Ulm were eligible for inclusion. Results Of the 1275 eligible patients, 67% (n = 854) consented to participate in the survey. Forty-eight percent of the study participants stated that they were currently using CAM. The most frequently used therapies were exercise (63%), herbal medicine (54%) and dietary supplements (53%). Only 16% of the patients discussed CAM usage with their attending physician. Half of the patients (48%) were interested in CAM consultations. More than 80% of the patients desired reliable CAM information and stated that physicians should be better informed about CAM. Conclusions The frequency of CAM usage and the need for CAM counselling among hospitalized patients at university medical centres in Baden-Württemberg are high. To better meet patients’ needs, CAM research and physician education should be intensified. Trial registration German Clinical Trial register (DRKS00015445).

Background Little is known about the medical material and practices of tribes in the western border areas of Pakistan. The local population has inhabited this remote and isolated area for centuries, and gained medicinal knowledge with personal experiences and knowledge learned from forefathers. Due to the geographical isolation of the communities in the Sulaiman hills of Pakistan and their unique culture, the area is of importance for exploration and assessment. Methods A total of 116 informants were interviewed in five foothill villages and the associated migratory mountain villages during 2010–2012 and 2015. Information was gathered mainly through semi-structured interviews and freelisting. Local diseases were categorized based on symptoms and affected organs. Descriptive statistics were used for data analysis. Results Depending on the type of illness, typically a pulse diagnoser or a religious specialist is consulted. Medicinal plant knowledge and use is mostly known and advised by elders within the family. A total of 44 plant species from 32 families (588 use reports), 7 animal species and 6 minerals and other sources (384 use reports) were documented as materia medica. Among the plants, the Lamiaceae is the most dominantly used plant family, followed by Pinaceae. The most frequently reported single species was Teucrium stocksianum. The most often mentioned diseases and treatments fall into the categories of gastrointestinal, ritual, and musculoskeletal diseases. The use of goat and sheep skin as medicine was pivotal in the local medicinal system. Remedies from animal parts and other biological and non-biological sources were mainly used for musculoskeletal ailments and ritual treatments. Overall, people rely on both traditional and biomedical medication and treatments and combination of these systems. Conclusion This paper provides insight into the pluralistic medication system of rural communities of northwest Pakistan. It highlights the materia medica most commonly in use. A considerable part of the documented materia medica and local practices is part of an oral tradition and cannot be found in written sources or scientific articles. The gaining of new medicinal knowledge in the area was the good sign of continuation of traditional medicinal practices.

Background Lycium barbarum polysaccharide (LBP), the most abundant functional component of wolfberry, is considered a potent antioxidant and an anti-ageing substance. This review aims to outline the hallmarks of ageing in the pathogenesis of osteoarthritis (OA), followed by the current understanding of the senolytic effect of LBP and its potential use in the prevention and treatment of OA. This will be discussed through the lens of molecular biology and herbal medicine. Methods A literature search was performed from inception to March 2020 using following keywords: “Lycium barbarum polysaccharide”, “DNA damage”, antioxidant, anti-apoptosis, anti-inflammation, anti-ageing, osteoarthritis, chondrocytes, fibroblasts, osteoblasts, osteoclasts, and “bone mesenchymal stem cell”. The initial search yielded 2287 papers, from which 35 studies were selected for final analysis after screening for topic relevancy by the authors. Results In literature different in vitro and in vivo ageing models are used to demonstrate LBP’s ability to reduce oxidative stress, restore mitochondrial function, mitigate DNA damage, and prevent cellular senescence. All the evidence hints that LBP theoretically attenuates senescent cell accumulation and suppresses the senescence-associated secretory phenotype as observed by the reduction in pro-inflammatory cytokines, like interleukin-1beta, and matrix-degrading enzymes, such as MMP-1 and MMP-13. However, there remains a lack of evidence on the disease-modifying effect of LBP in OA, although its chondroprotective, osteoprotective and anti-inflammatory effects were reported. Conclusion Our findings strongly support further investigations into the senolytic effect of LBP in the context of age-related OA.

BackgroundAdvances in systems science creates an opportunity to bring a complexity perspective to health care practices and research. While medical knowledge has greatly progressed using a reductionist and mechanistic philosophy, this approach may be limited in its capacity to manage chronic and complex illness. With its holistic foundation, naturopathy is a primary health profession with a purported alignment with a complexity perspective. As such this pilot study aimed to investigate the application of complexity science principles, strategies, and tools to primary health care using naturopathy as a case study.MethodsA network mapping and analysis of the naturopathic case management process was conducted. Mind maps were created by naturopathic practitioners to reflect their clinical conceptualisation of a common paper clinical case. These mind maps were inputed intoGephi, a network mapping, exploration, and analysis software. Various layouts of the data were produced, and these were analysed using exploratory data analysis and computational network analysis.ResultsSeven naturopathic practitioners participated in the study. In the combined network mapping, 133 unique elements and 399 links were identified. Obesity, the presenting issue in the case, was centrally located. Along with obesity, other keystone elements included: systemic inflammation, dysbiosis, diet, the liver, and mood. Each element was connected on average to 3.05 other elements, with a degree variation between one and 36. Six communities within the dataset were identified, comprising: the nervous system and mood, gastroinstetinal and dietary factors, systemic inflammation and obesity, the endocrine system and metabolism.ConclusionsThis pilot study demonstrates that it is feasible to apply a complexity science perspective to investigating primary health care case management. This supports a shift to viewing the human organism as a complex adaptive system within primary health care settings, with implications for health care practices that are more cognisant with the treatment of chronic and complex conditions and research opportunities to capture the complex clinical reasoning processes of practitioners.

Background Childbearing women have been using various herbs to assist with pregnancy, labour and birth for centuries. One of the most common is raspberry leaf. The evidence base for the use of raspberry leaf is however under-developed. It is incumbent on midwives and other maternity care providers to provide women with evidence-based information so they can make informed choices. The aim of this study was to review the research literature to identify the evidence base on the biophysical effects, safety and efficacy of raspberry leaf in pregnancy. Methods A systematic, integrative review was undertaken. Six databases were searched to identify empirical research papers published in peer reviewed journals including in vitro, in vivo, human and animal studies. The search included the databases CINAHL, MEDLINE, Cochrane Library, Scopus and Web of Science Core Collection and AMED. Identified studies were appraised independently by two reviewers using the MMAT appraisal instrument. An integrative approach was taken to analysis. Results Thirteen studies were included. Five were laboratory studies using animal and human tissue, two were experiments using animals, and six were human studies. Included studies were published between 1941 and 2016. Raspberry leaf has been shown to have biophysical effects on animal and human smooth muscle including the uterus. Toxity was demonstrated when high doses were administered intravenously or intaperitoneally in animal studies. Human studies have not shown any harm or benefit though one study demonstrated a clinically meaningful (though non-statistically significant) reduction in length of second stage and augmentation of labour in women taking raspberry leaf. Conclusions Many women use raspberry leaf in pregnancy to facilitate labour and birth. The evidence base supporting the use of raspeberry leaf in pregnancy is weak and further research is needed to address the question of raspberry leaf’s effectiveness.

Background The usage of medicinal plants as a key component of complementary and alternative medicine, has acquired renewed interest in developed countries. The current situation of medicinal plants in Spain is very limited. This paper provides new insights and greater knowledge about current trends and consumption patterns of medicinal plants in the Autonomous Community of Madrid (Spain) for health benefits. Methods A descriptive cross-sectional study was designed for a population-based survey on medicinal plants. The data were collected (May 2018 to May 2019) using semi-structured face-to-face interviews in independent pharmacies, hospital centers and primary care health centers in the Autonomous Community of Madrid. The survey had 18 multiple choice and open-ended questions. Quantitative indices were calculated: Fidelity Level (FL), Use Value (UV) and Informants Consensus Factor (ICF). Chi-square test was used for data analysis. Results Five hundred forty-three people were interviewed. The majority of the participants (89.6%) have used medicinal plants to treat health disorders in the past 12 months, mainly for digestive problems, sleep disorders and central nervous system diseases. A total of 78 plants were recorded, being Matricaria recutita, Valeriana officinalis, Tilia spp. and Aloe vera the most used. The highest UV was found for Mentha pulegium (UV 0.130) followed by Aloe vera (UV 0.097) and Vaccinium macrocarpon. (UV 0.080). The highest FL values were for Eucalyptus spp. (FL 90.47%) for respiratory conditions and, Matricaria recutita (85.55%) and Mentha pulegium (84.09%) for digestive problems. The highest ICF corresponded to metabolism and depression (ICF = 1), pain (ICF = 0.97), insomnia (ICF = 0.96) and anxiety (ICF = 0.95). Participants mostly acquired herbal medicines from pharmacies, herbal shops and supermarkets. Some side effects (tachycardia, dizziness and gastrointestinal symptoms) and potential interactions medicinal plants-drugs (V. officinalis and benzodiazepines) were reported. Conclusion Many inhabitants of the Autonomous Community of Madrid currently use herbal products to treat minor health problems. The most common consumer pattern are young women between 18 and 44 years of age with higher education. In order to confirm the pattern, further research should be focused to investigate current uses of medicinal plants in other Spanish regions.

Background Inflammatory bowel disease (IBD) is a severe digestive system condition, characterized by chronic and relapsing inflammation of the gastrointestinal tract. Scutellaria baicalensis Georgi (Huangqin, HQ) and Paeonia lactiflora Pall (Baishao, BS) from a typical herbal synergic pair in traditional Chinese medicine (TCM) for IBD treatments. However, the mechanisms of action for the synergy are still unclear. Therefore, this paper aimed to predict the anti-IBD targets and the main active ingredients of the HQ-BS herbal pair. Methods A systems pharmacology approach was used to identify the bioactive compounds and to delineate the molecular targets and potential pathways of HQ-BS herbal pair. Then, the characteristics of the candidates were analyzed according to their oral bioavailability and drug-likeness indices. Finally, gene enrichment analysis with DAVID Bioinformatics Resources was performed to identify the potential pathways associated with the candidate targets. Results The results showed that, a total of 38 active compounds were obtained from HQ-BS herbal pair, and 54 targets associated with IBD were identified. Gene Ontology and pathway enrichment analysis yielded the top 20 significant results with 54 targets. Furthermore, the integrated IBD pathway revealed that the HQ-BS herbal pair probably acted in patients with IBD through multiple mechanisms of regulation of the nitric oxide biosynthetic process and anti-inflammatory effects. In addition, cell experiments were carried out to verify that the HQ-BS herbal pair and their Q-markers could attenuate the levels of nitric oxide (NO), prostaglandin E2 (PGE2), inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in lipopolysaccharide (LPS)-stimulated THP-1-derived macrophage inflammation. In particular, the crude materials exerted a much better anti-inflammatory effect than their Q-markers, which might be due to their synergistic effect. Conclusion This study provides novel insight into the molecular pathways involved in the mechanisms of the HQ-BS herbal pair acting on IBD.

Background The aerial parts of Salvia miltiorrhiza, which was considered to be the waste part and discarded during the root harvest, is rich in protocatechuic aldehyde (PAI). This study investigated the health-promoting effects of extracts and PAI from the aerial parts of Salvia miltiorrhiza, including its anti-inflammatory effects and the underlying mechanisms of action in vitro and in vivo. Method Purification of the sample paste of Salvia miltiorrhiza was accomplished using HPLC analysis. TheMTT (Methylthiazolyldiphenyl-tetrazolium bromide) assay was employed to determine the cell viability. The production of inflammatory factors was detected by ELISA assays. The histopathological analysis was used to analyse the lungs and livers of mice treated with PAI. Western blot was performed to reveal the mechanism of PAI in anti-inflammatory. Results The extracts and PAI from the aerial parts of Salvia miltiorrhiza inhibited TNF-α, IL-6 production and promoted the production of IL-10 in vivo in mice and in vitro in the macrophage cell line RAW264.7. NF-κB and MAPKs kinase phosphorylation were also suppressed by PAI in vivo and in vitro, indicating that PAI exhibited an anti-inflammatory effect. Conclusion These findings suggest that the aerial parts of Salvia miltiorrhiza extract may serve as potential protective agents for inflammatory. Supplementary information Supplementary information accompanies this paper at 10.1186/s12906-020-03090-4.