Traditional Persian Medicine

Elham Akhtari et al. (2014) · Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences

This randomized, double-blind, placebo-controlled trial of 67 randomized women (60 analyzed) explored whether an extract of Tribulus terrestris, a low-growing plant also called puncture vine or bindii, affects sexual desire in women of childbearing age. The condition studied, hypoactive sexual desire disorder (HSDD), is a persistent lack of sexual thoughts and desire that causes personal distress, and the authors cite a prevalence of about 1 in 10 adult women in the USA and 30% in Iran. No drug is approved by the US Food and Drug Administration for it. In Iranian Traditional Medicine, texts including Avicenna's Canon of Medicine describe Tribulus as a remedy that boosts libido. The women, all married and living with a partner, were recruited at two medical centers in Tehran Province, Iran, between June 2012 and July 2013, with an average age of 36 years. After random assignment in a 1:1 ratio, one group took a syrup made from an ethanol extract of Tribulus leaves, 7.5 ml twice a day for four weeks, and the other took a look-alike sucrose syrup. Sexual function was scored with the Female Sexual Function Index (FSFI), a 19-item questionnaire covering desire, arousal, lubrication, orgasm, satisfaction and pain, completed at baseline and four weeks after treatment ended. Desire, the primary outcome, rose from 3.06 to 3.90 points in the Tribulus group but only from 2.66 to 2.86 with placebo, an adjusted difference of 0.71 points (95% CI 0.41 to 1.01, p < 0.001, meaning the gain was unlikely to be chance). Several other domains also favored Tribulus: satisfaction by 1.10 points, orgasm by 0.85, arousal by 0.75, lubrication by 0.50 and pain by 0.37 (p-values between < 0.001 and 0.041). The total FSFI score improved from 21.25 to 26.80 with Tribulus versus 20.89 to 22.41 with placebo (p = 0.040 in the results text, although the abstract gives p < 0.001). Only one participant reported a side effect, a mild (grade 1) abdominal cramp. Dropouts cited the very sweet taste and anxiety about taking an investigational drug. The authors interpret the results as supporting the traditional libido-boosting reputation of Tribulus and call for larger studies. Limitations include the small sample, only four weeks of treatment with a single follow-up, one country, and a cultural setting in which women may be reserved about reporting sexual matters. The dose is stated inconsistently between the abstract and the methods, and menopausal women were excluded, so the findings do not extend to them. The mechanism was not tested; the authors only propose a possible link to follicle-stimulating and luteinizing hormones.

Maryam Farahmand et al. (2020) · BMC complementary medicine and therapies

This randomized controlled trial with 84 women explored whether Echium amoenum (EA) — a purple-flowered herb known in Persian medicine as "Gol-e-gavzaban" and used since antiquity for mood and nervous-system complaints — could ease premenstrual syndrome (PMS). PMS is the recurring mix of mood, physical, and behavioral symptoms that shows up in the two weeks before a period, affecting an estimated 80-90% of women of reproductive age. EA is a relative of borage traditionally credited with calming and anti-inflammatory effects, governing how the body responds to hormonal shifts across the menstrual cycle. Researchers recruited 84 Iranian college students, aged 20 to 35, who met diagnostic criteria for PMS, and randomly assigned them to take either an EA extract capsule (450 mg per day, split into three doses) or an identical-looking placebo, for 10 days each cycle across two menstrual cycles. Severity was tracked with the Premenstrual Symptoms Screening Tool (PSST), a validated 19-question survey covering mood, physical symptoms, and how much they disrupted daily life, completed before treatment and after each cycle. By the second treatment cycle, women taking EA saw their average PSST score drop from 35.3 to 16.1 — more than double the improvement seen with placebo, which fell only from 31.0 to 28.3 (a reduction 11.6 points greater than placebo, 95% CI -14.7 to -8.5, p<0.001, meaning the difference is very unlikely to be chance). The benefit was already emerging after just one cycle (a 6.2-point edge over placebo, p=0.001). Every symptom tracked — irritability, anxiety, tearfulness, fatigue, and more — improved significantly more with EA than placebo, with anxiety and tearfulness showing the strongest response. Overeating and trouble concentrating improved the least, though still meaningfully more than placebo. Side effects were minimal: three women on placebo reported nausea, compared with none on EA, suggesting the herb was well tolerated over the two-cycle course. For women looking for a non-hormonal option to manage PMS, these findings offer encouraging early evidence that EA can meaningfully reduce symptom severity within one to two cycles, with mood symptoms responding best. That said, this was a single trial in college students over just two cycles, relying on self-reported symptoms, so the results may not generalize broadly. Larger, longer trials examining EA's active compounds and optimal dosing are still needed before it can be recommended with confidence.

Alireza Askari et al. (2024) · Frontiers in pharmacology

This randomized trial with 86 completing patients compared a traditional Persian medicine remedy — basil leaf oil blended with sesame oil — against a standard drugstore treatment, diclofenac gel, for knee osteoarthritis pain. Basil has been recommended for joint pain in Persian medical texts since Avicenna and Rhazes, roughly a thousand years ago, and this was the first study to directly test it head-to-head against a modern pharmaceutical. One hundred adults with knee osteoarthritis were randomly assigned to rub either the basil-sesame oil blend or 1% diclofenac gel onto their knees three times a day for 4 weeks; everyone could also take an as-needed pain pill if they needed more relief. Researchers tracked pain and stiffness using a standard osteoarthritis questionnaire (WOMAC), a 0-100 pain scale, how far patients could bend their knee, and how fast they could walk. Both treatments worked about equally well: there was no meaningful difference between the herbal oil and the diclofenac gel on any measure at 2 or 4 weeks, and both groups showed significant improvement in pain, stiffness and function compared to when they started. One interesting difference: people using diclofenac gel needed noticeably more rescue pain medication by the fourth week, while basil-oil users' need for extra medication stayed about the same — a pattern that could suggest diclofenac's effect wearing off faster. Importantly, nobody using the basil oil reported any side effects at all. These findings suggest this centuries-old herbal remedy may relieve knee osteoarthritis pain about as well as a standard anti-inflammatory gel, with an excellent safety record. That said, there was no "fake treatment" (placebo) group, so it's not fully clear how much of the improvement came from the oils themselves versus the natural ups and downs of the condition, and because sesame oil may have its own joint-protecting effects, the specific contribution of basil can't be pinned down. Larger studies with a placebo group and longer follow-up are needed before this becomes a routine recommendation.

Mohammad Mahdi Parvizi et al. (2017) · PLoS neglected tropical diseases

This triple-blind randomized controlled trial with 62 completing patients tested whether a cream made from Persian Juniper (Juniperus excelsa) leaf extract could improve treatment of cutaneous leishmaniasis (CL), a sand-fly-transmitted skin infection that causes slow-healing ulcers. Traditional Persian Medicine has described this exact condition for centuries, calling it "Rish-e-Balkhi" (Balkh sore), and prescribed Juniperus excelsa — known locally as Urs or Abhol — for infected, non-healing wounds long before modern medicine identified the parasite responsible. Researchers in Shiraz, Iran enrolled 72 adults with confirmed leishmania skin lesions and randomly assigned them to apply either a 5% Juniperus excelsa extract cream or a matching placebo cream three times a day, both combined with standard weekly freezing (cryotherapy) treatments, for up to 12 weeks. Lesions were measured weekly from photographs, and everyone was checked again 6 months later for any sign the infection had come back. The results were striking: 82% of patients using the Juniperus cream were completely cured, compared to just 34% on placebo — a difference far too large to be chance (p<0.001). The herbal-cream group also healed faster (about 6.5 weeks versus 8.7 weeks) and needed fewer freezing sessions to get there. Statistically, patients using the cream were about 13.5 times more likely to achieve a complete cure. None of the cured patients in either group saw their infection return over the following six months. Side effects were mild — about 15% of the cream group had temporary redness and itching after roughly five weeks, similar to rates in the placebo group, and only one person stopped using it (after already being cured). This traditional remedy, still cheap and easy to prepare today, appears to meaningfully boost cure rates and speed healing for cutaneous leishmaniasis when added to standard cryotherapy. Because every patient in the study also received cryotherapy, the cream's effect on its own — without freezing treatment — is still untested, and the trial excluded facial lesions and children. Larger studies, including one testing the cream by itself, would help confirm exactly how much of the benefit comes from the herb.

Ramin Ansari et al. (2024) · Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

This randomized, double-blind, placebo-controlled trial with 51 adults explored whether Mofatet powder — a six-herb formulation from Traditional Persian Medicine (TPM) — could shrink existing calcium kidney stones, not just prevent new ones. TPM is a centuries-old medical system, described in texts by Rhazes and Avicenna, that combines specific plant combinations for named conditions; Mofatet powder is one such combination, traditionally taken as a boiled decoction of six seeds and fruits in equal parts. Kidney stones affect up to 15% of people worldwide, and most current drugs only stop new stones from forming rather than dissolving the ones already there. Researchers recruited 51 adults (mean age about 50) with confirmed calcium stones at least 5mm across, in Shiraz, Iran. Twenty-six received capsules of a freeze-dried extract of the six-herb blend (cucumber seed, pumpkin seed, celery seed, fennel seed, anise seed, and tribulus fruit) twice daily for 5 weeks; 25 received a matching placebo. Stone size was tracked by ultrasound imaging, alongside urine and blood chemistry. The herbal group's stones shrank by 60.73% on average, compared to just 2.52% in the placebo group (a highly significant difference, p<0.001), and two people's stones disappeared entirely versus none on placebo. Urinary magnesium — a mineral that normally helps stop stone-forming crystals from growing — rose by nearly 58% in the herbal group, while urinary calcium (a stone-forming risk factor) dropped. Urine also became less concentrated (lower specific gravity), which reduces the conditions that let crystals form in the first place. Importantly, kidney and liver function tests (BUN, creatinine, AST, ALT) showed no meaningful changes in either group, and no significant side effects were reported over the five weeks — though the herbal group did show a rise in blood calcium that the researchers did not fully explain. These findings suggest this traditional formulation could be a safe, complementary option for people managing calcium kidney stones, likely by making urine less prone to crystal formation rather than by dissolving stones directly. The trial was conducted at a single center with a modest number of participants over a short 5-week window, so the results need confirming in larger, longer studies before this becomes a routine recommendation.

Simin Sadat Motevalli Haghi et al. (2024) · Avicenna journal of phytomedicine

This triple-blinded randomized trial with 80 women explored whether combining two traditional Persian herbs — fennel (Foeniculum vulgare) fruit and Echium amoenum flower — could ease premenstrual syndrome (PMS), the cluster of physical and mood symptoms that appears in the two weeks before a period. The herbs were chosen because fennel contains phytoestrogens (plant compounds that mimic estrogen) and Echium amoenum has serotonergic effects (influencing serotonin, the neurotransmitter tied to mood and pain sensitivity) — both hormone and neurotransmitter shifts are suspected drivers of PMS. Eighty women aged 18 to 35 with confirmed PMS were randomly split into two groups at clinics in Mashhad, Iran. The treatment group took capsules combining Echium amoenum (2 grams daily) and fennel (1 gram daily) during the second half of their cycle for two consecutive months; the control group took matching placebo capsules. Symptoms were tracked with the Daily Record of Severity of Problems (DRSP), a validated scale covering mood, sleep, and physical symptoms across 11 categories, while overall quality of life was measured with the SF-36 survey before and after treatment. Women taking the herbal combination showed significantly greater improvement than the placebo group across every DRSP symptom category at both one and two months (p<0.05 for all comparisons, meaning the difference was unlikely due to chance). Notably, depression, concentration, appetite, sleep, and sense of control improved only in the herb group — the placebo group saw no change in these — while symptoms like anxiety and irritability improved somewhat in both groups. Quality of life rose meaningfully in seven of eight SF-36 domains, with the total quality-of-life score climbing from about 64 to 80 out of 100 in the herbal group versus no change on placebo. One safety signal emerged: menstrual bleeding volume increased in the treatment group compared to placebo (p<0.05), a side effect worth watching. These results suggest the fennel-Echium combination may offer real relief for PMS, particularly the mood and cognitive symptoms that placebo alone did not touch. However, the two groups differed at the study's start in age, weight, and other factors, which could have influenced the outcome, and the trial was conducted at clinics in a single city. The increased bleeding volume also needs monitoring in future use. Larger, multicenter trials with better-matched groups are needed to confirm the effect and pin down the ideal dose and treatment length.

Seyedeh Zahra Maddahi et al. (2022) · Pharmacology research & perspectives

This pilot, double-blind, placebo-controlled trial with 34 newly diagnosed pulmonary tuberculosis patients explored whether Jujube (Ziziphus jujuba), a fruit long used in traditional Persian medicine for liver complaints, could guard the liver during the first weeks of standard four-drug anti-tuberculosis treatment. Anti-TB drugs commonly injure the liver, a complication called drug-induced hepatotoxicity (governing whether treatment can continue on schedule), reported in up to 28% of patients. Jujube's traditional reputation rests partly on compounds called phenols, which govern antioxidant activity by neutralizing the free radicals that anti-TB drugs generate in liver cells. Over four weeks across five Iranian health centers, participants aged 18 to 68 took either 10 cc of jujube syrup or an identical-tasting placebo syrup daily alongside their standard tuberculosis medications. Researchers measured liver enzymes by blood test at the start, two weeks, and four weeks in, and tracked cough, appetite loss, nausea, and overall quality of life using standardized questionnaires. Seventeen of the 34 enrolled participants, eight jujube and nine placebo, completed all four weeks, with a COVID-19 outbreak driving most of the dropout. By the two-week mark, more than a quarter of placebo-group patients (27.3%) had developed liver injury, compared to none in the jujube group, a statistically meaningful difference (p=.037, meaning this gap is unlikely to be chance). AST liver-enzyme levels were also significantly lower with jujube at two weeks (p=.039, a large effect), though the companion ALT measurement did not reach statistical significance (p=.114). Cough severity dropped significantly more with jujube at both two weeks (p=.046) and four weeks (p=.024), and overall quality of life improved significantly more by four weeks (p=.032), especially in physical well-being. Gastrointestinal symptoms like nausea and appetite loss improved similarly in both groups. No one in the jujube group stopped taking it because of side effects. These early results suggest jujube syrup could be a simple, low-cost addition to standard tuberculosis care that protects the liver during its highest-risk window while easing cough and improving daily life. The catch: only 17 patients completed the study, and a pandemic-driven dropout forced the trial to end as a small pilot rather than its originally planned larger version, so these findings point toward a promising direction rather than settled proof. Confirmation in a full-scale trial is the clear next step before jujube syrup could be recommended in tuberculosis treatment.