Open Access
Subscription Access
Open Access
Subscription Access
Polyherbal Formulation for Primary Dysmenorrhea: A Review
Subscribe/Renew Journal
Primary dysmenorrhea (PD) is defined as painful menstrual flow in teenagers who have no other gynaecological symptoms. High absenteeism to school and work have been reported in women with primary dysmenorrhea. Non-steroidal anti-inflammatory drugs (NSAIDs) and low dose oral contraceptive pills (OCPs) are the conventional treatment for primary dysmenorrhea. Despite their effectiveness, various side effects hinder the patients away from long time management with conventional treatment. Various polyherbal formulation have been used for centuries in the management of primary dysmenorrhea. However, scientific evidence of its mechanism of action and clinical effectiveness are scarce. A summarised overview of the molecular pathogenesis of the primary dysmenorrhea has been provided to understand the mechanistic pathway involved in primary dysmenorrhea. A total of 8 polyherbal formulations have been included. Pre-clinical and clinical trials of polyherbal formulation commonly used in primary dysmenorrhea have been discussed in this review to provide a picture of the current practice of traditional medicines in the management of primary dysmenorrhea. Most of the preparations demonstrated their actions through regulation of inflammatory markers and hormones in vivo. Inconsistency in sample size, doses of herbal preparation and primary outcomes of clinical trials created controversial findings on the effectiveness of the polyherbal preparation in human.
Keywords
Herbs, Polyherbal Formulation, Primary Dysmenorrhea, Traditional Medicines.
Subscription
Login to verify subscription
User
Font Size
Information
- Habibi N, Huang MSL, Gan WY, Zulida R, Safavi SM. Prevalence of Primary Dysmenorrhea and Factors Associated with Its Intensity Among Undergraduate Students: A Cross-Sectional Study. Pain Manag Nurs. 2015;16(6):855–61.
- Latthe P, Latthe M, Say L, Gülmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: A neglected reproductive health morbidity. BMC Public Health. 2006;6:177.
- Samani RO, Hashiani AA, Razavi M, Vesali S, Rezaeinejad M, Maroufizadeh S, et al. The prevalence of menstrual disorders in iran: A systematic review and meta-analysis. Vol. 16, International Journal of Reproductive BioMedicine. Research and Clinical Center for Infertility; 2018. p. 665–78.
- Zurawiecka M, Wronka I. Association of primary dysmenorrhea with anthropometrical and socio-economic factors in Polish university students. J Obstet Gynaecol Res. 2018;44(7):1259–67.
- Rafique N, Al-Sheikh MH. Prevalence of primary dysmenorrhea and its relationship with body mass index. J Obstet Gynaecol Res. 2018;44(9):1773–8.
- Fernández-Martínez E, Onieva-Zafra MD, Laura Parra-Fernández M. Lifestyle and prevalence of dysmenorrhea among Spanish female university students. PLoS One. 2018;13(8).
- Acheampong K, Baffour-Awuah D, Ganu D, Appiah S, Pan X, Kaminga A, et al. Prevalence and predictors of dysmenorrhea, its effect, and coping mechanisms among adolescents in Shai Osudoku district, Ghana. Obstet Gynecol Int. 2019;2019.
- Abd El-Mawgod MM, Alshaibany AS, Al-Anazi AM. Epidemiology of dysmenorrhea among secondary-school students in Northern Saudi Arabia. J Egypt Public Health Assoc. 2016;91(3):115–9.
- Zhou H-G, Yang Z-W, Group S. Prevalence of dysmenorrhea in female students in a Chinese university: a prospective study. Health (Irvine Calif). 2010;02(04):311–4.
- Chen L, Tang L, Guo S, Kaminga AC, Xu H. Primary dysmenorrhea and self-care strategies among Chinese college girls: A cross-sectional study. BMJ Open. 2019;9(9).
- Salmiah bt. Md. Sharif. Dysmenorrhoea [Internet]. 2014. Available from: http://www.myhealth.gov.my/dysmenorrhoea/
- Petraglia F, Bernardi M, Lazzeri L, Perelli F, Reis FM. Dysmenorrhea and related disorders. F1000Research. 2017;5(6):1645.
- Coco AS. Primary dysmenorrhea. Am Fam Physician. 1999;60(2):489–96.
- Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014;89(5):341–6.
- Latthe P, Mignini L, Gray R, Hills R, Khan K. Factors predisposing women to chronic pelvic pain: Systematic review. Br Med J. 2006;332(7544):749–51. 16. French L. Dysmenorrhea. Am Fam Physician. 2005;71(2):285–92.
- Ju H, Jones M, Mishra G. The prevalence and risk factors of dysmenorrhea. Epidemiol Rev. 2014;36(1):104–13.
- Charu S, Amita R, Sujoy R, Thomas GA. “Menstrual characteristics” and “prevalence and effects of dysmenorrhea” on quality of life of medical students. Int J Collab Res Intern Med Public Heal. 2012;4(4):276–94.
- Ayranci U, Tozun M, Unsal A. Headache among adults and its effect on quality of life in a town of Western Turkey. Pakistan J Med Sci. 2011;27(4):775–9.
- Vilšinskaitė DS, Vaidokaitė G, Mačys Ž, Bumbulienė Ž. The risk factors of dysmenorrhea in young women. Vol. 72, Wiadomosci lekarskie (Warsaw, Poland : 1960). 2019. p. 1170–4.
- Weissman AM, Hartz AJ, Hansen MD, Johnson SR. The natural history of primary dysmenorrhoea: A longitudinal study. BJOG An Int J Obstet Gynaecol. 2004;111(4):345–52.
- Hailemeskel S, Demissie A, Assefa N. Primary dysmenorrhea magnitude, associated risk factors, and its effect on academic performance: Evidence from female university students in Ethiopia. Int J Womens Health. 2016;8:489–96.
- Nohara M, Momoeda M, Kubota T, Nakabayashi M. Menstrual cycle and menstrual pain problems and related risk factors among Japanese female workers. Ind Health. 2011;49(2):228–34.
- Bajalan Z, Moafi F, MoradiBaglooei M, Alimoradi Z. Mental health and primary dysmenorrhea: a systematic review. J Psychosom Obstet Gynecol. 2018;40(3):185–94.
- Jensen MP, Turk DC. Contributions of psychology to the understanding and treatment of people with chronic pain. Am Psychol. 2014;69(2):105–18.
- Chatterton RT. The role of stress in female reproduction: animal and human considerations. Int J Fertil. 1990;35(1):8–13.
- Wang L, Wang X, Wang W, Chen C, Ronnennberg AG, Guang W, et al. Stress and dysmenorrhoea: A population based prospective study. Occup Environ Med. 2004;61(12):1021–6.
- Harel Z. Dysmenorrhea in adolescents. In: Annals of the New York Academy of Sciences. 2008. p. 185–95.
- Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. Br Med J. 2006;332(7550):1134–8.
- Zannoni L, Giorgi M, Spagnolo E, Montanari G, Villa G, Seracchioli R. Dysmenorrhea, absenteeism from school, and symptoms suspicious for endometriosis in adolescents. J Pediatr Adolesc Gynecol. 2014;27(5):258–65.
- Ortiz MI, Rangel-Flores E, Carrillo-Alarcón LC, Veras-Godoy HA. Prevalence and impact of primary dysmenorrhea among Mexican high school students. Int J Gynecol Obstet. 2009;107(3):240–3.
- Vlachou E, Owens DA, Lavdaniti M, Kalemikerakis J, Evagelou E, Margari N, et al. Prevalence, Wellbeing, and Symptoms of Dysmenorrhea among University Nursing Students in Greece. Diseases. 2019;7(1):5.
- IASP. Global Year Against Pain in Women. [Internet]. Vol. 22, Journal of pain & palliative care pharmacotherapy. Washington, DC; 2008. p. 90–1. Available from: https://s3.amazonaws.com/rdcms-iasp/files/production/public/Content/ContentFolders/GlobalYearAgainstPain2/20072008PaininWomen/GYAP_Overview_Slideshow_120207.ppt
- Orhan C, Çelenay ŞT, Demirtürk F, Özgül S, Üzelpasacı E, Akbayrak T. Effects of menstrual pain on the academic performance and participation in sports and social activities in Turkish university students with primary dysmenorrhea: A case control study. J Obstet Gynaecol Res. 2018;44(11):2101–9.
- Armour M, Parry K, Manohar N, Holmes K, Ferfolja T, Curry C, et al. The Prevalence and Academic Impact of Dysmenorrhea in 21,573 Young Women: A Systematic Review and Meta-Analysis. J Women’s Heal. 2019;28(8):1161–71.
- I Liliwati, LKM Verna OK. Dysmenorrhoea and its Effects on School Activities Among Adolescent Girls in a Rural School in Selangor, Malaysia. Med Heal. 2007;2(1):42–7.
- Sundell G, Milsom I, Andersch B. Factors influencing the prevalence and severity of dysmenorrhoea in young women. BJOG An Int J Obstet Gynaecol. 1990;97(7):588–94.
- Dawood MY. Primary dysmenorrhea: Advances in pathogenesis and management. Obstet Gynecol. 2006;108(2):428–41.
- Csapo AI, Pinto-Dantas CR. The cyclic activity of the nonpregnant human uterus. A new method for recording intrauterine pressure. Fertil Steril. 1966;17(1):34–8.
- Liedman R, Hansson SR, Howe D, Igidbashian S, Mcleod A, Russell RJ, et al. Reproductive hormones in plasma over the menstrual cycle in primary dysmenorrhea compared with healthy subjects. Gynecol Endocrinol. 2008;24(9):508–13.
- Nissenson R, Flouret G, Hechter O. Opposing effects of estradiol and progesterone on oxytocin receptors in rabbit uterus. Proc Natl Acad Sci U S A. 1978;75(4):2044–8.
- Joelsson I, Ingelman‐Sundberg A, Sandberg F. The in vivo effect of oxytocin and vasopressin on the non pregnant human uterus. BJOG An Int J Obstet Gynaecol. 1966;73(5):832–6.
- Ākerlund M, Andersson KE. Vasopressin response and terbutaline inhibition of the uterus. Obstet Gynecol. 1976;48(5):528–36.
- Laudanski T, Kostrzewska A, Åkerlund. Involvement of prostaglandins in the effect of cupric ions on the human uterus. Prostaglandins. 1986;32(1):33–41. 45. ÅKerlund M, Strömberg P, Forsling ML. Primary dysmenorrhoea and vasopressin. BJOG An Int J Obstet Gynaecol. 1979;86(6):484–7.
- Wilhelmsson L, Lindblom B, Wiqvist N. The human uterotubal junction: Contractile patterns of different smooth muscle layers and the influence of prostaglandin E2, prostanglandin F2α, and prostaglandin I2 in vitro. Fertil Steril. 1979;32(3):303–7.
- Ekström P, Akerlund M, Forsling M, Kindahl H, Laudanski T, Mrugacz G. Stimulation of vasopressin release in women with primary dysmenorrhoea and after oral contraceptive treatment—effect on uterine contractility. BJOG An Int J Obstet Gynaecol. 1992;99(8):680–4.
- Fang L, Gu C, Liu X, Xie J, Hou Z, Tian M, et al. Metabolomics study on primary dysmenorrhea patients during the luteal regression stage based on ultra performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry. Mol Med Rep. 2017;15(3):1043–50.
- NAYLOR B, POYSER NL. Effects of oestradiol and progesterone on the in vitro production of prostaglandin F2α by the guinea‐pig uterus. Br J Pharmacol. 1975;55(2):229–32.
- Ozsoy AZ, Karakus N, Yigit S, Cakmak B, Nacar MC, Yilmaz Dogru H. The evaluation of IL6 and ESR1 gene polymorphisms in primary dysmenorrhea. Immunol Invest. 2016;45(1):75–86.
- Bonney RC, Qizilbash ST, Franks S. Endometrial phospholipase A2 enzymes and their regulation by steroid hormones. J Steroid Biochem. 1987;27(4–6):1057–64.
- Ma H, Hong M, Duan J, Liu P, Fan X, Shang E, et al. Altered Cytokine Gene Expression in Peripheral Blood Monocytes across the Menstrual Cycle in Primary Dysmenorrhea: A Case-Control Study. PLoS One. 2013;8(2).
- Milne SA, Jabbour HN. Prostaglandin (PG) F2α receptor expression and signaling in human endometrium: Role of PGF2α in epithelial cell proliferation. J Clin Endocrinol Metab. 2003;88(4):1825–32.
- Matsumoto T, Sagawa N, Yoshida M, Mori T, Tanaka I, Mukoyama M, et al. The prostaglandin E2 and F(2α) receptor genes are expressed in human myometrium and are down-regulated during pregnancy. Biochem Biophys Res Commun. 1997;238(3):838–41.
- Sugimoto Y, Yamasaki A, Segi E, Tsuboi K, Aze Y, Nishimura T, et al. Failure of parturition in mice lacking the prostaglandin F receptor. Science (80- ). 1997;277(5326):681–3.
- Jabbour HN, Sales KJ. Prostaglandin receptor signalling and function in human endometrial pathology. Vol. 15, Trends in Endocrinology and Metabolism. 2004. p. 398–404.
- Powell AM, Chan WY, Alvin P, Litt IF. Menstrual-PGF2α, PGE2 and TXA2 in normal and dysmenorrheic women and their temporal relationship to dysmenorrhea. Prostaglandins. 1985;29(2):273–89.
- Toppozada M, Gaafar A, Shaala S. In vivo inhibition of the human non-pregnant uterus by prostaglandin E2. Prostaglandins. 1974;8(5):401–10.
- Martin JN, Bygdeman M. The effect of locally administered PGE2 on the contractility of the nonpregnant human uterus in vivo. Prostaglandins. 1975;10(2):253–65.
- Pickles VR, Hall WJ, Best FA, Smith GN. Prostaglandins in endometrium and menstrual fluid from normal and dysmenorrhoeic subjects. BJOG An Int J Obstet Gynaecol. 1965;72(2):185–92.
- Sorbie J. Prostaglandin inhibitors: rational therapy for dysmenorrhea. Can Fam Physician [Internet]. 1982 Jan;28:91–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21289848%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC2306303
- Turnbach ME, Seth Spraggins D, Randich A. Spinal administration of prostaglandin E2 or prostaglandin F2α primarily produces mechanical hyperalgesia that is mediated by nociceptive specific spinal dorsal horn neurons. Pain. 2002;97(1–2):33–45.
- Minami T, Uda R, Horiguchi S, Ito S, Hyodo M, Hayaishi O. Allodynia evoked by intrathecal administration of prostaglandin E2 to conscious mice. Pain. 1994;57(2):217–23.
- Ylikorkala O, Mäkilä UM. Prostacyclin and thromboxane in gynecology and obstetrics. Am J Obstet Gynecol. 1985;152(3):318–29.
- Bieglmayer C, Hofer G, Kainz C, Reinthaller A, Kopp B, Janisch H. Concentrations of various arachidonic acid metabolites in menstrual fluid are associated with menstrual pain and are influenced by hormonal contraceptives. Gynecol Endocrinol. 1995;9(4):307–12.
- Wilhelmsson L, Wikland M, Wiqvist N. PGH2, TxA2 and PGI2 have potent and differentiated actions on human uterine contractility. Prostaglandins. 1981;21(2):277–86.
- Nigam S, Benedetto C, Zonca M, Leo-Rossberg I, Lubbert H, Hammerstein J. Increased concentrations of eicosanoids and platelet-activating factor in menstrual blood from women with primary dysmenorrhea. Eicosanoids. 1991;4(3):137–41.
- Rees MC, DiMarzo V, Tippins JR, Morris HR, Turnbull AC. Leukotriene release by endometrium and myometrium throughout the menstrual cycle in dysmenorrhoea and menorrhagia. J Endocrinol. 1987;113(2):291–5.
- Fujiwara H, Konno R, Netsu S, Odagiri K, Taneichi A, Takamizawa S, et al. Efficacy of montelukast, a leukotriene receptor antagonist, for the treatment of dysmenorrhea: A prospective, double-blind, randomized, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol. 2010;148(2):195–8.
- Parasuraman S, Thing GS, Dhanaraj SA. Polyherbal formulation: Concept of ayurveda. Pharmacogn Rev [Internet]. 2014 Jul;8(16):73–80. Available from: https://pubmed.ncbi.nlm.nih.gov/25125878
- Gritsanapan W, Tangyuenyongwatana P. Standardization of Prasaplai, a Thai traditional preparation for antidysmenorrhea. Bot Targets Ther. 2015;2016(6):1.
- Sriyakul K, Kietinun S, Pattaraarchachai J, Ruangrungsi N. A comparative double-blinded randomized study: The efficacy of prasaplai herbal extract versus mefenamic acid in relieving pain among primary dysmenorrhea patients. Open Complement Med J. 2012;4:16–21.
- Waltenberger B, Schuster D, Paramapojn S, Gritsanapan W, Wolber G, Rollinger J, et al. In silico strategy for the identification of cyclooxygenase inhibitors from the Thai medicinal mixture Prasaplai. Planta Med. 2010;76(12):1173–1173.
- Nualkaew S, Tiangda C, Gritsanapan W. Inhibitory action on rat uterine muscle contraction in vitro and acute toxicity in rats of the thai traditional preparation prasaplai. Nat Prod Res. 2013;27(4–5):491–5.
- Kamalashiran C LOT. The comparative study of the efficacy and side effect of Prasaplai extract versus Mefenamic acid on relieving primary dysmenorrhea: A clinical phase II trials. Thammasart Med J. 2012;12:749–56.
- Leem J, Jo J, Kwon CY, Lee H, Park KS, Lee JM. Herbal medicine (Hyeolbuchukeo-tang or Xuefu Zhuyu decoction) for treating primary dysmenorrhea: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2019 Feb;98(5):e14170.
- Xing Z, Xia Z, Peng W, Li J, Zhang C, Fu C, et al. Xuefu Zhuyu decoction, a traditional Chinese medicine, provides neuroprotection in a rat model of traumatic brain injury via an anti-inflammatory pathway. Sci Rep. 2016;6.
- Yeh CW, Liu HK, Lin LC, Liou KT, Huang YC, Lin CH, et al. Xuefu Zhuyu decoction ameliorates obesity, hepatic steatosis, neuroinflammation, amyloid deposition and cognition impairment in metabolically stressed APPswe/PS1dE9 mice. J Ethnopharmacol. 2017;209:50–61.
- Li M, Hung A, Yang AWH. Guizhi Fuling Wan for uterine fibroids: A systematic review of in vivo studies. J Ethnopharmacol. 2019;245:112177.
- Xiong Z, Lang L, Gao X, Xiao W, Wang Z, Zhao L. An integrative urinary metabolomic study of the therapeutic effect of Guizhi Fuling capsule on primary dysmenorrheal rats based 1 H NMR and UPLC–MS. J Pharm Biomed Anal. 2019;164:750–8.
- Sun L, Liu L, Zong S, Wang Z, Zhou J, Xu Z, et al. Traditional Chinese medicine Guizhi Fuling capsule used for therapy of dysmenorrhea via attenuating uterus contraction. J Ethnopharmacol. 2016;191:273–9.
- Cheng Y, Chu Y, Su X, Zhang K, Zhang Y, Wang Z, et al. Pharmacokinetic–pharmacodynamic modeling to study the anti-dysmenorrhea effect of Guizhi Fuling capsule on primary dysmenorrhea rats. Phytomedicine. 2018;48:141–51.
- Rowlands DK, Cui YG, So SC, Tsang LL, Chung YW, Chan HC. Bak Foong Pills induce an analgesic effect by inhibiting nociception via the somatostatin pathway in mice. Cell Biol Int. 2012;36(1):63–9.
- Rowlands DK, Cui YG, Wong HY, Gou YL, Chan HC. Traditional Chinese medicine Bak Foong Pills alters uterine quiescence - Possible role in alleviation of dysmenorrhoeal symptoms. Cell Biol Int. 2009;33(12):1207–11.
- Gou YL, Ho ALS, Rowlands DK, Chung YW, Chan HC. Effects of Bak Foong Pill on blood coagulation and platelet aggregation. Biol Pharm Bull. 2003;26(2):241–6.
- Pu BC, Fang L, Gao LN, Liu R, Li AZ. Animal study on primary dysmenorrhoea treatment at different administration times. Evidence-based Complement Altern Med. 2015;2015.
- Dai N, Fang L, Li YB, Wang YM, Yin J, Pu BC. Effect of Jingqian Zhitong Fang on serum sex hormone levels in women with primary dysmenorrhea. Evidence-based Complement Altern Med. 2014;2014.
- Hsu CS, Yang JK, Yang LL. Effect of “Dang-Qui-Shao-Yao-San” a Chinese medicinal prescription for dysmenorrhea on uterus contractility in vitro. Phytomedicine. 2006;13(1–2):94–100.
- Lee HW, Jun JH, Kil KJ, Ko BS, Lee CH, Lee MS. Herbal medicine (Danggui Shaoyao San) for treating primary dysmenorrhea: A systematic review and meta-analysis of randomized controlled trials. Maturitas. 2016;85:19–26.
- Shen AY, Wang TS, Huang MH, Liao CH, Chen SJ, Lin CC. Antioxidant and antiplatelet effects of Dang-Gui-Shao-Yao-San on human blood cells. Am J Chin Med. 2005;33(5):747–58.
- Edward A, Herbalist C. The Usages of “Dang Gui Shao Yao San” for Gynaecological disorders . Contrast the theory with reported clinical research [Internet]. 2005. Available from: http://www.fengshuijinyan.com/E08_TCM_Articles/007 Dang Gui Shao Yao San for Gynaecological Disorders.pdf
- Liu P, Duan JA, Hua YQ, Tang YP, Yao X, Su SL. Effects of Xiang-Fu-Si-Wu Decoction and its main components for dysmenorrhea on uterus contraction. J Ethnopharmacol. 2011;133(2):591–7.
- Li S shan, Chen Z chao, Zhang C hui. Effect of tao-hong-si-wu-tang, a traditional Chinese herbal medicine formula, on physical fatigue in mice. Afr J Tradit Complement Altern Med. 2012;10(1):60–5.
- Yeh LLL, Liu JY, Lin KS, Liu YS, Chiou JM, Liang KY, et al. A randomised placebo-controlled trial of a traditional Chinese herbal formula in the treatment of primary dysmenorrhoea. PLoS One. 2007;2(8).
- Sosorburam D, Wu Z, Zhang S, Hu P, Zhang H, Jiang T, et al. Therapeutic effects of traditional Chinese herbal prescriptions for primary dysmenorrhea. Chinese Herb Med. 2019;11(1):10–9.
- Luo ZR, Li H, Xiao ZX, Shao SJ, Zhao TT, Zhao Y, et al. Taohong Siwu Decoction Exerts a Beneficial Effect on Cardiac Function by Possibly Improving the Microenvironment and Decreasing Mitochondrial Fission after Myocardial Infarction. Cardiol Res Pract. 2019;2019.
- Zuo C, Zhang Y, Wang J, Han L, Peng C, Peng D. Deciphering the intervention mechanism of Taohong Siwu Decoction following the abnormal uterine bleeding rats based on serum metabolic profiles. J Pharm Biomed Anal. 2019;170:204–14.
- Cheng JF, Lu ZYJ, Su YC, Chiang LC, Wang RY. A traditional Chinese herbal medicine used to treat dysmenorrhoea among Taiwanese women. J Clin Nurs. 2008 Oct;17(19):2588–95.
- Park DM, Kim SH, Park YC, Kang WC, Lee SR, Jung IC. The comparative clinical study of efficacy of Gamisoyo-San (Jiaweixiaoyaosan) on generalized anxiety disorder according to differently manufactured preparations: Multicenter, randomized, double blind, placebo controlled trial. J Ethnopharmacol. 2014;158(PART A):11–7.
- Mizowaki M, Toriizuka K, Hanawa T. Anxiolytic effect of Kami-Shoyo-San (TJ-24) in mice possible mediation of neurosteroid synthesis. Life Sci. 2001;69(18):2167–77.
- Wu HC, Chen YH, Lai JN, Hwang JS, Wang J Der. Improving sleep quality in climacteric women with insomnia: A randomized, head-to-head trial between Jia-Wei-Shiau-Yau San (JWSYS) and Suan-Zao-Ren Tang (SZRT). Eur J Integr Med. 2011;3(3).
- Tangyuenyongwatana P, Gritsanapan W. Prasaplai: An essential Thai traditional formulation for primary dysmenorrhea treatment. TANG [HUMANITAS Med. 2014;4(2):10.1-10.8.
- The European Pharmacopoeia Commission. Manufacture of Herbal Medicinal Products. Vol. 4, The Rules Governing Medicinal Products in the European Union. Bangkok. Thailand; 2008.
- Zhang L, Jiang Z, Yang J, Li Y, Wang Y, Chai X. Chemical material basis study of Xuefu Zhuyu decoction by ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. J Food Drug Anal. 2015;23(4):811–20.
- Yang T, Li X, Lu Z, Han X, Zhao M. Effectiveness and safety of Xuefu Zhuyu decoction for treating coronary heart disease angina: A systematic review and meta-analysis. Med (United States). 2019;98(9).
- Jo J, Leem J, Lee JM, Park KS. Herbal medicine (Hyeolbuchukeo-tang or Xuefu Zhuyu decoction) for treating primary dysmenorrhoea: Protocol for a systematic review of randomised controlled trials. Vol. 7, BMJ Open. 2017.
- Akhlaghi F, Zyrak N, Nazemian S. Effect of vitamin E on primary dysmenorrhea. HAYAT [Internet]. 2009;15(1):Pe13–9, en82. Available from: http://journals.tums.ac.ir/abs.aspx?segment=fa&issue_id=1614&culture_var=en&journal_id=10&org_id=59&manuscript_id=13770%0Ahttps://www.cabdirect.org/cabdirect/abstract/20123009918
- Li J, Hua Y, Ji P, Yao W, Zhao H, Zhong L, et al. Effects of volatile oils of Angelica sinensis on an acute inflammation rat model. Pharm Biol. 2016;54(9):1881–90.
- Lin YR, Wu MY, Chiang JH, Yen HR, Yang ST. The utilization of traditional Chinese medicine in patients with dysfunctional uterine bleeding in Taiwan: A nationwide population-based study. BMC Complement Altern Med. 2017;17(1):427.
- Chen HY, Lin YH, Su IH, Chen YC, Yang S hung, Chen J liang. Investigation on chinese herbal medicine for primary dysmenorrhea: Implication from a nationwide prescription database in taiwan. Complement Ther Med. 2014;22(1):116–25.
Abstract Views: 272
PDF Views: 0