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Apa itu Pueraria mirifica?

Sumber: Perubatan Tumbuhan, Institut Penyelidikan, Jabatan Sains Perubatan, Kementerian Kesihatan Awam, Thailand; Julai 2000

Kwao Krua adalah tumbuhan herba asli yang ditemui di hutan di wilayah utara Thailand. Ianya terkenal di kalangan penduduk tempatan selama bertahun-tahun disebabkan oleh khasiat semulajadinya serta keberkesanan sebagai penawar kepada beberapa penyakit . Ianya dianggap sebagai identiti kebangsaan perubatan tradisional di negeri Thailand. Para Penyelidik dan ahli akademik menggunakan kebijaksanaan dan pengetahuan orang-orang tua bagi mengetahui keajaiban tumbuhan ini manakala banyak universiti-universiti negeri memasukkan tanaman Kwao Krua sebagai kajian dalam kursus-kursus ijazah sarjana mereka. Terdapat 4 jenis Kwao Krua yang bermanfaat dan boleh digunakan bagi tujuan perubatan, sebagai makanan tambahan dan pembuatan bahan kosmetik iaitu White Kwao Krua (Pueraria Mirifica), Kwao Krua Merah (Butea Superba), Hitam Kwao Krua dan Grey Dull Kwao Krua.

Masyarakat tempatan di Thailand menggunakan Pueraria Mirifica lebih daripada 100 tahun, bagi tujuan anti penuaan dari satu generasi ke generasi lain dan perkara ini telah di dedahkan dalam penerbitan oleh Luang Anusan Suntara.

Pada bulan Mei tahun 1931, Luang Anusan Suntara menerbitkan risalah mengenai subjek "Kwao Krua" yang menerangkan cara-cara menggunakan Pueraria Mirifica dalam perubatan dan sebagai anti penuaan. Ia ada dinyatakan di dalam risalah bahawa Pueraria Mirifica:

  • Bertindak sebagai agen anti kedut;
  • Meningkatkan pertumbuhan rambut dan membantu melambatkan pertumbuhan uban
  • Mengurangkan masalah katarak
  • Membantu orang yang mempunyai daya ingatan yang lembab atau hilang ingatan
  • Meningkatkan tenaga dan kecergasan, pergerakan tubuh badan yang lebih refleksif
  • Meningkatkan peredaran darah
  • Meningkatkan selera makan, dan
  • Mengurangkan gejala gangguan tidur atau sukar tidur malam

Pada tahun 1932, Dr. A.F.G. Kerr, Pengarah Seksyen Bunga Journal Persatuan Siam, telah menarik perhatian masyarakat saintifik bahawa tumbuhan Thailand "Kwao Krua", mempunyai nilai yang tinggi sebagai agen anti penuaan.

Dr. Kerr sebagai saintis pertama mewujudkan kesedaran antarabangsa mengenai keberkesana kwao krua ini sebagai anti penuaan dan seterusnya berjaya mengasingkan phyto estrogen yang terdapat di dalam Pueraria Mirifica pada tahun 1952. Dari sinilah nama Pueraria Mirifica diberi.

Berfungsi sebagai "Fountain of Youth" bagi lelaki dan wanita berusia.

Pueraria mirifica herba dapat meningkatkan saiz payudara

Ubi tuntutan biologi Thai boleh membesarkan saiz payudara

Berita Ekonomi Asia, Jan 11, 1999 BANGKOK, 4 Jan

Thailand Biologi hari ini mendakwa bahawa dia telah membuktikan batang tumbuh-tumbuhan yang dikenali sebagai "Kwao Krua," boleh menghasilkan hormon seks estrogen wanita di kalangan wanita dan meningkatkan saiz payudara mereka. Wichai Cherdshewasart, profesor madya di Universiti Chulalongkorn berkata beliau menghabiskan hampir setahun menjalankan penyelidikan mengenai ubi Kwao Krua (Pueraria mirifica), mendakwa bahawa ujian menunjukkan payudara seorang wanita meningkat 2.5 sentimeter dalam tempoh lima hari melalui penggunaan bahan. Biologi itu berkata beliau telah memohon bagi mendapatkan paten untuk mengeluarkan ubat dari Kwao Krua dan kini dalam perancangan pengeluaran bagi industri perubatan. Tetapi keputusan yang tidak terjamin, kata Wichai, kira-kira 20% daripada kes-kes ujian menunjukkan tiada jawapan. "Ia bergantung kepada kesihatan anda. Jika anda berada dalam keadaan yang baik, antara 20 dan 45 tahun dan mempunyai struktur badan yang agak besar, anda akan mendapat keputusan yang baik," kata Wichai. "Ia adalah mustahil untuk seorang wanita yang nipis untuk membesarkan payudara dari 75 cm hingga 90 cm dengan mengambil Kwao Krua (Pueraria mirifica)." Kesan ubi yang bahan legenda, selagi lalu di wilayah utara Chiang Mai, batang tumbuhan mempunyai reputasi menghasilkan kesan meremajakan warga tua.

Menurut legenda, seorang perempuan tua yang mula haid lagi selepas sentiasa mengambil ubat yang dibuat Kwao Krua, manakala seorang lelaki tua yang mati pucuk sired terima kasih anak-anak kepada ubi keajaiban. Para saintis menghabiskan lebih daripada 10 tahun dalam usaha mereka untuk mengesan legenda Kwao Krua. Pada bulan Februari 1947, mereka akhirnya dikenal pasti sebagai Pueraria mirifica. Wichai mengesyorkan bahawa dalam sesetengah kes, wanita perlu minum susu di samping mengambil Kwao Krua. Satu wanita nipis yang dibesarkan payudara 72,5-cm 77,5 cm dalam tempoh sebulan dengan meminum sekurang-kurangnya satu liter susu setiap hari, katanya. Selain membesarkan saiz payudara, ubi juga boleh meluaskan pinggul, melembutkan kulit dan rambut gelap bagi orang-orang yang berpaling kelabu awal, menurut Wichai. Setelah Kementerian Kesihatan Awam Thailand mengesahkan paten, beliau berkata, perubahan dadah akan dibangunkan bagi wanita menopaus yang mengalami parit hormon. "Idea saya adalah sesuatu seperti mengisi hormon wanita untuk melaraskan fungsi organik kelenjar," katanya.

Kajian Pueraria mirifica di kalangan wanita premenopausal

Kajian Klinikal : Wanita Premenopausal

Jenis Produk : Pueraria mirifica Premium Grade

Fungsi : Makanan Kesihatan (Makanan Tambahan)

Tempoh ujian : 2 bulan

Bilangan Penguji :

31 Placebo

32 pengguna 400 mg / hari, 15 hari / bulan

34 pengguna 800 mg / hari, 15 hari / bulan

Keputusan diringkaskan dalam butir-butir berikut seperti di bawah;

Kumpulan placebo mengandungi 31 penguji telah menerima kapsul kanji ubi kayu diisi untuk mengambil 2 kapsul / hari untuk 15 hari / bulan bermula dari hari pertama tempoh haid, selama 2 bulan berturut-turut. Kumpulan ini tidak menunjukkan sebarang perubahan penting dalam semua parameter rekod.

Kumpulan pertama yang diuji mengandungi 32 penguji, telah menerima 200 mg @ 2 kapsul setiap hari per kapsul Pueraria mirifica diisi dalam keadaan yang sama seperti kumpulan placebo.

Kumpulan ini menunjukkan perubahan penting dengan nombor yang berbeza dalam semua parameter yang direkodkan, termasuk sakit susu (44%) yang berkaitan dengan ketegasan payudara dan boleh dikaitkan juga untuk pembesaran payudara, kulit pulih (88%), rambut sihat (75%), pembersihan karisma (100%), meningkatkan rembesan faraj (44%), sihat haid (6%), ketegasan payudara (44%), pembesaran payu dara (9%), dan pembesaran pinggul (9%)

Kumpulan kedua yang diuji mengandungi 34 penguji telah menerima 200 mg @ 4 kapsul - Pueraria mirifica diisi kapsul untuk mengambil 4 kapsul / hari dalam keadaan yang sama seperti kumpulan placebo.

Kesimpulan

Kesimpulannya, ujian manusia sebagai makanan atau produk makanan berfungsi telah menunjukkan kesan-kesan estrogen jelas antara penguji, termasuk kulit diperbaharui, rambut kerumitan, payudara ketegasan, dan mungkin untuk mendorong pembesaran payu dara.

Sumber: Perubatan Tumbuhan, Institut Penyelidikan, Jabatan Sains Perubatan, Kementerian Kesihatan Awam, Thailand; Julai 2000

Kajian Pueraria mirifica

Ubi pembesaran bawah tanah itu akan berkumpul phytoestrogen isoflavones yang terdiri daripada (daidzin, daidzein, genistin, genistein dan puerarin) dan lain-lain seperti Miroestrol dan derivatif, beta-Sitosterol, stigmasterol, coumestrol, puerarin, mirificoumestan, kwakhurin dan mirificin.

Skop kajian kami adalah bioteknologi Putih, Merah dan Kwao Krua. Kajian kami telah dilakukan oleh perjalanan ke hutan banyak di bahagian-bahagian yang banyak Thailand untuk mencari dan memilih untuk kultivar yang betul dan terbaik herba-herba ini bergantung kepada ciri-ciri botani, analisis kimia, sejarah penggunaan, ujian toksikologi serta ujian makmal dan percubaan klinikal .

Hasil kajian di bawah dikawal oleh penyelidik

Menurut penyelidikan kami telah menunjukkan bahawa Pueraria Mirifica dan Butea Superba adalah selamat untuk digunakan manusia dalam dos tertentu serta tempoh penggunaan.

Hasilnya menunjukkan bahawa Mirifica kultivar Pueraria yang dipilih mengandungi isoflavon yang sangat tinggi kandungan dan menunjukkan kesan anti-mutagenik tinggi serta kesan membunuh tinggi selaras sel kanser susu manusia.

Kini pakar pemakanan mengesyorkan pengguna untuk mengambil isoflavon tetap untuk tujuan perlindungan kanser yang biasanya ditemui pada pos-menopaus dan orang-orang yang Ketidakseimbangan Hormon.

Apakah faedah Miroestrol dan derivatif?

Miroestrol dan derivatif juga bahan kimia yang berharga di White Kwao Krua yang mempromosikan estrogenik dan monogenic kesan kepada pelbagai tisu sebagai pembesaran payudara atau payudara reformasi tisu dan organ-organ seperti ovari, rahim, dan kulit sebagai HRT (Hormon Replacement Therapy).

Apa yang berbeza antara Soya dan Pueraria Mirifica?

Soya, makanan timur dan Alfalfa yang utama, produk kesihatan makanan barat mengandungi jumlah yang lebih rendah phyto-estrogen terutamanya terdapat tiada Miroestrol dan derivatif. Manfaat mereka kepada badan adalah jauh kurang daripada Pueraria Mirifica. Penyelidikan mengesahkan bahawa bahan kimia ini adalah anti-payudara mujarab kanser, anti-prostat hiperplasia, anti-kanser kolon, anti-osteoporosis dan juga anti-penyakit kardiovaskular melalui pengurangan kuat kolesterol darah dan sindrom anti-menopaus.

Sumber: Perubatan Tumbuhan, Institut Penyelidikan, Jabatan Sains Perubatan, Kementerian Kesihatan Awam, Thailand; Julai 2000

Kajian Puearia mirifica dalam kanser Payudara

Sumber: Institut Penyelidikan Perubatan Tumbuhan Jabatan Sains Perubatan, Kementerian Kesihatan Awam, Malaysia

Satu siri kajian yang melibatkan garisan sel payudara dan aktiviti Pueraria mirifica in vitro telah dijalankan oleh Sekolah Perubatan Universiti Emory di Atlanta, Georgia, Amerika Syarikat, dan Jabatan Obstetrik dan Ginekologi, Phramongkutklao College of Medicine, Bangkok, Thailand. Kajian-kajian ini telah ditunjukkan bahawa Pueraria mirifica akar ekstrak telah mujarab anti-estrogen hartanah terhadap garisan kanser yang agresif sel in vitro, terutamanya yang estrogen proliferatif-positif reseptor (ER +) kanser garisan payu dara (T47-D, MCF-7, dan ZR-75- 1) didapati daripada Institut Kanser MD Anderson (Texas) dan Institut Kanser Negara (NCI) di Institut Kebangsaan Amerika Syarikat of Health (NIH).

Pueraria mirifica menggalakkan fibroblas dalam sel payu dara normal dan menghalang sel-sel kanser payudara yang bergantung kepada estrogen. Yang tidak diterbitkan, 2001, Sawatsri, S., Juntayanee, B., Jitpatima, S., Boonnao, P., Kampoo, C., Ayuttaya, N., Wongyai, S. dan Sidell, N.

Menurut kajian yang dijalankan di Sekolah Perubatan, Universiti Saint Mariane, Tokyo, Jepun oleh Kuramoshi, T. dan Smitasiri, Y. mengenai kajian awal Pueraria mirifica pada wanita Jepun, 50 sukarelawan yang sihat wanita haid, usia 20 hingga 49, diberi antara 100 hingga 600 mg secara lisan serbuk akar Pueraria mirifica setiap hari sebagai kapsul selama 7 hari, dua minggu selepas haid. Tiada laporan haid yang luar biasa berat, teruk, atau terlepas.

Ujian haiwan: Terdapat laporan sepanjang tahun 1960-1961 dari penyelidik British untuk menguji kesan Miroestrol; bahan kimia utama dari herba ini dalam ovariectomized dan tikus perempuan pramatang. Hasil kajian menunjukkan kesan estrogen bahan kimia ini. Ia tersirat bahawa estrogen sythetic atau haiwan estrogen ataupun estrogen manusia boleh digantikan oleh bahan kimia ini.

Ujian manusia: Miroestrol telah juga telah diuji dalam manusia dan telah dilaporkan pada tahun 1961 sebagai kesan estrogen satu mujarab. Doktor perubatan Thailand telah menguji ekstrak mentah dalam pesakit pada tahun 1941. Hasilnya juga menunjukkan permohonan menjanjikan herba ini.

Ujian kulit: Enam tikus albino perempuan rambut yang dipotong dan disuntik dengan 0.1% daripada ekstrak Pueraria mirifica. Ujian telah selesai dan tidak menunjukkan sebarang alahan kepada kulit. Ia menyatakan bahawa diffsion kulit tidak menyebabkan sebarang iritasi kulit ke kulit. Oleh itu, ekstrak Pueraria mirifica boleh dibentangkan dalam kosmetik tanpa apa-apa kesan alahan.

Penyelidikan dan Kajian Pueraria mirifica

Ia telah diturunkan baru-baru ini bahawa Pueraria mirifica adalah selamat untuk digunakan manusia dalam dos tertentu serta tempoh penggunaan. Penyelidik telah menjalankan beberapa siri penyelidikan yang merangkumi analisis kimia, kultur tisu, penyebaran besar-besaran, peningkatan kultivar, pengeluaran, pembangunan dan pengujian produk dan sebagainya selama 9 tahun.

Hasilnya menunjukkan bahawa Pueraria mirifica mengandungi kandungan isoflavon yang sangat tinggi dan menunjukkan kesan antimutagenic tinggi serta kesan membunuh tinggi selaras sel kanser susu manusia. Kini, pakar pemakanan mengesyorkan pengguna untuk mengambil isoflavon secara teratur untuk tujuan perlindungan kanser yang biasanya ditemui pada pasca-menopaus dan orang-orang yang mempunyai ketidakseimbangan hormon.

Kelebihan Miroestrol dan Derivatif dalam Pueraria mirifica Miroestrol dan derivatif juga bahan kimia yang berharga dalam putih Kwao Krau yang menggalakkan kesan estrogen dan mammogenic kepada pelbagai tisu seperti pembesaran payudara atau payudara tisu reformasi.

Perbezaan antara Soya dan Pueraria mirifica

Soya, produk makanan barat kesihatan, mengandungi jumlah yang lebih rendah fitoestrogen terutamanya terdapat tiada Miroestrol dan derivatif. Manfaat mereka kepada badan adalah jauh kurang daripada Pueraria mirifica. Penyelidikan mengesahkan bahawa bahan kimia ini adalah anti-payudara mujarab kanser, anti-prostat hiperplasia, anti-kanser kolon, anti-osteoporosis dan juga anti-penyakit kardiovaskular melalui pengurangan kuat kolesterol darah dan sindrom anti-menopaus.

terbalik, ia berkata, tidak ada bahaya seperti yang ditakuti. Selain itu, ia berkuat kuasa mencegah kanser dada dan di samping itu membantu membina sel-sel otak, yang mampu mencegah penyakit Alzheimer.

- Jawatankuasa peringkat ditubuhkan untuk menolak untuk eksport pemprosesan nasional

Dr. Suraphong Suepwongli Timbalan Menteri Kesihatan Awam, telah berkata bahawa Kementerian Kesihatan Awam (MOPH) mengadakan mesyuarat kumpulan kajian Pueraria mirifica bekerja di 27 Ogos, di mana penyelidik yang berkaitan dari pelbagai agensi dan institut hadir, apa-apa dari Universiti Chulalongkorn, Institut Kanser Negara, Institut Dermatiology, Jabatan Sains Perubatan, Mae Fa Luang University, dan lain-lain, untuk menentukan cara untuk menggalakkan penggunaan Pueraria mirifica sebagai bahan mentah dalam industri satu topping dengan tujuan rata dikomersilkan, yang, setakat perbincangan, boleh disimpulkan bahawa penyelidik dari institusi beberapa mendapati bahawa Pueraria mirifica secara klinikal berkesan untuk digunakan sebagai ganti untuk hormon di kalangan wanita menopaus dan ada satu trend bahawa ia akan digunakan untuk membesarkan payu dara, termasuk mengubati penyakit Alzheimer, kerana beberapa penemuan penyelidikan bahawa ia boleh menjana pertumbuhan semula sel-sel otak.

"Berkenaan dengan ketoksikan jangka panjang, 2-3 tahun yang lalu terdapat penyelidik yang mengkaji mengenai Pueraria mirifica setakat membuat berita tersebar, menyebabkan pakar-pakar MOPH risau sangat bahawa penggunaan mungkin menyebabkan ketoksikan jangka panjang menyebabkan kanser payudara. mesyuarat ini ia telah diakui bahawa di National Cancer Institute, yang telah mencuba untuk tempoh masa yang, mendapat satu kesimpulan yang berkata Pueraria mirifica adalah bukan-karsinogenik dan ini sesuai dengan penyelidikan yang Hospitat Raja Mongkut, yang dijumpai dan hasil yang bertentangan, iaitu Pueraria mirifica, pada Sebaliknya, mempunyai kesan yang boleh juga mencegah kanser dada, "kata Dr. Suraphong.

Pueraria mirifica mengurangkan kejadian tumor payudara

Prarawatan dengan tumbuhan yang kaya dengan phytoestrogen mengurangkan kejadian tumor payudara dan mempamerkan profil rendah ERα susu dan ERβ

Sumber: Maturitas Jilid 58, Terbitan 2, 20 Oktober 2007, Muka surat 174-181

Wichai Cherdshewasart, Rattana Panriansaen dan Porntipa telefon bimbit. Jabatan Biologi, Fakulti Sains, Universiti Chulalongkorn, Phyathai Road, Patumwan, Bangkok 10330, Thailand Program Bioteknologi, Fakulti Sains, Universiti Chulalongkorn, Phyathai Jalan, Patumwan, Bangkok 10330, Thailand

Seksyen Oncotherapy Eksperimen, Bahagian Penyelidikan, Institut Kanser Kebangsaan, Kementerian Kesihatan Awam, RamaVI Road, Ratchathewi, Bangkok 10400, Thailand

Diterima 19 Mei 2007; disemak 2 Ogos 2007; accepted 9 Ogos 2007. Boleh didapati dalam talian 17 September 2007.

Abstrak

Objektif

Fitoestrogen telah dilaporkan untuk mempamerkan antiproliferation kepada sel-sel kanser payudara manusia dalam vitro. Kami menguji phytoestrogen yang kaya, Pueraria mirifica terhadap tikus induksi kanser payudara in vivo.

Kaedah

Weanling wanita Spargue-Dawley tikus pretreated dengan serbuk berakar Umbi P. mirifica pada dos 0, 10, 100 dan 1000 mg / kg BW / hari selama empat minggu berturut-turut. Pembangunan tumor mammary ketika itu didorong dengan dos tunggal 7,12-DMBA, 80 mg / kg BW, diikuti dengan peperiksaan mingguan untuk saiz dan kepelbagaian tumor mammary selama 20 minggu dan akhirnya bangkai. Tisu susu disiasat bagi kebisaan tumor dan antibodi juga monoklonal berlumuran terhadap ERα dan ERβ.

Prarawatan 1000 mg / (kg BW hari) Pueraria mirifica berakar Umbi serbuk yang mengakibatkan penurunan kebisaan pembangunan tumor tikus. Tisu tumor susu menunjukkan profil yang lebih rendah ERα dan ERβ serta ERα / ERβ.

Kesimpulan

Pueraria mirifica dipamerkan pencegahan tumor tikus 7,12-DMBA-induced susu, dengan mekanisme yang dicadangkan mengikat kukuh yang kompetitif fitoestrogen yang ERα dan / atau sintesis penindas-ERα.

Katakunci: Phytoestrogen ; Breast cancer ; Estrogen receptor ; 7,12-DMBA; Pueraria mirifica ; Isoflavonoid

Keberkesanan fitoestrogen

Sumber: Jabatan Biologi, Fakulti Sains, Universiti Chulalongkorn, Bangkok, Thailand

Laporan Perubatan Keberkesanan fitoestrogen

February 4, 2002 Seperti yang dilaporkan di BERITA BERSIH 5: Cleveland, Ohio, March 12, 1999

Terdapat maklumat baru yang menunjukkan tumbuhan herba akan meningkatkan dada anda. News Channel 5 laporan baru mencari menunjukkan jika wanita mengambil herba yang bernama Pueraria mirifica ia akan meningkatkan saiz payudara mereka.

"Akar dianggap tidak mengandungi bahan-bahan yang mungkin mempunyai kesan ke atas kelenjar", kata pakar tumbuhan perubatan Tyler, Ph.D. "Herba ini begitu popular bahawa permintaan outweighing bekalan"

Rujukan:

[[1] Hukum DG, Pope GS. Light-penyerapan dan kimia sifat-sifat Miroestrol, oestrogenic bahan Pueraria mirifica. J Chem Soc 1960: 3696-705.

[2] Cain JC. Miroestrol: 1 oestrogenic dari loji Pueraria mirifica. Nature 1960; 188: 774-7.

[3] Hayodom M. juzuk akar berakar Umbi Pueraria mirifica. [Master Tesis Jabatan Kimia]. Bangkok: Siswazah sekolah Universiti Chulalongkorn; 1971.

[4] Ingham JL, Tahara S, Dziedzic SZ. Coumestans dari akar Pueraria mirifica. Z Naturforsch Ser C 1988; 43 (1 / 2): 5-10.

[5] Jones heh, Pope GS. Satu kaedah bagi pengasingan Miroestrol dari Pueraria mirifica. J Endocrinol 1961; 22: 303-12.

[6] Kashemsanta L, Suvatabandhu K, Airy Shaw AK. A spesies baru Pueraria (Leguminosae) dari Thailand, menghasilkan satu prinsip oestrogenic. Kew Bull 1952; 4: 549-51.

[7] Knight DC, Eden JA. Kajian semula kesan klinikal fitoestrogen. Obstetrik & Ginekologi 1996; 87 (5): 897-904.

[8] Tahara S, Ibrahim RK. Isoflavonoids Prenylated update. Fitokimia 1995; 38 (5): 1073-1094.

[9] Wang C, kurzer MS. Kepekatan phytoestrogen menentukan kesan ke atas sintesis DNA dalam sel-sel kanser payudara manusia. Kanser Nutr 1997; 28 (3): 236-47.

Pueraria mirifica mengurangkan risiko kanser-payudara

David Ingram, Katherine Sanders, Marlene Kolybaba. Derrick Lopez

University Department of Surgery, Queen Elizabeth II Medical Centre, Perth, Australia Barat

(D Ingram FRACS, K Sanders BSC, M Kolybaba MPH, D Lopez M Measci)

Surat-menyurat ke: Atau David Ingram, Suite 44.146 kenderaan kepada Katakanlah Road, 6000 Perth, Australia Barat

Ringkasan

Fitoestrogen latar belakang kumpulan yang berlaku secara semulajadi bahan kimia yang berasal dari tumbuh-tumbuhan: mereka mempunyai struktur yang serupa dengan estrogen, dan menjadi sebahagian daripada diet kita. Mereka juga mempunyai aktiviti biologi yang berpotensi anticarcinogenic. Kami telah melakukan satu kajian kes-kawalan untuk menilai hubungan antara pengambilan phytoestrogen (seperti yang diukur oleh perkumuhan air kencing) dan risiko kanser payudara.

Kaedah

Wanita dengan awal kanser payudara didiagnosis telah ditemuramah oleh cara soal selidik, dan koleksi h 72 air kencing dan sampel darah telah diambil sebelum sebarang rawatan bermula. Kawalan dipilih secara rawak daripada daftar pemilih selepas hampir sama untuk umur dan kawasan kediaman. 144 pasangan termasuk untuk analisis. Sampel air kencing assayed untuk fitoestrogen isoflavonic daidzein, genistein, dan equol, dan lignans enterodiol, enterolactone, dan matairesinol.

Penemuan

Selepas pelarasan bagi umur pada datang haid, pariti, pengambilan alkohol, dan jumlah pengambilan lemak, perkumuhan yang tinggi kedua-dua equol dan enterolactone telah dikaitkan dengan pengurangan yang besar dalam risiko kanser payudara, dengan trend yang ketara melalui kuartil: equol kemungkinan nisbah 1,00. 0-45 (95% Cl 0,20, 1,02), 0,52 (0,23, 1,17), dan 0,27 (0.10,0.69)-trend p = 0,009 dan enterolactone kemungkinan nisbah 1,00, 0.91 (0.4, 1,98), 0,65 (0,29, 1.44), 0,36 (0,15, 0,86)-trend p = 0,013. Bagi kebanyakan fitoestrogen lain terdapat pengurangan dalam risiko. tetapi ia tidak mencapai kepentingan. Kesukaran dengan analisis assay genistein dihalang bahan itu.

Tafsiran

Terdapat pengurangan yang besar dalam risiko kanser payudara di kalangan wanita dengan pengambilan yang tinggi (seperti yang diukur oleh perkumuhan) fitoestrogen, terutamanya isoflavonic fitoestrogen equol dan lignan enterolactone. Penemuan ini boleh penting dalam pencegahan kanser payudara.

Pengenalan

Ada bukti wabak kuat logik bahawa diet mempunyai peranan dalam pembangunan kanser payudara. Bukti-bukti ini pada mulanya datang dari kajian penduduk dan migrasi, kohort dan kes-kawalan seterusnya kajian manusia, dan daripada eksperimen binatang. Sebahagian besar kajian ini adalah berdasarkan hipotesis bahawa diet yang kaya dengan lemak mempengaruhi seorang wanita untuk kanser payudara. Keputusan kajian kohort yang besar, bagaimanapun, tidak menyokong hipotesis ini, dan faedah yang telah dipindahkan ke lain-lain faktor pemakanan.

Fitoestrogen adalah kumpulan sebatian biologi aktif yang baru-baru ini telah menarik perhatian. Mereka adalah satu kumpulan yang pelbagai bahan-bahan, dengan struktur kimia yang serupa dengan estrogen sreroidal, dan terdapat dalam banyak tumbuh-tumbuhan yang boleh dimakan. Kedua-dua varieti utama isoflavonoids dan lignans. Apabila dimakan, isoflavonoids loji dan lignans menjalani metabolisme oleh mikroflora usus, dan kedua-dua metabolit dan sebatian ibu bapa diserap untuk berubah-ubah extent.3 '4 Lisan pengambilan makanan yang kaya dalam fitoestrogen diikuti oleh perkumuhan air kencing puncak dalam 24 berikutnya h; perkumuhan pulangan kepada kadar sebelum ini dalam 48-72 h. "Lebih daripada 15 phytoesorogens setakat ini telah dikenal pasti dalam air kencing manusia.

Fitoestrogen mempunyai beberapa aktiviti biologi yang berpotensi anticarcinogemc, dan dengan itu boleh mempunyai peranan dalam aetiology pemakanan, kanser payudara. Fitoestrogen telah antiangiogenic, oestrogenic, dan sifat-sifat anti estrogen, dan juga boleh menghalang enzim. Your budaya kajian dan eksperimen haiwan menunjukkan bahawa sebatian ini menghalang tumor. Walaupun kajian manusia yang terhad, populasi Asia yang memakan dalam jumlah yang besar fitoestrogen yang diperolehi dari diet yang kaya dengan soya mempunyai frekuensi yang lebih rendah daripada tumor payudara dan prostat.

Kajian kawalan kes kami menyiasat peranan fitoestrogen dalam kanser payudara manusia.

Kaedah

Populasi kajian

Wanita yang disebut untuk pengurusan kanser payudara disahkan di klinik swasta (DI) atau klinik pesakit luar Sir Charles Gairdner Hospital (Perth, Australia Barat), adalah direkrut untuk kajian antara Disember, 1992 dan November 1994. Kes-kes yang layak yang berumur antara 30 dan 84 tahun dan penduduk kawasan Perth. Kriteria Penyingkiran: kehamilan; rawatan antibiotik dalam 6 minggu sebelumnya; sejarah kanser payudara sebelum ini; ketidakupayaan untuk bercakap atau membaca Bahasa Inggeris yang mencukupi; dirancang pembedahan dalam tempoh 72 jam diagnosis; dan tiada diagnosis pasti kanser payudara sebelum pembedahan.

Kes individu berarak, mengikut kumpulan umur 5 tahun, wanita yang dipilih secara rawak dari daftar Perth pilihan raya 1993, yang tinggal di kawasan yang sama pos kod. Cocok kawalan dijemput oleh surat untuk mengambil bahagian dalam kajian diet, dengan menyebut tiada kanser payudara. Surat susulan telah dihantar jika tiada jawapan diterima selepas 2 minggu sekiranya kedua sambutan bukan, percubaan telah dibuat di hubungi telefon. Jika ini tidak mungkin atau jika perempuan itu enggan untuk mengambil bahagian, prosedur itu diulangi sehingga peserta yang sesuai ditemui. Kriteria pengecualian untuk kawalan yang sama seperti yang memilih untuk kes-kes, kecuali kawalan dengan menggunakan antibiotik yang baru-baru ini telah dimasukkan, dengan syarat mereka melambatkan pengumpulan air kencing mereka sehingga sekurang-kurangnya 6 minggu selepas penggunaan antibiotik yang berhenti. Wanita yang melaporkan sejarah peribadi kanser payudara tidak layak sebagai kawalan.

Pengumpulan data

Semua peserta telah dimaklumkan mengenai sifat dan keperluan kajian dan memberi kebenaran bertulis. Kes-kes dan kawalan telah ditemuramah oleh salah satu daripada tiga pembantu penyelidik dengan soal selidik piawai bagi mendapatkan maklumat tentang ciri-ciri demografi, pembiakan, dan gaya hidup.

Dalam kebanyakan kes, penyelidik yang sama ditemu bual kedua-dua kes dan kawalan dipadankan. Tatacara bagi pemungutan sampel air kencing h 72 telah menjelaskan kepada setiap wanita. Satu sampel darah tunggal telah ditarik oleh tusukan urat. Bagi kes-kes, spesimen air kencing dikumpul sebelum dimasukkan ke hospital untuk pembedahan: wanita kawalan yang disediakan sampel air kencing pada kemudahan terawal mereka. Pelantikan kedua telah dibuat untuk mengumpul sampel air kencing dan soal selidik kekerapan makanan; kedua diperiksa untuk jawapan yang tidak jelas atau tidak dijawab.

Pengumpulan sampel

Setiap wanita mengumpul tiga berturut-turut 24 h spesimen air kencing dalam botol plastik yang berasingan yang mengandungi 2 g asid askorbik. Botol yang telah disimpan sejuk selepas pungutan. Tiga spesimen telah dikumpulkan, bercampur-campur, dan jumlah isi padu air kencing diukur. Tiga sampel dari air kencing yang dikumpulkan setiap wanita telah disimpan di -20 C. 50 kiub boleh guna mL plastik, mengandungi 0-1% (g / L) natrium azida, sehingga analisis untuk lignans dan fitoestrogen isoflavonoid. Serum telah dipisahkan dari sampel darah dan disimpan dalam 1 gelas cawan mL di -20 C.

Assay sampel

Kadar perkumuhan air kencing lignans, enterodiol, enterolactone dan matairesinol dan fitoestrogen isoflavonoid, equol, daidzein dan genistein, diukur oleh isotop-pencairan gas chromatograpny-spektrometri jisim (GC-MS) dalam pemilihan mod pemantauan yang digunakan oleh Adiercreutz dan rakan-rakan sekerja. Kira-kira 1 / 1000 jumlah air kencing diekstrak pada Ci Sep-Pak kartrij (Waters Associates, Milford, MA, USA), pecahan conjugated 'lignans dan isoflavonoids yang diasingkan oleh kromatografi pada diethyIaminoethyl-Sephadex (Pharmacia Kimia Fine, Uppsala, Sweden) ruangan dalam bentuk asetat, dan standard deuterared dalaman semua sebatian yang dikenali terkini cheeluare. Hidrolisis enzim (glucuronidase / sulphatase dari Helix pomatia; Boehringer-Mannheim, Jerman) yang telah dilakukan, diikuti oleh pengekstrakan Sep-Pak, dan kromatografi pada Dlethyl (2 hydroxypropyl) aminoemyl [QAE]-Sephadex A-25 kolum dalam bentuk asetat.

Kromatografi menyebabkan dua pecahan: pecahan 1, yang concained equol, enterolacione, enterodiol, matairesinol, dan oescrogens; dan pecahan 2, yang mengandungi daidzein dan genistein. Pecahan 1 menjalani penulenan selanjutnya untuk menghapuskan estrogen oleh kromatografi borang karbonat QAE-Sephadex. Kedua-dua pecahan yang mengandungi lignans dan fitoestrogen isoflavonoid dan standard deuterated dalaman masing-masing telah ditukar kepada eter trimemylsilyl mereka, dan kuantitinya oleh GC-MS dengan pemantauan ion pilih.

Pengukuran dilakukan pada II Saturn GC-MS (Varian Chromatography Systems, Walnut Creek, CA, USA) yang dilengkapi dengan penyuntik automatik (Siri 8100) dan komputer antara muka (Satum Software Semakan C). Kami dikira lignan dan kandungan phytoestrogen dengan membandingkan saya nisbah ion bagi sebatian kencing dan deuterated standard dalaman dengan nisbah yang sama standard yang membentuk lengkung standard.

Sampel dianalisis dalam 30 kelompok sepanjang tempoh 1 tahun. Sampel dari kes dan kawalan dipadankan telah dianalisis dengan kumpulan assay yang sama. Pekali antara assay variasi untuk sampel kolam kawalan air kencing untuk enterolactone, enterodiol, equol, dan daidzein% 10-9, 15-1% 20-5% dan 21-8% masing-masing. Pekali antara assay, variasi untuk matairesinol pada kepekatan min 11-0 ng / mLwas 42 - 6% ketidakstabilan terbitan trimethylsilyl-eter genistein, bersama-sama dengan gangguan yang berterusan dari kawasan yang tidak diketahui, menghalang kita mengukur ini isoflavonoid pasti; Oleh itu, tiada data untuk genistein diberikan.

Satu contoh air kencing dari setiap peserta assayed untuk urea dan ammonia supaya ukuran jumlah perkumuhan nitrogen sepanjang tempoh 72 h kajian boleh diperolehi sebagai indeks daripada jumlah pengambilan makanan. "Urea kencing diukur dengan menggunakan kaedah kadar enzim pada Hitachi automatik 747 Analyser (Boehringer Mannheim, Australia) Kami mengukur ammonia kencing oleh kaedah dehydrogenase enzim glutamat (Roche Cobas Bio; Roche, Australia).

Kemasukan dan analisis data

Data yang dipungut dengan soal selidik telah dikodkan, dikategorikan dan disunting dengan SPSS untuk Windows Base System (Keluaran 6.0,1993), dan statistik deskriptif diperolehi.

Jadual 1: ciri-ciri kajian deskriptif

Pembolehubah reproduktif, termasuk umur pada datang haid, umur pada kelahiran pertama penuh panjang, pariti, bulan laktasi, dan umur pada putus haid, dikategorikan mengikut klasifikasi untuk diterbitkan. "Terapi penggantian hormon, adalah dikategorikan sebagai" semasa "atau" tidak semasa " digunakan. Sejarah keluarga kanser payudara (saudara-mara ijazah pertama dan kedua), gangguan payudara benigna, status menopaus dan pengguguran diklasifikasikan "ya" atau "tidak". Bagi wanita yang menopaus status adalah tidak jelas, kepekatan serum folikel-merangsang hormon dan oestradiol diukur oleh radioimmunoassay untuk membenarkan pengkategorian yang benar. nilai-nilai phytoestrogen dibahagikan kepada kuartil mengikut pengagihan mereka di kalangan penduduk kawalan.

Sejak wanita telah dipadankan dengan usia dan kawasan perumahan, kami melakukan analisis dengan regresi logistik bersyarat dalam pakej statistik Egret (versi 1.02.01). Suatu nisbah kemungkinan digunakan untuk mewakili risiko relatif, dan CI 95% dinilai bagi setiap pemboleh ubah pendedahan, serta apa-apa faktor yang berpotensi membingungkan yang berkaitan dengan pembolehubah di bawah kajian. Sama ada pembolehubah mempunyai kesan yang ketara ke atas risiko kanser payudara telah diadili oleh nilai-nilai p nisbah kemungkinan-(bermuka-muka), yang diperolehi apabila istilah ditambah sama ada sebagai pembolehubah kira atau unfactored. Jika nilai p adalah kurang daripada atau sama dengan 0-05, kesan itu dianggap ketara. Kami telah regresi logistik multivarian untuk menilai persatuan antara risiko kanser payudara dan lignan masing-masing dan kadar perkumuhan isoflavonoid fitoestrogen. Ujian bagi trend linear, yang mewakili kesan tindak balas dos berpotensi, telah dilakukan oleh pemasangan pembolehubah berterusan.

Satu analisis awal faktor risiko dalam peserta menunjukkan bahawa umur pada datang haid, pariti, dan pengambilan lemak dikaitkan dengan risiko kanser payudara. Oleh itu, kita dianggap pembolehubah yang berkaitan untuk kawalan, dan termasuk mereka sebagai pembolehubah membaurkan. Sejak beberapa kajian telah menunjukkan bahawa pengambilan alkohol mempunyai persatuan yang lemah atau sederhana dengan risiko kanser payudara, dan sejak satu unsur pemakanan mempunyai potensi untuk mengganggu metabolisme fitoestrogen, pengambilan alkohol juga dimasukkan sebagai pembolehubah yang membingungkan. Oleh itu, model regresi akhir termasuk keempat-empat pemboleh ubah.

Keputusan

Populasi kajian

341 wanita didiagnosis dengan kanser payudara semasa tempoh kajian. Sebilangan besar wanita tidak memenuhi kriteria kajian, terutamanya kerana pembedahan mereka dijadualkan dalam tempoh 3 hari diagnosis atau diagnosis itu tidak disahkan sehingga masa itu operasi mereka. Hanya wanita sahaja enggan mengambil bahagian. Daripada 149 wanita yang bersetuju, dan yang memenuhi kriteria kelayakan, dua mengubah minda mereka, dan satu enggan untuk melengkapkan soal selidik kekerapan makanan. Ralat dalam usia yang hampir sama yang menyebabkan pengecualian berikutan kes lain. Daripada 441 wanita kawalan yang dipilih secara rawak untuk kajian, 249 tidak ingin menyertai, dan 45 tidak dapat dihubungi. Satu adalah dikecualikan kerana mengandung. 144 pasangan kekal untuk analisis. Ciri-ciri kes dan kawalan adalah sama (Jadual 1).

Terdapat tiada perbezaan yang signifikan di antara kumpulan umur, umur semasa datang haid atau menopaus, pariti, umur pada kelahiran pertama penuh panjang, tempoh laktasi, pembolehubah anthropometry, atau pemboleh ubah pemakanan (iaitu pengambilan alkohol, jumlah tenaga, lemak total, atau peratusan tenaga dari lemak).

Jadual 2: nisbah kemungkinan mentah dan diselaraskan untuk risiko kanser payudara yang dikaitkan dengan pengambilan fitoestrogen

Odds nisbah

Unadjusted kemungkinan nisbah anggaran menunjukkan bahawa meningkatkan perkumuhan daidzein, equol, dan enterolactone telah dikaitkan dengan pengurangan risiko yang ketara dalam pembangunan kanser payudara (jadual 2). Kesan ini amat jelas untuk equol-risiko untuk kuartil tertinggi perkumuhan

after adjustment for confounding variables was one quarter that of the lowest quartile of excretion (adjusted odds ratio 0-27 [95% CI 0-10-0-69] );this represents a four-fold reduction in risk. The test for trend through the quartiles was also significant (p=0-009). The lignan enterolactone showed a three-fold reduction in risk for the highest compared with the lowest

quartile of excretion, even after adjustment for sonfound mg variables (adjusted odds ratio 0-36 [0-15-0-86]). Again, me trend through the quartiles was significant (p=0-013). The crude odds ratio for daidzein

Table 3 : Excretion rates of ligans, isoflavonoid, phytoestrogen, and total nitorgen

also showed a three-fold reduction in risk for the highest quartile of excretion, but this association ceased to be significant after control for confounding variables. The data were analysed separately for pre-menopausal and postmenopausal women, and there were similar trends for each group.

Median excretion of phytoestrogens

Because the distributions of the lignan and phytoestrogen excretion rates were skewed, we have reported the medians and IQRs rather than the means and SDs (table 3). For all phytoestrogens, the control women had higher median excretion rates than the cases; for enterolactone, the control median excretion was 50% higher, though the differences were smaller for the other phytoestrogens. We found little difference between cases and controls in the excretion of total nitrogen per 24 h, which suggests that differences in phytoestrogen excretion reflect differences in the types of foods consumed, and not just a general reduction in food intake.

Discussion

Our study shows that increased excretion of some phytoestrogens is associated with a substantial reduction in breast-cancer risk. This finding supports previous observational studies that reported higher phytoestrogen excretion among populations with a low frequency of breast cancer.

A case-control study of Singapore Chinese women found that soya consumption protected against breast cancer, though there were other significant dietary influences at work including B-carotene as a protective substance. Other studies do not support this property of soya consumption. The lower excretion of enterolactone by breast-cancer patients in our study accords with the findings of a previous small study (seven cases) in which enterolactone excretion was significantly lower in postmenopausal breast-cancer patients than in omnivorous and vegetarian controls. Isoflavonic phytoestrogens, especially the unfermented forms, are found predominantly in soya products, whereas lignans are found in the fibre present in such foods as whole grains, berries, fruit and vegetables, and, particularly, flax seed. Cow's milk has also been identified as a source of equol; this may be particularly important in Western Australia, where the pastures contain clover high in esorogens. Some researchers report that consumption of milk products can protect against breast cancer.

Given the size of the risk reduction in our study, the clear step-wise trend, and be confidence intervals (which did not include one for the lowest compared with the highest quartile), it is unlikely that our findings result from chance. Nevertheless, we have looked for potential bias. The cases were predominantly from a private clinic and the controls from the electoral roll. It is thus possible that cases came from a wealthier socioeconomic group with differences in dietary intake. Matching for residential area, however, should counteract this bias. Another potential bias was the recruitment procedure. Cases were asked by the attending specialist at the time of their appointment to participate, and few declined.

By contrast, controls were recruited from the community by a letter from the specialist, which resulted in a much lower participation rate. It is possible that women with an interest in their health and diet would be more likely to volunteer, though the effect of this self-selection process on our findings is not clear. Finally, the timing of urine collection may also have introduced bias. There is no ideal time to study cases/but immediately after diagnosis was preferable to any later period, so that factors such as admission to hospital, surgery, medications, and an increased awareness of the role of diet in breast cancer would have little influence on the women's usual diet. The period immediately after diagnosis is very stressful, and it is possible that these women ate less during the time of urine collection, though they were asked to continue with their usual eating habits. We attempted to measure this potential bias by assaying the urine samples for total nitrogen excretion," since there was no significant difference between cases and controls in total nitrogen excretion, this bias was probably not important.

An advantage of our study over other studies of nutrition and breast cancer is that it did not rely solely on dietary recall or records. The direct measurement of phytoestrogen excretion in urine provides not only an index of intake and subsequent metabolism by the gut flora, but also an indication of bioavailability." This is an important factor in the analysis of the mechanisms by which phytoestrogens might influence breast-cancer development.

Several laboratory studies have shown anti proliferative effects of phytoestrogens on human breast-cancer cell lines, and in animal experiments." Several possible mechanisms have been proposed. First, phytoestrogens may influence breast-cancer development by alteration of sex-hormone metabolism. The diphenolic structure of the isoflavonic phytoestrogens is similar to that of synthetic estrogens, and all are weakly estrogenic." Some investigators have suggested that isoflavonic phytoestrogens may also act as antiestrogens by competing with oestradiol for nuclear estrogen-binding sites, and thereby inhibit the growth and proliferation of hormone-dependent cells.' There is evidence that lignans and isoflavonic phytoestrogens may stimulate sex-hormone binding globulin in the liver/" and thus reduce the percentage of free, biologically active estradiol in the plasma. Furthermore, several lignans and isoflavonic phyto-oestrogens inhibit aromaiase—the enzyme that converts androstenedione to oestrone"—and thus may reduce the amount of circulating estrogen.

Our findings have implications for the control of breast cancer. Early detection by screening mammography and adjuvant systemic therapy both reduce breast-cancer mortality, but these techniques do not prevent the occurrence of cancer in the first place. They do little, therefore, to reduce the enormous emotional and physical suffering the disease causes—nor do they reduce the massive financial cost to me community. Prevention is the only way to reduce this suffering and cost.

The indication in our study that phytoestrogen consumption reduces breast-cancer development provides a potential dietary mechanism for control. However, the association between breast-cancer risk and phytoestrogen excretion is not necessarily causal, and may merely result from some other dietary characteristic. Nevertheless, we are aware of no previously investigated preventive factor chat has shown a degree of risk reduction similar to that found for some phytoestrogens in this study; and none has equal potential as a simple intervention as phytoestrogens. A cultural movement towards increased consumption of phytoestrogen containing foods is taking place, encouraged by magazines and other lay media. Our findings go some way towards providing a rationale for these changes.

Contributors

David Ingram designed the study, secured funding, and coordinated the study. Kathy Sanders interviewed the women, collected samples, and set up and undertook the urinary assays. Marlene Kolybaba interviewed the women, collected samples, and undertook statistical analyses. Derrick Lopez assisted with the laboratory assays and data analysis. All authors contributed to the writing of the paper.

Acknowledgments

We thank Herman Adiercreutz for providing the standards; Healthway (Health Promotion Fund of Western Australia) for their financial support; the various private donors who contributed funds; to the study; King Edward Memorial Hospital for the use of their laboratory; Jodie Ross for typing the paper; and all the women who took part in the study.

Pueraria mirifica herb on vaginal health

Beneficial Estrogenic Effects of Pueraria mirifica on Vaginal Health in Postmenopausal Women

Source: Menopause. 2007; 14(5):919-924.
Manonai J, Chittacharoen A, Theppisai U, Theppisai H.
the Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

OBJECTIVE:

To evaluate the effect of Pueraria mirifica on vaginal symptoms, vaginal health index, vaginal pH, and vaginal cytology in healthy postmenopausal women.

DESIGN:

A randomized, double-blind, placebo-controlled study. Healthy postmenopausal women, age 45 to 60 years old, were enrolled voluntarily and randomly received 20, 30, or 50 mg of Pueraria mirifica in capsules or placebo in identical capsules once daily for 24 weeks.

RESULTS:

After 24 weeks of treatment, 71 women were evaluated. Fifty-one of 71 randomly received one of the three doses of Pueraria mirifica, and the remaining 20 received placebo. The mean vaginal dryness symptom in the Pueraria mirifica group decreased after 12 weeks of treatment. Pueraria mirifica increased vaginal maturation index (parabasal:intermediate:superficial cells) from 46:43:11 to 11:65:24 after 24 weeks of treatment. There was no significant difference of adverse effects between the Pueraria mirifica and placebo groups in this study.

CONCLUSIONS:

Pueraria mirifica was proven to exhibit estrogenicity on vaginal tissue, to alleviate vaginal dryness symptoms and dyspareunia, to improve signs of vaginal atrophy, and to restore the atrophic vaginal epithelium in healthy postmenopausal women.

Urogenital atrophy can develop in postmenopausal women due to declining levels of estrogen. This condition is associated with vaginal dyspareunia (painful sexual intercourse), dryness, itching, and burning and abnormal discharge, which often result in a diminished libido. A meta-analysis clearly showed the beneficial effects of estrogen therapy on urogenital atrophy; however, the results of the Women's Health Initiative (WHI), published in July 2002, raised concerns about the adverse effects of estrogen therapy. As a result of the WHI, estrogen-replacement therapy has decreased worldwide, and the interest in alternative therapies for the treatment of menopausal symptoms has increased.

Kwao Krua (also spelled as Kwao Kreu, Pueraria mirifica), an herb indigenous to Thailand, has been consumed by Thai women for more than 100 years to alleviate the symptoms of menopause. This herb contains several compounds with phytoestrogenic activity, such as phenol miroestrol and deoxymiroestrol. Miroestrol has been estimated to have estrogenic activity one fourth [2.5 x 10-1] that of 17beta-estradiol, the highest activity among known phytoestrogens. The objective of this study was to evaluate the effect of Pueraria mirifica consumption on vaginal symptoms, vaginal cytology, and vaginal pH in postmenopausal women.

Healthy, postmenopausal, nonhysterectomized women of age 45-60 years with untreated vaginal atrophy were recruited from the general population of Thailand between 2001 and 2004 for this randomized, double-blind, placebo-controlled study. The women were randomly assigned to consume 20, 30, or 50 mg of Pueraria mirifica extract or placebo in capsule form once daily for 24 weeks. The women were interviewed about their vaginal health at baseline and after 12 and 24 weeks of treatment, and vaginal symptoms were rated according to their intensity on a scale from 0 (none) to 3 (severe). A vaginal health index was calculated on the basis of vaginal moisture, fluid volume, elasticity, epithelial integrity, and vaginal pH on a scale ranging from 1 (poorest) to 5 (best) by the same blinded investigator. A vaginal smear and an endometrial biopsy sample were collected from each subject before and after the intervention. A maturation value was determined under light microscopy, and the biopsy samples were examined histologically.

Seventy-one women completed the examination, 51 in the 3 Pueraria mirifica groups and 20 in the placebo group. No significant differences were observed between groups at baseline. Vaginal dryness symptoms improved significantly (P < 0.05) in the Pueraria mirifica groups after 12 weeks of treatment and were maintained over the 24-week treatment period. However, no other significant differences in symptoms between the Pueraria mirificagroups and the placebo group were found. Vaginal dryness symptom scores decreased from 2.47 plus/equal to 1.32 at baseline to 1.44 plus/equal to 1.29 after 12 weeks to 1.28 plus/equal to 1.22 after 24 weeks in the Pueraria mirifica groups. [These values are given in the text but each differ from those given in Table 2] Dyspareunia frequency in the study group was reduced from 56.9% to 39.2% but did not change in the placebo group.

The vaginal health index total score improved significantly from baseline in the Pueraria mirifica groups after 12 and 24 weeks of treatment (P < 0.05). After 12 weeks of treatment, most measures of vaginal health were significantly greater in the Pueraria mirifica groups than in the placebo group, except for vaginal elasticity and pH. The pH score did increase significantly in the study group compared to baseline and placebo values (P < 0.05). In the intention-to-treat analysis, all measures of vaginal health were significantly better in the Pueraria mirifica groups than in the placebo group. After 12 and 24 weeks of treatment, the mean maturation value increased significantly (P < 0.05) in the Pueraria mirifica groups and was significantly greater in the Pueraria mirifica groups than in the placebo group. No significant differences in endometrial measures or in occurrence of adverse effects were observed between the Pueraria mirifica and placebo groups. All adverse effects were mild; urticaria was the most common in the study group, occurring in 9 (17.6%), but was not found in the placebo group.

Pueraria mirifica had an estrogenic effect on vaginal tissue and ameliorated the symptoms of vaginal dryness, dyspareunia, and signs of vaginal atrophy and decreased vaginal pH in the postmenopausal women in this study. Furthermore, Pueraria mirifica treatment restored the atrophic vaginal epithelium. Due to concerns about proliferative effects from estrogenic agents on sensitive tissues, large-scale, long-term studies that carefully monitor phytoestrogen content and hormonal activity are important to establish its safety. While the endometrial biopsies were within the normal range at 24 weeks, this would likely be too soon to note hyperplasia.

The authors of this study conclude that Pueraria mirifica may be helpful and safe in the management of postmenopausal vaginal atrophy.

Pueraria mirifica herb in Menopause I

Challenges in the conduct of Thai herbal scientific study:

Efficacy and Safety of phytoestrogen, pueraria mirifica (white kwao krua) phase I, in the alleviation of climacteric symptoms in perimenopausal women.

Publication Type: Clinical Trial, Phase I; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: Journal of the Medical Association of Thailand = Chotmaihet thangphaet (J Med Assoc Thai).

Reference: 2007-Jul; vol 90 (issue 7) : pp 1274-80

PMID: 17710964 (status: MEDLINE) (last retrieval date: 12/14/2007)

Laemlertkittikul S., Chandeying V.

Affiliation: Department of Obstetrics and Gynecology, HatYai Regional Hospital, Songkhla 90110, Thailand.

OBJECTIVE:

To evaluate the preliminary efficacy and safety of Pueraria mirifica (white kwao krua), phytoestrogen, for the alleviation of climacteric symptoms.

MATERIAL AND METHOD:

Perimenopausal women attending with climacteric symptoms, such as hot flushes and night sweats, were invited to join the present study, conducted at the Menopausal Clinic, Hat Yai Regional Hospital. The patients were voluntarily enrolled and randomly received the raw material of Pueraria mirifica, oral 50 and 100 mg capsule, once daily for six months, as an open-label study.

RESULTS:

Of the 10 enrolled patients, 8 cases were completely evaluated. The modified Greene climacteric scale (MGCS) was satisfactorily decreased in both groups. The average scale declined from 44.1 at baseline, to be 26, 17, and 11.1 at 1-, 3-, and 6- month follow-up respectively. No other laboratory abnormalities, except one case had transiently increased the creatinine level, and one case of increased blood urea nitrogen. The mean serum estradiol was slightly increased, while the mean serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were nearly stable.

CONCLUSION:

Pueraria mirifica is relatively safe and preliminarily alleviates the climacteric symptoms in perimenopausal. women, but the data is insufficient to draw definite conclusions regarding the estrogenic effect.

Pueraria mirifica herb in menopause II

Source: J Med Assoc Thai, 2004 Jan; 87(1) 33-40.

Laemlertkittikul S., Chandeying V.

Affiliation: Department of Obstetrics and Gynecology, HatYaiRegionalHospital, Songkhla90110, Thailand.

OBJECTIVES:

To evaluate the preliminary efficacy and safety of Pueraria mirifica in the treatment of vasomotor symptoms.

DESIGN:

Open-label study. SETTING: Hat Yai Regional Hospital, Thailand.

SUBJECTS:

Pre and postmenopausal women with vasomotor symptoms, such as hot flushes and night sweats. Other unpleasant symptoms, urogenital and psychological symptoms, were also evaluated.

MATERIAL AND METHOD:

Patients were enrolled voluntarily and randomly received 50 mg or 100 mg of Pueraria mirifica in capsules, once daily for six months.

RESULTS:

Of the 48 enrolled patients, 11 cases were excluded for failing to complete the initial work-up. Thirty-seven cases were evaluated. 20 of 37 (54.1%) randomly received a dose of 50 mg/day of Pueraria mirifica (Group A), and 17 of 37 (45.9%) received 100 mg/day of Pueraria mirifica (Group B). The mean of the modified Greene climacteric scale decreased from 35.6 to 26.6, 17.2 and 15.1 in group A, while group B, declined from 32.6 to 21.0, 14.8 and 13.6 at 1-, 3- and 6-month respectively. The mean serum estradiol, fluctuated from the baseline of 76.6 to 55.4, 56.7, 72.5, 69.2, 114.2 and 74.5 pg/ml at 1-, 2-, 3-, 4-, 5- and 6-month respectively. Whereas the mean serum follicle-stimulating hormone (FSH)/luteinizing hormone (LH) was stable in the range of; 27.1/12.6, 28.3/12.9 and 22.5/11.4 mIU/ml at baseline, 3- and 6-month respectively.

CONCLUSIONS:

Pueraria mirifica, containing phytoestrogens, relatively alleviated the climacteric symptoms in perimenopausal women. The transient negative profiles occurred in a small number of subjects that included anemia, and liver profiles. While there was a slight decrease in lipoproteins and an increase in hormonal profiles, Pueraria mirifica demonstrates great promise in the treatment of climacteric symptoms among perimenopausal women. However, optimal doses should be clinically assessed, to meet appropriate individual responses.

Pueraria mirifica herb in menopause III

Efficacy comparison of Pueraria mirifica (PM) against conjugated equine estrogen (CEE) with/without medroxyprogesterone acetate (MPA) in the treatment of climacteric symptoms in perimenopausal women:

phase III study

Publication Type: Clinical Trial; Clinical Trial, Phase III; Journal Article; Research Support, Non-U.S. Gov't

Journal of the Medical Association of Thailand (J Med Assoc Thai) 2007-Sep; vol 90 (issue 9) : pp 1720-6

PMID: 17957910 (status: MEDLINE) (last retrieval date: 12/14/2007)

Laemlertkittikul S., Chandeying V.

Affiliation: Department of Obstetrics and Gynecology, HatYai Regional Hospital, Songkhla 90110, Thailand.

OBJECTIVE:

To evaluate the efficacy comparison of Pueraria mirifica, name in Thai is Kwao Krua Khao, against conjugated equine estrogen (CEE) with/without medroxyprogesterone acetate (MPA) in the treatment of perimenopuasal women with climacteric symptoms.

MATERIAL AND METHOD:

Perimenopausal women attending the Menopausal clinic of Hat Yai Regional Hospital were voluntarily recruited. The vasomotor symptoms such as hot flushes and night sweats, as well as other unpleasant symptoms, urogenital and psychological symptoms, were also assessed. Patients were voluntarily enrolled and randomly received daily 50 mg raw material of PM, Group A, or daily 0.625 mg of conjugated equine estrogen (CEE) with/without 2.5 mg of medroxyprogesterone acetate (MPA), Group B, depend on non-hysterectomized/hysterectomized condition.

RESULTS:

Seventy-one patients were enrolled. Eleven of those were excluded for failing to complete the initial work-up and follow-up. Sixty cases were evaluated, 30 cases in Group A and 30 cases in Group B. After medication, the mean of modified Greene climacteric scale (MGCS) in Group A/Group B had decreased from 29.0/32.26 to 17.86/18.1, 12.56/9.57 and 9.9/8.16 at 1-, 3-, and 6- month respectively. The clinical satisfaction using MGCS was not statistically significant between Pueraria mirifica (Group A) and CEE with/without MPA (Group B) in the alleviation of climacteric symptoms (p-value > 0.05). There were no statistically significant changes of three serum markers: estradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) between both groups.

CONCLUSION:

Pueraria mirifica, containing phytoestrogens, has estrogenic effect as similar as CEE, and can alleviate the climacteric symptoms in perimenopausal women. Pueraria mirifica demonstrates great promise in the treatment of climacteric symptoms. However, optimal doses should be clinically assessed to meet appropriate individual responses.

Pueraria mirifica herb in treatment of menopausal syndrome

Finished herbal product as an alternative treatment for menopausal symptoms in climacteric women.

Publication Type: Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't

Journal: Journal of alternative and complementary medicine (New York, N.Y.) (J Altern Complement Med).

Reference: 2005-Dec; vol 11 (issue 6) : pp 1075-84

PMID: 16398600 (status: MEDLINE) (last retrieval date: 12/14/2007)

Jung-Nein Lai, Jing-Shiang Hwang, Huey-Jeng Chen, Jung-Der Wang

Affiliation: Department of Obstetrics and Gynecology; Department of Chinese Medicine, Taipei Municipal Yang Ming Hospital, Taipei, Taiwan.

BACKGROUND:

There is a paucity of scientific evidence supporting the efficacy of herbal medicines in treating menopausal symptoms.

OBJECTIVE:

The aim of this study was to evaluate safety and efficacy of the finished herbal product TMN-1 in the treatment of menopausal symptoms in climacteric women.

DESIGN AND SETTING:

A multicenter, prospective, observational follow-up study was conducted from July 2003 to December 2004 in four hospitals in Taiwan.

PARTICIPANTS:

Initially, 126 women were included who were between 45 and 55 years of age, were experiencing hot flashes, and were without hormone replacement therapy. Women were excluded if they had any signs of active cancer. Of the participants, 82% completed the study. The reasons for withdrawal included adverse effects (n = 7), failed to return (n = 7), lack of efficacy (n = 6), and from protocol deviation (n = 3).

INTERVENTION:

Every participant received TMN-1 treatment 4 g, 3 times per day, for 12 weeks.

MAIN OUTCOME MEASURE:

Primary measures were change in frequency of hot flashes and severity of menopausal symptoms measured by Kupperman Index (KI). Secondary outcomes included changes in quality of life and adverse events.

RESULTS:

Significant improvement in scores of hot flashes and KI were found at weeks 4 and 12 in the 50 peri- and 53 postmenopausal women who completed this study (p < 0.001). Logistic regression analyses showed that perimenopausal women with hot flashes had sevenfold (95% confidence interval [CI], 1.8-28.0) odds of improvement in favor of treatment, whereas that of the postmenopausal group was 1.5 (95% CI, 0.5 to 4.2). Further analyses showed that TMN-1 produced superior benefit in women with moderate and severe menopausal symptoms (KI > or = 21), compared to those with mild symptoms. It also improved symptoms of insomnia, nervousness, melancholia, and palpitation in perimenopausal women. Five (5) adverse drug reactions were detected:

three single events of nausea, abdominal pain, and abdominal fullness; and two events of diarrhea.

CONCLUSIONS:

This study provides evidence that 12 weeks of TMN-1 therapy is a viable alternative treatment to consider in perimenopausal women with hot flashes, particularly in those with palpitations, emotional disturbance, and insomnia.

Pueraria mirifica herb prevents bone loss I

Pueraria mirifica, a phytoestrogen-rich herb, prevents bone loss in orchidectomized rats.

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Maturitas (Maturitas).

Reference: 2007-Mar; vol 56 (issue 3) : pp 322-31

PMID: 17101247 (status: MEDLINE) (last retrieval date: 12/12/2007)

Nontakorn Urasopon Yuzuru Hamada Kazuo Asaoka Wichai Cherdshewasart Suchinda Malaivijitnond

Affiliation: Biological Science Ph.D. Program, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand.

OBJECTIVE:

Estrogens and estrogen-like substances have been reported to play an important role in male bone homeostasis and to prevent bone loss. Pueraria mirifica (Leguminosae), a Thai herbal plant, containing a high amount of phytoestrogens was a choice of interest for this study. We examined the effects of crude Pueraria mirifica on bone loss and influences on reproductive organs in male rats.

METHODS:

Using fully mature and orchidectomized (ORX) rats, the effects of 0, 10, 100 and 1000 mg/kgB.W./day of P. mirifica and 0.1mg/kg B.W./day of 17 alpha-ethinylestradiol (a positive control) were evaluated on bone mineral density (BMD) and bone mineral content (BMC) measured with a peripheral Quantitative Computerized Tomography (pQCT) densitometry.

RESULTS:

Bone loss in trabecular and cortical bones of the various sites of axial bone (fourth lumbar vertebral body) and long bones (tibia and femur) after ORX was dose-dependently prevented by P. mirifica. The effects were specific on bone types and sites. The weights of the accessory sex organs, seminal vesicle and ventral prostrate gland, which significantly decreased after 3-month of ORX, were not altered by P. mirifica.

CONCLUSION:

The results suggest that Pueraria mirifica treatment may be useful to prevent an osteoporosis in elderly hypogonadism subjects without influences on reproductive organs.

Pueraria mirifica herb prevents bone loss II

Bone loss is one major menopause symptom. Pueraria mirifica improves bone loss caused by estrogen deficiency.

J Reprod Dev. 2004 Dec;50(6):639-45.

Long-term treatment effects of Pueraria mirifica phytoestrogens on parathyroid hormone and calcium levels in aged menopausal cynomolgus monkeys.

Trisomboon H, Malaivijitnond S, Suzuki J, Hamada Y, Watanabe G, Taya K.

Biological Science Ph.D. Program, Faculty of Science, Chulalongkorn University, Bangkok, Tokyo, Japan.

PMID: 15647615 [PubMed - indexed for MEDLINE]

To determine the effect of Pueraria mirifica (PM) on serum parathyroid hormone (PTH) and calcium levels on aged menopausal monkeys (Macaca fascicularis), subjects were treated with 10, 100, or 1,000 mg/day of PM. Blood samples were collected every 5 days for 30, 90, and 60 days during pre-treatment, treatment, and post-treatment periods, respectively. Sera were assayed for PTH, estradiol, and calcium levels. PM-1,000 had the strongest effect on the decrease in PTH (0.001)

The results suggest that long-term treatment with 1,000 mg/day of Pueraria mirifica decreases serum PTH and calcium levels in aged menopausal monkeys, indicating that Pueraria mirifica ameliorates bone loss caused by estrogen deficiency.

Effects and safety of Pueraria mirifica on lipid profiles and biochemical markers of bone turnover rates in healthy postmenopausal women

Source: Menopause. 2008 May-Jun;15(3):530-5.

Manonai J, Chittacharoen A, Udomsubpayakul U, Theppisai H, Theppisai U.

Department of Obstetrics and Gynaecology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. rajmo[at]mahidol.ac.th

OBJECTIVE:

To evaluate the effect of Pueraria mirifica on lipid profiles and biochemical markers of bone turnover rates in healthy postmenopausal women and to evaluate the safety of Pueraria mirifica on endometrium; breast tissue; and hematologic, hepatic, and renal systems.

DESIGN:

This was a randomized, double-blind, placebo-controlled study in a university hospital of healthy postmenopausal women aged 45 to 60 years old. Women were enrolled voluntarily and randomly received 20, 30, or 50 mg Pueraria mirifica in capsules or identical placebo once daily for 24 weeks. Outcome measures were lipid profiles, bone-specific alkaline phosphatase level, endometrial thickness, endometrial histology, breast ultrasonography, complete blood count, liver function test, and renal function test.

RESULTS:

After 24 weeks of treatment, 71 women were evaluated. Of the 71 women, 51 randomly received varying doses of Pueraria mirifica and 20 received placebo. Pueraria mirifica and placebo significantly increased triglyceride levels by 15% from baseline levels (P<0.05). The Pueraria mirifica group showed a significant decrease in bone-specific alkaline phosphatase levels after 24 weeks of treatment compared with the placebo group; from 0.22+/-0.18 U/L to 0.13+/-0.01 U/L in the Pueraria mirifica group and from 0.20+/-0.10 U/L to 0.20+/-0.14 U/L in the placebo group. Endometrial thickness did not change after treatment in both groups (P>0.05). No endometrial proliferation or hyperplasia was reported after 24 weeks of treatment in both groups. There were no significant differences in adverse effects on breast tissue, complete blood count, and liver and renal function tests between the Pueraria mirifica and placebo groups in this study.

CONCLUSION:

Pueraria mirifica at a dose of 20, 30, and 50 mg/d for a 24-week period demonstrated an estrogen-like effect on bone turnover rate. Pueraria mirifica did not demonstrate an estrogen-like effect on endometrial thickness and endometrial histology. Mild adverse effects occurred after Pueraria mirifica and placebo treatment.

The effect of Pueraria mirifica on cytologic and urodynamic findings in ovariectomized rats

Source: Menopause. 2009 Mar-Apr;16(2):350-6.

Manonai J, Seif C, Böhler G, Jünemann KP.

Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

OBJECTIVE:

To evaluate the effect of Pueraria mirifica on vaginal and urethral cytology, bladder pressure and capacity, residual urine, and leak point pressure in ovariectomized rats. METHODS: Seventy-two adult, ovariectomized, female Sprague-Dawley rats were placed into one of four groups: control, estradiol, or 100 or 1,000 mg/kg of Pueraria mirifica (PM-100 and PM-1000, respectively). The vaginal and urethral smears were checked after 30 days of ovariectomy at pretreatment and at day 28 of treatment.A single cystometry, defined as the micturition interval, filling pressure, threshold pressure, micturition pressure, and voided volume, was performed. Peak bladder pressure was calculated for each leak point pressure measured at half bladder capacity by slowly and manually increasing abdominal pressure until a leak occurred, at which point external pressure was rapidly released. Leak point pressure was tested three times per rat.

RESULTS:

After 28 days of treatment, the estradiol, PM-100, and PM-1000 groups had significantly higher numbers of vaginal and urethral superficial cells compared with the control group (P < 0.05). Regarding the urodynamic parameters, the threshold pressure, micturition pressure, and leak point pressure were higher in the estradiol, PM-100, and PM-1000 groups compared with the control group (P < 0.05). The control, PM-100, and PM-1000 groups had the same values for micturition interval, bladder capacity, voided volume, and residual volume (P > 0.05) but lower values compared with the estradiol group (P < 0.05).

CONCLUSIONS:

Pueraria mirifica 100 and 1,000 mg/kg/day showed an estrogen-like effect on the vaginal and urethral epithelium of ovariectomized rats. They did not change bladder capacity and residual urine volume but increased leak point pressure according to urodynamic study.

PMID: 19098688 [Pubmed - in process]

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43. Ritchie M PhD MRSC, Young, R PhD MNIMH. Protocol for Assessment of Mechanism of Action of Pueraria Mirifica on the Alpha and Beta Receptor of a Selected Breast Cancer Cell Line. Napier University August 4, 2007. (CONFIDENTIAL)

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45. Chandeying V. MD, Sangthawan M. MD. Faculty of Medicine, Prince of Songkhla University, Hat Yai, Songkla, Hat Yai Regional Hospital, Hat Yai, Songkla. Efficacy Comparison of Pueraria Mirifica (PM) Against Conjugated Equine Estrogen (CEE)With/Without Medroxyprogesterone Acetate (MPA) in the Treatment of Climacteric Symptoms in Perimenopausal Women: Phase III Study. J Med Assoc Thai 2007; 90 (9): 1720-6.

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