Anti-HIV activity in traditional Chinese medicine: clinical implications of monomeric herbal remedies and compound decoctions

Acquired immunodeficiency syndrome (AIDS), a doubtlessly deadly infectious ailment, is brought on by the human immunodeficiency virus (HIV), which ends up in a debilitating compromise of the host’s immune system. Consequently, a cascade of opportunistic infections or malignancies ensues, finally leading to mortality for these troubled (1, 2). The Joint United Nations Programme on HIV/AIDS predicted that, by the top of 2022, 39 million sufferers could be affected with HIV/AIDS globally, with 1.3 million novel HIV infections reported throughout that yr (3).

The first targets of HIV are CD4+ T lymphocytes, which play a pivotal function within the immune response in opposition to microbial antigens (4). Following viral invasion, the envelope protein Gag, particular to the primary area of CD4 floor marker molecules, orchestrates an onslaught in opposition to CD4+ T cells, precipitating a precipitous decline of their numbers (5). Consequently, HIV embarks on a quick however potent replication interval, initiating early harm to the host immune system. Owing to its swift development, formidable challenges, grave repercussions, and wide-ranging results, HIV/AIDS has emerged as a pivotal public well being problem.

Acquired immunodeficiency syndrome is an immunological illness that poses an immense world menace to human wellbeing. Though standard extremely energetic antiretroviral remedy (HAART) has achieved outstanding progress in viral suppression and immune augmentation, its unwanted effects and long-term therapeutic influence stay non-negligible. In opposition to this backdrop, conventional Chinese language medication (TCM), which has a venerable historical past in healthcare programs, is gaining growing recognition. Within the therapy of AIDS, TCM therapies have demonstrated the potential to alleviate medical signs, improve immune operate, and lengthen the onset of elevated severity of the illness. Consequently, analysis establishments and consultants have begun to delve deeper into TCM therapies for HIV, adopting rigorous scientific methodologies to probe its pharmacological mechanisms, efficacy, and doable unwanted effects. A number of natural treatments have yielded constructive leads to medical observe, offering helpful case research on the applying of natural medicines in HIV remedy.

Current advances into natural therapies for HIV have included a collection of breakthroughs, encompassing the screening of numerous herbs and the identification of antiviral energetic constituents. Natural screening has more and more targeted on discovering crops that exhibit pronounced anti-HIV exercise. By way of systematic pharmacological evaluations and laboratory analysis, a number of natural extracts of crops have been recognized as potent HIV inhibitors. These natural extracts probably suppress viral replication and invasion mechanisms. Moreover, some research have unveiled the potential of herbs to inhibit key enzyme actions, reminiscent of HIV reverse transcriptase. Identification of energetic constituents is a pivotal side of natural medication analysis because it gives a extra exact understanding of anti-HIV mechanisms.

Furthermore, natural medicines have the potential for immune modulation; HIV an infection severely undermines the immune system of the physique, rendering it ineffective in opposition to viruses. Therefore, research have explored the potential of herbs to reinforce immune operate. Some herbs increase immune cell exercise, stimulate cytokine secretion, facilitate the restoration of immune homeostasis, and bolster resistance. Along with laboratory investigations, the variety of medical trials investigating the efficacy of natural medicines in HIV therapy has elevated. Natural formulations have been built-in into medical observe, leading to constructive outcomes. Researchers have evaluated the consequences of natural medicines in randomized managed trials to evaluate the enhancements in medical signs, CD4+ T cell counts, and viral load management. These endeavors have engendered novel views and potentialities for the applying of natural medicines in HIV remedy.

Conventional Chinese language medication derives its elements from numerous sources, together with crops, animals, and minerals; of those, crops are essentially the most generally used. Plant-derived medicines are essentially the most extensively researched class in anti-HIV therapies inside TCM. The energetic chemical parts of notable anti-HIV herbs in TCM are listed in Figure 1.

Determine 1. Constituents with anti-HIV exercise which might be current in single herbs.

2.1 Licorice

Licorice, a solitary natural treatment inside TCM, is often used as an HIV therapy in medical settings, that includes prominently as an additive in natural formulations. The efficient chemical constituents of licorice, reminiscent of glycyrrhizic acid, glycyrrhizin, glycyrrhetinic acid, and their derivatives exhibit a pronounced potential to inhibit viral replication and successfully get rid of dormant viruses, thus demonstrating a broad-spectrum antiviral impact (6). Glycyrrhizin is primarily discovered within the roots of licorice and has immune-activating properties (7). Glycyrrhizin doubtlessly lowers membrane fluidity and inhibits intercellular viral infections. Harada (8) demonstrated that cells handled with glycyrrhizin exhibit time-dependent will increase in membrane fluidity and sensitivity to an infection and fusion when positioned in a glycyrrhizin-free alternative tradition medium, offering proof for an in depth affiliation between membrane fluidity and viral an infection. Sasaki et al. (9) discovered that glycyrrhizin induced β-chemokine manufacturing in peripheral blood mononuclear cell (PBMC) cultures from sufferers contaminated with HIV, thus inhibiting the entry of NSI-HIV. Ninety p.c of HIV replication was inhibited in 31% of the samples. Researchers from China (10) found that glycyrrhizin supplementation (100 mg/kg/day) protected rats in opposition to R5-type HIV-1 gp120 harm by safeguarding rat myocardial operate whereas sustaining regular rat physique weight, lipid metabolism, and antioxidant metabolism. Japanese researchers (11) have extracted phenolic parts from glycyrrhizin, which improve its antagonistic impact in opposition to HIV in ATL-IK cells. Two novel glycyrrhizin derivatives inhibited HIV proliferation at low concentrations. As well as, a impartial water-soluble polysaccharide, glycyrrhiza polysaccharide (GPS), was remoted from the glycyrrhiza residue and exhibited a 36.2% inhibition price in opposition to HIV (12).

2.2 Arnebia euchroma

Research because the Nineteen Nineties revealed that Arnebia euchroma, an vital medicinal plant in Xinjiang, exhibited sturdy anti-HIV exercise. Kashwada et al. (13) established the potent anti-HIV-1 exercise of hot-water extracts from dried A. euchroma roots, particularly a 70% aqueous ketone extract, which displayed effectiveness in opposition to HIV replication in H9 cells throughout acute an infection. Sodium and potassium salts of caffeic acid tetramers from A. euchroma had been recognized as energetic parts. Chen et al. (14) found that Shikonin inhibits chemokine-induced leukocyte migration and monocyte chemotaxis whereas lowering leukocyte calcium inflow. Shikonin considerably downregulated the mRNA expression of the HIV-1 co-receptor CCR5, inhibiting HIV-1 replication, suggesting that the anti-HIV-1 motion of Shikonin is said to interference with chemokine receptor expression and performance. Maierdan et al. (15, 16), extracted a water-soluble part from A. euchroma that protected MT-2 cells in opposition to HIV-1 an infection and inhibited HIV-1 integrase (HIV-1 IN) exercise. A. euchroma polysaccharide, one other energetic part, possesses immune-enhancing properties and enhances the diminished proliferative response of splenic lymphocytes in immunosuppressed mice, having immunomodulatory results (17).

2.3 Isatis tinctoria

Isatis tinctoria, recognized for its pronounced immune-regulating and broad-spectrum antiviral results, started to garner analysis consideration within the late 20^th century. Chang and Yeung (18) demonstrated that extracts from I. tinctoria fully inhibited HIV development in H9 cells at sub-toxic concentrations, establishing that they’ll successfully block HIV replication in a dose-dependent method. Ngan et al. (19) discovered that dimethyl sulfoxide (DMSO) extracts of I. tinctoria successfully inhibited HIV-1 in vitro. I. tinctoria extracts didn’t induce interferons or inactivate extracellular HIV or herpes simplex virus; they particularly inhibited HIV however not herpes simplex virus. These research reported the anti-HIV exercise of I. tinctoria; nonetheless, did not establish the energetic compounds. Wang et al. (20) characterised cyclic peptides in I. tinctoria and recognized 5 novel and three recognized cyclic peptides. A few of these peptides displayed anti-HIV exercise, with cyclolinopeptide Y5 being the simplest in accordance with testing with an XTT-based in vitro anti-HIV assay.

2.4 Honeysuckle

The antiviral efficacy of honeysuckle has been validated in quite a few experimental and medical research. Compounds remoted from honeysuckle, reminiscent of 3,5-O-dicaffeoylquinic acid and three,5-O-dicaffeoylquinic acid methyl ester, exhibit robust inhibitory results on HIV-1 reverse transcriptase and HDNAP-γ. At concentrations 1–6 μM, all dicaffeoylquinic acids inhibited HIV-1 replication in T-cell traces (21). Different research have recognized 13 further caffeoylquinic acids, caffeic acids, and caffeic acid methyl esters in honeysuckle, all of which have demonstrated antiviral exercise in opposition to respiratory viruses (22).

2.5 Astragalus

Astragalus, famend for its wide-ranging antiviral and immunomodulatory properties (23, 24), incorporates compounds reminiscent of astragaloside, astragaloside IV, and astragalus polysaccharide, all of which have antiviral results. Research on the inhibitory results of astragaloside on HIV-1 demonstrated that each astragaloside and isoastragaloside I’ve an inhibitory impact on HIV-1 an infection. At a focus of fifty g/mL, isoastragaloside I exhibited noticeable inhibition of virus an infection that was decrease than the efficient focus of astragaloside I at 100 g/mL. Moreover, astragaloside and isoastragaloside I inhibit the combination of viral DNA into the host cell genome (25).

2.6 Huangcen

Huangcen is a well-liked TCM materials that’s used to deal with HIV. Research on the antiviral results of Huangcen have targeted on its molecular mechanism (26). Huangcen extract incorporates two flavonoid compounds, baicalein and baicalin, which inhibit HIV an infection and replication (27). They suppress numerous phases of HIV-1 replication, together with viral entry into cells, viral protease exercise, and reverse transcriptase exercise (28). With greater than 90% inhibition when current at 2 μg/mL, baicalein was the primary compound to be reported to successfully inhibit reverse transcriptase exercise of murine leukemia virus and HIV. Baicalein exhibited excessive specificity for reverse transcriptase (29). In response to Chen (30), baicalein inhibited HIV-1 in H9 cell cultures with continual HIV-1 an infection, suppressing the exercise of HIV-1 reverse transcriptase and cytopathic results in addition to inhibiting viral immunofluorescent and P24 antigens. Li et al. (31) found that the anti-HIV-1 exercise of baicalin was additionally noticed in major human PBMC cultures contaminated with HIV-1 in vitro and that baicalin considerably inhibited the replication of HIV-1 in a dose-dependent method (32). Moreover, Li et al. (33) discovered that baicalein at non-cytotoxic concentrations inhibited the fusion of cells expressing CD4+/CXCR4 or CD4+/CCR5 with X4 and R5 HIV-1 Env proteins, respectively. Moreover, baicalein blocked the preliminary stage of HIV-1 adsorption, stopping the early termination of DNA replication inside cells. In a research by Wang et al. (34), the in vitro anti-HIV-1 exercise of the baicalein-zinc (BA-Zn) complicated was in contrast with that of baicalein and BA-Zn. The outcomes confirmed that, in comparison with these of baicalein, BA-Zn had decrease cytotoxicity and better anti-HIV-1 exercise. Utilizing electrochemical strategies, Solar et al. (35) studied the interplay between baicalein and DNA and speculated that baicalein binds to DNA by intercalation.

2.7 Salvia miltiorrhiza

Salvia miltiorrhiza is a extensively used TCM materials. In 1996, Chen et al. (36) found that S. miltiorrhiza extracts had anti-HIV and anti-HBV actions. The water-soluble parts of S. miltiorrhiza are its main energetic elements, which include greater than 20 distinct monomeric compounds. All compounds possess robust antioxidant properties, with the very best content material and exercise present in salvianolic acid A and salvianolic acid B (37). Abd-Elazem et al. (38) remoted and purified two water-soluble compounds, M522 and M532, from S. miltiorrhiza. Excessive concentrations of those compounds exhibited no cytotoxicity in H9 cells and so they weren’t in a position to forestall HIV from coming into H9 cells or inhibit reverse transcriptase exercise in contaminated cells. Nevertheless, they strongly inhibited acute HIV-1 an infection in H9 cells. Qin et al. (39) remoted 4 compounds from S. miltiorrhiza, together with a novel compound and demonstrated anti-HIV exercise of the compounds in opposition to HIV-1 integrase and HIV-1 reverse transcriptase. Zhang et al. (40) found three novel polyphenolic derivatives in S. miltiorrhiza water extracts, examined their anti-HIV-1 exercise by inhibiting the P24 antigen in MT-4 cells that had been contaminated with HIV-1, and examined their HIV-1 reverse transcriptase exercise. Mori et al. (41) discovered that lithospermic acid, derived from S. miltiorrhiza, exhibited robust inhibitory results on nucleocapsid protein (NC) with out spontaneous oxidation. On condition that HIV-1 NC is a perfect goal for antiretroviral remedy, these outcomes place it as a promising place to begin for growing extremely efficient NC inhibitors.

2.8 Herba Andrographis

Herba Andrographis is a TCM materials with notable anti-inflammatory and antiviral properties. Present analysis on Herba Andrographis primarily focuses on its parts, together with lactones, neochuanxinlian lactones, deoxychuanxinlian lactones, and dehydrochuanxinlian lactones (42). Dehydrochuanxinlian lactone succinate (DASM), remoted from Herba Andrographis lactones, inhibited HIV in vitro. In a earlier research, DASM prevented HIV-induced cell fusion and HIV binding to H9 cells (43). Ma et al. (44) found that rat serum containing Herba Andrographis diminished the exercise of CXCR4 and CCR5 promoters in H9 cultured cells in vitro. In human research, Herba Andrographis diminished the floor expression of CXCR4 and CCR5 in peripheral blood CD4+ T lymphocytes, indicating its anti-HIV-1 exercise. Mayur et al. synthesized a collection of derivatives of Herba Andrographis lactones. One compound (compound 9) displayed a excessive therapeutic index and inhibited HIV-1 an infection by blocking gp120-CD4+/CXCR4/CCR5 interactions. These compounds have been urged to bind to the V3 loop of the HIV-1 envelope protein gp120. All these research demonstrated the potential of Herba Andrographis and its derivatives as anti-HIV medication (45).

2.9 Ganoderma

Ganoderma has been used for medicinal functions for greater than 2,000 years. Ganoderma is assumed to own immunomodulatory, antiviral, anti-tumor, anti-aging, and hypoxia tolerance-enhancing actions (46, 47). Along with Ganoderma extracts, polysaccharides and triterpenoids have been the topic of research on Ganoderma‘s antiviral properties. Kim et al. (48) extracted two parts of various molecular weights from Ganoderma fruiting our bodies and noticed that the low-molecular-weight part strongly inhibited the cytopathic results of HIV-1 on CEM cells. El-Mekkawy et al. (49) remoted a number of triterpenoid compounds from methanol extracts of Ganoderma fruiting our bodies. Amongst these compounds, ganoderiol F and ganodermanontriol exhibited anti-HIV-1 exercise. Each compounds had inhibition concentrations of seven.8 μg/mL, whereas ganoderic acid B, ganoderiol B, ganoderic acid C1, 3β-5α-dihydroxy-6β-methoxyergosta-7,22-diene, ganoderic acid α, ganoderic acid H, and ganoderiol A confirmed reasonable inhibitory exercise in opposition to HIV-1 protease, with an IC₅₀ of 0.17 ± 0.23 mM. Min et al. (50) remoted triterpenoid compounds, together with Ganodermaol A and ganoderic acid β, from Ganoderma fruiting our bodies and seen that ganoderic acid β, lucidumol B, ganoderic acid C1, 3β-5α-dihydroxy-6β-methoxyergosta-7,22-diene, ganoderic acid α, ganoderic acid H, and ganoderiol A exhibited important anti-HIV-1 protease exercise with IC₅₀ values starting from 20–90 μM. Devinna et al. (51) investigated the response of Ganoderma triterpenoid compounds with HIV-1 aspartic proteinase and fibrinolysin I and noticed that ganoderic acid B confirmed the very best affinity for HIV-1 proteinase, additional confirming the anti-HIV exercise of Ganoderma. Cheng et al. (52) discovered that Ganoderma antler-shaped fruiting our bodies had a better inhibition share (54.3% ± 6.2%) and better cytotoxicity (CC₅₀ <300 ppm) in comparison with Ganoderma crude extract at 150 ppm.

2.10 Polygonum cuspidatum

Polygonum cuspidatum is utilized in a variety of medical functions in TCM, with its rhizomes as the important thing medicinal part. Not too long ago, notable progress has been made in understanding its pharmacological actions, together with its lipid-lowering, anti-inflammatory, anti-shock, antioxidant, anti-HIV-1, antimicrobial, and hepatoprotective results. Schinazi et al. (53) demonstrated that anthraquinone compounds present in P. cuspidatum possess anti-HIV exercise, with emodin exhibiting an IC₅₀ of 36.3 μmol/L in opposition to HIV-1. Jiang (54) contaminated MT-4 cells with HIV after which handled them with a P. cuspidatum water extract to watch HIV-1 proliferation. Steady mixing of contaminated cells with uninfected cells, together with the addition of the P. cuspidatum water extract, fully inhibited large cell formation. These outcomes recommend that the extract acts on the floor of the virus to forestall its attachment to the cells. The water extract of P. cuspidatum had an inhibitory impact on the binding of recombinant gp120 to CD4, suggesting that one of many mechanisms of its anti-HIV-1 exercise is the prevention of virus attachment to cells. Moreover, Jiang et al. (55) discovered {that a} 10% P. cuspidatum water extract successfully inhibited the binding of HIV-1 floor gp120 to CD4 on cell surfaces in vitro, partially inhibiting splenomegaly, immune suppression, and viremia in AIDS mice. Moreover, P. cuspidatum extract was demonstrated to considerably inactivate HIV-1 reverse transcriptase in vitro, suggesting that its antiviral impact could also be associated to enzyme inactivation. In response to Lin et al. (56), a 70% ethanol extract of P. cuspidatum had an inhibitory impact on HIV-1-induced syncytium formation in vitro at non-cytotoxic concentrations, with an EC₅₀ of 13.94 ± 3.41 μg/mL.

2.11 Prunella vulgaris

Prunella vulgaris is a generally used TCM in medical observe that reveals antiviral and immunosuppressive actions. It incorporates numerous chemical parts helpful for human well being and its energetic elements have been the topic of accelerating analysis. Yao et al. (57) discovered {that a} purified P. vulgaris extract successfully inhibited HIV-1 replication within the lymphocyte cell line MT-4, monocyte cell line U937 and peripheral blood monocytes at concentrations of 6, 30, and 12.5 μg/mL, respectively. The extract additionally blocked cell-to-cell transmission of HIV-1 and interfered with the binding of HIV-1 and purified gp120 to CD4. Total, the purified P. vulgaris extract antagonizes HIV-1 an infection in inclined cells by stopping the virus’s attachment to the CD4 receptor. In response to Kageyama et al. (58), P. vulgaris extract inhibits HIV reverse transcription replication in vitro and the energetic parts may be detected within the plasma after oral administration, demonstrating its feasibility for oral administration. Liu et al. (59) screened P. vulgaris extracts from numerous conventional Chinese language herbs and located that they exhibit robust antiviral exercise and successfully inhibit HIV-1 gp41 six-helix bundle exercise. Zhang (60) studied HIV-1-infected PBMCs induced with P. vulgaris polysaccharides and investigated their ranges of apoptosis and the cytokines IL-2 and IL-4. The IL-2 ranges in HIV-infected PBMC had been considerably decrease than these within the wholesome management group, indicating that P. vulgaris polysaccharides might enhance IL-2 ranges in HIV-infected people and partially right irregular immune operate. Oh et al. (61) discovered that, in comparison with the ethanol extract, the water extract of P. vulgaris exhibited stronger antiviral exercise, and the inhibition of the HIV-1 virus primarily occurred by interference with early and post-virus binding occasions, suggesting that these extracts have potential as antiviral brokers in opposition to HIV-1.

Because the in depth analysis of growing anti-HIV medication has been carried out, increasingly more TCM have been discovered to have important or potential therapy efficacy. Amongst them, the extracts or energetic monomer parts of TCM have been reported to have numerous results; the mechanisms of those results have primarily been attributed to inhibiting HIV transcription and replication, blocking HIV binding to host cells, or lowering the expression of CD4+ T cell floor receptors. Though there’s plenty of analysis on this discipline, few experiences have in contrast the consequences of various TCM extracts or energetic monomer parts, which can change into the main focus of future analysis. Researchers are extra involved concerning the results of combination which consist of various TCM extracts or energetic parts. Maybe they consider that utilizing them alone will not be absolutely useful, and the blending results are higher, which can also be according to the idea of TCM compatibility. Beneath, we’ll focus on the analysis on combined medicine.

Compound decoctions, a type of TCM natural preparations, have garnered consideration just lately for the therapy of sufferers with HIV/AIDS. A number of medical trials have assessed the efficacy of compound decoctions in controlling HIV an infection, bettering immune operate, and enhancing the standard of lifetime of sufferers. These medical trials usually make use of a double-blind, randomized, placebo-controlled strategy wherein sufferers are divided into teams receiving compound decoctions and placebo. The observations included modifications in medical signs, viral load, CD4+ T lymphocyte counts, and different related indicators. Preliminary findings recommend that some compounded tonics could also be more practical in suppressing HIV, bettering immune operate of sufferers and assuaging signs. Medical knowledge on compounded tonics which were proven to be efficient in suppressing HIV are listed in Table 1. The distribution of the period of the medical analysis within the research inhabitants was additionally decided (Figure 2).

Desk 1. Medical knowledge on compounded tonics with a extra important impact on HIV viral suppression.

Determine 2. Distribution of the period of medical analysis for the research inhabitants.

3.1 Yi Ai Kang capsules

Yi Ai Kang capsules include an natural formulation with a wealthy composition, together with ginseng, Astragalus, Ligusticum wallichii, fried atractylodes, Rehmannia, Ophiopogon, Poria cocos, Angelica sinensis, peony, scutellaria, and licorice, endowing them with numerous pharmacological properties reminiscent of invigorating Qi, fortifying the spleen, nourishing Yin, dispelling wind and warmth, and detoxifying dampness (157). Not too long ago, quite a few medical research have confirmed the potential efficacy of Yi Ai Kang capsules in treating sufferers with AIDS, notably these with lung-spleen Qi deficiency syndrome (65–69). Along with bettering medical signs and indicators, they cut back the incidence of opportunistic infections, stabilize viral hundreds, enhance CD4+ T lymphocyte counts, lengthen affected person survival, and decrease mortality charges (62–70, 157, 158).

In response to Li et al. (62), Yi Ai Kang capsules, along with conventional Chinese language syndrome differentiation therapy, notably improved medical signs and indicators, diminished viral load, elevated CD4+ T lymphocyte counts, and decreased the incidence of opportunistic infections. Zhang (65) additionally employed a mix of Yi Ai Kang capsules and conventional Chinese language syndrome differentiation therapy, suggesting that the mechanism of bettering immune operate in sufferers could contain blocking the PD-1 and ID2/E2AmRNA signaling pathways, thereby enhancing immune operate. The medical knowledgeable group of the Henan Provincial Conventional Chinese language Medication AIDS Therapy emphasizes that intervention with Yi Ai Kang capsules in sufferers with HIV can stabilize or gradual the decline in CD4+ T lymphocytes, cut back viral hundreds, improve high quality of life, and lengthen survival (59). Yang (64) identified that combining Yi Ai Kang capsules with HAART can enhance high quality of life by assuaging medical signs and growing CD4+ T lymphocyte counts. Analysis by Wang (66) demonstrated that combining Yi Ai Kang capsules with HAART is extra advantageous than HAART monotherapy for immune reconstitution in sufferers with poor immune operate (lung-spleen Qi deficiency syndrome). Moreover, Zhang et al.’s research (70) means that combining Yi Ai Kang capsules with a cough-relieving components successfully improves cough signs in sufferers, reaching an total efficacy price of 93.75%. The Yi Ai Kang capsules additionally exhibit the potential to manage immune capabilities. In response to analysis by Liu et al. (67), the Yi Ai Kang capsules promote a balanced ratio of Th17/Treg cells, successfully regulate the disruption of the intestine microbiota, and improve immunity. Li et al. (68) discovered that Yi Ai Kang can enhance the expression of helper receptors and irregular cell activation ranges in sufferers with AIDS, thereby mitigating immune harm following HIV an infection. Zhao et al. (159) demonstrated the regulation of immune operate by a mixed therapy of Yi Ai Kang capsules mixed with IPVr, selling the differentiation of CD4+ T cells into CD4Tcm cells. Moreover, Xu (69) revealed that Yi Ai Kang capsules can cut back viral replication and immune harm by modulating the NF-κB signaling pathway.

3.2 Aikeqing capsules

Aikeqing capsules, a TCM natural compound, include numerous medicinal herbs, together with P. vulgaris, Scutellaria baicalensis, S. miltiorrhiza, Epimedium, P. cuspidatum, Astragalus membranaceus, Glycyrrhiza uralensis, Eucommia ulmoides, Lithospermum erythrorhizon, and Atractylodes macrocephala. These capsules possess the therapeutic properties of warmth clearing, cleansing, kidney tonification, Qi enhancement, bettering blood circulation, and stasis removing. Aikeqing capsules have numerous functions within the therapy of sufferers with HIV/AIDS who’ve spleen and kidney deficiencies, in addition to lingering pathogenic components, to ameliorate medical signs and improve the standard of life. With advances in medical analysis, quite a few research have confirmed the therapeutic efficacy of Aikeqing capsules within the therapy of sufferers with HIV/AIDS. This paper gives a quick overview and evaluation of the consultant research to function a reference for exploring the efficacy of Aikeqing capsules in HIV therapy.

The effectiveness of Aikeqing capsules for the therapy of HIV/AIDS has been validated in a number of medical research. Li and Zuo (71, 72) demonstrated that extended use of Aikeqing capsules alone can stabilize and elevate CD4+ T lymphocyte counts in sufferers with HIV, particularly for these with CD4+ T counts within the vary of 200 to 350 cells/μL. Cao and Dong et al. (73, 74) mixed Aikeqing capsules with HAART therapy for over 12 months and demonstrated improved CD4+ T lymphocyte counts and ameliorated medical signs in contrast with these of HAART monotherapy. Moreover, Wang et al. examined the impact of Aikeqing capsules on post-HAART irritation in sufferers with HIV/AIDS from the angle of ADAM17. Though there have been no important variations in sure indicators, this research highlights the regulatory function of Aikeqing capsules (75). In abstract, Aikeqing capsules demonstrated potential efficacy within the therapy of sufferers with HIV/AIDS. They will stabilize and elevate CD4+ T lymphocyte counts, ameliorate medical signs, improve high quality of life, and present a sure stage of security to be used. Additional large-scale medical trials are required to validate the exact efficacy and mechanism of motion of Aikeqing Capsules for the therapy of HIV/AIDS.

3.3 Fuzheng Paidu tablets

Fuzheng Paidu tablets are compound Chinese language natural medicines containing elements reminiscent of A. membranaceus, Panax notoginseng, Ligustrum lucidum, Cornus officinalis, Hedyotis diffusa, Forsythia suspensa, A. macrocephala, Saposhnikovia divaricata, and G. uralensis (76). They’ve properties of replenishing Qi and nourishing Yin, clearing warmth, and inflicting cleansing. They’ve demonstrated important efficacy in medical functions and can be found as mature formulations. Fuzheng Paidu tablets enhance signs and indicators of “deficiency of righteous Qi and lurking pathogenic components” in asymptomatic people contaminated with HIV (160). They enhance or stabilize CD4 cell counts in contaminated people and cut back the viral load. This medicine improves the general high quality of lifetime of contaminated people and has been safely administered in medical observe. Moreover, Fuzheng Paidu tablets regulate the human immune system, improve physique resistance, and alleviate affected person discomfort.

Peng and Wang (77) discovered that Fuzheng Paidu Capsules keep the soundness of CD4+ T cell counts in sufferers with an efficient price of 82.69%, considerably bettering medical signs and enhancing immune operate. Equally, Liu (78) demonstrated a lower in main signs of a affected person to various levels after therapy with Fuzheng Paidu tablets, with a therapy effectiveness price of 91.3% for viral load discount. A number of research have revealed the mechanisms of motion of Fuzheng Paidu tablets in HIV/AIDS therapy. In response to Jiang et al. (80), Fuzheng Paidu tablets upregulate IFN-α expression by regulating the interplay between CD40 and CD40L, thereby enhancing antiviral and immune-regulatory capabilities. Moreover, Peng et al. (161) demonstrated that Fuzheng Paidu tablets enhanced the phagocytic operate of peritoneal macrophages in immunosuppressed mice, promoted the formation of hemolysin, and elevated the transformation of peripheral blood lymphocytes. Tan urged that Fuzheng Paidu tablets enhance CD4 + T lymphocyte counts, stabilize viral load, and shield liver operate when used to deal with HIV/HCV co-infection (79). Shi et al. (162) additional revealed that these tablets considerably enhance CD3+ and CD4+ cell counts in immunosuppressed mice, elevate the CD4+/CD8+ ratio, and enhance total immune operate. In abstract, Fuzheng Paidu tablets have exhibited important efficacy within the therapy of HIV/AIDS. They enhance or stabilize CD4+ cell counts, ameliorate medical signs, improve high quality of life, and possess a sure diploma of immunoregulatory and antiviral exercise.

3.4 Ailing Granules

Ailing Granules, a standard Chinese language natural compound, primarily include elements reminiscent of A. membranaceus, S. baicalensis, and Persica. These granules possess the medicinal properties of primarily concentrating on signs of Qi deficiency and blood stasis whereas additionally tonifying Qi, nourishing Yin, selling blood circulation, and detoxifying (81, 88, 90). They’re used within the medical therapy of sufferers with HIV/AIDS who exhibit a mix of deficiencies and extra syndromes, offering a holistic strategy to restoring well being. This text gives a complete evaluation of a number of medical research to discover the composition, therapeutic results, particular indications, and medical therapy outcomes of Ailing Granules, offering a reference for the applying of conventional Chinese language medication in HIV/AIDS therapy.

A number of medical research have explored the applying and therapeutic results of Ailing Granules in HIV/AIDS therapy. In a research by Liu (81), Ailing Granules, when used along with HAART for long-term therapy of sufferers with HIV/AIDS who had Qi deficiency and blood stasis, improved medical signs and indicators, elevated CD4+ T lymphocyte counts, enhanced immune operate, and didn’t compromise the effectiveness of the antiretroviral remedy. A number of research carried out by Jian’an additionally demonstrated that Ailing Granules management the rise in viral load (82, 84, 86), inhibit HIV-1 virus replication (86, 87), enhance CD4+ T lymphocyte counts (82, 85, 87), enhance affected person signs and indicators (84), improve immune operate (83, 84, 87), and stabilize HIV-infected people (82–88). In analysis specializing in sufferers with HIV/AIDS who’ve Qi deficiency, blood stasis, and lingering pathogenic components, Ailing Granules additionally exhibited important therapeutic results (88). In response to Music et al. (89), Ailing Granules may affect the development of AIDS by restoring CD4+ T cell counts, enhancing their IFN-γ secretion capability, and lowering CD8+ T cell secretion of IL-4, thereby rebalancing Th1 and Th2 cytokines. Jin (90) indicated that Ailing Granules, together with HAART, promoted the secretion of IFN-α by MDC and PDC, thereby bettering affected person immune operate. This discovering was additionally supported by different research (81–83). In response to Chen et al. (91), in people contaminated with HIV, Ailing Granules might, to some extent, delay the shift of Th1-type cells to Th2-type cells, rebalancing Th1 and Th2 cytokines. In response to a number of research, Ailing Granules enhance CD4+ T cell counts, improve immune operate, and stabilize the viral load. Some research have targeted on sufferers with Qi deficiency and blood stasis, whereas others have included many forms of sufferers with HIV/AIDS. These variations might have an effect on the specificity and generalizability of the outcomes.

3.5 Kangai capsules

Kangai capsules comprise 21 TCM herbs, together with Viola yedoensis, S. baicalensis, Morus alba bark, P. vulgaris, Isatis indigotica, Panax ginseng, A. membranaceus, Dioscorea oppositifolia, and P. cocos. These herbs include a number of energetic elements and exhibit numerous pharmacological actions, together with immune regulation, anti-inflammation, and antioxidation. Kangai capsules have been demonstrated in a number of research to enhance HIV/AIDS therapy primarily by growing CD4+ T cell counts (95–106), controlling viral load (96, 103, 105), and enhancing immune operate (95, 99, 101). Wang et al. (95) discovered that Kangai capsules considerably improved CD4+ T cell counts in sufferers, aiding in sustaining immune operate. In response to Li (97), Kangai capsules mixed with HAART elevated CD4+ T cell numbers, improved immune operate, alleviated the extent of venous dilatation, and lowered the degrees of inflammatory components. These research demonstrated the constructive results of Kangai capsules in bettering the immune standing of sufferers with HIV/AIDS. He et al. (101) noticed that the mix remedy of HAART with Kangai capsules diminished plasma viscosity and improved inflammatory issue ranges in sufferers. Medical research have proven that Kangai capsules don’t exhibit important peripheral blood cell toxicity (104) and should even shield kidney operate (103). In medical observations carried out by Ba (106), for HIV-infected people with inherent components of dampness and Qi-Yin deficiency, Kangai capsules improved signs and indicators on the T-cell stage. Kangai capsules have exhibited a constructive influence on CD4+ T cell counts, immune operate, viral load, and high quality of life in numerous research (95, 96, 98, 100, 102). Moreover, some research have explored the applying of Kangai capsules in numerous affected person teams, reminiscent of intravenous drug customers and people with sexually transmitted infections (99), offering novel instructions for additional analysis. In abstract, Kangai capsules demonstrated important efficacy and potential for HIV/AIDS therapy. Their mechanisms of motion could contain immune regulation, anti-inflammation, and antioxidation, involving a number of pathways.

3.6 Aifukang capsules

Aifukang capsules, a TCM preparation, have proven distinctive therapeutic results and potential for HIV/AIDS therapy. Aifukang capsules are composed of conventional Chinese language herbs, together with S. baicalensis, Lonicera japonica, Clematis chinensis, Herba Lycopi, Cortex Fraxini, and P. cuspidatum. These elements have capabilities reminiscent of clearing warmth, detoxifying, selling blood circulation, and eradicating obstructions within the meridians. Wu et al. (107) demonstrated that Aifukang capsules enhance immune operate of sufferers, enhance physique weight, and alleviate medical signs reminiscent of fatigue, decreased urge for food, and headache. This means that Aifukang capsules include parts that improve immune system operate and alleviate signs.

Aifukang capsules have proven a collection of constructive therapeutic results in HIV/AIDS therapy. In response to Mao et al. (108) and Mao (109), Aifukang capsules improved immune indicators and diminished the viral load in sufferers with HIV/AIDS with sizzling toxins and inner accumulation whereas assuaging the poisonous unwanted effects of HAART (110). Nevertheless, owing to the variations between numerous research, additional medical and fundamental analysis is required to validate its efficacy and security. In abstract, the applying prospects of Aifukang capsules in HIV/AIDS therapy stay promising, providing novel insights and approaches for the event of the sector.

3.7 Fuzheng Kang’ai components

The Fuzheng Kang’ai Formulation consists of varied conventional Chinese language herbs, together with A. membranaceus, Codonopsis pilosula, Curcuma longa, and G. uralensis. This components strictly adheres to the therapy precept of “strengthening the physique’s basis to get rid of the foundation trigger whereas dispelling pathogenic components to handle the signs.” It combines TCM data with trendy pharmacological analysis to create well-balanced formulations. This components balances nourishment and purging with chilly and heat properties, promotes blood circulation to dispel toxins, and clears blockages to assist the physique resist and expel pathogens (111). It’s appropriate for sufferers with AIDS exhibiting signs of “Qi deficiency and blood stasis.”

Liu (112) confirmed that Fuzheng Kang’ai Formulation considerably improved affected person signs and indicators, elevated CD4 cell ranges, inhibited and stabilized viral replication, and had some inhibitory results on CCR5 and CXCR4 expression. Moreover, the components successfully alleviated signs reminiscent of fatigue, poor urge for food, hair loss, belly distension, and muscle ache in sufferers with AIDS identified with the TCM sample of “Qi deficiency and blood stasis” (113). Liu (163) additional confirmed that the components might improve mobile immune operate in mice and block HIV an infection by aggressive binding with CCR5. These findings recommend that the Fuzheng Kang’ai Formulation incorporates parts that improve immune operate, promote blood circulation to get rid of toxins, and inhibit viral replication.

The Fuzheng Kang’ai Formulation has proven important therapeutic results in medical research. A number of research have proven that this components enhances immune operate, alleviates medical signs, stabilizes viral load, and slows illness development. Wang (111) demonstrated that the Fuzheng Kang’ai Formulation elevated the secretion of IL-2 and IFN-γ, elevated T cell counts and enhanced immune operate. The Fuzheng Kang’ai Formulation demonstrated enhanced therapy results when used along with antiretroviral medication (HAART). The impact of the components on T cell floor PD-1 expression and CD8+ T lymphocyte rely varies amongst totally different research. Some research have additionally explored the mechanism of motion of the Fuzheng Kang’ai Formulation, reminiscent of its regulation of phospholipid transport and its results on the TLR4 receptor. Medical observations have proven that the Fuzheng Kang’ai Formulation is protected for treating sufferers with HIV/AIDS, which synergistically enhances immune reconstruction and improves high quality of life, particularly when utilized in mixture with HAART.

3.8 Taiqi Peiyuan granules

Taiqi Peiyuan granules are a TCM compound preparation composed of varied Chinese language herbs. The most important elements embrace A. membranaceus, C. pilosula, C. longa, Rehmannia glutinosa, Ophiopogon japonicus, and G. uralensis. These herbs are primarily used for sufferers with HIV/AIDS who exhibit deficiencies in each Qi and Yin and lung and kidney deficiencies. A number of medical observational research have proven that Taiqi Peiyuan granules enhance immune operate (114, 115, 121), enhance CD4+ T lymphocyte counts (114–116, 118), elevate the CD4+/CD8+ ratio, improve immune operate, management virus replication (114–116), and keep the well being of sufferers (114–117, 120–122, 164). The components additionally has a constructive influence on medical signs in sufferers with HIV/AIDS, presenting with signs reminiscent of insomnia, restlessness, night time sweats, spontaneous sweating, fatigue, susceptibility to chilly, and phlegm manufacturing (116). Taiqi Peiyuan granules affect the expression of PD-1 on T cell surfaces, affecting T cell activation (115). The components assists in lowering the viral load when utilized in mixture with antiretroviral medication, probably owing to its regulation of immune cell operate (116). Medical observations have indicated that Taiqi Peiyuan granules are protected for the therapy of HIV/AIDS, notably when used along with HAART, as this mixture can synergistically improve immune reconstitution and enhance high quality of lifetime of sufferers (114, 115, 117–119, 121).

3.9 Immunity 1

Immunity 1 primarily consists of elements reminiscent of western ginseng, Cordyceps sinensis, and Isodon amethystoides. It’s a TCM compound granule developed based mostly on the mechanism of HIV/AIDS by long-term medical observe for the prevention and therapy of AIDS, with efficacy in strengthening the physique and offering cleansing. Immunity 1 successfully improved immune operate in sufferers with latent HIV/AIDS. In response to analysis findings, immunity 1 primarily acts on the elevation of CD45RO; nonetheless, after 6 months of therapy, it primarily acts on CD45RA (123). Combining Immunity 1 with antiretroviral remedy (HAART) considerably promoted immune reconstitution in sufferers with HIV/AIDS. Immunity 1 therapy successfully improves signs and indicators in sufferers with HIV/AIDS, notably digestive system signs, reminiscent of poor urge for food and diarrhea (124). As a TCM prescription, Immunity 1 reveals a big immune regulatory impact within the therapy of sufferers with AIDS. By selling improved immune operate, Immunity 1 helps to raise the extent of immune reconstitution in sufferers, particularly these with HIV/AIDS.

3.10 Immunity 2

Immunity 2 is a TCM compound prescription that primarily consists of Western ginseng, C. sinensis mycelia, and Schisandra chinensis, amongst different elements. By adhering to the ideas of tonifying the physique and eliminating pathogenic components whereas clearing warmth and detoxifying, Immunity 2 goals to strengthen the physique’s basis, resist pathogenic components, promote immune reconstitution, and both suppress illness development or keep a stability between well being and illness in sufferers with AIDS. Immunity 2 will increase absolutely the rely of CD4 cells in sufferers, promotes immune reconstitution, and successfully improves immune operate (125, 129). Therapy with Immunity 2 considerably improves signs reminiscent of fatigue, joint and muscle ache, pores and skin itching, and shortness of breath, and enhances the standard of life (126, 165). Research have indicated that Immunity 2 can partially restore CD45RA and CD45RO cell subpopulations (129). Moreover, when treating sufferers with HIV/AIDS with immune reconstitution deficiency, Immunity 2 impacts the TLR9-mediated signaling pathway, which can be one of many mechanisms for bettering irregular immune activation (165). Immunity 2 therapy can enhance the CD4 lymphocyte rely in sufferers with immune reconstitution deficiency, thereby enhancing the physique’s immune response (127). Immunity 2 demonstrates important therapeutic results in sufferers with immune reconstitution deficiency. By way of immune operate regulation and the promotion of elevated CD4 cell counts, this prescription successfully improves medical signs, enhances high quality of life, and helps restore irregular immune states.

3.11 Different conventional Chinese language medication compound formulations

A number of medical trials have proven that numerous different TCM preparations had constructive results on the immune operate and medical symptom enchancment of sufferers with HIV/AIDS (130, 132, 156). These TCM formulations assist in growing CD4+ T lymphocyte counts, lowering the viral load, bettering immune operate, assuaging medical signs, and finally enhancing the standard of lifetime of sufferers. For instance, Qian Kun Ning, Zhen Qi Fu Zheng capsules, and compound Astragalus granules have been proven to considerably enhance CD4+ T cell counts, thereby enhancing immune operate (132, 133, 138, 148, 150). As well as, Xiao Yao San He Er Chen Tang, Wen Bu Pi Shen Fang, Pu Le Kang Oral Liquid, and different TCM formulations have been efficient in inhibiting virus replication, lowering viral load, bettering medical signs, and considerably enhancing high quality of lifetime of sufferers (130, 133, 137, 139, 140, 154). Moreover, enhancements in medical signs, reminiscent of elevated physique weight and diminished fatigue, have been noticed with using these formulations (137, 142, 151). Nevertheless, discrepancies had been there within the outcomes, with some research not observing important therapeutic results (135, 150), which can be attributed to components reminiscent of the particular formulation and the research inhabitants. Security evaluation is one other essential side of those research, with most indicating that TCM formulations are protected for therapy with no obvious hostile reactions or poisonous unwanted effects (133, 152, 154). Nevertheless, some research reported potential unwanted effects that require additional verification (146, 153). This underscores the significance of a excessive stage of security in TCM therapy.

Nonetheless, totally different TCM formulations exhibit variations of their therapy efficacy and mechanisms. Medical observational knowledge point out that the efficacies and mechanisms of motion of varied TCM formulations aren’t an identical. For instance, Qian Kun Ning primarily improves sufferers’ blood lipid ranges and medical signs by assuaging signs associated to liver despair, spleen deficiency, and phlegm stagnation (131). Conversely, Qian Kun Ning successfully reduces mortality and plasma viral load and will increase CD4+ T cell counts in sufferers with HIV/AIDS (132). Zhen Qi Fu Zheng capsules, when utilized in mixture with HAART, enhance neutrophil and CD4+ T lymphocyte counts, enhance high quality of life, and cut back hostile reactions to HAART medication (133). Due to this fact, whereas TCM therapy reveals constructive results generally, choices relating to therapy choices ought to take into account the particular circumstances of the sufferers and be supported by knowledge from medical trials.

Compound natural formulations have been extensively examined by in vitro and in vivo animal research to know their mechanisms of motion in opposition to HIV. These research investigated their influence on points reminiscent of viral replication, viral invasion of host cells, and immune regulation. Varied energetic elements inside compound formulations could exert their results by totally different pathways, together with the inhibition of HIV viral replication enzymes, anti-inflammatory actions, and modulation of cytokine manufacturing. Some pharmacological experiments have proven that compound formulations inhibit HIV replication, cut back viral load, and modulate the immune system (166). Moreover, some compound formulations promote the expansion and useful restoration of CD4+ T lymphocytes (162, 163). Qian et al. (158) and Zeng et al. (164) discovered that Yi Ai Kang Capsules and Taiqi Peiyuan granules, respectively, inhibited NK cell apoptosis and controlled the immune operate of immunocompromised mice by growing NK cell numbers (158, 164). Yi Ai Kang Capsule belong to at least one type of TCM which consists of varied herbs, together with Ginseng, Astragalus membranaceus, Saposhnikovia divaricate, and others, with the operate of assuaging the signs of AIDS opportunistic an infection. Yi Ai Kang Capsules have been demonstrated to decrease the permeability of the intestinal mucosal barrier broken by HIV, cut back cell apoptosis charges, and keep the integrity of the intestinal mucosal barrier (167–169). Yi Ai Kang Capsules can alleviate lopinavir-induced lipid metabolism issues, promote the uptake and transport of fatty acids, and improve lipid clearance, thereby exerting a lipid-lowering impact (168). Fuzheng Paidu pill consists of Western ginseng, Astragalus membranaceus, Forsythia suspensa and different conventional Chinese language herbs. Fuzheng Paidu pill regulates the immune operate of immunosuppressed mice, primarily by selling lymphocyte transformation and enhancing the formation of hemolysins and hemolysis plaques (161, 162).

In medical research, TCM preparations are continuously used as adjunctive therapies, typically mixed with HAART, to enhance therapy outcomes. Totally different TCM preparations have demonstrated numerous synergistic results when utilized in mixture with HAART. For instance, Zhen Qi Fu Zheng Capsules, one type of oral TCM, primarily embrace Astragalus membranaceus and Ligustrum lucidum. Zhen Qi Fu Zheng Capsules mixed with HAART cut back the hostile results of HAART medication and enhance CD4+ T lymphocyte counts, and so they don’t have any important influence on HIV viral load conversion charges (133). Equally, when mixed with HAART, Wen Bu Pi Shen Fang and Wen Shen Jian Pi Fang promote immune reconstitution in HAART non-responders, enhance the distribution of NK cell subpopulations, and improve affected person high quality of life (140, 141). This means that utilizing TCM along with HAART will additional improve therapy effectiveness, enhance immune operate, and cut back treatment-related hostile reactions.

In medical settings, compound natural formulations are usually used along with trendy antiretroviral remedy (HAART) to realize higher therapy outcomes. The function of natural formulations on this mixed therapy strategy could contain a number of components reminiscent of:

1. Synergistic viral suppression: Compound natural formulations with HAART medication synergistically inhibit viral replication by way of totally different pathways, thereby enhancing the effectiveness of viral replication inhibition.

2. Immune operate restoration: Compound natural formulations could assist restore the broken immune programs of sufferers with HIV/AIDS by immune modulation, growing the physique’s pure protection mechanisms and strengthening its potential to fight the virus.

3. Mitigation of unwanted effects: Some parts inside compound natural formulations could possess anti-inflammatory and antioxidant properties, doubtlessly serving to to alleviate the unwanted effects of HAART medication and enhance high quality of lifetime of sufferers.

The function of natural formulations is attribute by combining compound with HAART ought to be carried out beneath the steerage of a medical skilled, with dosages and therapy plans adjusted in accordance with the particular circumstances of every affected person. Additional medical trials and in-depth research are wanted to validate the protection and efficacy of this mixed therapy technique.

Though natural medicines have therapeutic potential in HIV/AIDS therapy, many unknown areas require additional analysis. First, a deeper understanding of the particular antiviral mechanisms of herbs is required, together with their results at totally different phases of the viral life cycle. Present research confirmed that a number of natural medication, reminiscent of Golobe Halmahera, Pangium edule Reinw, and Love natural (LH) medication, have important antiviral results (170–172). The parts of those natural medication have the potential to be developed into chemotherapeutic medication, particularly with the clear acquisition of a few of their constructions, which permits for in-depth useful analysis. Due to this fact, to discover the constructions of chemical compositions of TCM talked about on this evaluation can also be a spotlight of future analysis.

Second, rational combos of herbs improve their therapeutic results, and the synergistic interactions between natural medicines require additional exploration. Moreover, optimizing the dosage types of natural preparations is essential for making certain the soundness and bioavailability of energetic elements.

6.3 Future work on TCM in HIV/AIDS therapy T

In abstract, natural medicines present promise for the therapy of HIV/AIDS. Along with instantly inhibiting viral exercise, in addition they regulate immune operate and cut back hostile reactions. Nevertheless, the therapeutic results of TCM want additional analysis and validation. Future research ought to concentrate on the antiviral mechanisms of herbs, rational combos, and dosage kind optimization. In medical functions, to make sure the most effective therapy outcomes for sufferers, warning ought to be exercised, and the steerage of recent medication ought to be thought of. Natural medication holds huge potential as an adjunctive therapy for HIV/AIDS and is anticipated to offer extra therapy choices and enhance the standard of lifetime of sufferers with HIV/AIDS. Due to this fact, clarifying the efficacy and mechanisms of TCM in treating HIV/AIDS and bettering analysis and therapy system for AIDS could be the long run analysis theme.

The Supplementary Materials for this text may be discovered on-line at: https://www.frontiersin.org/articles/10.3389/fmed.2024.1322870/full#supplementary-material

Supplementary Desk 1. Scientific names matching literary names of every TCM had been displayed.