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The scientification of jamu: a study of Indonesian’s traditional medicine

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Abstract

Various species of medicinal plants in Indonesia commonly used by residents as herbal medicine. Indigenouse knowledge of herbal medicine has never been scientifically researched, whether it is related to the benefits, the technology of manufacture, the effort of obtaining qualified herbs, and the compound components in medicinal plants. The purpose of this study was to document information and saintification about ethnomedicine in Semarang City, Central Java, Indonesia. This is a qualitative study, with data collection techniques through field studies to the research sites to gather information from traditional drug makers through semi-structured interviews and field observations. The data obtained is further analyzed to obtain a scientific explanation. The focus of this research is the type of traditional herbal products, how to make herbs, composition making, and how to produce the best herbal medicine based on information from traditional medicine maker. Two types of traditional herbal medicine are analyzed. Each type of traditional herbal medicine is described from the aspect of benefits, the main compound, the way of making, the creative idea aspect to produce the best herbal medicine, and the best material composition.
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The scientification of jamu: a study of Indonesian’s traditional medicine
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5th ICMSE2018
Journal of Physics: Conference Series 1321 (2019) 032057
IOP Publishing
doi:10.1088/1742-6596/1321/3/032057
1
The scientification of jamu: a study of Indonesian’s traditional
medicine
W Sumarni*, S Sudarmin and S S Sumarti
Chemistry Department, Mathematics and Natural Science Faculty Universitas Negeri
Semarang, Indonesia
* Corresponding author:woro@mail.unnes.ac.id
Abstract. Various species of medicinal plants in Indonesia commonly used by residents as
herbal medicine. Indigenouse knowledge of herbal medicine has never been scientifically
researched, whether it is related to the benefits, the technology of manufacture, the effort of
obtaining qualified herbs, and the compound components in medicinal plants. The purpose of
this study was to document information and saintification about ethnomedicine in Semarang
City, Central Java, Indonesia. This is a qualitative study, with data collection techniques
through field studies to the research sites to gather information from traditional drug makers
through semi-structured interviews and field observations. The data obtained is further
analyzed to obtain a scientific explanation. The focus of this research is the type of traditional
herbal products, how to make herbs, composition making, and how to produce the best herbal
medicine based on information from traditional medicine maker. Two types of traditional
herbal medicine are analyzed. Each type of traditional herbal medicine is described from the
aspect of benefits, the main compound, the way of making, the creative idea aspect to produce
the best herbal medicine, and the best material composition.
1. Introduction
Since ancient times, human health problems have been a concern. This can be seen from the use of
plants and animals as a source of traditional medicines which are depicted in temples, books and
inscriptions [1]. In addition to Indonesia, Indegenous Science for medicinal plants for centuries has
been known to the Chinese, Indian, Brazilian people, Ethiopia is integrated in many aspects of culture
[2]. Until now, the tradition of drinking traditional medicine is still very popular in several Asian
countries, Latin America, and Africa including Indonesia and India [3].
The Javanese people in particular and the Indonesian people in general, have long used medicinal
plants as a deterrent, inhibitor, and to diseases found in the body by drinking herbs derived from
medicinal plants. The indigenous knowledge of the efficacy of various medicinal plants is an ancestral
heritage that is still proven to be useful, and is safe based on empirical evidence [4, 5]. Various species
of medicinal plants as the basic ingredients of traditional medicine are widely grown in Indonesia,
especially various plants of empon-empon or herbs and spices in traditional Javanese medicinal
ingredients.
Traditional Indonesian herbal medicine that has been practiced for centuries in Indonesian society
is still very popular for maintaining health and treating diseases, because it is more believed to be safe
from chemical drugs. This traditional medicine is generally known as jamu [6]. In the past, some even
survived until now, the peddlers of this herbal medicine went around in a region by carrying the herbs
they were selling, so that they were often called jamugendong. The existence of advances in
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transportation technology, making most sellers peddle their wares with cart, ride a bike or opens their
outlet somewhere. However, the term jamugendong is still inherent in the minds of the people to name
the traditional medicine sold as a whole.
The knowledge of traditional jamu formulas preserved and transmitted down orally from one
generation to another. This is in accordance with the definition of traditional medicine delivered by the
World Health Organization (WHO), namely "a number of knowledge, skills and practices based on
indigenous beliefs and experiences, whether explained or not, used in health care, and in prevention,
diagnosis, improvement or treatment of physical and mental illness ".
Traditional medicinal plants are very important as preparation for curative and protective drugs
[7,8]. Utilization of medicinal plants that grow on community land as part of the procurement of
traditional medicinal materials has been carried out by the community since ancient times [6]. In
Javanese society in particular, various traditional medicines made from natural spices have been used
by ancestors, prepared as assistance in the Borobudur Temple which is concerned with processing /
making herbal medicine. Various spices and empon as a form of Javanese local wisdom are usually
referred to as herbal medicine, among others, jamukunir asem, jamu beras kencur, jamu paitan, jamu
godhongkates, jamucabepuyang, and jamutemulawak. The names of these herbs are the main
components in the herbal ingredients, such as jamukunirasem, then the components are turmeric and
tamarind. In the jamuberaskencur, the supporting components are rice and kaempferiagalanga. In
addition to the main components, some herbalist may added various ingredients to complement the
desired benefits. For example, in jamuberaskencur, aside from two basic ingredients, namely rice and
kaempferiagalanga, they added it with kawak acid, kedawung seeds, ginger rhizome, cardamom seeds,
temukunci, cinnamon, turmeric, lemon and nutmeg.
The observations found that the ingredients used to make the herbs came from nature without
synthetic chemicals, so that the herbs can be consumed regularly and there are relatively no side
effects [5]. The taste of the ingredients also varies depending on the ingredients used. Some are bitter,
sour, sweet and fresh. To reduce bitter taste, added natural sweeteners such as brown sugar, granulated
sugar, rock sugar or honey. The people's belief in the reliability of herbal medicine based on empirical
facts that are believed to be true is further investigated to determine the content of bioactive
compounds contained in the main ingredients used so as to produce a concoction of traditional
medicines that are safe and efficacious for the body [4].
Thus, based on the diversity and composition of ethnomedicine and how to mixtraditional
medicines from traditional herbalist and vendors around Gunungpati, Semarang City, Central Java,
Indonesia, thispresent studyaims to analyze the traditional medicine formulated and sold by traditional
medicine vendors.
2. Methods
This study uses a qualitative approach. This approach was chosen with consideration in order to
understand more deeply about indigenous knowledge about the types of local plants that have
medicinal properties traditional medicines. In accordance with the focus of the study, the research
subjects were sellers of herbal medicine, namely sellers and traditional medicine makers who peddled
their fairs around in Gunungpati District, Semarang City, Central Java. Gunungpati District is a sub-
district located in the southern part of Semarang City. The total area of 5,399,085 ha is divided into 16
urban villages, 93 RW and 472 RT. The technique of collecting data through observation of active
participation, followed by in-depth interviews, field observations and literature studies on traditional
medicine ingredients and their benefits. The informant selection technique in this study used purposive
sampling technique. Each traditional medicine maker involved in this study was informed about the
purpose of the survey, and each informant participated in the study with full agreement.
During the research study, each respondent was visited three times to verify the reliability of the
data obtained. Repeated visits also helped collect additional information not mentioned during the
previous interview. Interviews in the context of extracting and sharpening information on the original
knowledge of traditional medicine maker carried out at the place of manufacture of traditional
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medicine. Data collected from the results of observations and interviews with respondents, then
verified, reduced for data that does not contain scientific concepts, carried out saintification of
scientific knowledge of the community using relevant literature.
3. Results and Discussion
In this study, observation and interviews were conducted on 5(five) sellers who were also traditional
jamu makers in Gunungpati District, Semarang City, Central of Java. The vendors and makers of the
jamu have conveyed knowledge related to the knowledge, methods of making, and the efficacy of the
traditional medicines they make.
The results of observations and interviews with the five vendors and sellers of traditional medicine
obtained information that the techniques, methods and methods of using traditional medicines are still
the same as how the ancestors used them. The sellers of the jars carry their watches in liquid form to
be sold immediately. Although the actual way of using traditional medicine is various ways, such as
by brewing medicinal ingredients with hot water, boiling ingredients to boiling, smoothing the
ingredients to be distributed on the body surface or made as tapel (attached to certain body parts), but
the five respondents only peddling herbal in the form of liquid stew from various medicinal
ingredients. All herbs produced are recommended for drinking immediately. The results of the
identification of the types of traditional herbal medicine produced by the five sellers of herbal
medicine are listed in Table 1.
Table 1. Herbs produced by jamu makers
Traditional medicine of Medicine makers
Responden
1
Responden
2
Responden
3
Responden
4
Responden
5
Paitan
Beraskencur
KunirAsem
Godhongkates -
Temulawak
Kuncisuruh - - -
Gulaasem
Cabepuyang - - - -
The results showed that there were five types of traditional medicines which were commonly
formulated by traditional medicine sellers, namely (1) beraskencur, (2) kunirasem, (3) paitan, (4)
gulaasem (tamarind sugar), (5) temulawak. While other types of herbal medicine, the sellers deliver
only if there is a demand.
The types of ingredients added by each respondent to the five types of herbs sold are very
varied and this knowledge is also a habit they get from their parents or ancestors. In Table 2, several
types of ingredients are presented by respondents for the eight types of herbs.
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Table 2. Medicinal plants to each type of traditional drugs
Tradisional drugs
Main Materials and others Materials
JamuPaitan The raw material for paitanherbal medicine is sambiloto, but there are also
other ingredients that add bitter taste such as brotowali, widorolaut
,doroputih, babakan pule, adas and or empon-empon (rhizome ingredients
used in spices).
JamuBeraskencur The raw material for kencur rice is rice and kencur. Other ingredients that are
usually mixed are kedawung, ginger, kapulogo, kawak acid, temukunci,
keningar wood, turmeric, lime, and nutmeg. As a sweetener used brown
sugar and white sugar
JamuKunirAsem The raw material for tamarind turmeric is turmeric and tamarind, sometimes
it is mixed with sinom (young tamarind leaves), ginger, kedawung, and lime.
As a sweetener used brown sugar mixed with white sugar and salt
JamuGodhongkates The raw material for herbal medicine godhongkates is papaya leaves [9], but
some herbal makers add temuireng [10], adaspulowaras, and salt
JamuTemulawak The raw material for temulawak herbal medicine is ginger rhizome, often
added with kencur, seedless asemkawak, palm sugar, fresh pandan leaves,
and cumin.
JamuKuncisuruh The raw material for jamukuncisuruh is temukunci rhizome and betel leaf.
Usually kawak acid is added. Some jamu sellers add other ingredients
commonly used in concoction of whitish herbal medicine such as
pomegranates, areca nuts, pepet, majakan, jambe, cinnamon, beluntas, and
kencur. As a sweetener used sugar and brown sugar and salt
Gulaasem The tamarind sugar is commonly used to reduce the bitter taste of herbal
medicine or as an antidote to the bitter taste after consuming herbs. The raw
material for tamarind sugar is tamarind, boiled water, brown sugar and salt
JamuCabepuyang The main ingredients of the herbal medicine for cabelempuyang are chili
and lempuyang, added with other ingredients such as temuireng, temulawak,
ginger, kudu, adas, pulosari, turmeric, pepper, kedawung, keningar,
tamarind, andtemukunci. As a sweetener used brown sugar, white sugar and
salt
According to respondents, variations in the types of medicinal plants used in each herb from parents or
habits carried out by their ancestors. Respondents only know that certain types of herbal medicine can
treat certain diseases based on beliefs and empirical experiences that have been proven since ancient
times. In general, traditional medicine makers and vendors did not know the reason why traditional
medicines with herbal ingredients such as turmeric, ginger, and kencur which are formulated have
various properties for human health. The herbal medicine makers never know why a medicinal plant
can have certain efficacy. They only do the work as is the custom that has been done by the previous
generation.
The results of the scientific certification of indigenous knowledge related to the making of
traditional Paitan and KunirAsem traditional medicines are presented in Table 3.
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Table 3. Description of the Scientific Analysis of Community Knowledge on Traditional Medicine.
No Types of Traditional Medicine
and Its Benefits
The Scientific Analysis
Indigenous Science
1 Traditional medicine Paitan
Traditional medicinal paitan is
considered as the most bitter
traditional medicine
Interviewees of makers and seller
of traditional medicine paitan
convey the benefits of traditional
medicine bitter is for various
health problems, such as dialysis /
itching remover, biduran, appetite
enhancer, diabetes, body odor,
lower cholesterol, abdominal
bloating / acne, aches, and
dizziness.
Andrographispaniculata boiling
water is often called traditional
female health recipe because the
main ingredient that is used are
andrographispaniculata leaf which
has anti-infection and anti-
inflammatory effects. Benefits of
boiled water
Andrographispaniculata leaf for
women is to treat vaginal
discharge as well as overcome the
cold, reduce fever and flu.
The basic ingredients of traditional medicine paitan is
Andrographis Paniculata. But there are also other
materials such as Tinosporacrispa, Ziziphusmauritiana,
doroputih, Alstoniascholaris, fennel and rhizome
cooking seasoning).
Scientific analysis of the bitter taste of the traditional
medicine, due to the presence of alkaloids secondary
metabolite compounds that have a bitter taste, for
alkaloids plants as antitoxin.
According to traditional drug sellers, boiling the
ingredients of traditional medicines still use kwali /
kettle from clay, because it will not eliminate the
efficacy in traditional herbs. Technique to mash ethno-
medicine by not using metal tools, but using alu from
wood or stone.
In order for traditional medicine to be more nutritious, in
the process of manufacture, try to dry all ingredients that
will be boiled, so that the sap that is on the plant does
not inhibit the absorption process in the body.
Scientific science Traditional medicine sellers are
creative to maintain the efficacy of traditional medicine .
The interviewees conveyed information that traditionally
'the composition of traditional drug making materials of
all aspects (the type of material, how to prepare, the
dosage and the time and manner of use) must correspond
to the hereditary heritage from our ancestors.
Deviation from one aspect of the possibility may cause
the ingredients of the traditional Medicines that are safe
to be safe or harmful to health.
2 Traditional medicine KunirAsam
Traditional Turmeric acid
medicine by traditional drug
sellers is referred to as traditional
medicine 'adem-ademan or seger-
segeran' which can be interpreted
as a traditional medicine to
refresh the body or can make the
body become cold, to avoid the
heat or canker sores, making the
belly cold. And to quicken
menstruation.
Main ingredients: acidic fruit plus turmeric, sometimes
there are mixed with sinom (young acid leaves),
temulawak, kedawung, and lemon juice. Brown sugar
mixed with white sugar and a little salt are used as a
sweetener.
Making traditional medicine bitter is by boiling all the
ingredients with water, until the cooking water left about
half. This method is intended for all nutritious
substances contained in the material can dissolve into
boiling water (extraction process).The stew has a very
bitter taste, and the creative idea of traditional medicine
makers to reduce the bitterness is consumers are given
other traditional medicine that has a sweet and fresh
taste like sinom, beraskencuror kunirasam
The concept of Science that emerged techniques of
isolation, extraction, separation and purification of
secondary metabolite substances, the concept of solution
and colloids.
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Some studies show that turmeric, ginger, quail, kencur contain the main compounds called
curcumin with the molecular formula C21H20O6 (Mr = 368) with polyphenol structures that have been
clinically tested to cure inflammatory diseases or protect the skin from inflammation / red spots,
improve stamina by increasing the activity of estrogen and estrogen hormones, and antioxidants and
the risk of heart disease by neutralizing free radicals, saturated fatty acids and increasing the activity
of antioxidant enzymes the body has, anticancer by suppressing cancer growth, development and
distribution at the molecular and antimicrobial levels [11, 5].
The herbal ingredients used by the respondents are all from plant parts in the form of fresh and dry
simplicia, starting from the roots, rhizomes, stems, leaves, flowers and fruit, not just the extraction or
isolation of the active ingredients [12]. Potions use traditional doses. The beginning of herbal medicine
is known as jamugodog for boiling fresh and dry simplicia. There are also those that are brewed with
hot water for simplicia from flowers and leaves. Of the various materials commonly used by
respondents in making their herbal ingredients, there are several ingredients that have been clinically
tested namely greetings, bitter herbs, turmeric, red ginger, Dutch teak, ginger, guava, and Java
chili[11, 13]
4. Conclusion
The results of the study show that herbal medicines with various health benefits have been formulated
by sellers of herbal medicines in the city of Semarang. There are 5 types of herbs that are popular
among the people, namely jamupaitan, jamukunirasem, jamuberaskencur, jamutemulawak, and sugar
asem. The scientific results of each type of herbal medicine find the main types of compounds in
herbal medicine, herbal functions for the health of the human body, and traditional equipment used in
the manufacture of herbs. In addition to the main ingredients used as medicine, there are ingredients
added to herbal ingredients such as kedawung seeds, cumin, pandan leaves, lemongrass, lime,
cinnamon and ginger. As a sweetener used in Javanese sugar.
Making ginger herbs with the addition of ginger, tamarind, palm sugar, pandan leaves and cumin,
both for children and the elderly because it can cure complaints of dizziness, nausea, and relieve
symptoms of colds. Of all types of traditional herbal medicine, paitan herbs are the most difficult to
enjoy, because they are made of Tinosporacordifolia. But properties such as relieving pain, eliminating
swelling, anti-inflammatory, and overcoming arthritis make many people continue to consume bitter
herbs.
JamuCabaiLempuyang made from lempuyang and chilli java. This herbal drink can overcome
fatigue and stiffness, prevent colds, increase energy, reduce flatulence, etc. JamuKunyitAsam is one of
the most popular types of herbs, made from turmeric and acid. The properties of this herb are lowering
blood pressure, menstrual pain in women, and overcoming constipation. JamuBerasKencur is a herb
that is believed to eliminate stiffness in the body. By drinking this herb, the body will avoid the aches
and pains that usually arise after working too hard. In addition, there are many opinions that this herb
can stimulate appetite, so that appetite increases and the body becomes healthier.
Acknowledgement
The research team would like to thank the Rector of Universitas Negeri Semarang who has funded the
research of scientific development grant (PHPK) for professors, as well as all those who have assisted
with the implementation of this research.
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... Indonesia: It is one of most important plant in Batak traditional medicine, forming one of the five species of kesaya silima lima (five main plants in traditional medicine), and hosaya sitolu-tolu (three main plants in traditional medicine; Batak Karo) (Silalahi 2014). The jamu beras kencur ( jamu ¼ fresh traditional concoction drinks; beras ¼ rice; kencur ¼ galangal), a Javanese heritage formulation has been long used to maintain health and stamina (Sumarni et al. 2019). ...
... Indonesia: Rhizomes and young shoots have been traded as economic commodities in both traditional and modern markets, for use as spices or in traditional medicine. The jamu beras kencur is sold by Javanese women in Semarang, Central Java (Sumarni et al. 2019). Lao: Rhizomes are traded as medicinal ingredient in the traditional markets of Vientiane province (Delang 2007). ...
... We employ various active chemicals that are extensively included in herbal medicine plants found in Java. The active chemicals that we utilize in this investigation include Theaflavin, Deoxypodophyllotoxin, Gallocatechin Gallate, Allicin, Quercetin, Annonamine, Curcumin, 6-Gingerol, Curcubitacin B [24], [25]. We chose these compounds because they are frequently found in herbal plants in Java that are frequently used by the general population. ...
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Indonesia's diversity of natural resources presents an intriguing opportunity for the exploration of potential herbal medicines. Numerous compounds, both purified and crude, have been reported to exhibit antiviral activity. The ACE-2 receptor may be a therapeutic target for SARS-CoV-2 infection. We used a search engine to search for herbal medicines with ACE-2 inhibitory activity to predict the potential inhibition of natural compounds (i.e., theaflavin, deoxypodophyllotoxin, gallocatechin, allicin, quercetin, annonamine, Curcumin, 6-gingerol, and cucurbitacin B) to SARS-CoV2 – ACE-2 complex. We performed molecular docking analysis using the ACE-2 protein target from Protein Data Bank. Protein stabilization was carried out to adjust to the body's physiology, carried out using Pymol by removing water atoms and adding hydrogen atoms. Ligands of active compounds from natural resources were selected and downloaded from the PubChem database, then optimized by Pymol software. The complexes of the tested ligand compounds and ACE-2 receptors, which have a bond strength smaller than the control were selected for analysis. Theaflavin, Deoxypodophyllotoxin, Gallocatechin, Curcumin, and Cucurbitacin B had a strong bond affinity than the control ligands. Based on our data, deoxypodophylotoxin and Curcumin had the same interaction amino acid residus compare to the control ligand. This study concludes that deoxypodophyllotoxin and Curcumin have the greatest potential to inhibit the formation of the SARS-Cov2-ACE-2 complex; additionally, these compounds exhibit favorable pharmacological and pharmacodynamic properties. It is suggested that additional research be conducted to determine the biological effects of deoxypodopyllotoxin and Curcumin on ACE-2 receptors.
... These tea products are then named according to local potential, traditional knowledge and descriptions of each area. Herbal tea product industry must be based on local potency, main components and knowledge [11]. Thus, based on the local potency, wisdom, and knowledge of Bentian Besar and Kelay, this present study aims to produce herbal teabag products, beginning from production process, cost of production, brand naming until product design, and strengthening an organization to manage or manufacture herbal teabags from these two villages. ...
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On May 10, 2019, the Directorate General of Sustainable Production Forest Management with online shopping @shopee_id began collaboration to promote and market Non-Timber Forest Products in order to improve Indonesian economic. The potential of non-timber forest products in East Kalimantan, Indonesia is abundant, especially the utilization as medicinal plants based on local wisdom, such as in Merabu village, Berau district, and Dilang Puti village, West Kutai district, East Kalimantan. Traditional medicinal products tend to be less regulated and have no selling value. This study aims to develop herbal teabag products, beginning from production process, the cost of production, brand naming, and to strengthening an organization for manage or manufacture herbal teabags from these two villages. Merabu has high potential of gaharu ( Aquilaria malaccensis ), karamunting ( Melastoma malabatricum ), and ironwood ( Eusideroxylon zwageri ). The product made is prima tea, with main ingredients of mixed leaves of A. malaccensis , R. tomentosa and a little amount of E. zwageri powder as a dye. Meanwhile, Dilang Puti has high potential of laban ( Vitex pubescens ), and ginger ( Zingiber officinale ). Thus, a tea product namely Pusaka tea is introduced, with the main ingredients of mixed inner bark of V. pubescens and Z. officinale powder. All processing implements a cooperative model to produce herbal teabags, with raw materials taken from members’ garden. The product manufacturing training process tends to be faster and easier, while naming is quite long due to a common name should recognized by all parties, beginning from young people, general public, and customary elders. Furthermore, herbal tea bag products are packaged and sold through established organizations, which then have a positive impact on local communities’ income.
... C. longa is widely used in a variety of traditional health dishes and drinks by local communities of Indonesia. Jamu kunir asam ( jamu ¼ fresh traditional concoction drinks; kunir ¼ tumeric; asam ¼ tamarind) is a Javanese heritage herbal medicine used to maintain stamina and to treat a variety of diseases (Nahdi and Kurniawan 2019;Sumarni et al. 2019). Vietnam: In North Vietnam, C. longa is used as food coloring agent in steamed sticky rice dishes (Luh-Dam et al. 2016). ...
Article
A combination of herbals medicines is an alternative treatment choice for developing anticancer therapy because of its benefits, active compounds, and non-toxic side effect. This study investigates the anticancer and antioxidant activity of Phyllanthus urinaria and Curcuma longa water extract combination. The analysis of their bio-active components was done using LC-HRMS. The biological activity prediction was made using PassOnline and Cytoscape. Anticancer activity, apoptosis, and cell cycle assay were tested on treated T47D breast cancer cells line with the combination herbal extract and individual herbal extract compare to the untreated and cisplatin-treated control cells. This study also determined the antioxidant activity and phenolic and flavonoid total assay. The result showed that these herbs' compounds were predicted to have a biological function in cancer treatment. The herbal combination has efficiency inducing apoptosis with more than 50% compared to the individual herbal treatment and untreated control cells. Cell cycle analysis shows these herbals affect cell cycle arrest at G2/M phase compared to the control cells. The antioxidant activity and total phenol and flavonoid of P. urinaria and C. longa combination positively correlate with the anticancer activity result. Compusyn test results on cell toxicity parameters showed that the combination of both herbs had an additive effect (C = 1). Although this combination has no synergism effect, the water extract of P. urinaria and C. longa combination can be an anticancer agent.
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Typically, ethnobotanical/ethnopharmacological (EB/EP) surveys are used to describe uses, doses/dosages, sources and methods of preparation of traditional herbal medicines; their application to date in examining the adverse effects, contraindications and other safety aspects of these preparations is limited. From a pharmacovigilance perspective, numerous challenges exist in applying its existing methods to studying the safety profile of herbal medicines, particularly where used by indigenous cultures. This paper aims to contribute to the methodological aspects of EB/EP field work, and to extend the reach of pharmacovigilance, by proposing a tool comprising a list of questions that could be applied during interview and observational studies. The questions focus on the collection of information on the safety profile of traditional herbal medicines as it is embedded in traditional knowledge, as well as on identifying personal experiences (spontaneous reports) of adverse or undesirable effects associated with the use of traditional herbal medicines. Questions on the precise composition of traditional prescriptions or 'recipes', their preparation, storage, administration and dosing are also included. Strengths and limitations of the tool are discussed. From this interweaving of EB/EP and pharmacovigilance arises a concept of ethnopharmacovigilance for traditional herbal medicines: the scope of EB/EP is extended to include exploration of the potential harmful effects of medicinal plants, and the incorporation of pharmacovigilance questions into EB/EP studies provides a new opportunity for collection of 'general' traditional knowledge on the safety of traditional herbal medicines and, importantly, a conduit for collection of spontaneous reports of suspected adverse effects. Whether the proposed tool can yield data sufficiently rich and of an appropriate quality for application of EB/EP (e.g. data verification and quantitative analysis tools) and pharmacovigilance techniques (e.g. causality assessment and data mining) requires field testing.
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