Traditional Herbal Remedies in the Management of Metabolic Disorders in Ethiopia: A Systematic Review of Ethnobotanical Studies and Pharmacological Activities

Abstract

Background:
MetS are common throughout the world, including Ethiopia. These have traditionally been treated using medicinal plants, particularly in rural areas where they are freely accessible. This systematic review tried to investigate the treatment of MetS with Ethiopian medicinal herbs and made recommendations for more validation research. A careful analysis of the literature was also conducted on the therapeutic effects of these and other Ethiopian medicinal plants with hepatoprotective and antihypertensive activities.

Methods:
The relevant keywords "Ethnomedicinal + hypertension," "Ethnopharmacological + hypertension," "Ethnomedicinal + hepatitis, jaundices, and liver disease," "Ethnopharmacological + hepatic disorder," and "Ethnomedicinal + weight loss" were used to search for relevant articles in the major electronic scientific databases, including PubMed, Science Direct, Web of Science, and Google Scholar. The search strategy included all articles with descriptions that were accessible until April 30, 2022. The study's subjects, methods, or year of publication were no restrictions in the search. The outcomes were compiled using descriptive statistics.

Results:
Fifty-four (54) studies were examined in the review that satisfied the inclusion and exclusion criteria for the treatment of MetS in Ethiopia. The most often used ethnobotanical plant species for the treatment of hypertension and hepatic disorders were Moringa stenopetala and Croton macrostachyus. Both hepatic and hypertensive disorders were treated more frequently with leaves (52% and 39%, respectively) than with roots (20% and 13%, respectively). Some intriguing studies came from an ethnobotanical investigation into medicinal herbs' hepatoprotective and antihypertensive properties. The most often investigated medicinal plant for its antihypertensive effects is Moringa stenopetala.

Conclusion:
The study revealed that Ethiopians often use anti-MetS herbal remedies. We advocate the experimental validation of the commonly used medicinal plants with the identification of active compounds and the development of effective alternative drugs for the treatment of MetS.

Full text

Review Article
Traditional Herbal Remedies in the Management of Metabolic
Disorders in Ethiopia: A Systematic Review of Ethnobotanical
Studies and Pharmacological Activities
Mekdes Alemu Tola , Fozia Ibrahim, Haregua Melak, Temesgen Tafesse,
Mekdelawit Alemayehu, and Gashaw Nigussie
Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
Correspondence should be addressed to Mekdes Alemu Tola; mekdesalemu1@gmail.com
Received 3 August 2022; Revised 7 December 2022; Accepted 8 December 2022; Published 12 January 2023
Academic Editor: Daniel Dias Runo Arcanjo
Copyright ©2023 Mekdes Alemu Tola et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Background. MetS are common throughout the world, including Ethiopia. ese have traditionally been treated using medicinal
plants, particularly in rural areas where they are freely accessible. is systematic review tried to investigate the treatment of MetS
with Ethiopian medicinal herbs and made recommendations for more validation research. A careful analysis of the literature was
also conducted on the therapeutic eects of these and other Ethiopian medicinal plants with hepatoprotective and antihy-
pertensive activities. Methods. e relevant keywords “Ethnomedicinal + hypertension,” “Ethnopharmacological + hypertension,”
“Ethnomedicinal + hepatitis, jaundices, and liver disease,” “Ethnopharmacological + hepatic disorder,” and “Ethno-
medicinal + weight loss” were used to search for relevant articles in the major electronic scientic databases, including PubMed,
Science Direct, Web of Science, and Google Scholar. e search strategy included all articles with descriptions that were accessible
until April 30, 2022. e study’s subjects, methods, or year of publication were no restrictions in the search. e outcomes were
compiled using descriptive statistics. Results. Fifty-four (54) studies were examined in the review that satised the inclusion and
exclusion criteria for the treatment of MetS in Ethiopia. e most often used ethnobotanical plant species for the treatment of
hypertension and hepatic disorders were Moringa stenopetala and Croton macrostachyus. Both hepatic and hypertensive disorders
were treated more frequently with leaves (52% and 39%, respectively) than with roots (20% and 13%, respectively). Some
intriguing studies came from an ethnobotanical investigation into medicinal herbs’ hepatoprotective and antihypertensive
properties. e most often investigated medicinal plant for its antihypertensive eects is Moringa stenopetala.Conclusion. e
study revealed that Ethiopians often use anti-MetS herbal remedies. We advocate the experimental validation of the commonly
used medicinal plants with the identication of active compounds and the development of eective alternative drugs for the
treatment of MetS.
1. Introduction
Metabolic syndrome (MetS), a cluster of interrelated
metabolic disorders, is becoming more common around the
world. According to the International Diabetes Federation,
MetS aects around 25% of the world’s adult population,
and its prevalence is expected to rise in the next few decades
[1]. MetS are on the rise and pose a serious threat to public
health, especially in countries in sub-Saharan Africa with
limited resources [2]. Governments in underdeveloped
countries have already spent billions of dollars to tackle the
widespread eects of MetS and related risk factors [3]. e
emergence of risk factors for MetS and an increase in its
incidence worldwide have all been related to genetic, epi-
genetic, and environmental factors [4]. e adoption of
sedentary lifestyles, which are dened by low physical ac-
tivity or exercise and the intake of high-energy foods, is also
to blame for this epidemic [5]. e risk factors for MetS are
Hindawi
Evidence-Based Complementary and Alternative Medicine
Volume 2023, Article ID 1413038, 15 pages
https://doi.org/10.1155/2023/1413038

being addressed through dietary modications and the use
of pharmaceutical drugs that primarily target specic
biochemical pathways involved in food metabolism [6].
Pharmaceutical medications usually cost a lot of money,
have poor patient compliance, and have been associated
with the emergence of a variety of undesirable side eects
with prolonged usage. In addition, they are mono-
therapeutic, concentrating on just a few health outcomes
associated with metabolic dysregulation. Alternative and
complementary approaches to the management of meta-
bolic diseases must be studied and developed urgently.
Herbal remedies should be used in these alternate MetS risk
factor management strategies. Medicinal plants are dened
as any plant or plant preparation that has benecial ther-
apeutic and/or preventive properties or that provides
health-promoting properties and temporary relief [7].
Medicinal plants are now accepted by healthcare providers
as having a role to play in the management and prevention
of metabolic disorders [8]. e use of herbal medicine is no
longer limited to developing countries; it has grown into
a multibillion-dollar industry that spans all demographic
and socioeconomic groups [9]. Medicinal plants include
pharmacodynamic bioactive compounds that have a ther-
apeutic impact that is additive and synergistic in the
treatment of metabolic disorders [10]. Most pharmaceutical
drugs are derived from medicinal plants using local
knowledge and then isolating the main active compounds
[11]. Plant material utilized in the preparation of medicinal
remedies could be used as a template for the development of
pharmaceutical drugs. e identication of benecial
phytochemical compounds in medicinal plants and their
application in the treatment of MetS have reduced the -
nancial burden of relying on costly synthetic pharmaceu-
tical drugs. According to the WHO, even in the presence of
pharmaceutical drugs, most rural and urban-based com-
munities in Africa still rely on traditional remedies for their
primary healthcare [12]. When compared to some of the
pharmaceutical drugs now being used in the management of
metabolic disorders, another driving factor in the usage of
medicinal plants is the impression that they are free of
adverse side eects and acute toxicity [13]. Despite the fact
that some people prefer to use medicinal plants due to their
perceived safety, scientic validation is required to ensure
the safety and consistency of medicinal preparations. In
fact, the WHO recommends demonstrating safety before
determining the therapeutic benet of medicinal plants
used in primary care [14]. In this review, we looked at how
medicinal plants are currently being used or studied in
Ethiopia to treat and prevent MetS risk factors such as
obesity, cardiovascular disease, and liver disease.
2. Methods
2.1. Search Strategy. Scientic search engines such as Google
Scholar, PubMed, Scopus, Science Direct, and Research Gate
were used to look up Ethiopia, “Ethnomedicinal +
hypertension,” “Ethnopharmacological + hypertension,”
“Ethnomedicinal + hepatitis, jaundices, and liver disease,”
“Ethnopharmacological + hepatic disorder,” and
“Ethnomedicinal + weight loss.” e search was conducted
without regard to the subjects, methods, or year of
publication.
2.2. Inclusion and Exclusion Criteria. Our inclusion criteria
were as follows: (i) articles must be written in English; (ii)
articles must be eld studies (surveys); (iii) studies must
provide complete ethnobotanical information; and (iv)
studies should include medicinal plants with antihyper-
tensive and hepatoprotective activities. Exclusion criteria
included (i) articles with no study areas or scientic plant
names, (ii) articles with only an abstract, (iii) articles written
in a non-English language, (iv) newspapers, (v) reviews, and
(vi) for species reported as “sp.” without a species name,
such as Euphorbia sp., which was not counted because other
Euphorbia species were present.
2.3. Assessment of Methodological Quality. Before being
included in the review, all 54 papers were critically appraised
using established procedures to ensure methodological
validity [15]. Preferred Reporting of Systematic Reviews and
Meta-Analysis (PRISMA) criteria were employed to ensure
scientic rigor (see selection process in Figure 1).
2.4. Data Abstraction and Review Process. Using the in-
clusion/exclusion criteria, the articles underwent screen-
ing. e following information was extracted from each
study using abstraction forms: scientic, family, plant parts
used, methods of preparation and mode of action, ex-
traction solvent utilized, models used, and eects of
pharmacological medicinal plants. e International Plant
Name Index (https://www.ipni.org) and the Kew Botanical
Garden plant name database (https://www.kew.org) were
used to verify species names and synonyms. Data extrac-
tion was carried out twice independently, after which the
datasheet was checked for methodological compliance and
any errors were xed. e results were summarized by
descriptive statistics.
3. Result and Discussion
3.1. Literature Search Results. e scanning of databases
yielded two hundred fty-four (254) relevant articles, 95 of
which were duplicates. After analyzing our inclusion and
exclusion criteria, one hundred ve (105) articles were ex-
cluded, and the remaining fty-four (54) articles were in-
cluded (Figure 1).
3.2. Medicinal Plants in the Management of Obesity.
According to the World Health Organization, risk factors
related to being overweight or obese account for 2.8 million
deaths annually, making obesity the seventh greatest cause of
mortality [16]. In Africa, the overweight population of
under-ves has risen by around 24% since 2000 [16].
According to a recent systematic review and meta-analysis
obesity and overweight were found to be prevalent in
Ethiopian cities at 22.4% and 6.2%, respectively [17]. Obesity
2Evidence-Based Complementary and Alternative Medicine

occurs when eating a meal with a high caloric value
(carbohydrates) is combined with a decrease in physical
activity to burn the calories absorbed [18]. Being overweight
has been linked to a variety of comorbidities, including
cardiovascular disorders (stroke and heart), type 2 diabetes
mellitus, and the malignancies of breast, prostate, kidney,
and colon cancer [19]. Leading a healthy lifestyle, engaging
in regular physical activity, consuming less free sugars and
salts, decreasing saturated fat consumption while increasing
consumption of dietary vegetables and whole grains, as well
as pharmacological therapies and surgical interventions, are
all recommended for weight loss [20]. However, treating
obesity is dicult because only 5–10% of people maintain
their weight loss over time [21]. ere is a reversal of weight
loss when pharmacotherapy is stopped or a healthy lifestyle
is abandoned [22]. Also, some of the synthetic drugs used
have unfavorable side eects [23]. Herbal supplements are
an alternative to pharmacological drugs for weight loss. ey
are eective, safe, and less expensive than pharmacological
drugs. However, there is no serious attention given to obesity
disease research in Ethiopia presently. In this review, we
included some plants that are frequently consumed for
weight loss in Ethiopia, along with their parts and prepa-
ration techniques (Table 1). e mentioned herbal remedies
have not been evaluated for their safety and ecacy in the
management of obesity. Consequently, both in vitro and in
vivo studies were necessary.
3.3. Medicinal Plants in the Management of Cardiovascular
Diseases. According to the World Health Organization
(WHO), high blood pressure is responsible for an esti-
mated 62% of cardiovascular diseases (CVDs) and 49
percent of ischemic heart disorders worldwide [27].
Hypertension (HTN) is a chronic medical disorder in
which the blood pressure (BP) in the arteries is too high. It
makes it more dicult for the heart to pump blood via the
blood vessels. Hypertension aects an estimated 1.28
billion adults worldwide aged 30 to 79, with the majority
(two-thirds) living in low- and middle-income nations
[29]. HTN accounts for at least 45 percent of all heart
disease deaths and 51 percent of all stroke deaths [30].
According to a meta-analysis of the prevalence of HTN in
Ethiopia, it is on the increase, with an estimated prevalence
of 19.6% [31]. In this section of the review, we looked at
how medicinal plants are used in Ethiopian traditional and
complementary medicine to treat liver disease. Twenty-
two (22) medicinal plants from fourteen (14) families were
found in this ethnobotanical review, and the traditional
healer used them to treat hypertension. e plant families
with the most species are Lamiaceae (n= 4), Fabaceae
(n= 2), and Polygonaceae (n= 2) (Table 1). Analysis of the
eligible ethnobotanical ndings revealed that dierent
parts of the medicinal plants were utilized in the prepa-
ration of MetS remedies. e antihypertensive medicinal
’plants’ leaves (39%) and roots (13%) are the parts that are
most frequently harvested (Figure 2). e most often cited
ethnobotanical plant species for the treatment of hyper-
tension was Moringa stenopetala (Table 2 and Figure 3).
Moringa stenopetala, often known as the African Moringa
or cabbage tree, is a deciduous tree native to Kenya and
Ethiopia in the Moringa genus of owering plants [54].
M. stenopetala contains alkaloids, amino acids, essential
oils, fatty acids, avonoids, phenolic compounds, and
sterols [55]. Some pharmacological activities of
M. stenopetala have been reported in the literature in-
cluding antimicrobial [56–58], antidiabetic [59–61],
antitrypanosomal [62], antimalarial [63], anti-Leishmania
Records identified through data base
searching, n = 254
Number of duplicates identified,
n = 95
Records screened after removal of
duplicates, n = 159
Records excluded,
n = 105
Studies included after exclusion
criteria, n = 54
Reason for exclusion
Abstract only
Non English language
No scientific plant names
No full ethnobotanical
information
Review
For species reported as "sp."
without a species name, such
as Euphorbia sp.
(i)
(ii)
(iii)
(iv)
(v)
(vi)
Identification
ScreeningIncluded
Figure 1: Flow chart used for the design of the current review.
Evidence-Based Complementary and Alternative Medicine 3

Table 1: List of medicinal plants and their preparation methods for the treatment of hypertension.
Species name Family name Local name Plant part
used
Methods of
herbal material
preparation and
mode of
action
Ref
Verbascum sinaiticum Scrophulariaceae Daba Keded
Am
Root Crushing the root orally [24]
Trigonella foenumgraecum Leguminosae Abish
Am
Seed Grind, powdered, add water, and drunk [25]
Syzygium guineense Myrtaceae Duuwancho
Or
Bark & fruit e ripe fruits of the plant are eaten in small amounts
for some time [26]
Dorstenia barnimiana Moraceae Work Bemeda
Am
Root
Root powder mixed with honey and fermented for seven
days is taken
orally in the morning
[27, 28]
Brucea antidysenterica Simaroubaceae Aballo
Am
Root Root powder mixed with honey is taken orally [27]
Am, Amharigna; Or, Afaan Oromoo.
4Evidence-Based Complementary and Alternative Medicine

[64], anti-inammatory and analgesic [65, 66], antihy-
pertensive [67], antioxidant [61, 68, 69], anticancer [70],
and thyroid function [71]. It could be more eective than
other antihypertensive medicinal plants in terms of
treatment.
3.3.1. Antihypertensive Activity of Potential Ethiopian Me-
dicinal Plants. e antihypertensive properties of six (6)
Ethiopian medicinal plants from ve (10) families were
investigated in Ethiopia. Male Wistar rats, guinea pigs, and
Sprague-Dawley rats have all been utilized as a variety of
animal models to test these herbs’ potential antihypertensive
eects. Blood pressure (SBP, MABP, and DBP), diuretic,
natriuretic, kaliuretic, and aortic relaxation were among the
parameters used to assess these plants. In all models, it was
discovered that the medicinal plants had a signicant an-
tihypertensive eect. Four of the plant species included in
(Table 2) have antihypertensive activity (Table 3), which
supports their traditional uses. ymus schimperi,Moringa
stenopetala,Otostegia integrifolia, and Satureja punctata are
a few examples. e most studied plant parts were leaves,
and the most extractive solvents were aqueous.
3.4. Medicinal Plants in the Management of Hepatic Diseases.
e liver is one of the body’s largest and most inuential
organs. It plays an important role in a variety of physio-
logical processes, including macronutrient metabolism,
blood volume regulation, immune system support, endo-
crine control of growth signaling pathways, lipid homeo-
stasis, and xenobiotic detoxication, including drug
detoxication [80]. Dierent illness conditions, on the other
hand, aect its structure and function. Changes in lifestyle
and dietary habits, contamination of food or drink, chemical
and drug addiction, and hepatic infections have all con-
tributed to an increase in the incidence of hepatic illnesses
around the world. Hepatitis, cirrhosis, fatty liver, bile duct
obstruction, and jaundice are the most common hepatic
diseases. Globally, they constitute the leading cause of
morbidity and mortality [81]. An earlier clinical in-
vestigation in Ethiopia found that liver disease was re-
sponsible for 12% of hospital admissions and 31% of hospital
mortality [82]. Since a large portion of Ethiopia’s population
lives in poverty and has limited access to modern healthcare,
traditional medicine is used to treat liver disease. Traditional
medicines used to treat liver disease are thus an important
topic to address in future discussions about how to treat this
problem. A variety of plant species that are utilized by
traditional healers and herbalists in the treatment of liver
diseases have been identied through ethnobotanical
studies. In this section of the review, we’ll look at how
medicinal plants are used in Ethiopian traditional and
complementary medicine to treat liver disease. In this
ethnobotanical review, twenty-six (26) medicinal plants
from twenty-one (21) families were identied, and the
traditional healer used them to treat liver disease. Fabaceae
(n�3) and Cucurbitaceae (n�3) are the plant families with
the most species (Table 4). is could be since these are
among Ethiopia’s Flora Regions’ most widely spread families
[90]. e eligible ethnobotanical data analysis revealed that
dierent parts of the medicinal plants were employed to
make MetS remedies. e leaves (52%) and roots (22%) of
plants used as hepatic remedies are the parts that are har-
vested most frequently (Figure 4). Croton macrostachyus was
the most commonly employed ethnobotanical plant species
for the treatment of hepatic disorders (Table 4, Figure 5).
Croton macrostachyus is a medium-sized monoecious or
deciduous tree that grows up to 30 meters tall in tropical
Africa [96]. C. macrostachyus fruits, leaves, stem bark, and
twigs contain alkaloids, amino acids, anthraquinones, car-
bohydrates, cardiac glycosides, coumarins, essential oil, fatty
acids, avonoids, phenolic compounds, phlorotannins,
polyphenols, phytosterols, saponins, sterols, tannins, ter-
penoids, and unsaturated sterols [97, 98]. Some pharma-
cological activities of C. macrostachyus have been reported in
the literature including anthelmintic [99], antibacterial
[100], anticonvulsant and sedative [101], antidiabetic [102],
antidiarrheal [97], anti-inammatory [103], anti-Leishmania
Leaves
39%
Roots
13%
Fruits
9%
Stems
9%
Areial Parts
5%
Bulbs
4%
Seeds
9%
Shoot tips
4%
Flowers
4%
Rhizomes
4%
Figure 2: Frequency distribution of plant parts used to prepare remedies.
Evidence-Based Complementary and Alternative Medicine 5

Table 2: List of medicinal plants and their preparation methods for the treatment of hypertension.
Species name Family name Local name Plant part
used
Methods of
herbal material
preparation and
mode of
action
Ref
Allium cepa Liliaceae Key shinkurt Bulbs e bulb is chopped, macerated in water, ltered, and drunk [32]
Hordeum vulgare Poaceae Gebs Seeds
Mashilla (Sorghum spp.) and Gebs (germinated barley) are baked together in the same way that
bread is prepared. is is broken up and fermented with beqil (malt starter) before being
brewed, distilled, and served in a shot glass
[33]
ymus schimperi Lamiaceae Tosigne Leaves Tea made from boiled leaves [33, 34]
Lupinus albus Fabaceae Gibtto Seeds Seeds infused in water and ltrate are taken orally [35]
Rumex abyssinicus Polygonaceae Mekmoko Roots
e decoction is taken on an empty stomach [35]
In a blender, crush the root and combine it with the Allium sativum bulbs. Boil the
combination, and then drink the hot decoction or powdered root with milk [36, 37]
Crinum abyssinicum Amaryllidaceae Yejib shinkurt Shoot tips Fresh shoot tips squeezed the liquid, mixed with water, drunk it [25]
Citrus aurantifolia Rutaceae Lemon Fruits Lemon juice is drunk from the fruit [25]
Foeniculum vulgare Apiaceae Ensilal Leaves Fresh leave of Foeniculum vulgare add to boiled tea and drink it [25, 36]
Moringa stenopetala Moringaceae Shiferaw Leaves Dry/fresh leave make as tea and drink it or fresh leave boil with
Allium cepa and Capsicum annuuam, add oil and taken [25, 38–41]
Dovyalis abyssinica Flacortiaceae Yabesha Qoshm Roots & stem tubers Root and stem tuber is smashed with “Tela” and drunk it [36]
Bersama abyssinica Melianthaceae Azamr Roots & leaves Fresh root and leave crushed and mixed with honey and taken once daily for 3 consecutive
days [42]
Cadaba farinosa Capparidaceae Qalaanqaal (som) Roots Chopped, boiled with meat soup, and drunk [39]
Leucaena leucocephala Fabaceae Stems Chopped, macerated, ltered, mixed with honey and milk, and drunk [39]
Citrus aurantium Rutaceae Komtatie Flowers Drink the fresh juice ower [37]
Otostegia integrifolia Lamiaceae Tinjute Leaves Leaves are boiled in water and a cup of the solution is taken every
morning until recovery [43]
Acanthospermum hispidum Asteraceae Leaves Leaves are crushed and boiled and one teacup is drunk at 12h
intervals for a week [44]
Salvia tiliifolia Lamiaceae Aqorarach Leaves Fresh leaf juice is mixed with little water and given
Orally [45]
Rumex nepalensis Polygonaceae Tullet Leaves Fresh leaves are boiled and drunk [46]
Zingiber ocinale Zingiberaceae Gengible Rhizomes e rhizome is chewed [43]
Rosa abyssinica Rosaceae Kega Fruits Powdered fruits are, mixed with water and drunk [47]
Satureja punctata Lamiaceae Lomishet Aerial parts e decoction of the dried aerial parts of the plant is taken orally as a tea [48]
Artemisia absinthium Asteraceae Ariti Leaves Pounded; chewed orally [49]
6Evidence-Based Complementary and Alternative Medicine

(a) (b)
(c) (d)
Figure 3: Frequently cited antihypertensive medicinal plants. (a) Moringa stenopetala [50]. (b) ymus Schimperi [51]. (c) Rumex
abyssinicus [52]. (d) Foeniculum vulgare [53].
Table 3: Antihypertensive activities of Ethiopian medicinal plants.
Species Family Plant parts
used Extracts Models used Eects Ref
ymus
schimperi Leaves
Aqueous (250, 500, 750
and
1000 mg/kg)
Male Wistar rats
At 500 mg/kg, the extract had the highest
diuretic index. Greater doses of T. schimperi
(500 mg/kg) and the standard drug captopril
(20 mg/kg/day) signicantly (p<0.01)
reduced SBP when compared to the
salt-sucrose group
[72]
Moringa
stenopetala Moringaceae
Leaves
Aqueous and 70% ethanol
(250, 500, and 1000 mg/
kg)
Male Wistar rats
When compared to the positive and normal
control groups, which received captopril
(20 mg/kg/day) and distilled water
(adlibitum), the highest daily oral dose of AQ
crude extract (1000 mg/kg) signicantly
reduced SBP, MAP, and DBP rises. At the
highest dose of 70% EtOH crude extract, SBP,
MAP, and DBP all signicantly lowered
[73]
Leaves Aqueous (10, 20, 30, and
40 mg/kg) Guinea pigs
SBP, DBP, and MABP in normotensive
anesthetized Guinea pigs declined
signicantly
[67]
Leaves
Aqueous (62.5, 125, 250,
and
500 mg/kg) and hot tea
infusion
Male Wistar rats
e diuretic, natriuretic, and kaliuretic eects
of both the aqueous crude extract and the hot
tea infusion of the leaves are signicant
(p<0.01). e strongest diuretic ecacy was
found in the aqueous crude extract (125 mg/
kg) and hot tea infusion (2 tsp), which were
comparable to the reference drug furosemide
(10 mg/kg)
[74]
Leaves
Aqueous crude, 70%
ethanol
crude (1.25, 2.5, 5, and
10 mg/mL)
In vitro (thoracic aortic ring
of a Guinea pig)
In pre-contracted isolated entire, spirally cut
thoracic aortic strips of Guinea pigs, both
extracts had a relaxing (vasodilatory) eect in
a dose-dependent manner
[75]
Evidence-Based Complementary and Alternative Medicine 7

Table 3: Continued.
Species Family Plant parts
used Extracts Models used Eects Ref
Calpurnia
aurea Fabaceae Seed Methanol (15, 30, and
45 mg/kg) Sprague-Dawley rats
In renal hypertensive and normotensive rats,
blood pressure (SBP, DBP, and MABP)
reduced dose-dependently and signicantly
after treatment
[76]
Syzygium
guineense Myrtaceae Leaves Methanol (50, 100, and
150 mg/kg) Sprague-Dawley rats
SBP, MAP, and DBP all decreased
signicantly at the maximum dose of crude
extract. At a concentration of 5–70 mg/mL,
the extract elicited a dose-dependent
relaxation of the aorta pre-contracted with
KCl, with a maximal relaxation of 56.22% at
the 70 mg/mL concentration
[77]
Otostegia
integrifolia Lamiaceae Leaves Methanol (250, 500 and
1000 mg/kg) Sprague-Dawley rats
In a dose-dependent manner, blood pressure
was signicantly reduced. At a concentration
of 6.25–125 g/L, the extract elicited
a dose-dependent relaxation of the aortic
strip pre-contracted with KCl, with
a maximal relaxation (100 percent) achieved
at a cumulative concentration of 318.75 g/ml
[78]
Satureja
punctata Lamiaceae Aerial parts Aqueous (10, 20 and
30 mg/kg) Guinea pig
SBP, DBP, and MABP all decreased in
a dose-dependent manner when compared to
baseline hypertensive BP. At concentrations
ranging from 2.5 to 40 mg/ml, the extract
caused a dose-dependent relaxation of the
aorta pre-contracted with KCl, with
a maximal relaxation of 98.19% achieved at
40 mg/ml
[79]
Table 4: List of medicinal plants and their preparation methods for the treatment of hepatic disorders.
Species name Family name Local name Plant part
used
Methods of herbal material
preparation and mode of action Ref
Mentha spicata L. Lamiaceae Leaves Boiling the leaves in water makes tea, or pounding the leaves and mixing
them with honey makes a drink [83]
Rhus retinorrhoea Anacardiaceae Tilem Roots Rhus retinorrhoea roots, Catha edulis owers, and Rumex nervosus roots
are crushed and mixed with water and a teaspoon of salt before being drunk [36]
Rumex abyssinicus Polygonaceae Mekmeko Roots e roots are crushed, powdered, and mixed with the dried and powdered
meat of a bat and eaten once or twice [32]
Acacia tortilis Fabaceae Grar Roots Crushed and mixed with water and consumed like tea (decoction) [83]
Calpurnea aurea (Alt.)
Benth Papilionaceae Digitta Leaves Fresh leaves squeezed and drunk [25]
Dioscorea alata L. Dioscoriaceae Boye Stems Fresh stem cooked mixed with Allium sativum and eat [25]
Acacia abyssinica Fabaceae Simithia Leaves Leave juice is given orally in the early morning for 15 days [84]
Acokanthera schimperi Apocynaceae Merenz Leaves Crush, dry then fumigate [37, 85]
Adhatoda schimperiana Acanthaceae Leaves ree fresh leaves crushed and juice taken with cow milk in empty stomach
for 3 consecutive days [42]
Treminalia brownii Combretaceae Aballo Barks
Inner bark peeled, chopped, macerated in water, ltered, and drunk [39]
Concocted with the bark of Croton macrostachyus and drink a cup of
infusion [86]
Lagenaria siceraria Cucurbitaceae Fruits e fruit was dissected and the patient’s face was covered with the inside
part of the dissected fruit [39]
Euphorbia abyssinica Euphorbiaceae Kulkual Roots Fresh root crush, immerse in water then drink or bake with bread then eat [37]
Phytolacca dodecandra Phytolaccaceae Endod Leaves Fresh leave crush and drink with water [37]
Leaves are crushed, squeezed and one cup of juice is taken daily for 21 days [43]
Rumex nervosus Polygonaceae Embocho Roots Crushed, homogenized in water, and drunk [9]
Justicia shimperans Acanthaceae Sensel Leaves Leaves are pounded and juice is prepared and taken orally [87]
Schinus mole Ancardiaceae Qundo-berbere Leaves e fresh leaf is crushed, mixed with water, ltered, and drink at the time of
pain [88]
Carica papaya Caricaceae Papaya Leaves Leaves are pounded and juice is prepared and taken [87]
Cucumis cifolius Cucurbitaceae Yemidir Embuy Roots/
leaves
Roots are chewed, or fresh leaf is crushed, mixed with tella/milk, and drunk
it [43, 88]
Croton Macrostachyus Euphorbiaceae Bisana
Leaves e fresh leaf of being squeezed and one glass of juice with milk or tella is
drunk for three days [88]
Roots e root bark is dried and pounded into powder and two to three spoons of
powder are added to a cup containing water. Treatment is taken for 21 days [43]
Barks Dry bark is powdered and mixed with latex from its young twinges and
applied to the wound [89]
Leaves Leaf powder mixed with water is taken orally for seven days [27]
8Evidence-Based Complementary and Alternative Medicine

Table 4: Continued.
Species name Family name Local name Plant part
used
Methods of herbal material
preparation and mode of action Ref
Calpurnia aurea Fabaceae Digita Seeds Dry seeds crushed and swallowed [25]
Hypericum quartinianum Hypericaceae Ameja Leaves
Leaf with roots of Asparagus sp. pounded and homogenized in water and
given to the patient orally for three consecutive days. Half a glass is the limit
for a day
[90]
Coee Arabica Rubiaceae Buna Barks e bark of C. africana is powdered together with the stem bark of Croton
macrostachyus, the paste is then boiled with milk and given orally [91]
Dodonaea angustifolia Sapindaceae Kitkita Leaves A st of the leaf is grounded to get half a cup of juice, which is given orally
in the morning and evening until the cure [91]
Verbascum sinaiticum Scrophulariaceae Kutitina Roots e fresh root is crushed, mixed with water, ltered, and drunk [88]
Vitis vinifera Vitaceae Weyne Leaves Grinding the leave with Ficus carica leave separately; mix them with honey
then drink 3 times a day by tea glass [92]
Zehneria scabra Cucurbitaceae Hareg Resa Leaves e fresh leaf is pounded and squeezed and then drunk in half a cup of tea [34]
Leaves
52%
Roots
22%
Stems
3%
Barks
10%
Fruits
3% Seeds
10%
Figure 4: Frequency distribution of plant parts used to prepare remedies.
(a) (b)
(c)
Figure 5: Frequently cited antihepatic medicinal plants. (a) Croton macrostachyus [93]. (b) Cucumis cifolius [94]. (c) Acokanthera
schimperi [95].
Evidence-Based Complementary and Alternative Medicine 9

Table 5: Hepatoprotective activity of Ethiopian medicinal plants.
Species
name
Family
name
Plant
part
used
Extracts
used/dosage
Models
used Histopathology Parameters
estimated
Toxicity
(LD
50
)Ref
Lippia adoensis Verbenaceae Leaves Aqueous (200 and
400 mg/kg CCl
4
-induced Hepatocyte regeneration and peripheral mononuclear
inltration are reduced in comparison to CCl
4
Albumin and total protein levels increased, while AST,
ALT, ALP, and TBIL levels reduced — [107]
Ethanol (200 and
400 mg/kg) CCl
4
-induced Hepatocyte regeneration was observed when
compared to CCl
4
Total protein and albumin increased while AST, ALT,
ALP, and TBIL reduced — [107]
Ensete
ventricosum Musaceae Cheesman Methanol (200 and
400 mg/kg)
Isoniazid and rifampicin-
induced
Hepatocyte regeneration was observed when
compared to isoniazid and rifampicin-induced
hepatocyte induced
A dose of 400 mg/kg and 100 mg/kg of silymarin
signicantly decreased ALT, AST, ALP, and TBIL when
compared to isoniazid and rifampicin
— [108]
ymus
serrulatus Lamiaceae Aerial
parts
Essential oil (200 L/
kg) Paracetamol—induced Except for a few inammatory cell inltrations,
normal hepatocytes were seen in 200 L/kg EO
When compared to paracetamol, AST, ALT, and ALP
levels were reduced — [109]
ymus schimperi Lamiaceae Aerial
parts
Essential oil (200 L/
kg) Paracetamol—induced Except for certain inammatory cell inltrations,
200 L/kg EO revealed normal hepatocytes
When compared to paracetamol, AST, ALT, and ALP
levels were reduced — [109]
Justicia
schimperiana Acanthaceae Leaves Methanol (200 mg/
kg) CCl
4
-induced e mice’s livers were signicantly protected from
CCl
4
-induced damage
AST and ALT were signicantly suppressed compared to
CCl
4
1000 [110]
Verbascum
sinaiticum Scrophulariaceae Leaves Methanol (200 mg/
kg) CCl
4
-induced e mice’s livers were signicantly protected from
CCl
4
-induced damage
In comparison to CCl
4
- induced rats, AST and ALT were
signicantly reduced — [110]
Phytolacca
dodecandra Phytolaccaceae Root Methanol (200 and
400 mg/kg) CCl
4
-induced
200 and 400 mg/kg doses, normalized the defects in the
histology of the liver of mice treated with CCl
4
nearly
to the level of the negative control group
ALP, ALT, AST, GGT, LDH, and bilirubin levels were all
signicantly lower, whereas albumin and total protein
levels were signicantly higher. At 400 mg/kg, the extract
had a hepatoprotective eect comparable to silymarin
2000 [111]
Satureja punctata Lamiaceae Aerial part Aqueous (250 and
500 mg/kg) Nitrillotriacetate-induced
Showed a normal lobular pattern with minor necrosis
and lymphocyte inltration that was comparable to the
control and silymarin-treated groups
When compared to Fe-NTA administered controls, ALP,
ALT, and AST levels were considerably lower 2000 [112]
Solanecio
angulatus Asteraceae Leaves Methanol (200 and
400 mg/kg) Nitrillotriacetate-induced Not reported ALP, ALT, and AST levels were signicantly lower than
Fe-NTA administered controls 2000 [112]
Cucumis cifolius Cucurbitaceae Root Methanol (125, 250,
and 500 mg/kg) CCl
4
-induced
Improved the histology of the liver in mice treated
with CCl
4
to nearly the same level as the positive
control group silymarin in 500 mg/kg doses
ALP, ALT, and AST levels were lower in these animals
than in CCl4-induced mice. e 500 mg/kg dose showed
the greatest hepatoprotective eect
2000 [94]
Clutia abyssinica Euphorbiaceae Leaves Methanol (200 and
400 mg/kg) CCl
4
-induced
Inammatory cells, vascular congestion, cellular
degradation, necrosis, and vacuoles were reduced or
absent
AST, ALT, and ALP levels were signicantly lower than
CCl4-induced controls. e higher dose (400 mg/kg) had
a better hepatoprotective eect
2000 [113]
Rumex
abyssinicus Polygonaceae Rhizome Methanol (125, 250,
and 500 mg/kg) CCl
4
-induced
At 500 mg/kg, the architecture was maintained, there
was modest necrosis, and there were minor
lymphocytic inltrates
AST, ALT, and ALP levels were markedly decreased and
were comparable to silymarin (100mg/kg) at 500 mg/kg 2000 [114]
Croton
macrostachyus Euphorbiaceae Root bark Ethanol (200 and
400 mg/kg) Paracetamol-induced Hepatocytes were normal and liver cells were
regenerated at 400 mg/kg
In comparison to paracetamol induced the level of AST,
ALT, ALP, and total bilirubin was lowered at a higher
dose (400 mg/kg)
2000 [115]
Cineraria
abyssinica Asteraceae Leaves Methanol (200 mg/
kg) CCl
4
-induced Minor necrosis and focal inammation AST, ALT, and ALP levels were markedly decreased and
were comparable to silymarin (100mg/kg) at 500 mg/kg 3000 [116]
Cordia africana Boraginaceae Stem bark Methanol (100, 200,
and 400 mg/kg) Acetaminophen-induced It showed moderate necrosis and vacuolar
degeneration at 400 mg/kg
e level of AST, ALT, and ALP was decreased at a higher
dose (400 mg/kg) compared to acetaminophen-induced 3000 [117]
Terminalia
brownii Combretaceae Leaves Methanol (250 and
500 mg/kg) CCl
4
-induced
At 250 mg/kg, the hepatocyte cell membrane’s
structural integrity was only marginally protected;
however, at 500 mg/kg, there was no ballooning and
a signicant level of protection
e levels of ALP, ALT, and AST were lower than those
in mice that had been CCl4-induced. Especially in terms
of preserving ALT and AST levels, the percentage of
hepatoprotective activity at 500 mg/kg was comparable to
the standard drug silymarin at 100 mg/kg
5000 [118]
10 Evidence-Based Complementary and Alternative Medicine

[104], antioxidant [105], and antimalarial [106]. It could be
more eective than other antihepatic medicinal plants in
terms of treatment.
3.4.1. Hepatoprotective Activity of Potential Ethiopian Me-
dicinal Plants. e hepatoprotective activity of sixteen
(16) Ethiopian medicinal plants from ten (10) families
was investigated in Ethiopia. ese plants have been
scientically tested for hepatotoxicity using a variety of
experimental models, including CCl
4
and paracetamol.
Several parameters, including liver markers (AST, ALT,
ALP, total protein, albumin, and bilirubin) and histo-
pathological examination, were used to evaluate these
plants. In animal models, all of the medicinal herbs were
revealed to have a signicant hepatoprotective eect.
Some of the plant species listed in Table 5 have hep-
atoprotective activity, which supports the traditional uses
listed in Table 4. ese include Verbascum sinaiticum,
Croton macrostachyus, Cucumis cifolius, Justicia shim-
perans, Phytolacca dodecandra, Treminalia brownie, and
Rumex abyssinicus. Although more polar solvents such as
water, methanol, and ethanol are frequently recom-
mended for use only in traditional preparations [119].
Signicantly, the majority of the plant species studied had
hepatoprotective ecacy that matched high-polarity
(methanol) plant extracts in most studies. is is ad-
vantageous because it permits therapeutic components to
absorb through the gut lumen into the circulatory system,
where they are needed, according to Lipinski’s rules of 5
[120]. As a result, active compounds interact with cell
surface receptors, and polar components oer in vivo
potency that is therapeutically meaningful. In oral acute
toxicity tests, the majority of the test extracts exhibited
LD
50
values greater than or equivalent to 2000 mg/kg,
which would account for the plant’s safe folkloric use.
4. Conclusion
Noncommunicable diseases, as well as MetS risk factors, add
signicantly to Ethiopia’s healthcare burden. Ethiopia has
a diverse plant biodiversity with ethnobotanically and sci-
entically conrmed therapeutic characteristics that can and
should be used to reduce the cost of providing health care.
e gut microbiota’s function in metabolic disorders has
gotten a lot of attention recently. A large variety of plants
used by indigenous people to treat various disorders, in-
cluding MetS (obesity, hypertension, and hepatic problems),
have been described as a result of numerous ethnobotanical
investigations conducted in Ethiopia. Moringa stenopetala
and Croton macrostachyus were the most commonly
employed ethnobotanical plant species for the treatment of
hypertension and liver diseases. Leaves were utilized as
a therapeutic preparation more frequently than other parts.
e antihypertensive and hepatoprotective properties of the
species studied are discussed. Some ethnobotanical studies
of medicinal plants investigated their antihypertensive and
hepatoprotective properties, and they found some good
results. Moringa stenopetala is the most commonly studied
medicinal plant for its antihypertensive properties. is
indicates that plants have traditionally been used to treat
hypertension and liver disorders. However, there was no
evidence of further study into the ecacy of some plant
species that have been identied as having antihypertensive
and hepatoprotective properties. More studies are needed to
identify active compounds and develop successful novel
drugs for the treatment of MetS.
Data Availability
All data generated or analyzed during this study are included
in this published article.
Conflicts of Interest
e authors declare that they have no conicts of interest.
Acknowledgments
e authors would like to acknowledge the Armauer Hansen
Research Institute for providing access to various journal
databases.
References
[1] S. O’Neill and L. O’Driscoll, “Metabolic syndrome: a closer
look at the growing epidemic and its associated pathologies,”
Obesity Reviews, vol. 16, no. 1, pp. 1–12, 2015.
[2] P. B. Nolan, G. Carrick-Ranson, J. W. Stinear, S. A. Reading,
and L. C. Dalleck, “Prevalence of metabolic syndrome and
metabolic syndrome components in young adults: a pooled
analysis,” Preventive medicine reports, vol. 7, pp. 211–215,
2017.
[3] D. Boudreau, D. Malone, M. Raebel et al., “Health care
utilization and costs by metabolic syndrome risk factors,”
Metabolic Syndrome and Related Disorders, vol. 7, no. 4,
pp. 305–314, 2009.
[4] P. D. Gluckman, M. A. Hanson, T. Buklijas, F. M. Low, and
A. S. Beedle, “Epigenetic mechanisms that underpin meta-
bolic and cardiovascular diseases,” Nature Reviews Endo-
crinology, vol. 5, no. 7, pp. 401–408, 2009.
[5] A. K. Chen, C. K. Roberts, and R. J. Barnard, “Eect of
a short-term diet and exercise intervention on metabolic
syndrome in overweight children,” Metabolism, vol. 55,
no. 7, pp. 871–878, 2006.
[6] D. E. Moller, “New drug targets for type 2 diabetes and the
metabolic syndrome,” Nature, vol. 414, no. 6865, pp. 821–
827, 2001.
[7] G. Nigussie, “A review on traditionally used medicinal plants
for scabies therapy in Ethiopia,” Advances in Traditional
Medicine, vol. 21, no. 2, pp. 199–208, 2021.
[8] M. Tahir, L. Gebremichael, T. Beyene, and P. Van Damme,
“Ethnobotanical study of medicinal plants in adwa district,
central zone of tigray regional state, northern Ethiopia,”
Journal of Ethnobiology and Ethnomedicine, vol. 17, no. 1,
pp. 71–13, 2021.
[9] G. Nigussie, “Isolation and characterization of the roots of
Rumex nervosus,” Journal of Tropical Pharmacy and
Chemistry, vol. 5, no. 1, pp. 39–50, 2020.
[10] C. J. Dillard and J. B. German, “Phytochemicals: nutra-
ceuticals and human health,” Journal of the Science of Food
and Agriculture, vol. 80, no. 12, pp. 1744–1756, 2000.
Evidence-Based Complementary and Alternative Medicine 11

[11] A. Altemimi, N. Lakhssassi, A. Baharlouei, D. Watson, and
D. Lightfoot, “Phytochemicals: extraction, isolation, and
identication of bioactive compounds from plant extracts,”
Plants, vol. 6, no. 4, p. 42, 2017.
[12] S. Mlilo and S. Sibanda, “An ethnobotanical survey of the
medicinal plants used in the treatment of cancer in some
parts of Matebeleland, Zimbabwe,” South African Journal of
Botany, vol. 146, pp. 401–408, 2022.
[13] N. Naghdi, “Folklore medicinal plants used in liver disease:
a review,” International Journal of Green Pharmacy, vol. 12,
no. 3, 2018.
[14] Who, Traditional Medicine Strategy: 2014-2023, World
Health Organization, Geneva, Switzerland, 2013.
[15] T. G. McGinn, G. H. Guyatt, P. C. Wyer et al., “Users’ guides
to the medical literature: XXII: how to use articles about
clinical decision rules,” JAMA, vol. 284, no. 1, pp. 79–84,
2000.
[16] WHO, “Obesity And Overweight,” 2021, https://www.who.
int/news-room/fact-sheets/detail/obesity-and-overweight.
[17] A. M. Kassie, B. B. Abate, and M. W. Kassaw, “Prevalence of
overweight/obesity among the adult population in Ethiopia:
a systematic review and meta-analysis,” BMJ Open, vol. 10,
no. 8, Article ID e039200, 2020.
[18] P. G. Kopelman, “Obesity as a medical problem,” Nature,
vol. 404, no. 6778, pp. 635–643, 2000.
[19] G. A. Bray, “Medical consequences of obesity,” Journal of
Clinical Endocrinology & Metabolism, vol. 89, no. 6,
pp. 2583–2589, 2004.
[20] K. M. McTigue, R. Harris, B. Hemphill et al., “Screening and
interventions for obesity in adults: summary of the evidence
for the US Preventive Services Task Force,” Annals of Internal
Medicine, vol. 139, no. 11, pp. 933–949, 2003.
[21] A. N. Howard, “e historical development, ecacy and
safety of very-low-calorie diets,” International Journal of
Obesity, vol. 5, no. 3, pp. 195–208, 1981.
[22] C. C. Curioni and P. M. Lourenço, “Long-term weight loss
after diet and exercise: a systematic review,” International
Journal of Obesity, vol. 29, no. 10, pp. 1168–1174, 2005.
[23] S. Z. Yanovski and J. A. Yanovski, “Long-term drug treat-
ment for obesity: a systematic and clinical review,” JAMA,
vol. 311, no. 1, pp. 74–86, 2014.
[24] D. Alemneh, “Ethnobotanical study of plants used for human
ailments in Yilmana densa and Quarit districts of west
Gojjam Zone, Amhara region, Ethiopia,” BioMed Research
International, vol. 2021, pp. 2021–18, 2021.
[25] R. Regassa, “Assessment of indigenous knowledge of me-
dicinal plant practice and mode of service delivery in
Hawassa city, southern Ethiopia,” Journal of Medicinal
Plants Research, vol. 7, no. 9, pp. 517–535, 2013.
[26] N. Tuasha, B. Petros, and Z. Asfaw, “Medicinal plants used by
traditional healers to treat malignancies and other human
ailments in Dalle District, Sidama Zone, Ethiopia,” Journal of
Ethnobiology and Ethnomedicine, vol. 14, no. 1, pp. 15–21,
2018.
[27] T. Teklehaymanot and M. Giday, “Ethnobotanical study of
medicinal plants used by people in Zegie Peninsula,
Northwestern Ethiopia,” Journal of Ethnobiology and Eth-
nomedicine, vol. 3, no. 1, pp. 12–11, 2007.
[28] T. Teklehaymanot, “Ethnobotanical study of knowledge and
medicinal plants use by the people in Dek Island in
Ethiopia,” Journal of Ethnopharmacology, vol. 124, no. 1,
pp. 69–78, 2009.
[29] Who, “Hypertension,” 2021, https://www.who.int/news-
room/fact-sheets/detail/hypertension.
[30] T. T. Nyakudya, T. Tshabalala, R. Dangarembizi,
K. H. Erlwanger, and A. R. Ndhlala, “e potential thera-
peutic value of medicinal plants in the management of
metabolic disorders,” Molecules, vol. 25, no. 11, p. 2669, 2020.
[31] K. T. Kibret and Y. M. Mesn, “Prevalence of hypertension
in Ethiopia: a systematic meta-analysis,” Public Health Re-
views, vol. 36, no. 1, pp. 14–12, 2015.
[32] Y. Limenih, S. Umer, and M. Wolde-Mariam, “Ethnobo-
tanical study on traditional medicinal plants in dega damot
woreda, amhara region, north Ethiopia,” International
Journal of Research in Pharmacy and Chemistry, vol. 5, no. 2,
pp. 258–273, 2015.
[33] E. d’Avigdor, H. Wohlmuth, Z. Asfaw, and T. Awas, “e
current status of knowledge of herbal medicine and me-
dicinal plants in Fiche, Ethiopia,” Journal of Ethnobiology
and Ethnomedicine, vol. 10, no. 1, pp. 38–33, 2014.
[34] M. Meragiaw, Z. Asfaw, and M. Argaw, “e status of
ethnobotanical knowledge of medicinal plants and the im-
pacts of resettlement in Delanta, northwestern Wello,
northern Ethiopia,” Evidence-based Complementary and
Alternative Medicine, vol. 2016, pp. 1–24, 2016.
[35] Z. Birhanu, “Traditional use of medicinal plants by the ethnic
groups of Gondar Zuria District, North-Western Ethiopia,”
Journal of Natural Remedies, vol. 13, no. 1, pp. 46–53, 2013.
[36] G. Seyoum and G. Zerihun, “An ethnobotanical study of
medicinal plants in Debre Libanos Wereda, Central Ethio-
pia,” African Journal of Plant Science, vol. 8, no. 7,
pp. 366–379, 2014.
[37] G. Chekole, Z. Asfaw, and E. Kelbessa, “Ethnobotanical study
of medicinal plants in the environs of Tara-gedam and Amba
remnant forests of Libo Kemkem District, northwest
Ethiopia,” Journal of Ethnobiology and Ethnomedicine,
vol. 11, no. 1, pp. 4–38, 2015.
[38] B. M. Habte, T. Kebede, T. G. Fenta, and H. Boon, “Use of
medicinal plants among Ethiopian patients with diabetes:
a qualitative exploration,” e Ethiopian Journal of Health
Development, vol. 31, no. 1, pp. 18–26, 2017.
[39] B. Paulos, T. G. Fenta, D. Bisrat, and K. Asres, “Health
seeking behavior and use of medicinal plants among the
Hamer ethnic group, South Omo zone, southwestern
Ethiopia,” Journal of Ethnobiology and Ethnomedicine,
vol. 12, no. 1, pp. 44–13, 2016.
[40] B. N. Tefera and Y.-D. Kim, “Ethnobotanical study of me-
dicinal plants in the hawassa zuria district, sidama zone,
southern Ethiopia,” Journal of Ethnobiology and Ethno-
medicine, vol. 15, no. 1, pp. 25–21, 2019.
[41] A. Wendimu, W. Tekalign, and B. Asfaw, “A survey of
traditional medicinal plants used to treat common human
and livestock ailments from Diguna Fango district, Wolaita,
southern Ethiopia,” Nordic Journal of Botany, vol. 39, no. 5,
Article ID njb.03174, 2021.
[42] Z. Birhanu, A. Endale, and Z. Shewamene, “An ethno-
medicinal investigation of plants used by traditional healers
of Gondar town, North-Western Ethiopia,” Journal of me-
dicinal plants studies, vol. 3, no. 2, pp. 36–43, 2015.
[43] S. Araya, B. Abera, and M. Giday, “Study of plants tradi-
tionally used in public and animal health management in
Seharti Samre District, Southern Tigray, Ethiopia,” Journal of
Ethnobiology and Ethnomedicine, vol. 11, no. 1, pp. 22–25,
2015.
[44] M. A. Eshete, E. Kelbessa, and G. Dalle, “Ethnobotanical
study of medicinal plants in guji agro-pastoralists, blue hora
district of borana zone, oromia region, Ethiopia,” Journal of
medicinal plants studies, vol. 4, no. 2, pp. 170–184, 2016.
12 Evidence-Based Complementary and Alternative Medicine

[45] A. Enyew, Z. Asfaw, E. Kelbessa, and R. Nagappan, “Eth-
nobotanical study of traditional medicinal plants in and
around Fiche District, Central Ethiopia,” Current Research
Journal of Biological Sciences, vol. 6, no. 4, pp. 154–167, 2014.
[46] F. Mesn, T. Seta, and A. Assefa, “An ethnobotanical study of
medicinal plants in Amaro Woreda, Ethiopia,” Ethnobotany
Research and Applications, vol. 12, pp. 341–354, 2014.
[47] G. Alemayehu, Z. Asfaw, and E. Kelbessa, “Ethnobotanical
study of medicinal plants used by local communities of
minjar-shenkora district, north shewa zone of amhara re-
gion, Ethiopia,” Journal of Medicinal Plants Studies, vol. 3,
no. 6, pp. 1–11, 2015.
[48] H. Yineger, E. Kelbessa, T. Bekele, and E. Lulekal, “Plants
used in traditional management of human ailments at bale
mountains national park, southeastern Ethiopia,” Journal of
Medicinal Plants Research, vol. 2, no. 6, pp. 132–153, 2008.
[49] M. Agize, S. Demissew, and Z. Asfaw, “Ethnobotany of
medicinal plants in Loma and Gena bosa districts (woredas)
of dawro zone, southern Ethiopia,” Topclass Journal of
Herbal Medicine, vol. 2, no. 9, pp. 194–212, 2013.
[50] S. Haseena, S. Shanavas, T. Ahamad et al., “Investigation on
photocatalytic activity of bio-treated α-Fe2O3 nanoparticles
using Phyllanthus niruri and Moringa stenopetala leaf ex-
tract against methylene blue and phenol molecules: kinetics,
mechanism and stability,” Journal of Environmental
Chemical Engineering, vol. 9, no. 1, Article ID 104996, 2021.
[51] S. T. Geneti, G. A. Mekonnen, H. C. A. Murthy et al.,
“Biogenic synthesis of magnetite nanoparticles using leaf
extract of ymus schimperi and their application for
monocomponent removal of chromium and mercury ions
from aqueous solution,” Journal of Nanomaterials, vol. 2022,
pp. 1–15, 2022.
[52] N. Augustin, V. K. Nuthakki, M. Abdullaha, Q. P. Hassan,
S. G. Gandhi, and S. B. Bharate, “Discovery of helmintho-
sporin, an anthraquinone isolated from Rumex abyssinicus
Jacq as a dual cholinesterase inhibitor,” ACS Omega, vol. 5,
no. 3, pp. 1616–1624, 2020.
[53] M. A. Rather, B. A. Dar, S. N. So, B. A. Bhat, and
M. A. Qurishi, “Foeniculum vulgare: a comprehensive review
of its traditional use, phytochemistry, pharmacology, and
safety,” Arabian Journal of Chemistry, vol. 9, pp. S1574–
S1583, 2016.
[54] A. Leone, A. Spada, A. Battezzati, A. Schiraldi, J. Aristil, and
S. Bertoli, “Cultivation, genetic, ethnopharmacology, phy-
tochemistry and pharmacology of Moringa oleifera leaves: an
overview,” International Journal of Molecular Sciences,
vol. 16, no. 12, pp. 12791–12835, 2015.
[55] N. Z. Abd Rani, K. Husain, and E. Kumolosasi, “Moringa
genus: a review of phytochemistry and pharmacology,”
Frontiers in Pharmacology, vol. 9, p. 108, 2018.
[56] U. Eilert, B. Wolters, and A. Nahrstedt, “e antibiotic
principle of seeds of Moringa oleifera and Moringa sten-
opetala,” Planta Medica, vol. 42, no. 05, pp. 55–61, 1981.
[57] A. Manilal, K. R. Sabu, M. Shewangizaw et al., “In vitro
antibacterial activity of medicinal plants against biolm-
forming methicillin-resistant Staphylococcus aureus: ecacy
of Moringa stenopetala and Rosmarinus ocinalis extracts,”
Heliyon, vol. 6, no. 1, Article ID e03303, 2020.
[58] S. Seleshe and S. N. Kang, “In vitro antimicrobial activity of
dierent solvent extracts from Moringa stenopetala leaves,”
Preventive nutrition and food science, vol. 24, no. 1, pp. 70–
74, 2019.
[59] A. Toma, E. Makonnen, Y. Mekonnen, A. Debella, and
S. Adisakwattana, “Antidiabetic activities of aqueous ethanol
and n-butanol fraction of Moringa stenopetala leaves in
streptozotocin-induced diabetic rats,” BMC Complementary
and Alternative Medicine, vol. 15, no. 1, pp. 242–248, 2015.
[60] A. Toma, E. Makonnen, Y. Mekonnen, A. Debella, and
S. Addisakwattana, “Intestinal α-glucosidase and some
pancreatic enzymes inhibitory eect of hydroalcholic extract
of Moringa stenopetala leaves,” BMC Complementary and
Alternative Medicine, vol. 14, no. 1, pp. 180–185, 2014.
[61] S. Habtemariam, “Investigation into the antioxidant and
antidiabetic potential of Moringa stenopetala: identication
of the active principles,” Natural Product Communications,
vol. 10, no. 3, Article ID 1934578X1501000, 2015.
[62] Y. Mekonnen, V. Yardley, P. Rock, and S. Croft, “In vitro
antitrypanosomal activity of Moringa stenopetala leaves and
roots,” Phytotherapy Research, vol. 13, no. 6, pp. 538-539,
1999.
[63] T. Kieyohannes, G. Terefe, Y. H. Tolossa, M. Giday, and
N. Kebede, “Eect of crude extracts of Moringa stenopetala
and Artemisia absinthium on parasitaemia of mice infected
with Trypanosoma congolense,” BMC Research Notes, vol. 7,
no. 1, pp. 390–397, 2014.
[64] G. K. Kinuthia, C. O. Anjili, N. K. Gikonyo, E. M. Kigondu,
J. M. Ingonga, and E. W. Kabiru, “In vitro and in vivo ac-
tivities of blends of crude aqueous extracts from Allium
sativum L, Callistemon citrinus (Curtis) Skeels and Moringa
stenopetala (Baker F) Cufodontis against Leishmania major,”
International Journal of Medicinal and Aromatic Plants,
vol. 3, no. 2, pp. 234–246, 2013.
[65] Y. Tamrat, T. Nedi, S. Assefa, T. Teklehaymanot, and
W. Shibeshi, “Anti-inammatory and analgesic activities of
solvent fractions of the leaves of Moringa stenopetala
Bak.(Moringaceae) in mice models,” BMC Complementary
and Alternative Medicine, vol. 17, no. 1, pp. 473–510, 2017.
[66] Y. Mekonnen, “Eects of ethanol extract of Moringa sten-
opetala leaves on Guinea-pig and mouse smooth muscle,”
Phytotherapy Research, vol. 13, no. 5, pp. 442–444, 1999.
[67] M. Mengistu, Y. Abebe, Y. Mekonnen, and T. Tolessa, “In
vivo and in vitro hypotensive eect of aqueous extract of
Moringa stenopetala,” African Health Sciences, vol. 12, no. 4,
pp. 545–551, 2012.
[68] T. A. Yalew, Y. Mekonnen, and N. Retta, “Comparison of
total phenolic content, free radical scavenging potential and
antihyperglycemic condition from leaves extract of Moringa
stenopetala and Moringa oleifera,” Ethiopian Journal of
public health and Nutrition, vol. 1, pp. 20–27, 2019.
[69] T. Tebeka and S. Libsu, “Assessment of antioxidant potential
of <i&gt;Moringa stenopetala&lt;/i&gt; leaf extract,” Ethio-
pian Journal of Science and Technology, vol. 7, no. 2,
pp. 93–104, 2015.
[70] S. Habtemariam, “Methodology for rapid Isolation of
moringin: potential anticancer compound from the seeds of
Moringa stenopetala,” Pharmaceutica Analytica Acta,
vol. 08, no. 08, 2017.
[71] A. Z. Golla, “yroid function prole, and its association to
consumption of cassava and &lt;i&amp;gt;Moringa sten-
opetala&amp;lt;/i&amp;gt; in pregnant women,” Advances
in Biological Chemistry, vol. 03, no. 05, pp. 448–454, 2013.
[72] H. Haji, E. Makonnen, A. Debella, and B Geleta, “Evaluation
of diuretic and antihypertensive activity of leaf extracts of
<em&gt;ymus schimperi</em&gt; in rats,” British Journal
of Pharmacology and Toxicology, vol. 7, no. 1, pp. 1–8, 2016.
[73] B. Geleta, E. Makonnen, A. Debella, and A. Tadele, “In vivo
antihypertensive and antihyperlipidemic eects of the crude
extracts and fractions of Moringa stenopetala (Baker f.)
Evidence-Based Complementary and Alternative Medicine 13

Cufod. leaves in rats,” Frontiers in Pharmacology, vol. 7, p. 97,
2016.
[74] N. Fekadu, H. Basha, A. Meresa, S. Degu, B. Girma, and
B Geleta, “Diuretic activity of the aqueous crude extract and
hot tea infusion of <em&gt;Moringa stenopetala </em&gt;
(Baker f.) Cufod. leaves in rats,” Journal of Experimental
Pharmacology, vol. 9, pp. 73–80, 2017.
[75] B. Geleta, E. Makonnen, A. Debella, A. Abebe, and N Fekadu,
“In vitro vasodilatory activity and possible mechanisms of
the crude extracts and fractions of <em&gt;Moringa sten-
opetala&lt;/em&gt; (Baker f.) Cufod. leaves in isolated
thoracic aorta of Guinea pigs,” Journal of Experimental
Pharmacology, vol. 8, pp. 35–42, 2016.
[76] Y. Getiye, T. Tolessa, and E. Engidawork, “Antihypertensive
activity of 80% methanol seed extract of Calpurnia aurea
(Ait.) Benth. subsp. aurea (Fabaceae) is mediated through
calcium antagonism induced vasodilation,” Journal of Eth-
nopharmacology, vol. 189, pp. 99–106, 2016.
[77] Y. Ayele, K. Urga, and E. Engidawork, “Evaluation of in vivo
antihypertensive and in vitro vasodepressor activities of the
leaf extract of syzygium guineense (willd) DC,” Phytotherapy
Research, vol. 24, no. 10, pp. 1457–1462, 2010.
[78] A. Degu, A. Abebe, and E. Engidawork, “Methanol (80%) leaf
extract of Otostegia integrifolia Benth (Lamiaceae) lowers
blood pressure in rats through interference with calcium
conductance,” BMC complementary medicine and therapies,
vol. 21, no. 1, pp. 49–11, 2021.
[79] D. Hika, Antihypertensive Activity of Aerial Parts of Satureja
Punctata (Benth.) Briq.(Lamiaceae), Addis Ababa University,
Addis Ababa, Ethiopia, 2015.
[80] R. Williams, “Global challenges in liver disease,” Hepatology,
vol. 44, no. 3, pp. 521–526, 2006.
[81] M. Asadi-Samani, N. Kafash-Farkhad, N. Azimi, A. Fasihi,
E. Alinia-Ahandani, and M. Raeian-Kopaei, “Medicinal
plants with hepatoprotective activity in Iranian folk medi-
cine,” Asian Pacic Journal of Tropical Biomedicine, vol. 5,
no. 2, pp. 146–157, 2015.
[82] E. Tsega, “Current views on liver diseases in Ethiopia,”
Ethiopian Medical Journal, vol. 15, no. 2, pp. 75–82, 1977.
[83] A. Shimels, K. Atinafu, M. Akalu, and M. Getachew, “Eth-
nobotanical study of medicinal plants used by agro pasto-
ralist Somali people for the management of human ailments
in Jeldesa Cluster, Dire Dawa Administration, Eastern
Ethiopia,” Journal of Medicinal Plants Research, vol. 11, no. 9,
pp. 171–187, 2017.
[84] M. Ragunathan and S. M. Abay, “Ethnomedicinal survey of
folk drugs used in Bahirdar Zuria district, Northwestern
Ethiopia,” Indian Journal of Traditional Knowledge, vol. 8,
no. 2, pp. 281–284, 2009.
[85] M. Giday, T. Teklehaymanot, A. Animut, and Y. Mekonnen,
“Medicinal plants of the shinasha, agew-awi and amhara
peoples in northwest Ethiopia,” Journal of Ethno-
pharmacology, vol. 110, no. 3, pp. 516–525, 2007.
[86] A. Belayneh and N. F. Bussa, “Ethnomedicinal plants used to
treat human ailments in the prehistoric place of Harla and
Dengego valleys, eastern Ethiopia,” Journal of Ethnobiology
and Ethnomedicine, vol. 10, no. 1, pp. 18–17, 2014.
[87] T. Gabriel and T. Guji, “Ethnopharmacological survey of
medicinal plants in Agaro district, Jimma zone, South West
Ethiopia,” International Journal of Pharmaceutical Sciences
and Research, vol. 5, no. 8, p. 3551, 2014.
[88] L. Kidane, G. Gebremedhin, and T. Beyene, “Ethnobotanical
study of medicinal plants in ganta afeshum district, eastern
zone of tigray, northern Ethiopia,” Journal of Ethnobiology
and Ethnomedicine, vol. 14, no. 1, pp. 64–19, 2018.
[89] Z. Kassa, Z. Asfaw, and S. Demissew, “Ethnobotanical study
of medicinal plants used by the local people in tulu korma
and its surrounding areas of ejere district, western shewa
zone of oromia regional state, Ethiopia,” Journal of Medicinal
Plants Studies, vol. 4, no. 2, pp. 24–47, 2016.
[90] A. Kefalew, Z. Asfaw, and E. Kelbessa, “Ethnobotany of
medicinal plants in ada’a district, east shewa zone of oromia
regional state, Ethiopia,” Journal of Ethnobiology and Eth-
nomedicine, vol. 11, no. 1, pp. 25–28, 2015.
[91] M. Ragunathan and M. Solomon, “e study of spiritual
remedies in orthodox rural churches and traditional me-
dicinal practice in Gondar Zuria district, Northwestern
Ethiopia,” Pharmacognosy Journal, vol. 1, no. 3, 2009.
[92] T. Mekuanent, A. Zebene, and Z. Solomon, “Ethnobotanical
study of medicinal plants in Chilga district, Northwestern
Ethiopia,” Journal of Natural Remedies, vol. 15, no. 2,
pp. 88–112, 2015.
[93] W. S. Aga, S. K. Fantaye, and S. A. Jabasingh, “Biodiesel
production from Ethiopian ‘Besana’-Croton macrostachyus
seed: characterization and optimization,” Renewable Energy,
vol. 157, pp. 574–584, 2020.
[94] E. M. Araya, B. A. Adamu, G. Periasamy, B. Sintayehu, and
M. Gebrelibanos Hiben, “In vivo hepatoprotective and in
vitro radical scavenging activities of Cucumis cifolius A.
rich root extract,” Journal of Ethnopharmacology, vol. 242,
Article ID 112031, 2019.
[95] A. Kenubih, E. Belay, and K. Lemma, “Evaluation of the
antimicrobial activity of leaf extracts of Acokanthera
schimperi against various disease-causing bacteria,” Journal
of Experimental Pharmacology, vol. 13, pp. 889–899, 2021.
[96] S. Edwards, M. Tadese, and I. Hedberg, Flora of Ethiopia and
Eritrea Vol. 2 Part 2: Canellaceae to Euphorbiaceae,
Sue Edwards and Tadese Mesn, Eds., Addis Abeba Uni-
versity, Ethiopia, 1995.
[97] A. Degu, E. Engidawork, and W. Shibeshi, “Evaluation of the
anti-diarrheal activity of the leaf extract of Croton macro-
stachyus Hocsht. ex Del.(Euphorbiaceae) in mice model,”
BMC Complementary and Alternative Medicine, vol. 16,
no. 1, pp. 379–411, 2016.
[98] A. Maroyi, “Ethnopharmacological uses, phytochemistry,
and pharmacological properties of Croton macrostachyus
Hochst. Ex Delile: a comprehensive review,” Evidence-based
Complementary and Alternative Medicine, vol. 2017, pp. 1–
17, 2017.
[99] T. Eguale, T. Getachew, M. Giday, and Y. Mekonnen, “In
vitro anthelmintic activities of four Ethiopian medicinal
plants against Haemonchus contortus,” Pharmacologyonline,
vol. 3, pp. 153–165, 2006.
[100] J. K. Obey, A. von Wright, J. Orjala, J. Kauhanen, and
C. Tikkanen-Kaukanen, “Antimicrobial activity of Croton
macrostachyus stem bark extracts against several human
pathogenic bacteria,” Journal of Pathogens, vol. 2016, pp. 1–5,
2016.
[101] E. Ngo Bum, E. Ngah, R. Ngo Mune et al., “Decoctions of
Bridelia micrantha and Croton macrostachyus may have
anticonvulsant and sedative eects,” Epilepsy and Behavior,
vol. 24, no. 3, pp. 319–323, 2012.
[102] W. Arika, Y. A. Abdirahman, M. A. Mawia et al., “In vivo
antidiabetic activity of the aqueous leaf extract of Croton
macrostachyus in alloxan induced diabetic mice,” Pharma-
ceutica Analytica Acta, vol. 6, no. 11, pp. 1–5, 2015.
14 Evidence-Based Complementary and Alternative Medicine

[103] T. B. Nguelefack, R. C. Dutra, A. F. Paszcuk,
E. L. de Andrade, and J. B. Calixto, “TRPV1 channel in-
hibition contributes to the antinociceptive eects of Croton
macrostachyus extract in mice,” BMC Complementary and
Alternative Medicine, vol. 15, no. 1, pp. 293–299, 2015.
[104] H. Gelaw, L. Adane, Y. Tariku, and A. Hailu, “Isolation of
crotepoxide from berries of Croton macrostachyus and
evaluation of its anti-leishmanial activity,” Journal of
Pharmacognosy and Phytochemistry, vol. 1, no. 4, pp. 15–24,
2012.
[105] C. T. Mofor, D. C. R. Sonfack, R. Fokom, V. P. Beng, and
Z. P. H. Amvam, “Antifungal and antioxidant activity of
crude extracts of three medicinal plants from Cameroon
pharmacopea,” Journal of Medicinal Plants Research, vol. 7,
no. 21, pp. 1537–1542, 2013.
[106] J. K. Obey, M. M. Ngeiywa, P. Kiprono et al., “Antimalarial
activity of Croton macrostachyus stem bark extracts against
Plasmodium berghei in vivo,” Journal of pathogens, vol. 2018,
Article ID 2393854, 6 pages, 2018.
[107] Y. Wasihun, E. Makonnen, M. Afewerk, and W. Ergete,
“Hepatoprotective activity of aqueous and ethanol extract of
Lippia adoensis leaf against carbon tetrachloride-induced
hepatotoxicity in mice,” Pathology and Laboratory Medicine,
vol. 1, no. 1, pp. 5–13, 2017.
[108] A. D. Dubiwak, T. W. Damtew, M. W. Senbetu et al.,
“Hepatoprotective eect of corm of ensete ventricosum
(welw.) cheesman extract against isoniazid and rifampicin
induced hepatotoxicity in Swiss albino mice,” Journal of
Toxicology, vol. 2021, pp. 2021–8, Article ID 4760455, 2021.
[109] D. Damtie, C. Braunberger, J. Conrad, Y. Mekonnen, and
U. Beifuss, “Composition and hepatoprotective activity of
essential oils from Ethiopian thyme species (ymus ser-
rulatus and ymus schimperi),” Journal of Essential Oil
Research, vol. 31, no. 2, pp. 120–128, 2019.
[110] S. Umer, K. Asres, and C. Veeresham, “Hepatoprotective
activities of two Ethiopian medicinal plants,” Pharmaceutical
Biology, vol. 48, no. 4, pp. 461–468, 2010.
[111] B. G. Meharie and T. A. Tunta, “Phytolacca dodecandra
(phytolaccaceae) root extract exhibits antioxidant and
hepatoprotective activities in mice with CCl4-induced acute
liver damage,” Clinical and Experimental Gastroenterology,
vol. 14, pp. 59–70, 2021.
[112] T. Wolde, E. Engidawork, K. Asres, and W. Eregete,
“Evaluation of hepatoprotective activities of satureja punc-
tata benth briq and solanecioangulatus vahl jerey in ferric
nitrillotriacetate induced hepatotoxicity in rats,” Ethiopian
Pharmaceutical Journal, vol. 28, no. 2, pp. 63–74, 2010.
[113] B. G. Meharie, G. G. Amare, and Y. M. Belayneh, “<p&gt;
Evaluation of Hepatoprotective Activity of the Crude Extract
and Solvent Fractions of <em&gt;Clutia abyssinica&lt;/
em&gt; (<em&gt;Euphorbiaceae&lt;/em&gt;) Leaf against
CCl&lt;sub&gt;4&lt;/sub&gt;-Induced Hepatotoxicity in
Mice&lt;/p&gt,” Journal of Experimental Pharmacology,
vol. 12, pp. 137–150, 2020.
[114] B. A. Adamu, Y. K. Emiru, B. Sintayehu, E. M. Araya,
G. Periasamy, and M Gebrelibanos Hiben, “<p&gt;In vivo
Hepatoprotective and in vitro Radical Scavenging Activities
of Extracts of <em&gt;Rumex abyssinicus&lt;/em&gt; Jacq.
Rhizome&lt;/p&gt,” Journal of Experimental Pharmacology,
vol. 12, pp. 221–231, 2020.
[115] G. Gebremedhin, K. B. Tuem, A. Kahsu, and
R Balasubramanian, “<p&gt;In vitro Antioxidant and in vivo
Hepatoprotective Activities of Root Bark Extract and Solvent
Fractions of <em&gt;Croton macrostachyus&lt;/em&gt;
Hochst. Ex Del. (<em&gt;Euphorbiaceae&lt;/em&gt;) on
Paracetamol-Induced Liver Damage in Mice&lt;/p&gt,”
Journal of Experimental Pharmacology, vol. 12, pp. 301–311,
2020.
[116] B. Sintayehu, F. Bucar, C. Veeresham, and K. Asres,
“Hepatoprotective and free radical scavenging activities of
extracts and a major compound isolated from the leaves of
cineraria abyssinica sch. Bip. exA. Rich,” Pharmacognosy
Journal, vol. 4, no. 29, pp. 40–46, 2012.
[117] G. D. Geresu, S. Umer, M. Arayaselassie, G. Ashebir, and
E. Makonnen, “Hepatoprotective eects of crude stem bark
extracts and solvent fractions of Cordia africana against
acetaminophen-induced liver injury in rats,” Canadian
Journal of Gastroenterology and Hepatology, vol. 2022, Ar-
ticle ID 1449286, 11 pages, 2022.
[118] B. Sintayehu, B. B. Kakoti, M. S. Kataki et al., “Hep-
atoprotective, antixidant and anticancer activities of <i&gt;
Terminalia brownii&lt;/i&gt; Fresen leaf abstract,” Ethiopian
Pharmaceutical Journal, vol. 33, no. 1, pp. 29–38, 2018.
[119] M. Willcox, “Improved traditional phytomedicines in cur-
rent use for the clinical treatment of malaria,” Planta Medica,
vol. 77, no. 06, pp. 662–671, 2011.
[120] L.-T. Lin, W.-C. Hsu, and C.-C. Lin, “Antiviral natural
products and herbal medicines,” Journal of traditional and
complementary medicine, vol. 4, no. 1, pp. 24–35, 2014.
Evidence-Based Complementary and Alternative Medicine 15