Peppermint and menthol: a review on their biochemistry, pharmacological activities, clinical applications, and safety considerations.

In this manuscript, we conducted a comprehensive review of the diverse effects of peppermint on human health and explored the potential underlying mechanisms. Peppermint contains three main groups of phytochemical constituents, including essential oils (mainly menthol), flavonoids (such as hesperidin, eriodictyol, naringenin, quercetin, myricetin, and kaempferol), and nonflavonoid phenolcarboxylic acids. Peppermint exhibits antimicrobial, antioxidant, anti-inflammatory, immunomodulatory, anti-cancer, anti-aging, and analgesic properties and may be effective in treating various disorders, including gastrointestinal disorders (e.g., irritable bowel syndrome, dyspepsia, constipation, functional gastrointestinal disorders, nausea/vomiting, and gallbladder stones). In addition, peppermint has therapeutic benefits for psychological and cognitive health, dental health, urinary retention, skin and wound healing, as well as anti-depressant and anti-anxiety effects, and it may improve memory. However, peppermint has paradoxical effects on sleep quality and alertness, as it has been shown to improve sleep quality in patients with fatigue and anxiety, while also increasing alertness under conditions of monotonous work and relaxation. We also discuss its protective effects against toxic agents at recommended doses, as well as its safety and potential toxicity. Overall, this review provides the latest findings and insights into the properties and clinical effects of peppermint/menthol and highlights its potential as a natural therapeutic agent for various health conditions.

Topical Nigella sativa L. product: a new candidate for the management of diabetic peripheral neuropathy.

BACKGROUND: Diabetic neuropathy is one of the most common complications of diabetes. The synthetic drugs available in the market have side effects and limitations for diabetic patients, the vast majority of whom are in the upper age group. In this regard, based on Persian medicinal sources, Nigella sativa (N. sativa) has proved to have beneficial effects on neuropathic pain and neurological disorders. In this study, the effect of N. sativa is investigated topically in patients with diabetic neuropathy. METHODS: This study was performed as a double-blind clinical trial on 120 neuropathic patients. The patients were divided into three groups. The first group received a topical N. sativa product as an ointment, the second group was given a topical placebo, and the third received 300 mg gabapentin capsules. The blindness was done in first and second groups. Diabetic neuropathy was assessed before the study using the Michigan Neuropathy Screening Instrument (MNSI). In addition, neuropathy symptoms were evaluated after the trial using the MNSI questionnaire. RESULTS: The data were elicited from the patients' answers to a number of questions in the Michigan questionnaire. There were statistically significant differences between the group that received the topical N. sativa product and the other two groups in terms of legs and feet numbness (p value = 0.001), burning pain in feet or legs (p value = 0.001), muscle cramps in feet or legs (p value = 0.001), prickling fleeing in feet or legs (p value = 0.001), hurting of the skin when the bed covers touch it (p value = 0.005), aggravated symptoms at night (p value = 0.001) and hurting feelings in the legs when walking (p value = 0.032). However, the three studied groups were not statistically different in distinguishing hot water from cold water. CONCLUSION: According to the results of this study, the topical use of N. sativa, compared to the current drugs, has acceptable improving effects on diabetic neuropathic patients.

Protective effect of freeze-dried extract of Persicaria bistorta Samp. on acetic acid-induced colitis model in rats: Involvement of nitric oxide and opioid system.

Inflammatory bowel disease is a chronic inflammatory disorder accompanied by occasional flare-ups, abdominal pain, and rectal bleeding. Persicaria bistorta Samp. is a medicinal plant repeatedly mentioned in traditional Persian medicine for the treatment of bleeding and tissue damage in different organs, including the intestines. The current study aimed to evaluate the effect of bistort root in an animal model of colitis. Freeze-dried aqueous extract of the plant (PB) was prepared and analyzed using liquid chromatography-mass spectrometry and high-performance liquid chromatography. The anti-inflammatory effect of oral PB (300, 500, and 700 mg/kg) was evaluated in acetic acid-induced colitis in Wistar rats compared with negative control and positive control (dexamethasone). The role of nitric oxide (NO), opioid receptors, Toll-like receptors (TLR-4), interleukin (IL)-1ß, IL-6, TNF-α, NF-κB, myeloperoxidase, and intestinal tissue damage using immunohistochemistry staining for cyclooxygenase-2 (COX-2) were also assessed. A total of 29 compounds were identified in the extract. The gallic acid content of the extract was 4.973 ± 1.102 mg/g. PB significantly ameliorated the gross morphological damage from 4.66 ± 0.577 in negative control to 1.33 ± 0.56 in PB 700 (p < 0.001). Also, PB 700 lowered the levels of TNF-α (p < 0.01), TLR-4 (p < 0.001), NF-κB (p < 0.0001), IL-1ß (p < 0.0001), and IL-6 (p < 0.0001) compared to the negative control. Additionally, while blocking NO and opioid pathways, the therapeutic effect of the extract was not significant, compared to the negative control, suggesting that PB 700 has exerted its therapeutic effect via these two pathways. However, further mechanistic and clinical studies are recommended to confirm PB as a natural treatment for colitis.

The history of medieval bladder stone surgery in Persia.

INTRODUCTION: People's understanding of bladder stones has a long history. Since around the sixth century BC, surgery has been selected as the most specialized and last treatment and has continuously evolved. Meanwhile, many missing links have sometimes been a turning point in bladder stone surgery. The efforts of Iranian medicine scholars in advancing this treatment method are part of the impressive ups and downs of this path, which is discussed in this research. METHODS: This review research is based on Persian medicine sources, such as Al-Hawi fi al-Tabb, The Kitab al-Tasrif, and Al-Qanun fi al-Tebb. It has also used reliable databases such as Pub Med, Scopus, and Elsevier, as well as search engines such as Google Scholar, with related keywords. RESULTS: Surgery as the last treatment method for bladder stones was first proposed in the Golden Age (800-1300AD) of Persian traditional medicine by Ali ibn Rabben Tabari (810-895 AD) and Rhazes (865-925 AD), who discussed it in more detail. Then Hally Abbas, Albucasis, and Avicenna completed and enriched it. Albucasis's role is imposing due to his unique techniques in perineal cystolithotomy, forceps to extract bladder stones, and primary lithotrity until the nineteenth century. CONCLUSION: Examining the evolution and progress of bladder stone treatment shows the efforts of physicians in different medical schools. The brilliance of the sages of Persian Medicine, who invented seven different types of bladder stone surgery, improved the techniques of the predecessors and created a significant leap in the progress of this surgery.

An approach to the milestones of spine surgery in Persian traditional medicine.

BACKGROUND: The diagnosis and treatment of spine disorders have been challenging for thousands of years in different nations and medical schools. Despite this long history, there are many information gaps in this regard. The current research deals with the milestones and progress of spine surgery from ancient times until now, emphasizing the innovations of sages in the Persian traditional medicine era. METHODS: The present study is based on searching original and library documents, data from databases such as PubMed, Scopus, and Science Direct, and search engines such as Google Scholar. RESULTS: In Persian traditional medicine, Rhazes (865-925 AD) was the first sage who applied spine surgery based on the innovative knowledge of Galen (second century AD) and Paulus Aegineta (seventh century AD). Hally Abbas (tenth century AD), by suturing two separated bones during spine surgery, and Albucasis (936-1013 AD), by inventing, describing, and drawing the surgical instruments involved in surgeries in this area, and also using cauterization in the treatment of children's hunchback, were the innovators of new methods. CONCLUSION: The modern knowledge of spine surgery is based on intelligent experiences and prominent thoughts from thousands of years worldwide. However, sometimes, these key points have remained hidden. This issue necessitates investigating this science in different schools and territories for comparative studies, identifying the firsts in the prominent points of this field, preserving the identity of sages and nations, and preventing scientific plagiarism.

Prevalence of Complementary and Alternative Medicine Use and Its Associated Factors among Iranian Diabetic Patients: A Cross-Sectional Study.

Objective: This cross-sectional study aimed to assess the prevalence of complementary and alternative medicine (CAM) use and its associated factors among diabetic patients in Fasa, a city in southern Iran. Methods: Data were collected from diabetic patients who visited the endocrinology clinics at Fasa University of Medical Sciences. A structured questionnaire was administered to gather information on CAM use, including the types of CAM modalities used, and reasons for use. The patient's demographic and clinical characteristics, such as age, gender, duration of diabetes, glycosylated hemoglobin (HbA1c) levels, and quality of life (QoL) were also recorded. Descriptive statistics were used to determine the prevalence of CAM use, while logistic regression analysis was employed to identify factors associated with CAM use. Results: A total of 376 diabetic patients participated in the study, with more than 89% reporting CAM use within the past year. Herbal preparations were the most commonly used type of CAM, with a prevalence rate of 99.4%. Factors associated with CAM use included patients' psychological health, attitude towards the safety of CAM, belief in the synergistic effects of combining routine medications with CAM, and previous positive experiences with CAM. Conclusion: The high prevalence of CAM use highlights the importance of considering it in diabetes management and the need for healthcare professionals' engagement in open discussions with patients about their CAM practices. Understanding the factors influencing CAM use can inform healthcare providers and policymakers in developing appropriate strategies for integrating CAM approaches into conventional diabetes care.

Avicenna's views on pest control and medicinal plants he prescribed as natural pesticides.

The present study aimed to introduce Avicenna's views on pest control and the medicinal plants he proposed as natural pesticides. Also, we addressed the strategies that he leveraged to formulate and prescribe them, and, finally, we put his views into perspective with modern science. The data were collected using Al-Qanun Fi Al-Tibb (The Canon of Medicine) as well as scientific databases. According to Al-Qanun Fi Al-Tibb, 42 medicinal plants are described as natural pest control agents. After introducing the pest control properties of each plant, Avicenna explained the appropriate strategies for use of these plants. These strategies or formulations included incensing, spraying, spreading, rubbing, smudging, and scent-dispersing, which are equivalent to the modern pesticide formulations of fumigants, aerosols, pastes and poisoned baits, lotions, creams, and slow-release formulations, respectively. This study revealed that Avicenna introduced the pest control approach with natural plants in his book Al-Qanun Fi Al-Tibb and, thus, harnessed the power of nature to control nature. Future research is recommended to find the pest control merits of the presented medicinal plants, in order to incorporate them into pest control programs and reduce environmental pollution resulting from the complications of current synthetic pesticides.

Exploring the Effectiveness of Ajwain Cream in Treating Taxane-induced Peripheral Neuropathy in Cancer Patients: A Pilot, Randomised and Double-blind Clinical Trial.

Objectives: Chemotherapy-induced peripheral neuropathy is a common disorder among cancer patients receiving various chemotherapeutic protocols. The present study aimed to explore the feasibility of ajwain (Trachyspermum ammi [L.] Sprague) cream in treating peripheral neuropathy symptoms triggered by taxane chemotherapeutic agents. Materials and Methods: This was a pilot, double-blind, and randomised clinical trial on patients with peripheral neuropathy attributable to chemotherapy with taxane drugs during 2021-2022 in Tehran. Patients received ajwain or placebo cream for four weeks and filled out the chemotherapy-induced peripheral neuropathy assessment tool (CIPNAT) at the start and end finale of the trial. Side effects were also noted. Results: Thirty patients suffering from breast, lung, gastro-intestinal, or prostate cancer were allocated to each of the drug and placebo groups. The mean difference in CIPNAT score between the groups was 0.83, demonstrating the statistical ineffectiveness of the drug compared with the placebo (P = 0.372). The safety profile showed promising outcomes at the end of the trial. Conclusion: Although the effectiveness of ajwain cream was unacceptable in treating chemotherapy-induced peripheral neuropathy symptoms, multicentre controlled trials with ample sample size are mandatory for an all-inclusive inference.

Avicenna's clinical toxicology approach and beneficial materia medica against oral poisoning.

Considering the rich background of Persian Medicine in the use of materia medica for the treatment of diseases, the huge burden of oral poisonings in the world, and the urgent need to find scientific solutions, the purpose of this study was to determine Avicenna's approach toward clinical toxicology and his proposed treatments for oral poisonings. In Al-Qanun Fi Al-Tibb, Avicenna addressed the materia medica for the treatments of oral poisonings after explaining the ingestion of different toxins and also elucidating the clinical toxicology approach toward poisoned patients. These materia medica were from different classes including emetics, purgatives, enemas, diaphoretics, antidiarrheals, inhaled drugs, sternutators, anticoagulants, antiepileptics, antitussives, diuretics, cooling drugs, stimulants, cardiotonic drugs, and heating oils. By applying different therapies, Avicenna endeavored to attain main goals in clinical toxicology that are comparable with modern medicine. They included removing the toxins from the body, decreasing the severity of the deleterious effects of toxins on the body, and counteracting the effects of toxins inside the body. Aside from introducing different therapeutic agents that played an important role in the treatment of oral poisonings, he emphasized the ameliorating effects of nutritive foods and beverages. Further research using other Persian medical resources is recommended to elucidate the applicable approaches and treatments for different poisonings.

Fractional Exhalation Nitric Oxide (FeNO) changes in cystic fibrosis patients induced by compound honey syrup: a pretest-posttest clinical trial.

OBJECTIVE: To evaluate the effect of Persian medicine Syrup 'compound honey syrup (CHS)' on fractional exhalation nitric oxide (FENO) changes in patients with cystic fibrosis (CF). STUDY DESIGN: We conducted a before-after clinical trial on 70 CF patients. All patients received classical treatments for CF along with CHS (including honey, Ginger, cinnamon, saffron, cardamom and galangal), 5-10 cc (depending on the age and weight of patients) in 100 cc of warm boiled water twice a day, 30 min after meals. In this clinical trial, before and 12 weeks after the start of the CHS, FeNO test was evaluated. RESULTS: From 70 patients were enrolled, 44 patients completed this 12-week course of treatment. At the end of the study, changes in FeNO was significantly different before and after treatment (P-value < 0.05). At the end of the study, no dangerous side effects of CHS was reported. CONCLUSIONS: This study revealed that CHS can be effective as a complementary and safe drug in the medication of CF patients.

The historical course of varicose vein surgery in the Persian medicine.

INTRODUCTION: Dawali (varicose veins) is the disease of chronic dilation of veins. The veins of the legs become dilated and blue due to excessive accumulation of blood. This disease and the effort to identify and treat it has a very long history. The condition may have first been described in the Ebers Papyrus more than 3500 years ago. The present study deals with the turning points and progress of varicose vein surgery since ancient times, emphasizing the innovations of the scholars of the Islamic period. METHODS: The present study is based on searching library documents and database data such as PubMed, Scopus, Science Direct, and search engines such as Google Scholar. In the end, the Prisma flow chart was drawn. RESULTS: Besides diagnosing different varicose veins (legs, thighs, abdomen, uterus, and testes), the scholars of the Islamic period were well-versed in their prevention, etiology, and treatment. In treating varicose veins, these physicians used methods such as cleansing, phlebotomy, compression, leech therapy, and surgery, and some of them were the founders of new treatments. CONCLUSION: The surgical treatment of varicose veins in the past was similar to modern surgical therapies. What distinguishes yesterday's varicose vein surgery from today's surgery is a more advanced tool. There is no denying the remarkable progress in using health principles, treatment techniques, and surgical instruments to facilitate surgery and reduce the disease's complications and recurrence. However, the treatment framework and foundation, such as phlebectomy and compression, were all invented and introduced in the distant past.

Cauterization's history in the Persian medicine school.

BACKGROUND: Cauterization has been used in various medical schools to prevent and treat diseases. Its application dates back to shortly after the invention of fire. Despite its long history, different aspects and the importance of cauterization in various medical schools have remained elusive. The present study addressed the milestones and progress of cauterization from ancient times to the present, emphasizing the innovations of the Persian medicine school. METHODS: The present study is based on searching in the library documents of famous Persian medicine scholars and data from databases such as Ovid, PubMed, Science Direct, Scopus, ProQuest, and Google Scholar search engines. RESULTS: Persian Medicine scholars used various cauterization methods such as hot metals and corrosive drugs to stop bleeding, prevent the development and spread of infection, and treat hydrocephalus and rabies. Cauterization has been associated with considerations to prevent irreversible tissue damage and whether or not it is internal or external. CONCLUSION: Cauterization has been associated with different practical purposes. With evolutionary progress and the use of different techniques and tools throughout history, the tools such as Electrocautery or Galvanocautery are some manifestations of new applications of cauterization. Numerous studies have indicated the continuation of newer applications, indicating the inexhaustible human interest in this ancient technique.

Rhazes' (865-925 CE) contribution to surgery in Liber Almansoris.

BACKGROUND: Surgery has deep historical roots. Rhazes (865-925 CE), a Persian physician, made a significant contribution to the development of medical sciences in the medieval era. Liber Almansoris is one of his significant works on medicine. This book is a medical textbook for medical students. It covers every aspect of the medical sciences. This article discusses Rhazes' contribution to surgery, based on Liber Almansoris. METHOD: This study examines Rhazes' contribution to surgery, based on his book, Liber Almansoris. RESULTS: Rhazes's Liber Almansoris contains a chapter (seventh chapter) on orthopedics, which includes surgical approaches. This chapter also describes surgical procedures for traumas and skull fractures. In other chapters, he also recommends surgical options for treating certain complications when discussing different treatment methods. DISCUSSION: Although Rhazes mentioned surgical procedures as a medical treatment method, he did not include a separate chapter on surgery. This strategy can be found in his other medical works, such as Liber Continens or Al-Hawi. It appears that Rhazes adheres to the Galenic (Greek) perspective on surgery. In this context, surgery is not an independent major but a method that a physician can employ as needed. It differs from an alternative approach in that era that adheres to ancient Persian perspectives, which identified surgery as a major like other medical sciences disciplines.

The effect of oral use of concentrated pomegranate juice by mothers on hyperbilirubinemia in neonates under phototherapy: A randomized clinical trial.

Background: Hyperbilirubinemia is a common problem in neonates that causes hospitalization. The aim of this study was to investigate the effects of concentrated pomegranate juice (CPJ) consumption by breastfeeding mothers on neonatal hyperbilirubinemia. Materials and Methods: In this open-labeled, add-on, randomized clinical trial, 86 breastfeeding mothers and their neonates were allocated into two groups. In the control group, neonates received phototherapy. Besides neonates' phototherapy in the intervention group, their mothers received CPJ (1 tablespoon [15 g] three times a day) up to discharge. The bilirubin level was the primary outcome. The duration of phototherapy, the duration of hospital stay, and the need for exchange transfusions were secondary outcomes. Results: CPJ reduced the bilirubin level of hospitalized neonates within 48 h after consumption (P = 0.048, standard mean difference = 0.648). It also resulted in reduced duration of hospital stay and faster discharge of the neonates. Furthermore, in 48 h after discharge, bilirubin was significantly lower in the CPJ group (P = 0.003, partial eta squared = 0.123). Conclusion: Compared to the control group, consumption of CPJ by lactating mothers whose infants underwent phototherapy resulted in lower bilirubin levels, shorter hospital stay, and faster discharge.

Methodological issues on "Stakeholder attitudes to the regulation of traditional and complementary medicine professions: a systematic review".

Systematic reviews cling to the doctrine that science has an updating databank and attempt to identify all available evidence by featured eligibility criteria to find the answer to a unique scientific question. Therefore, to reach this aim, these researches should use a wise method and comprehensive search strategy, as they are widely used to guide clinical and political decisions and the establishment of future researches. We would like to appreciate Jenny Carè, Amie Steel, and Jon Wardle for the valuable article "Stakeholder attitudes to the regulation of traditional and complementary medicine professions: a systematic review". Some important missed search terms in the field of traditional medicine names and traditional and complementary medicine (T&CM) regulation concepts were discussed in the article.

Mansur ibn Ilyas Shirazi (1380-1422 AD), a pioneer of neuroanatomy.

History of anatomy is as long as the history of medicine itself. Development of this basic science was not possible without the dedicative effort of those physicians and scholars who were committed to discover the mysteries of human anatomy. In this regard, Iranian scholars played an important role in the development of the anatomical sciences despite the religious limitations in their societies. Mansur ibn Ilyas Shirazi is an Iranian physician of fourteenth century who wrote the first color illustrated anatomical book, Mansur's Anatomy. A considerable portion of the book has been dedicated to the central and peripheral nervous system so that he could be considered as one of the pioneers of neuroanatomy.

A randomized, double-blind placebo-controlled phase I clinical study on safety and efficacy of the G-Rup® syrup (a mixture of ginger extract and honey) in symptomatic treatment of knee osteoarthritis.

WHAT IS KNOWN AND OBJECTIVES: Present study evaluated the safety profile and efficacy of G-Rup® syrup (100 mg/ml ginger extract plus 150 mg/ml honey) in symptomatic treatment of knee osteoarthritis (OA). METHODS: Patients diagnosed with knee OA were randomly assigned (1:1) to receive either of a 30 ml twice daily regimen of G-Rup® syrup or placebo over a 12-week period. Primary endpoints of the study comprised of an improvement in the joint's stiffness, physical functioning and pain score, assessed by WOMAC questionnaire and the visual analog scale (VAS). Secondary objectives comprised of safety and tolerability of the syrup by patients. RESULTS AND DISCUSSION: The 30 ml twice-daily regimen of G-Rup® syrup was safe and well tolerated by patients. Moreover, in whole studied time points, treatment with G-Rup® syrup could significantly Power the VAS score (p < 0.001) whereas improving WOMAC total score (p < 0.001) and pain (p < 0.001), physical functioning (p < 0.001), and stiffness sub-scores (p = 0.006) compared to the placebo receiving group. WHAT IS NEW AND CONCLUSION: Based on obtained results, the G-Rup® syrup, composed of a combination of honey and ginger, may be a proper supplementary choice, along with routine therapeutic regimens, for improvement of symptomatic treatment of OA.

Protective effects of functional foods against Parkinson's disease: A narrative review on pharmacology, phytochemistry, and molecular mechanisms.

In Persian Medicine (PM), PD (brain-based tremor) is a known CNS disorder with several therapeutic and preventive options. In their medical textbooks and pharmacopeias, Persian great scientists such as Rhazes (854-925 AD), Avicenna (980-1037 AD), and Jorjani (1042-1136 AD), have discussed pharmacological and nutritional strategies for the prevention, slowing progression, and treatment of PD. In the present study, we surveyed plant- and animal-based foods recommended by PM for the prevention and treatment of CNS-related tremors. In vivo and in-vitro pharmacological evidence supporting the beneficial effects of PM-recommended foods in prevention and alleviating PD, major active phytochemicals along with the relevant mechanisms of action were studied. Several PM plants possess potent antioxidant, antiinflammatory, and PD preventing properties. Garlic and allicin, cabbage and isothiocyanates, chickpea seed and its O-methylated isoflavones biochanin A and formononetin, cinnamon, and cinnamaldehyde, saffron and its crocin, crocetin, and safranal, black cumin and its thymoquinone, black pepper and piperine, pistachio and genistein and daidzein, and resveratrol are among the most effective dietary itemsagainst PD. They act through attenuating neurotoxin-induced memory loss and behavioral impairment, oxidative stress, and dopaminergic cell death. PM-recommended foods can help alleviate PD progression and also discovering and developing new neuroprotective anti-PD pharmaceuticals.

Synergistic effects of Nepeta menthoides and Melissa officinalis aqueous extracts on reserpine-induced depressive-like behaviors in mice.

Nepeta menthoides Boiss. & Buhse and Melissa officinalis are extensively used in Persian medicine for the treatment of depression. Considering the active ingredients and main phenolic compounds of these plants and possible synergistic effects, this study examined the antidepressant and antioxidant activities of aqueous extract of N. menthoides (NM) and M. officinalis (MO) in reserpinized mice alone and combination. Mice were pretreated orally for 1-week with normal saline (10 ml/kg), fluoxetine (20 mg/kg), imipramine (10 mg/kg), NM (50-100-200-400 mg/kg), MO (150-350-550-750 mg/kg), and combination (NM 50 with MO 150 mg/kg). The behavioral changes were evaluated using forced swim, tail suspension, and open field tests, 24 hr after reserpine injection (4 mg/kg) on eighth day. The amounts of active components in the extracts and catalase (CAT) as a brain oxidative stress were measured with enzyme-linked immunosorbent assay. Data showed that this combination produced a synergistic action on behaviors and a significant increase in CAT activity. High-performance liquid chromatography results showed that rosmarinic acid contents in MO and NM were 6.42 ± 1.1 and 11.03 ± 2.16 mg/g of dried extract, respectively. Total flavonoid and phenolic contents of MO were higher than NM. The findings suggest that the present combination produces an antidepressant-like effect, which is possibly triggered by its antioxidant properties.

Efficacy of herbal treatments for functional dyspepsia: A systematic review and meta-analysis of randomized clinical trials.

Functional dyspepsia (FD) is a very common condition globally. Relevant keywords were searched for in title and abstract of selected databases, that is, Medline/PubMed, Scopus, Embase, Web of knowledge, and Google Scholar. Placebo and active-control trials on herbal remedies amongst adults who were diagnosed with FD were included. Dichotomous outcomes were presented as relative risk (RR) with 95% confidence interval (CI) and continuous outcomes were presented as pooled standardized mean difference (SMD) with 95% CI. Forty-nine randomized controlled trials (RCTs) were entered into meta-analysis (6,987 subjects). Herbal remedies resulted in a higher improvement in FD symptoms in comparison with the placebo (SMD = -0.58 [-0.66- -0.51], p < .00001 and RR = 1.73 [1.62-1.85], p < .00001). No significant difference between herbal remedies and placebo in the incidence of adverse events was observed (12.27 vs. 8.41%, RR = 1.06 [0.91-1.23], p = .45). Also, herbal remedies resulted in a higher improvement in quality of life in comparison with placebo (SMD = -0.64 [-0.73- -0.55], p < .00001). When comparing herbal remedies with conventional medicine through sensitivity analysis, no outcomes were significantly different (p > .05). Herbal remedies might be efficacious and safe in treating FD, and demonstrate comparable effect sizes for efficacy to conventional treatments. Further high-quality studies are warranted to firmly establish the clinical efficacy of the herbal remedies.