Jung Chao1
Chien-Yu Ko2Chin-Yu Lin3,4Maeda Tomoji5,4Chia-Hung Huang6Hung-Che Chiang7Jeng-Jer Yang8Shyh-Shyun Huang2,9*
Shan-Yu Su10,11*- 1Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
- 2School of Pharmacy, China Medical University, Taichung, Taiwan
- 3Institute of New Drug Development, China Medical University, Taichung, Taiwan
- 4Tsuzuki Institute for Traditional Medicine, China Medical University, Taichung, Taiwan
- 5Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan
- 6Department of Pharmacy, Kinmen Hospital, Kinmen, Taiwan
- 7College of Medicine, China Medical University, Taichung, Taiwan
- 8Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
- 9Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
- 10Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- 11School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
Natural medicinal materials have been used to promote breast milk secretion. Here, we investigated the natural medicinal materials prescribed in traditional Chinese medicine (TCM) pharmacies across Taiwan to induce lactation. We collected medicinal materials from 87 TCM pharmacies, identified them in the prescriptions, and analyzed their drug contents. We examined their botanical origins, biological classifications, traditional usage, and modern pharmacological properties. We used the TCM Inheritance Support System to identify core medicinal materials in galactogenous prescriptions. We collected 81 medicinal materials from 90 galactogenous prescriptions. Leguminosae accounted for 12%, whereas Apiaceae accounted for 7% of all materials examined. The primary medicinal plant parts used were roots and seeds. Nineteen frequently used medicinal materials had a relative frequency of citation of greater than or equal to 0.2. According to their efficacy, 58% were warm, 54% were sweet, and 63% were tonifying; 74% of the frequently used medicinal materials have been showed efficacy against breast cancer. The primary core medicinal material was Angelica sinensis (Oliv.) Diels, whereas the secondary core medicinal materials were Tetrapanax papyrifer (Hook.) K. Koch and Hedysarum polybotrys Hand.-Mazz. Most galactogenous prescriptions consisted of multiple materials from Leguminosae and Apiaceae. The mechanisms underlying galactogenous efficacy warrant further investigations.
Introduction
Breast milk is rich in proteins, lipids, carbohydrates, vitamins, and minerals, making it the optimum nutrient source for infant growth and development (Suzuki et al., 1972). Breastfeeding prevents the death of approximately 823,000 children aged less than 5 years annually. Moreover, the incidence of breast and ovarian cancers in women who breastfed their children is 7% and 35% lower than those who never breastfed, respectively (Victora et al., 2016). Therefore, the World Health Organization (WHO) and the American Academy of Pediatrics recommend that infants under 6 months of age should be exclusively breastfed (Eidelman, 2012; World Health Organization, 2017). However, the subsequent investigations have revealed that only 40% of all infants worldwide are exclusively breastfed (World Health Organization, 2020). Hence, the WHO set a target to increase the exclusive breastfeeding rate within the first 6 months by more than 50% by 2025 (World Health Organization, 2013).
Insufficient post-delivery milk secretion is due to the fact that many women cannot exclusively breastfeed their newborns. A US survey showed that 76% of all mothers do not produce sufficient breast milk to meet the nutritional requirements of their babies (Bazzano et al., 2017). Galactagogues are used to increase breast milk secretion in mothers who intend to breastfeed their newborns exclusively. The two primary categories of galactagogues are pharmaceutical agents and herbs. In Western medicine, galactogenous pharmaceutical agents with a high efficacy, such as metoclopramide, domperidone, and chlorpromazine, are widely used as galactagogues (Foong et al., 2020). Furthermore, herbs have been used to promote lactation in various parts of the world (Mortel and Mehta, 2013; Özalkaya et al., 2018). These medicinal materials significantly vary among regions, customs, and religious traditions. Medicinal plant materials that are most frequently used as natural galactagogues include Trigonella foenum-graecum L. (fenugreek) and Foeniculum vulgare Mill. (fennel), which are used in the United States, Australia, and China to promote milk production (Supplementary Table S1).
The “doing-the-month (one-month puerperal care)” custom is practiced in several countries that have a Chinese population (Liu Y. Q. et al., 2015), including Taiwan. In this custom, medicinal materials are routinely used to enhance physical recovery and increase milk secretion in puerperal mothers (Chen and Wang, 2000; Chuang et al., 2009; Tsai and Wang, 2019). This custom may account for the higher proportion of exclusively breastfed infants (46.3%) than the average for other parts of the world (Ministry of Health and Welfare, 2020). Moreover, the proportion of Taiwanese women with self-perceived milk insufficiency (nearly 50%) is lower than that reported for mothers in other parts of the world (Su, 2012). According to a previous survey, approximately 80% of all Chinese herbal medicines used by Taiwanese women during their puerperal period were purchased from traditional Chinese medicine (TCM) pharmacies (Ho et al., 2011). TCM pharmacies provide TCM formulae in various dosage forms including pills, powders, paste, pellets, and decoction pieces, and preserve the original forms of a TCM (Pharmaceutical Affairs Act, 2018). Most TCMs consumed by Taiwanese women following delivery are in the form of decoction pieces (Ho et al., 2011). Hence, in the present study, we selected TCM pharmacies as the primary investigation sites to clarify the current use of Chinese herbal galactogenous prescriptions by Taiwanese women.
In Taiwan, although “galactogenous prescriptions” may be procured from most TCM pharmacies, the prescriptions differ among TCM pharmacies in medicinal materials. To date, no study has investigated the types and combinations of medicinal materials in galactogenous prescriptions. Thus, the aims of this study were as follows: to 1) explore the compositions of galactogenous prescriptions sold in TCM pharmacies, 2) systematically analyze them, 3) identify their core components, and 4) elucidate the principles and preparation methods of TCM that are used to promote lactation in post-delivery Taiwanese women.
Materials and Methods
Ethical Review
This research was conducted from July 2019 to May 2020 and was reviewed and approved by the China Medical University & Hospital Research Ethics Center (No. CRREC-108-026) (Supplementary Figure S1).
Research Process
The research methods are summarized in the research flow chart (Figure 1). This study involved field investigation, medicinal material identification, and medicinal material analysis.
Figure 1. Research flowchart.
Field Investigation
Taiwan is an island in East Asia located at 21°45′–25°56′N and 119°18′–124°34′E, covering an area of 35,886.8623 km2. The Tropic of Cancer passes through it, and its climate is Humid Subtropical according to the Köppen Classification. This study lasted 12 months, from May 2019 to April 2020. Eighty-seven TCM pharmacies providing galactogenous prescriptions were visited (Figure 2). The relative numbers of pharmacies visited were proportional to the population ratio of each city and county. The outlets were located via online searches and various organizations associated with medicinal plants. Ninety galactogenous prescriptions were obtained. The TCM pharmacies investigated were distributed across northern, central, southern, and eastern Taiwan. As the Taiwanese population density is uneven, comparatively more samples were collected in the western part of the island. Each area where a TCM pharmacy was located had its own characteristic demographics, planting patterns, Chinese herbal medicine distribution, economic development level, and geography (Supplementary Table S2).
Figure 2. Geographical distribution of stores in Taiwan where galactogenous prescriptions were purchased.
Analysis of Medicinal Materials
All investigated medicinal materials were analyzed in terms of taxonomy, relative frequency of citation (RFC), inclusion status in each pharmacopoeia, modern pharmacological research related to application in women, and efficacy in traditional medicine.
Taxonomy comprised the scientific, kingdom, and family names and utilized parts. The information was derived from The Plant List (The Royal Botanic Gardens, 2013). Medicinal materials with an RFC of greater than or equal to 0.2 were defined as frequently used medicinal materials. RFC was calculated as follows (Ahmad et al., 2017):
For the inclusion status of the medicinal materials in the pharmacopoeia, the Third Edition of the Taiwan Herbal Pharmacopeia (Chen, 2018), the Pharmacopoeia of the People’s Republic of China (Chinese Pharmacopoeia Commission, 2020), and the Chinese Materia Medica (State Administration of TCM, 1999) were verified. Modern pharmacological studies related to women were searched and identified using PubMed by entering the scientific names of the medicinal materials as keywords and setting the sex as female and the inquiry period as 1992–2020. The traditional efficacy, property, and flavor of the medicinal materials were cited according to the records in the Taiwan Herbal Pharmacopeia, the Pharmacopoeia of the People’s Republic of China, and the Chinese Materia Medica.
The TCM Inheritance Support System (TCMISS) v. 2.5 conducted the network, composition, and correlation analyses. This system was designed to mine core Chinese material medica (CCMM) and visualize correlations based on nodes and links. The same materials may have different names; hence, the nomenclature was standardized for data input (Wu et al., 2020). With respect to composition setting for the network analysis, the frequency of occurrence of a medicinal material increased with a decrease in distance from the center of the network diagram. Thus, medicinal materials nearest to the center served as references to determine the core components of galactogenous prescriptions. When two medicinal materials co-occurred more than 41 times in the composition setting for the network analysis, they were considered as a high-frequency drug pair. Application frequency and confidence score were set, and the former was calculated as follows:
In the correlation analysis, when two different medicinal materials co-appeared more than 18 times, they were considered to be correlated and were connected by a line in the network diagram. The correlation analysis diagram was associated with the confidence level, which indicates the probability that a medicinal material co-occurs with another one. When the TCMISS was used to analyze the correlation among the medicinal materials used, the confidence was set to unity; in this way, medicinal materials that co-occurred with others were identified (Tang et al., 2019; Wu et al., 2019).
Results
Types and Taxonomic Characteristics of Galactogenous Prescriptions
Eighty-seven TCM pharmacies were visited in various cities and counties in Taiwan and 90 galactogenous prescriptions were purchased (Supplementary Figure S2); 81 medicinal materials were identified (Supplementary Table S3). Seventy-eight medicinal materials were plant based (95%), two were animal derived (4%), and one was a fungus (1%). Angelica sinensis (Oliv.) Diels was the most frequently used medicinal material (93%), followed by Tetrapanax papyrifer (Hook.) K. Koch (86%). Leguminosae members (12%) were the most frequently used, followed by Apiaceae members (7%). The roots (radix) were the most frequently utilized plant parts (33%), followed by the seeds (15%; Figure 3).
Figure 3. Taxonomy of 81 medicinal materials in 90 galactogenous prescriptions. (A) Kingdoms, (B) families, and (C) utilized parts. Parts collectively used less than 1% are summarized as “others.”
Traditional Efficacy and Modern Pharmacological Analyses of Medicinal Materials Frequently Used in Galactogenous Prescriptions
The RFC of 0.2 was set as the cutoff for frequently used medicinal materials, and accordingly, 19 medicinal materialswere identified among the 81 medicinal materials (Table 1). To understand the efficacy of medicinal materials in traditional medicine and the modern pharmacology of Chinese herbal medicine in promoting lactation, we analyzed the property, flavor, efficacy, and modern pharmacology research of these frequently used medicinal materials in women (Figure 4A).
TABLE 1. Medicinal properties of materials frequently used in galactogenous prescriptions (RFC ≥ 0.2) and modern pharmacological research on their applications for women.
Figure 4. Characteristics of 19 medicinal materials with an RFC of greater than or equal to 0.2 in galactogenous prescriptions. (A) Selection of frequently used medicinal materials. (B) Radar chart of properties. (C) Radar chart of flavors. (D) Histogram of traditional efficacy classifications. (E) Modern pharmacological research related to women. RFC, relative frequency of citation; AB, Achyranthes bidentata Blume; ADa, Angelica dahurica (Hoffm.) Benth. and Hook. f. ex Franch. and Sav.; ADi, Araiostegia divaricata (Blume) M. Kato; AM, Atractylodes macrocephala Koidz.; AP, Astragalus propinquus Schischkin; AS, Angelica sinensis (Oliv.) Diels; BC, Bupleurum chinense DC.; CAu, Cuscuta australis R. Br.; CB, Cibotium barometz (L.) J. Sm.; CCC, Cinnamomum cassia (L.) J. Presl (cortex); CCR, Cinnamomum cassia (L.) J. Presl (ramulus); CM, Clematis montana Buch.-Ham. ex DC.; CNC, Cervus nippon Temminck (cornupantotrichum); CPil: Codonopsis pilosula (Franch.) Nannf.; CRe: Citrus reticulata Blanco; CS, Chaenomeles speciosa (Sweet) Nakai; DI, Dipsacus inermis Wall.; DL, Dimocarpus longan Lour.; DO, Dioscorea oppositifolia L.; EU: Eucommia ulmoides Oliv.; FV, Foeniculum vulgare Mill.; GMB, Glycine max (L.) Merr. (black); GU, Glycyrrhiza uralensis Fisch.; HP, Hedysarum polybotrys Hand.-Mazz.; LCh, Lycium chinense Mill.; LF, Liquidambar formosana Hance; LS, Ligusticum striatum DC.; MM, Melastoma malabathricum L.; MO, Morinda officinalis F.C.How; NNSe, Nelumbo nucifera Gaertn. (Semen); OI, Oroxylum indicum (L.) Kurz; OJ, Ophiopogon japonicus (Thunb.) Ker Gawl.; PCo, Poria cocos (Schwein.) F.A. Wolf; PCy, Polygonatum cyrtonema Hua; PGr, Platycodon grandiflorus (Jacq.) A. DC.; PLW, Paeonia lactiflora Pall. (white); PM, Pueraria montana var. lobata (Willd.) Sanjappa & Pradeep; PO, Polygonatum odoratum (Mill.) Druce; PQ, Panaxquin quefolius L.; RGC, Rehmannia glutinosa (Gaertn.) DC. (cooked); RM, Reynoutria multiflora (Thunb.) Moldenke; SF, Strobilanthes forrestii Diels; SM, Salvia miltiorrhiza Bunge; TK, Trichosanthes kirilowii Maxim.; TP, Tetrapanax papyrifer (Hook.) K. Koch; VH, Vaccaria hispanica (Mill.) Rauschert; ZJB, Ziziphus jujuba Mill. (black); ZJR, Ziziphus jujuba Mill. (red).
The medicinal materials frequently used in galactogenous prescriptions are warm (58%) and plain (26%) in terms of property (Figure 4B). Regarding flavor, most of the medicinal materials used were sweet (54%) (Figure 4C). With respect to traditional medicine efficacy, most of these medicinal materials were tonics (63%) (Figure 4D). With respect to modern pharmacological effects related to women, the related studies have most frequently investigated anticancer efficacy. Fourteen medicinal materials (74%) among those with an RFC greater than or equal to 0.2 have been reported to be effective against breast cancer, whereas nine (47%) were effective against gynecological (cervical, ovarian, and uterine) cancers (Figure 4E).
Analysis of High-Frequency Drug Pairs and Core Medicinal Materials
A TCMISS analysis disclosed 18 high-frequency drug pairs (Supplementary Table S4) and 2 medicinal materials that co-occurred more than 41 times including A. sinensis, T. papyrifer, Hedysarum polybotrys Hand.-Mazz., Lycium chinense Mill., Glycyrrhiza uralensis Fisch., Ligusticum striatum DC., Ziziphus jujuba Mill., Vaccaria hispanica (Mill.) Rauschert, Codonopsis pilosula (Franch.) Nannf., and Rehmannia glutinosa (Gaertn.) DC. The most frequently used drug pairs were A. sinensis plus T. papyrifer (frequency = 71) and A. sinensis plus H. polybotrys (frequency = 69).
A network analysis of the core components of the galactogenous prescriptions was conducted on medicinal materials with an RFC of greater than or equal to 0.2 (Figure 5). The top core medicinal materials were A. sinensis, followed by T. papyrifer and H. polybotrys. They were often co-prescribed with L. chinense, G. uralensis, L. striatum, Z. jujuba, V. hispanica, C. pilosula, R. glutinosa, Paeonia lactiflora Pall., and Melastoma malabathricum L. In certain prescriptions, Atractylodes macrocephala Koidz., Chaenomeles speciosa (Sweet) Nakai, Cinnamomum cassia (L.) J. Presl, Eucommia ulmoides Oliv., Poria cocos (Schwein.) F.A. Wolf, Z. jujuba, and Dimocarpus longan Lour. were added. These combinations may serve as a reference for a galactogenous prescription composition.
Figure 5. Network diagram representing the analysis of the core components in galactogenous prescriptions. AM, Atractylodes macrocephala Koidz.; AS, Angelica sinensis (Oliv.) Diels; CCR, Cinnamomum cassia (L.) J. Presl (ramulus); CPil, Codonopsis pilosula (Franch.) Nannf.; CS, Chaenomeles speciosa (Sweet) Nakai; DL, Dimocarpus longan Lour.; EU, Eucommia ulmoides Oliv.; GU, Glycyrrhiza uralensis Fisch.; HP, Hedysarum polybotrys Hand.-Mazz.; LCh, Lycium chinense Mill.; LS, Ligusticum striatum DC.; MM, Melastoma malabathricum L.; PCo, Poria cocos (Schwein.) F.A. Wolf; PLW, Paeonia lactiflora Pall. (white); RGC, Rehmannia glutinosa (Gaertn.) DC. (cooked); TP, Tetrapanax papyrifer (Hook.) K. Koch; VH, Vaccaria hispanica (Mill.) Rauschert; ZJB, Ziziphus jujuba Mill. (black); ZJR, Ziziphus jujuba Mill. (red).
A causality analysis of the occurrence of various medicinal materials in the galactogenous prescriptions was conducted based on association rules (Supplementary Table S5). The confidence score was set to unity. Angelica sinensis, T. papyrifer, H. polybotrys, and L. chinense were often combined with L. striatum, P. lactiflora, C. pilosula, C. cassia, V. hispanica, G. uralensis, Z. jujuba, A. macrocephala, E. ulmoides, and R. glutinosa.
Discussion
Field Investigation Sites
In the present study, a field investigation was conducted to explore the galactogenous prescriptions sold in TCM pharmacies across Taiwan to reflect the views and behaviors of some individuals over a certain period. Field investigations are especially practical for sociological, geographical, and cultural studies (Hirsch and Stewart, 2005), and are used to examine medications administered for certain diseases in certain realms of ethnopharmacological research. Field investigations related to herbal medicines have been performed to explore the composition of herbal teas (Huang et al., 2020), herbal medicines used to treat malaria (Odoh et al., 2018), and regional herbal medicines prescribed to expel parasites (Bajin Ba Ndob et al., 2016).
The “TCM pharmacies” in Taiwan are important for preserving TCM culture. In early agricultural societies, Western medicine was underdeveloped and medical resources were inadequate; TCM pharmacies provided medical care. During the period when the Japanese occupied Taiwan (1895), purveyors of TCMs were called “TCM merchants” or “medicinal material merchants” (Chang, 1995), whereas today, they are generally called “TCM merchants” or “TCM pharmacists” (Legislative Yuan, 2000). Under the Japanese medical care administrative measures in Taiwan, “an attitude of abandoning traditional Chinese medical care but retaining traditional Chinese medications” was adopted and medicine merchants were not strictly regulated (Ministry of Science and Technology, 2017). Therefore, TCM pharmacies in Taiwanese society are continued as the “traditional Chinese pharmaceutical industry” and provide both medical care and health maintenance. The TCM pharmacies provide Chinese medicinal materials based on customer requirements. They also furnish traditional dosage forms including pills, powder, paste, and decoction pieces prepared according to the fixed formulae (Pharmaceutical Affairs Act, 2018). The medical insurance of the Taiwanese Government covers only extracted granules of Chinese medicinal medica. Consequently, many consumers and TCM practitioners are unfamiliar with Chinese medicinal materials. The TCM pharmacies visited in the present study focused primarily on decoction pieces. Thus, it was ascertained that the techniques used to prepare TCM decoction pieces have been preserved by the TCM pharmacies in Taiwan. The results of the current investigation reflect the current prescription status of Chinese herbal decoction pieces for promoting lactation in Taiwanese women.
Types and Taxonomic Traits of Medicinal Materials in Galactogenous Prescriptions Sold in TCM Pharmacies Across Taiwan
Members of Leguminosae were the most frequently used medicinal materials in the galactogenous prescriptions across Taiwan, including Z. jujuba and G. uralensis, followed by Apiaceae members such as A. sinensis and L. striatum. Flavones are abundant in both Leguminosae and Apiaceae members. Some of these natural plant products are phytoestrogens, indicating that their effects are similar to those of estrogen (Badgujar et al., 2014; Mercer et al., 2020), which can induce mammary epithelial cell (MECS) proliferation in lactating women and promote milk secretion (Setchell, 2001; Tsugami et al., 2017; Tsugami et al., 2020).
Milk generation is closely associated with serum estrogen, progesterone, and prolactin levels. Estrogen and progesterone stimulate mammary gland growth and development in pregnancy. Following delivery, the serum prolactin level increases, and this in turn substantially increases milk production. Thyroid hormone, insulin, low estrogen level, and progesterone promote pituitary prolactin secretion. In contrast, dopamine, high estrogen level, and progesterone inhibit pituitary prolactin secretion (Peña and Rosenfeld, 2001; Silva et al., 2020).
In various regions of the world, several herbs are used to promote lactation, with T. foenum-graecum L. and F. vulgare Mill being the most common (Forinash et al., 2012; Mortel and Mehta, 2013; Sim et al., 2013; Sim et al., 2014; Sim et al., 2015; Bazzano et al., 2016; Javan et al., 2017; Zheng et al., 2020). The origin of the two herbs resembles those indicated in the present study. Trigonella foenum-graecum, similar to H. polybotrys and G. uralensis, is a member of Leguminosae. Pharmacological studies have reported that phytoestrogens that are abundant in T. foenum-graecum, promote mammary gland growth, increase prolactin secretion, and stimulate milk production via antagonizing dopamine receptors (Foong et al., 2020). Foeniculum vulgare, similar to A. sinensis and L. striatum, is a member of Apiaceae. Trans-anethole in F. vulgare competes with dopamine for its receptors, blocks the inhibitory effect of dopamine on prolactin, and indirectly stimulates prolactin biosynthesis (Javan et al., 2017; Foong et al., 2020).
Efficacy Analysis
TCM classifies medicinal materials according to their property and flavor. Their property include hot, warm, plain, cool, and cold. Hot and warm are opposites of cool and cold. Moreover, the degree of medicinal effects differs between warm and hot and between cool and cold materials (Zhang et al., 2020). Previous studies have reported that hot and warm traditional Chinese medicinal materials regulate the human endocrine system (Liang et al., 2013). Among the 19 medicinal materials identified in the galactogenous prescriptions collected here, 58% were warm. In general, warm medicinal materials have been widely used to increase milk secretion and their modes of action maybe associated with the endocrine system. The flavors of material medicines include sour, bitter, sweet, pungent, salty, plain, and astringent. Most sweet medicinal materials are tonics. TCM theory states that sweet medicinal materials are supplementing, moderating, and harmonizing (He et al., 2012). Here, sweet medicinal materials accounted for 54% of the 19 medicinal materials in the galactogenous prescriptions. These findings of the present study are consistent with the TCM theory.
Analysis of the Core Medicinal Materials in the Prescriptions
Angelica sinensis, H. polybotrys, and T. papyrifer were the core components in the galactogenous prescriptions. Angelica sinensis has been prescribed to enrich the blood, whereas H. polybotrys has been administered to nourish the qi (Chang et al., 2020). Previous pharmacological studies on Chinese herbal medicines have reported that A. sinensis, L. striatum, R. glutinosa, and Astragalus propinquus Schischkin are used to treat anemia and enrich hemoglobin (Liang et al., 2004; Li et al., 2012; Jia et al., 2019; Liu J. et al., 2019). In the present study, all four medicinal materials were found to be frequently used. The secretion and nutritional value of milk are reduced in breastfeeding women with anemia (França et al., 2013). The mechanism by which galactogenous prescriptions enhance milk production may be associated with collaborative hemoglobin promotion by A. sinensis, L. striatum, R. glutinosa, and A. propinquus. As the flavor and function of H. polybotrys are similar to those of A. propinquus, the former is often used as a substitute for the latter and has become more popular in Taiwan (Lu et al., 2007). Most prescriptions obtained in this field investigation contained H. polybotrys (74%), whereas only 12% had A. propinquus, indicating that the application of H. polybotrys is common. T. papyrifer may dredge milk ducts. Approximately 77.3% of all lactating women with insufficient milk production used T. papyrifer; 25.6% of all users believed it could increase lactation and alleviate breast pain (Zheng et al., 2020). T. papyrifermayinhibit inflammation and relieve breast pain associated with mastitis (Sugishita et al., 1983; Xu et al., 2016).
Limitations and Future Works
This study had certain limitations that should be addressed in future research. The network diagram created with the TCMISS did not discriminate the frequency of application among medicinal materials. The demarcating line between pairs of medicinal materials only showed that they appeared more than 18 times. However, the frequency of application could not be further compared. Hence, a second chart must be plotted to better display the relationships among the medicinal materials examined here. Moreover, although numerous medicinal materials promoting lactation were collected in the present study, limited studies have explored or reported their modes of action. Furthermore, it remains unknown whether these materials induce adverse reactions in lactating women or their babies. Hence, the mechanisms underlying milk secretion/stimulation and the associated adverse effects of these medicinal materials merit further investigation. Furthermore, clinical trials are also needed to be verify their efficacies in future work.
Conclusion
To the best of our knowledge, this study is the first ethnobotanical investigation of galactogenous prescriptions in Taiwan with the aim to assess the current status of TCM material prescribed and used to promote lactation. We generated valuable and comprehensive data on the galactogenous medicinal materials currently administered in Taiwan. The information compiled here will help preserve local knowledge regarding galactogenous medicinal materials in Taiwan and promote their prescription. Although galactogenous prescriptions have been used generally by Taiwanese lactating women, their function, efficacy, and safety warrant further investigation.
Data Availability Statement
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation, to any qualified researcher.
Author Contributions
JC and C-YK performed the field investigation and organized and analyzed the database. S-SH identified the botanical materials. JC drafted the manuscript. C-YL, TM, C-HH, and H-CC revised the manuscript and contributed to discussions on it. S-SH and S-YS provided guidance for the project and supervised the experiment and manuscript review.
Funding
This research was funded by the Tsuzuki Institute for Traditional Medicine, grant number 108727B8; China Medical University, grant numbers CMU106-N-24, CMU107-N-33, CMU108-N-22, and CMU-108-MF-116; the Ministry of Science and Technology, grant number MOST 107-2320-B-039-030-MY3; The China Medical University under the Higher Education Sprout Project and Teaching Practice Research Program, grant number 1077170A, of the Ministry of Education of Taiwan; and the Ministry of Health and Welfare, grant numbers M07G1358 and M08G1211.
Conflict of Interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Acknowledgments
The authors are grateful to the herbarium of China Medical University for providing us a space for storing the medicinal materials of this study.
Supplementary Material
The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fphar.2020.625869/full#supplementary-material.
References
Ahmad, K. S., Hamid, A., Nawaz, F., Hameed, M., Ahmad, F., Deng, J., et al. (2017). Ethnopharmacological studies of indigenous plants in Kel village, Neelum valley, Azad Kashmir, Pakistan. J. Ethnobiol. Ethnomed. 13, 68. doi:10.1186/s13002-017-0196-1
Amagase, H., and Nance, D. M. (2011). Lycium barbarum increases caloric expenditure and decreases waist circumference in healthy overweight men and women: pilot study. J. Am. Coll. Nutr. 30, 304–309. doi:10.1080/07315724.2011.10719973
Arentz, S., Abbott, J. A., Smith, C. A., and Bensoussan, A. (2014). Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism; a review of the laboratory evidence for effects with corroborative clinical findings. BMC Compl. Alternative Med. 14, 511. doi:10.1186/1472-6882-14-511
Arentz, S., Smith, C. A., Abbott, J., Fahey, P., Cheema, B. S., and Bensoussan, A. (2017). Combined lifestyle and herbal medicine in overweight women with polycystic ovary syndrome (PCOS): a randomized controlled trial. Phytother Res. 31, 1330–1340. doi:10.1002/ptr.5858
Badgujar, S. B., Patel, V. V., and Bandivdekar, A. H. (2014). Foeniculum vulgare Mill: a review of its botany, phytochemistry, pharmacology, contemporary application, and toxicology. BioMed Res. Int. 2014, 842674. doi:10.1155/2014/842674
Bajin Ba Ndob, I., Mengome, L. E., Bourobou Bourobou, H. P., Lossangoye Banfora, Y., and Bivigou, F. (2016). Ethnobotanical survey of medicinal plants used as anthelmintic remedies in Gabon. J. Ethnopharmacol. 191, 360–371. doi:10.1016/j.jep.2016.06.026
Bazzano, A. N., Cenac, L., Brandt, A. J., Barnett, J., Thibeau, S., and Theall, K. P. (2017). Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study. Int. J. Womens Health 9, 105–113. doi:10.2147/IJWH.S128517
Bazzano, A. N., Littrell, L., Brandt, A., Thibeau, S., Thriemer, K., and Theall, K. P. (2016). Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey. J. Multidiscip. Healthc. 9, 623–630. doi:10.2147/JMDH.S121788
Bourdy, G., and Walter, A. (1992). Maternity and medicinal plants in Vanuatu. I. The cycle of reproduction. J. Ethnopharmacol. 37, 179–196. doi:10.1016/0378-8741(92)90033-n
Buntuchai, G., Pavadhgul, P., Kittipichai, W., and Satheannoppakao, W. (2017). Traditional galactagogue foods and their connection to human milk volume in Thai breastfeeding mothers. J. Hum. Lactation 33, 552–559. doi:10.1177/0890334417709432
Cao, W., Li, X. Q., Wang, X., Fan, H. T., Zhang, X. N., Hou, Y., et al. (2010). A novel polysaccharide, isolated from Angelica sinensis (Oliv.) Diels induces the apoptosis of cervical cancer HeLa cells through an intrinsic apoptotic pathway. Phytomedicine 17, 598–605. doi:10.1016/j.phymed.2009.12.014
Chang, C. W., Chen, Y. M., Hsu, Y. J., Huang, C. C., Wu, Y. T., and Hsu, M. C. (2016). Protective effects of the roots of Angelica sinensis on strenuous exercise-induced sports anemia in rats. J. Ethnopharmacol. 193, 169–178. doi:10.1016/j.jep.2016.08.010
Chang, P.-Y. (1995). History of public health development in Taiwan. Taipei, Taiwan: Ministry Health and Welfare.
Chang, W. C., Yen, C. C., Cheng, C. P., Wu, Y. T., and Hsu, M. C. (2020). Chinese herbal decoction (DangguiBuxue Tang) supplementation augments physical performance and facilitates physiological adaptations in swimming rats. Pharm. Biol. 58, 545–552. doi:10.1080/13880209.2020.1774622
Chao, S. L., Huang, L. W., and Yen, H. R. (2003). Pregnancy in premature ovarian failure after therapy using Chinese herbal medicine. Chang Gung Med. J. 26, 449–452.
Chen, L.-L., and Wang, C.-C. (2000). Attitude and behavior towards postpartum recuperation in TCM. Nurs. Res. 8, 49–58. doi:10.7081/NR.200002.0049
Chen, S.-C. (2018). Taiwan herbal Pharmacopeia. 3rd Edn. Taipei, Taiwan: Ministry Health and Welfare.
Chen, W. D., Huang, H. S., Su, Y. C., Chou, S. C., Ho, W. C., Kao, M. C., et al. (2018). The characteristics and prescription patterns of Chinese herbal medicine in clinical practice for the treatment of anemia Taiwan. J. Obstet. Gynecol. 57, 570–577. doi:10.1016/j.tjog.2018.06.030
Cheng, Y., Chu, Y., Su, X., Zhang, K., Zhang, Y., Wang, Z., et al. (2018). Pharmacokinetic-pharmacodynamic modeling to study the anti-dysmenorrhea effect of Guizhi Fuling capsule on primary dysmenorrhea rats. Phytomedicine 48, 141–151. doi:10.1016/j.phymed.2018.04.041
Chinese Pharmacopoeia Commission (2020). Pharmacopoeia of the People’s Republic of China. 11th Edn. Beijing, China: China Medical Science Press.
Chuang, C. H., Chang, P. J., Hsieh, W. S., Tsai, Y. J., Lin, S. J., and Chen, P. C. (2009). Chinese herbal medicine use in Taiwan during pregnancy and the postpartum period: a population-based cohort study. Int. J. Nurs. Stud. 46, 787–795. doi:10.1016/j.ijnurstu.2008.12.015
de Souza Zanchet, M. Z., Nardi, G. M., de Oliveira Souza Bratti, L., Filippin-Monteiro, F. B., and Locatelli, C. (2017). Lycium barbarum reduces abdominal fat and improves lipid profile and antioxidant status in patients with metabolic syndrome. Oxid. Med. Cell. Longev. 2017, 9763210. doi:10.1155/2017/9763210
Du, H., Feng, Q., Yang, X., Xu, R., Li, H., Dong, X., et al. (2014). ‘Whole Chinese angelica’ microemulsion: its preparation and in vivo and in vitro evaluations. Drug Dev. Ind. Pharm. 40, 1330–1339. doi:10.3109/03639045.2013.819881
Eidelman, A. I. (2012). Breastfeeding and the use of human milk: an analysis of the American Academy of Pediatrics 2012 breastfeeding policy statement. Breastfeed. Med. 7, 323–324. doi:10.1089/bfm.2012.0067
Foong, S. C., Tan, M. L., Foong, W. C., Marasco, L. A., Ho, J. J., and Ong, J. H. (2020). Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants. Cochrane Database Syst. Rev. 5, CD011505. doi:10.1002/14651858.CD011505.pub2
Forinash, A. B., Yancey, A. M., Barnes, K. N., and Myles, T. D. (2012). The use of galactogogues in the breastfeeding mother. Ann. Pharmacother. 46, 1392–1404. doi:10.1345/aph.1R167
França, E. L., Silva, V. A., Volpato, R. M., Silva, P. A., Brune, M. F., and Honorio-França, A. C. (2013). Maternal anemia induces changes in immunological and nutritional components of breast milk. J. Matern. Fetal Neonatal Med. 26, 1223–1227. doi:10.3109/14767058.2013.776529
Fu, J., Ke, X., Tan, S., Liu, T., Wang, S., Ma, J., et al. (2016). The natural compound codonolactone attenuates TGF-β1-mediated epithelial-to-mesenchymal transition and motility of breast cancer cells. Oncol. Rep. 35, 117–126. doi:10.3892/or.2015.4394
Georgiev, K. D., Slavov, I. J., and Iliev, I. A. (2019). Antioxidant activity and antiproliferative effects of Lycium barbarum’s (goji berry) fractions on breast cancer cell lines. Folia Med. 61, 104–112. doi:10.2478/folmed-2018-0053
Gong, A. G., Lau, K. M., Xu, M. L., Lin, H. Q., Dong, T. T., Zheng, K. Y., et al. (2016). The estrogenic properties of DangguiBuxue Tang, a Chinese herbal decoction, are triggered predominantly by calycosin in MCF-7 cells. J. Ethnopharmacol. 189, 81–89. doi:10.1016/j.jep.2016.05.035
Gong, W., Zhang, N., Cheng, G., Zhang, Q., He, Y., Shen, Y., et al. (2019). Rehmannia glutinosa libosch extracts prevent bone loss and architectural deterioration and enhance osteoblastic bone formation by regulating the IGF-1/PI3K/mTOR pathway in streptozotocin-induced diabetic rats. Int. J. Mol. Sci. 20, 3964. doi:10.3390/ijms20163964
Hajirahimkhan, A., Simmler, C., Dong, H., Lantvit, D. D., Li, G., Chen, S. N., et al. (2015). Induction of NAD(P)H:quinone oxidoreductase 1 (NQO1) by Glycyrrhiza species used for women’s health: differential effects of the Michael acceptors isoliquiritigenin and licochalcone. A. Chem. Res. Toxicol. 28, 2130–2141. doi:10.1021/acs.chemrestox.5b00310
Hajirahimkhan, A., Simmler, C., Yuan, Y., Anderson, J. R., Chen, S. N., Nikolić, D., et al. (2013). Evaluation of estrogenic activity of licorice species in comparison with hops used in botanicals for menopausal symptoms. PloS One 8, e67947. doi:10.1371/journal.pone.0067947
Hamid, H. A., Ramli, A. N. M., Zamri, N., and Yusoff, M. M. (2018). UPLC-QTOF/MS-based phenolic profiling of Melastomaceae, their antioxidant activity and cytotoxic effects against human breast cancer cell MDA-MB-231. Food Chem. 265, 253–259. doi:10.1016/j.foodchem.2018.05.033
Han, K., Bose, S., Kim, Y. M., Chin, Y. W., Kim, B. S., Wang, J. H., et al. (2015). Rehmannia glutinosa reduced waist circumferences of Korean obese women possibly through modulation of gut microbiota. Food Funct 6, 2684–2692. doi:10.1039/c5fo00232j
He, Y., Zheng, X., Sit, C., Loo, W. T., Wang, Z., Xie, T., et al. (2012). Using association rules mining to explore pattern of Chinese medicinal formulae (prescription) in treating and preventing breast cancer recurrence and metastasis. J. Transl. Med. 10, S12. doi:10.1186/1479-5876-10-S1-S12
He, Z. P., Wang, D. Z., Shi, L. Y., and Wang, Z. Q. (1986). Treating amenorrhea in vital energy-deficient patients with Angelica sinensis-Astragalus membranaceus menstruation-regulating decoction. J. Tradit. Chin. Med. 6, 187–190.
Hirsch, E., and Stewart, C. (2005). Introduction: ethnographies of historicity. Hist. Anthropol. 16, 261–274. doi:10.1080/02757200500219289
Ho, M., Li, T. C., and Su, S. Y. (2011). The association between Traditional Chinese dietary and herbal therapies and uterine involution in postpartum women. Evid. Based Complement. Alternat. Med. 2011, 918291. doi:10.1155/2011/918291
Hook, I. L. (2014). Danggui to Angelica sinensis root: are potential benefits to European women lost in translation? A review. J. Ethnopharmacol. 152, 1–13. doi:10.1016/j.jep.2013.12.018
Hu, C., Liu, H., Du, J., Mo, B., Qi, H., Wang, X., et al. (2009). Estrogenic activities of extracts of Chinese licorice (Glycyrrhiza uralensis) root in MCF-7 breast cancer cells. J. Steroid Biochem. Mol. Biol. 113, 209–216. doi:10.1016/j.jsbmb.2008.12.019
Huang, S. S., Chen, T. Y., Deng, J. S., Pao, L. H., Cheng, Y. C., and Chao, J. (2020). An ethnobotanical study on Qīng-Căo-Chá tea in Taiwan. Front. Pharmacol. 11, 931. doi:10.3389/fphar.2020.00931
Huang, W. C., Su, H. H., Fang, L. W., Wu, S. J., and Liou, C. J. (2019). Licochalcone A inhibits cellular motility by suppressing E-cadherin and MAPK signaling in breast cancer. Cells 8, 218. doi:10.3390/cells8030218
Huang, X., Wang, S., Wang, L., Wang, H., Li, X., and Cui, D. (2018). Administration of an herbal powder based on traditional Chinese veterinary medicine enhanced the fertility of Holstein dairy cows affected with retained placenta. Theriogenology 121, 67–71. doi:10.1016/j.theriogenology.2018.08.008
Huh, J. E., Kim, S. J., Kang, J. W., Nam, D. W., Choi, D. Y., Park, D. S., et al. (2015). The standardized BHH10 extract, a combination of Astragalus membranaceus, Cinnamomum cassia, and Phellodendron amurense, reverses bone mass and metabolism in a rat model of postmenopausal osteoporosis. Phytother Res. 29, 30–39. doi:10.1002/ptr.5218
Iwaoka, Y., Hashimoto, R., Koizumi, H., Yu, J., and Okabe, T. (2010). Selective stimulation by cinnamaldehyde of progesterone secretion in human adrenal cells. Life Sci. 86, 894–898. doi:10.1016/j.lfs.2010.04.009
Jang, M., Lee, M. J., Lee, J. M., Bae, C. S., Kim, S. H., Ryu, J. H., et al. (2014). Oriental medicine Kyung-ok-Ko prevents and alleviates dehydroepiandrosterone-induced polycystic ovarian syndrome in rats. PloS One 9, e87623. doi:10.1371/journal.pone.0087623
Javan, R., Javadi, B., and Feyzabadi, Z. (2017). Breastfeeding: a review of its physiology and galactogogue plants in view of traditional Persian medicine. Breastfeed. Med. 12, 401–409. doi:10.1089/bfm.2017.0038
Jia, J., Li, Y., Lei, Z., Hao, Y., Wu, Y., Zhao, Q., et al. (2013). Relaxative effect of core licorice aqueous extract on mouse isolated uterine horns. Pharm. Biol. 51, 744–748. doi:10.3109/13880209.2013.764536
Jia, N., Qiao, H., Zhu, W., Zhu, M., Meng, Q., Lu, Q., et al. (2019). Antioxidant, immunomodulatory, oxidative stress inhibitory and iron supplementation effect of Astragalus membranaceus polysaccharide-iron (III) complex on iron-deficiency anemia mouse model. Int. J. Biol. Macromol. 132, 213–221. doi:10.1016/j.ijbiomac.2019.03.196
Jin, Y., Tang, Y. P., Zhu, Z. H., Shang, E. X., Pang, H. Q., Shi, X. Q., et al. (2017). Pharmacokinetic comparison of seven major bio-active components in normal and blood stasis rats after oral administration of herb pair Danggui-Honghua by UPLC-TQ/MS. Molecules 22, 1746. doi:10.3390/molecules22101746
Kawabata, K., Kitamura, K., Irie, K., Naruse, S., Matsuura, T., Uemae, T., et al. (2017). Triterpenoids isolated from Ziziphus jujuba enhance glucose uptake activity in skeletal muscle cells. J. Nutr. Sci. Vitaminol. 63, 193–199. doi:10.3177/jnsv.63.193
Khan, A. U., Yuan, Q., Khan, Z. U. H., Ahmad, A., Khan, F. U., Tahir, K., et al. (2018). An eco-benign synthesis of AgNPs using aqueous extract of Longan fruit peel: antiproliferative response against human breast cancer cell line MCF-7, antioxidant and photocatalytic deprivation of methylene blue. J. Photochem. Photobiol., B 183, 367–373. doi:10.1016/j.jphotobiol.2018.05.007
Kim, M. H., Choi, Y. Y., Cho, I. H., Hong, J., Kim, S. H., and Yang, W. M. (2014). Angelica sinensis induces hair regrowth via the inhibition of apoptosis signaling. Am. J. Chin. Med. 42, 1021–1034. doi:10.1142/S0192415X14500645
Kim, M. H., Kim, E. J., Choi, Y. Y., Hong, J., and Yang, W. M. (2017a). Lycium chinense improves post-menopausal obesity via regulation of PPAR-γ and estrogen receptor-α/β expressions. Am. J. Chin. Med. 45, 269–282. doi:10.1142/S0192415X17500173
Kim, M. H., Lee, J. E., Lee, J. S., and Yang, W. M. (2017b). Improvement of osteoporosis by Lycium chinense administration in ovariectomized mice. J. Chin. Med. Assoc. 80, 222–226. doi:10.1016/j.jcma.2016.11.006
Koppikar, S. J., Choudhari, A. S., Suryavanshi, S. A., Kumari, S., Chattopadhyay, S., and Kaul-Ghanekar, R. (2010). Aqueous cinnamon extract (ACE-c) from the bark of Cinnamomum cassia causes apoptosis in human cervical cancer cell line (SiHa) through loss of mitochondrial membrane potential. BMC Canc. 10, 210. doi:10.1186/1471-2407-10-210
Kubo, M., Asano, T., Shiomoto, H., and Matsuda, H. (1994). Studies on rehmanniae radix. I. Effect of 50% ethanolic extract from steamed and dried rehmanniae radix on hemorheology in arthritic and thrombosic rats. Biol. Pharm. Bull. 17, 1282–1286. doi:10.1248/bpb.17.1282
Lai, N., Zhang, J., Ma, X., Wang, B., Miao, X., Wang, Z., et al. (2015). Regulatory effect of catalpol on Th1/Th2 cells in mice with bone loss induced by estrogen deficiency. Am. J. Reprod. Immunol. 74, 487–498. doi:10.1111/aji.12423
Lang, F., Qu, J., Yin, H., Li, L., Zhi, Y., Liu, Y., et al. (2018). Apoptotic cell death induced by Z-Ligustilidein human ovarian cancer cells and role of NRF2. Food Chem. Toxicol. 121, 631–638. doi:10.1016/j.fct.2018.09.041
Lee, C. Y., Yang, C. Y., Lin, C. C., Yu, M. C., Sheu, S. J., and Kuan, Y. H. (2018). Hair growth is promoted by BeauTop via expression of EGF and FGF 7. Mol. Med. Rep. 17, 8047–8052. doi:10.3892/mmr.2018.8917
Lee, H. E., Yang, G., Han, S. H., Lee, J. H., An, T. J., Jang, J. K., et al. (2018). Anti-obesity potential of Glycyrrhiza uralensis and Licochalcone A through induction of adipocyte browning. Biochem. Biophys. Res. Commun. 503, 2117–2123. doi:10.1016/j.bbrc.2018.07.168
Lee, H. W., Kim, H., Ryuk, J. A., Kil, K. J., and Ko, B. S. (2014). Hemopoietic effect of extracts from constituent herbal medicines of Samul-tang on phenylhydrazine-induced hemolytic anemia in rats. Int. J. Clin. Exp. Pathol. 7, 6179–6185. doi:10.3746/jkfn.2009.38.12.1718
Lee, M. J., Jang, M., Bae, C. S., Park, K. S., Kim, H. J., Lee, S., et al. (2016). Effects of oriental medicine Kyung-ok-Ko on uterine abnormality in hyperandrogenized rats. Rejuvenation Res. 19, 456–466. doi:10.1089/rej.2015.1787
Legislative Yuan(2000). Bull. Legislative Yuan.Available at:https://lci.ly.gov.tw/LyLCEW/lcivCommMore.action/ (Accessed August 7 , 2020 )
Li, G., Sepkovic, D. W., Bradlow, H. L., Telang, N. T., and Wong, G. Y. (2009). Lycium barbarum inhibits growth of estrogen receptor positive human breast cancer cells by favorably altering estradiol metabolism. Nutr. Canc. 61, 408–414. doi:10.1080/01635580802585952
Li, J. W., Liu, X. F., Chen, H. Z., Chen, H. H., Shi, G. X., and Wang, S. J. (2014). [Effect of yanghehuayan decoction on precancerosis of breast cancer, protein and mRNA expression of Ki67: an experimental research]. J. Integr. Med. 34, 970–975.
Li, M., Hung, A., Lenon, G. B., and Yang, A. W. H. (2019). Chinese herbal formulae for the treatment of menopausal hot flushes: a systematic review and meta-analysis. PloS One 14, e0222383. doi:10.1371/journal.pone.0222383
Li, M., Zhang, N. D., Wang, Y., Han, T., Jiang, Y. P., Rahman, K., et al. (2016). Coordinate regulatory osteogenesis effects of icariin, timosaponin B II and ferulic acid from TCM formulas on UMR-106 osteoblastic cells and osteoblasts in neonatal rat calvaria cultures. J. Ethnopharmacol. 185, 120–131. doi:10.1016/j.jep.2016.03.023
Li, N., Lin, Z., Chen, W., Zheng, Y., Ming, Y., Zheng, Z., et al. (2018). Corilagin from longan seed: identification, quantification, and synergistic cytotoxicity on SKOv3ip and hey cells with ginsenoside Rh2 and 5-fluorouracil. Food Chem. Toxicol. 119, 133–140. doi:10.1016/j.fct.2018.05.018
Li, W., Guo, J., Tang, Y., Wang, H., Huang, M., Qian, D., et al. (2012). Pharmacokinetic comparison of ferulic acid in normal and blood deficiency rats after oral administration of Angelica sinensis, Ligusticum chuanxiong and their combination. Int. J. Mol. Sci. 13, 3583–3597. doi:10.3390/ijms13033583
Liang, F., Li, L., Wang, M., Niu, X., Zhan, J., He, X., et al. (2013). Molecular network and chemical fragment-based characteristics of medicinal herbs with cold and hot properties from Chinese medicine. J. Ethnopharmacol. 148, 770–779. doi:10.1016/j.jep.2013.04.055
Liang, Q. D., Lu, X. Q., Ma, Z. C., Tan, H. L., Ma, B. P., Gao, Y., et al. (2004). [Preliminary study on hematopoietic constituents of si-wu-tang. J. Chin. Materia. Medica. 29, 546–549. doi:10.1002/vjch.201800061
Liang, R. N., Liu, J., and Lu, J. (2008). [Treatment of refractory polycystic ovary syndrome by bushenhuoxue method combined with ultrasound-guided follicle aspiration]. J. Integr. Med. 28, 314–317.
Lim, D. W., and Kim, Y. T. (2014). Anti-osteoporotic effects of Angelica sinensis (Oliv.) Diels extract on ovariectomized rats and its oral toxicity in rats. Nutrition 6, 4362–4372. doi:10.3390/nu6104362
Lim, D. W., and Kim, Y. T. (2013). Dried root of Rehmannia glutinosa prevents bone loss in ovariectomized rats. Molecules 18, 5804–5813. doi:10.3390/molecules18055804
Lin, H. Q., Gong, A. G., Wang, H. Y., Duan, R., Dong, T. T., Zhao, K. J., et al. (2017). DangguiBuxue Tang (Astragali radix and Angelicae sinensis radix) for menopausal symptoms: a review. J. Ethnopharmacol. 199, 205–210. doi:10.1016/j.jep.2017.01.044
Ling, H., Zhang, Y., Ng, K. Y., and Chew, E. H. (2011). Pachymic acid impairs breast cancer cell invasion by suppressing nuclear factor-κB-dependent matrix metalloproteinase-9 expression. Breast Canc. Res. Treat. 126, 609–620. doi:10.1007/s10549-010-0929-5
Liu, C., Wang, L., Zhu, R., Liu, H., Ma, R., Chen, B., et al. (2019). Rehmanniae Radix Preparata suppresses bone loss and increases bone strength through interfering with canonical Wnt/β-catenin signaling pathway in OVX rats. Osteoporos. Int. 30, 491–505. doi:10.1007/s00198-018-4670-y
Liu, C., Wu, F., Liu, Y., and Meng, C. (2015). Catalpol suppresses proliferation and facilitates apoptosis of MCF-7 breast cancer cells through upregulating microRNA-146a and downregulating matrix metalloproteinase-16 expression. Mol. Med. Rep. 12, 7609–7614. doi:10.3892/mmr.2015.4361
Liu, J., Viswanadhapalli, S., Garcia, L., Zhou, M., Nair, B. C., Kost, E., et al. (2017). Therapeutic utility of natural estrogen receptor beta agonists on ovarian cancer. Oncotarget 8, 50002–50014. doi:10.18632/oncotarget.18442
Liu, J., Wei, J., Wang, C., Meng, X., Chen, H., Deng, P., et al. (2019). The combination of Radix Astragali and Radix Angelicae sinensis attenuates the IFN-γ-induced immune destruction of hematopoiesis in bone marrow cells. BMC Compl. Alternative Med. 19, 356. doi:10.1186/s12906-019-2781-4
Liu, Y. Q., Petrini, M., and Maloni, J. A. (2015). ‘Doing the month’: post-partum practices in Chinese women. Nurs. Health Sci. 17, 5–14. doi:10.1111/nhs.12146
Liu, Y. T., Hsiao, C. H., Tzang, B. S., and Hsu, T. C. (2019). In vitro and in vivo effects of TCM formula T33 in human breast cancer cells. BMC Complement Altern. Med. 19, 211. doi:10.1186/s12906-019-2630-5
Long, F., Wang, T., Jia, P., Wang, H., Qing, Y., Xiong, T., et al. (2017). Anti-tumor effects of Atractylenolide-I on human ovarian cancer cells. Med. Sci. Mon. Int. Med. J. Exp. Clin. Res. 23, 571–579. doi:10.12659/MSM.902886
Lu, K. T., Cheng, H. Y., Lo, C. F., Chang, H. C., and Lin, J. H. (2007). Discriminating between Achyranthis bidentatae radix and Cyathulae radix in Chinese medicine preparations by nested PCR and DNA sequencing methods. Planta Med. 73, 1322–1326. doi:10.1055/s-2007-990219
Ma, H., Li, L., Dou, G., Wang, C., Li, J., He, H., et al. (2017). Z-ligustilide restores tamoxifen sensitivity of ERa negative breast cancer cells by reversing MTA1/IFI16/HDACs complex mediated epigenetic repression of ERa. Oncotarget 8, 29328–29345. doi:10.18632/oncotarget.16440
Mazaro-Costa, R., Andersen, M. L., Hachul, H., and Tufik, S. (2010). Medicinal plants as alternative treatments for female sexual dysfunction: utopian vision or possible treatment in climacteric women? J. Sex. Med. 7, 3695–3714. doi:10.1111/j.1743-6109.2010.01987.x
Medicine, N. L. O. (2006). Turmeric, in drugs and lactation database (LactMed). Bethesda, MD: National Library of Medicine.
Mercer, K. E., Bhattacharyya, S., Sharma, N., Chaudhury, M., Lin, H., Yeruva, L., et al. (2020). Infant formula feeding changes the proliferative status in piglet neonatal mammary glands independently of estrogen signaling. J. Nutr. 150, 730–738. doi:10.1093/jn/nxz273
Ministry of Health and Welfare(2020). Taiwan health and welfare report 2019. Available at: http://www.cdway.com.tw/gov/mhw2/book108/book01/ (Accessed June 29 , 2020 ).
Ministry of Science and Technology (2017). Development and division of traditional medicine in East Asia. Available at: http://www.hss.ntu.edu.tw/model.aspx?no=581/ (Accessed August 7 , 2020 ).
Moini Jazani, A., Hamdi, K., Tansaz, M., Nazemiyeh, H., Sadeghi Bazargani, H., Fazljou, S. M. B., et al. (2018). Herbal medicine for oligomenorrhea and amenorrhea: a systematic review of ancient and conventional medicine. BioMed Res. Int. 2018, 3052768. doi:10.1155/2018/3052768
Mortel, M., and Mehta, S. D. (2013). Systematic review of the efficacy of herbal galactogogues. J. Hum. Lactation 29, 154–162. doi:10.1177/0890334413477243
Mullen, K. A., Lee, A. R., Lyman, R. L., Mason, S. E., Washburn, S. P., and Anderson, K. L. (2014). Short communication: an in vitro assessment of the antibacterial activity of plant-derived oils. J. Dairy Sci. 97, 5587–5591. doi:10.3168/jds.2013-7806
Odoh, U. E., Uzor, P. F., Eze, C. L., Akunne, T. C., Onyegbulam, C. M., and Osadebe, P. O. (2018). Medicinal plants used by the people of Nsukka Local Government Area, south-eastern Nigeria for the treatment of malaria: an ethnobotanical survey. J. Ethnopharmacol. 218, 1–15. doi:10.1016/j.jep.2018.02.034
Oh, K. O., Kim, S. W., Kim, J. Y., Ko, S. Y., Kim, H. M., Baek, J. H., et al. (2003). Effect of Rehmannia glutinosa Libosch extracts on bone metabolism. Clin. Chim. Acta 334, 185–195. doi:10.1016/S0009-8981(03)00238-9
Ok, H. M., Gebreamanuel, M. R., Oh, S. A., Jeon, H., Lee, W. J., and Kwon, O. (2015). A root-based combination supplement containing Pueraria lobata and Rehmannia glutinosa and exercise preserve bone mass in ovariectomized rats fed a high-fat diet. Calcif. Tissue Int. 97, 624–633. doi:10.1007/s00223-015-0057-7
Özalkaya, E., Aslandoğdu, Z., Özkoral, A., Topcuoğlu, S., and Karatekin, G. (2018). Effect of a galactagogue herbal tea on breast milk production and prolactin secretion by mothers of preterm babies. Niger. J. Clin. Pract. 21, 38–42. doi:10.4103/1119-3077.224788
Paritakul, P., Ruangrongmorakot, K., Laosooksathit, W., Suksamarnwong, M., and Puapornpong, P. (2016). The effect of ginger on breast milk volume in the early postpartum period: a randomized, double-blind controlled trial. Breastfeed. Med. 11, 361–365. doi:10.1089/bfm.2016.0073
Park, S. Y., Kwon, S. J., Lim, S. S., Kim, J. K., Lee, K. W., and Park, J. H. (2016). Licoricidin, an active compound in the hexane/ethanol extract of Glycyrrhiza uralensis, inhibits lung metastasis of 4T1 murine mammary carcinoma cells. Int. J. Mol. Sci. 17. doi:10.3390/ijms17060934
Peña, K. S., and Rosenfeld, J. A. (2001). Evaluation and treatment of galactorrhea. Am. Fam. Physician 63, 1763–1770.
Pharmaceutical Affairs Act (2018). Ministry of health and welfare. Available at: https://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?pcode=L0030001/ (Accessed July 1 , 2020 ).
Plastina, P., Bonofiglio, D., Vizza, D., Fazio, A., Rovito, D., Giordano, C., et al. (2012). Identification of bioactive constituents of Ziziphus jujube fruit extracts exerting antiproliferative and apoptotic effects in human breast cancer cells. J. Ethnopharmacol. 140, 325–332. doi:10.1016/j.jep.2012.01.022
Qi, H., Jiang, Z., Wang, C., Yang, Y., Li, L., He, H., et al. (2017). Sensitization of tamoxifen-resistant breast cancer cells by Z-ligustilide through inhibiting autophagy and accumulating DNA damages. Oncotarget 8, 29300–29317. doi:10.18632/oncotarget.16832
Rad, S. K., Kanthimathi, M. S., Abd Malek, S. N., Lee, G. S., Looi, C. Y., and Wong, W. F. (2015). Cinnamomum cassia suppresses caspase-9 through stimulation of AKT1 in MCF-7 cells but not in MDA-MB-231 Cells. PloS One 10, e0145216. doi:10.1371/journal.pone.0145216
Rock, E., and DeMichele, A. (2003). Nutritional approaches to late toxicities of adjuvant chemotherapy in breast cancer survivors. J. Nutr. 133 (Suppl. 1), 3785S–3793S. doi:10.1093/jn/133.11.3785S
Sakamoto, S., Yoshino, H., Shirahata, Y., Shimodairo, K., and Okamoto, R. (1992). Pharmacotherapeutic effects of kuei-chih-fu-ling-wan (keishi-bukuryo-gan) on human uterine myomas. Am. J. Chin. Med. 20, 313–317. doi:10.1142/S0192415X92000333
Salatino, S., Giacomelli, L., Carnevali, I., and Giacomelli, E. (2017). The role of natural galactagogues during breast feeding: focus on a Galega officinalis based food supplement. Minerva Pediatr. 69, 531–537. doi:10.23736/S0026-4946.16.04797-6
Seon, M. R., Park, S. Y., Kwon, S. J., Lim, S. S., Choi, H. J., Park, H., et al. (2012). Hexane/ethanol extract of Glycyrrhiza uralensis and its active compound isoangustone A induce G1 cycle arrest in DU145 human prostate and 4T1 murine mammary cancer cells. J. Nutr. Biochem. 23, 85–92. doi:10.1016/j.jnutbio.2010.11.010
Setchell, K. D. R. (2001). Soy isoflavones—benefits and risks from nature’s selective estrogen receptor modulators (SERMs). J. Am. Coll. Nutr. 20 (Suppl. l), 354S–362S. doi:10.1080/07315724.2001.10719168
Shan, T., Shan, T., Liu, F., Zheng, H., and Li, G. (2017). Effects of Lycium barbarum polysaccharides on the damage to human endometrial stromal cells induced by hydrogen peroxide. Mol. Med. Rep. 15, 879–884. doi:10.3892/mmr.2016.6080
Shen, A. Y., Wang, T. S., Huang, M. H., Liao, C. H., Chen, S. J., and Lin, C. C. (2005). Antioxidant and antiplatelet effects of dang-gui-shao-yao-san on human blood cells. Am. J. Chin. Med. 33, 747–758. doi:10.1142/S0192415X05003351
Shih, C. C., Lin, C. H., and Lin, W. L. (2009). Ameliorative effects of Vaccaria segetalis extract on osteopenia in ovariectomized rats. J. Nat. Med. 63, 386–392. doi:10.1007/s11418-009-0341-9
Shoemaker, M., Hamilton, B., Dairkee, S. H., Cohen, I., and Campbell, M. J. (2005). In vitro anticancer activity of twelve Chinese medicinal herbs. Phytother Res. 19, 649–651. doi:10.1002/ptr.1702
Silva, K. S. C., Aquino, N. S. S., Gusmao, D. O., Henriques, P. C., Reis, A. M., and Szawka, R. E. (2020). Reduced dopaminergic tone during lactation is permissive to the hypothalamic stimulus for suckling-induced prolactin release. J. Neuroendocrinol., e12880. doi:10.1111/jne.12880
Sim, T. F., Hattingh, H. L., Sherriff, J., and Tee, L. B. (2014). Perspectives and attitudes of breastfeeding women using herbal galactagogues during breastfeeding: a qualitative study. BMC Compl. Alternative Med. 14, 216. doi:10.1186/1472-6882-14-216
Sim, T. F., Hattingh, H. L., Sherriff, J., and Tee, L. B. (2015). The use, perceived effectiveness and safety of herbal galactagogues during breastfeeding: a qualitative study. Int. J. Environ. Res. Publ. Health 12, 11050–11071. doi:10.3390/ijerph120911050
Sim, T. F., Sherriff, J., Hattingh, H. L., Parsons, R., and Tee, L. B. (2013). The use of herbal medicines during breastfeeding: a population-based survey in Western Australia. BMC Compl. Alternative Med. 13, 317. doi:10.1186/1472-6882-13-317
Song, M. Y., Lim, S. K., Wang, J. H., and Kim, H. (2018). The root of Atractylodes macrocephala Koidzumi prevents obesity and glucose intolerance and increases energy metabolism in mice. Int. J. Mol. Sci. 19, 278. doi:10.3390/ijms19010278
State Administration of TCM (1999). “Chinese materia medica,” in “Chinese materia medica” editorial board, state administration of TCM (Shanghai, China: Shanghai Scientific and Technical Publishers).
Su, S.-Y. (2012). The relationship between life style, food and Chinese medicine intake during ZuoYuezi and the quality of life, postpartum recovery, and psychological status short term postpartum. Available at: https://dep.mohw.gov.tw/DOCMAP/dl-10866-1ba4fa56-292f-49f5-8014-73eb2b6844ec.html/ (Accessed July 31 , 2020 )
Su, Y. J., Huang, S. Y., Ni, Y. H., Liao, K. F., and Chiu, S. C. (2018). Anti-tumor and radiosensitization effects of N-butylidenephthalide on human breast cancer cells. Molecules 23, 240. doi:10.3390/molecules23020240
Sugishita, E., Amagaya, S., and Ogihara, Y. (1983). Studies on the mechanism of anti-inflammatory activities of papyriogenin A and papyriogenin C. J. Pharmacobiodyn. 6, 287–294. doi:10.1248/bpb1978.6.287
Sun, L., Liu, L. N., Li, J. C., Lv, Y. Z., Zong, S. B., Zhou, J., et al. (2017). The essential oil from the twigs of Cinnamomum cassia Presl inhibits oxytocin-induced uterine contraction in vitro and in vivo. J. Ethnopharmacol. 206, 107–114. doi:10.1016/j.jep.2017.05.023
Sun, L., Liu, L., Zong, S., Wang, Z., Zhou, J., Xu, Z., et al. (2016). TCM Guizhi Fuling capsule used for therapy of dysmenorrhea via attenuating uterus contraction. J. Ethnopharmacol. 191, 273–279. doi:10.1016/j.jep.2016.06.042
Suzuki, M., Osawa, S., and Hirano, M. (1972). A Lycium chinense Miller component inducing ovulation in adult female rabbits. Tohoku J. Exp. Med. 106, 219–231. doi:10.1620/tjem.106.219
Tahergorabi, Z., Abedini, M. R., Mitra, M., Fard, M. H., and Beydokhti, H. (2015). ‘Ziziphus jujuba’: a red fruit with promising anticancer activities. Pharm. Rev. 9, 99–106. doi:10.4103/0973-7847.162108
Tang, S. H., Shen, D., and Yang, H. J. (2019). Analysis on composition rules of Chinese patent drugs treating pain-related diseases based on data mining method. Chin. J. Integr. Med. 25, 861–866. doi:10.1007/s11655-017-2957-z
Tao, F., Ruan, S., Liu, W., Wang, L., Xiong, Y., and Shen, M. (2016). Fuling granule, a TCM compound, suppresses cell proliferation and TGFβ-induced EMT in ovarian cancer. PloS One 11, e0168892. doi:10.1371/journal.pone.0168892
The Royal Botanic Gardens (2013). Plant list. Available at: http://www.theplantlist.org/ (Accessed June 29 , 2020 )
Tsai, H. Y., Lin, H. Y., Fong, Y. C., Wu, J. B., Chen, Y. F., Tsuzuki, M., et al. (2008). Paeonol inhibits RANKL-induced osteoclastogenesis by inhibiting ERK, p38 and NF-kappaB pathway. Eur. J. Pharmacol. 588, 124–133. doi:10.1016/j.ejphar.2008.04.024
Tsai, S. S., and Wang, H. H. (2019). Role changes in primiparous women during “doing the month” period. Midwifery 74, 6–13. doi:10.1016/j.midw.2019.03.007
Tsugami, Y., Matsunaga, K., Suzuki, T., Nishimura, T., and Kobayashi, K. (2017). Isoflavones and their metabolites influence the milk component synthesis ability of mammary epithelial cells through prolactin/STAT5 signaling. Mol. Nutr. Food Res. 61, 156. doi:10.1002/mnfr.201700156
Tsugami, Y., Suzuki, N., Suzuki, T., Nishimura, T., and Kobayashi, K. (2020). Regulatory effects of soy isoflavones and their metabolites in milk production via different ways in mice. J. Agric. Food Chem. 68, 5847–5853. doi:10.1021/acs.jafc.0c01288
Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., et al. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 387, 475–490. doi:10.1016/S0140-6736(15)01024-7
Wang, L. U., He, C. L., He, B. K., Guo, Q., Xiao, C. G., and Yi, Q. (2012). Effects of Jin-Ying-Tang on Staphylococcus aureus-induced mastitis in rabbit. Immunopharmacol. Immunotoxicol. 34, 786–793. doi:10.3109/08923973.2012.655423
Wang, W., Chen, B., Zou, R., Tu, X., Tan, S., Lu, H., et al. (2014). Codonolactone, a sesquiterpene lactone isolated from Chloranthus henryi Hemsl, inhibits breast cancer cell invasion, migration and metastasis by downregulating the transcriptional activity of Runx2. Int. J. Oncol. 45, 1891–1900. doi:10.3892/ijo.2014.2643
Wawruszak, A., Czerwonka, A., Okła, K., and Rzeski, W. (2016). Anticancer effect of ethanol Lycium barbarum (goji berry) extract on human breast cancer T47D cell line. Nat. Prod. Res. 30, 1993–1996. doi:10.1080/14786419.2015.1101691
Wei, M., Lu, Y., Liu, D., and Ru, W. (2014). Ovarian failure-resistant effects of catalpol in aged female rats. Biol. Pharm. Bull. 37, 1444–1449. doi:10.1248/bpb.b14-00064
Wei, M., Zheng, S. Z., Ma, H., and Lv, Y. (2011). [Discussion of protective mechanism of Lyceum barbarum polysaccharides on ovarian tissue in female senile rats]. J. Chin. Med. Mater. 34, 1915–1918
World Health Organization (2013). Essential Nutrition actions: improving maternal, newborn, infant and young child health and nutrition. Available at: http://apps.who.int/iris/bitstream/10665/84409/1/9789241505550_eng.pdf?ua=1/ (Accessed June 29 , 2020 ).
World Health Organization (2020). Infant and young child feeding. Available at: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding/ (Accessed June 29 , 2020 ).
World Health Organization (2017). The international code of marketing of breast-milk substitutes: frequently asked questions 2017 update. Available at: http://apps.who.int/iris/bitstream/handle/10665/254911/WHO-NMH-NHD-17.1-eng.pdf?ua=1/ (Accessed June 29 , 2020 ).
Wu, D., Zhang, X., Liu, L., and Guo, Y. (2019). Key CMM combinations in prescriptions for treating mastitis and working mechanism analysis based on network pharmacology. Evid. Based Complement. Alternat. Med. 2019, 8245071. doi:10.1155/2019/8245071
Wu, Z., Yang, L., He, L., Wang, L., and Peng, L. (2020). Systematic elucidation of the potential mechanisms of core Chinese materiamedicas in treating liver cancer based on network pharmacology. Evid. Based Complement. Alternat. Med. 2020, 4763675. doi:10.1155/2020/4763675
Xia, B., Xu, B., Sun, Y., Xiao, L., Pan, J., Jin, H., et al. (2014). The effects of LiuweiDihuang on canonical Wnt/β-catenin signaling pathway in osteoporosis. J. Ethnopharmacol. 153, 133–141. doi:10.1016/j.jep.2014.01.040
Xie, Q. F., Xie, J. H., Dong, T. T., Su, J. Y., Cai, D. K., Chen, J. P., et al. (2012). Effect of a derived herbal recipe from an ancient Chinese formula. DangguiBuxue Tang. J. Ethnopharmacol. 144, 567–575. doi:10.1016/j.jep.2012.09.041
Xu, J. L., Gu, L. H., Wang, Z. T., Bligh, A., Han, Z. Z., and Liu, S. J. (2016). Seventeen steroids from the pith of Tetrapanax papyriferus. J. Asian Nat. Prod. Res. 18, 1131–1137. doi:10.1080/10286020.2016.1196194
Yang, D. M., Zhang, J. Q., and Fei, Y. F. (2017). Lycium barbarum polysaccharide attenuates chemotherapy-induced ovarian injury by reducing oxidative stress. J. Obstet. Gynaecol. Res. 43, 1621–1628. doi:10.1111/jog.13416
Yang, L., Chai, C. Z., Yan, Y., Duan, Y. D., Henz, A., Zhang, B. L., et al. (2017). Spasmolytic mechanism of aqueous licorice extract on oxytocin-induced uterine contraction through inhibiting the phosphorylation of heat shock protein 27. Molecules 22, 1392. doi:10.3390/molecules22091392
Yin, J., Tezuka, Y., Kouda, K., Tran, Q. L., Miyahara, T., Chen, Y., et al. (2004). Antiosteoporotic activity of the water extract of Dioscorea spongiosa. Biol. Pharm. Bull. 27, 583–586. doi:10.1248/bpb.27.583
Yoon, J. I., Al-Reza, S. M., and Kang, S. C. (2010). Hair growth promoting effect of Zizyphusjujuba essential oil. Food Chem. Toxicol. 48, 1350–1354. doi:10.1016/j.fct.2010.02.036
Yu, C. H., Chu, S. C., Yang, S. F., Hsieh, Y. S., Lee, C. Y., and Chen, P. N. (2019). Induction of apoptotic but not autophagic cell death by Cinnamomum cassia extracts on human oral cancer cells. J. Cell. Physiol. 234, 5289–5303. doi:10.1002/jcp.27338
Yu, Y., Yuan, X., Li, P., Wang, Y., Yu, M., and Gao, X. (2020). Vaccarin promotes proliferation of and milk synthesis in bovine mammary epithelial cells through the Prl receptor-PI3K signaling pathway. Eur. J. Pharmacol. 880, 173190. doi:10.1016/j.ejphar.2020.173190
Yuan, Z., Zhong, L., Hua, Y., Ji, P., Yao, W., Ma, Q., et al. (2019). Metabolomics study on promoting blood circulation and ameliorating blood stasis: investigating the mechanism of Angelica sinensis and its processed products. Biomed. Chromatogr. 33, e4457. doi:10.1002/bmc.4457
Zhang, C., Fan, L., Fan, S., Wang, J., Luo, T., Tang, Y., et al. (2019). Cinnamomum cassia Presl: a review of its traditional uses, phytochemistry, pharmacology and toxicology. Molecules 24, 3473. doi:10.3390/molecules24193473
Zhang, J., Guo, W., Li, Q., Sun, F., Xu, X., and Xu, H. (2020). Discriminant analysis of traditional Chinese medicinal properties based on holistic chemical profiling by (1). Evid. Based Complement. Alternat. Med. 2020, 3141340. doi:10.1155/2020/3141340
Zhang, M., Chiu, L. C., Cheung, P. C., and Ooi, V. E. (2006). Growth-inhibitory effects of a beta-glucan from the mycelium of Poria cocos on human breast carcinoma MCF-7 cells: cell-cycle arrest and apoptosis induction. Oncol. Rep. 15, 637–643
Zhang, R., Liu, Z. G., Li, C., Hu, S. J., Liu, L., Wang, J. P., et al. (2009). Du-Zhong (Eucommia ulmoides Oliv.) cortex extract prevent OVX-induced osteoporosis in rats. Bone 45, 553–559. doi:10.1016/j.bone.2008.08.127
Zhang, R., Pan, Y. L., Hu, S. J., Kong, X. H., Juan, W., and Mei, Q. B. (2014). Effects of total lignans from Eucommia ulmoides barks prevent bone loss in vivo and in vitro. J. Ethnopharmacol. 155, 104–112. doi:10.1016/j.jep.2014.04.031
Zhang, W., Fujikawa, T., Mizuno, K., Ishida, T., Ooi, K., Hirata, T., et al. (2012). Eucommia leaf extract (ELE) prevents OVX-induced osteoporosis and obesity in rats. Am. J. Chin. Med. 40, 735–752. doi:10.1142/S0192415X12500553
Zhang, W. L., Zheng, K. Y., Zhu, K. Y., Zhan, J. Y., Bi, C. W., Chen, J. P., et al. (2012). Chemical and biological assessment of Angelica herbal decoction: comparison of different preparations during historical applications. Phytomedicine 19, 1042–1048. doi:10.1016/j.phymed.2012.07.009
Zhang, Y. Q., Xu, S. B., Lin, Y. C., Li, Q., Zhang, X., and Lai, Y. R. (2000). Antagonistic effects of 3 sesquiterpene lactones from Atractylodes macrocephala Koidz on rat uterine contraction in vitro. Acta Pharmacol. Sin. 21, 91–96.
Zhang, Z., Liu, X., Wu, T., Liu, J., Zhang, X., Yang, X., et al. (2011). Selective suppression of cervical cancer Hela cells by 2-O-β-D-glucopyranosyl-L-ascorbic acid isolated from the fruit of Lycium barbarum L. Cell Biol. Toxicol. 27, 107–121. doi:10.1007/s10565-010-9174-2
Zheng, T., Chen, W., Hu, H., Wang, Y., Harnett, J. E., and Ung, C. O. L. (2020). The prevalence, perceptions and behaviors associated with traditional/complementary medicine use by breastfeeding women living in Macau: a cross-sectional survey study. Méd. Thérapeutique 20, 122. doi:10.1186/s12906-020-02921-8
Zhong, T., Zhang, H., Duan, X., Hu, J., Wang, L., Li, L., et al. (2017). Anti-obesity effect of radix Angelica sinensis and candidate causative genes in transcriptome analyses of adipose tissues in high-fat diet-induced mice. Gene 599, 92–98. doi:10.1016/j.gene.2016.11.017
Zhou, W. J., Wang, S., Hu, Z., Zhou, Z. Y., and Song, C. J. (2015). Angelica sinensis polysaccharides promotes apoptosis in human breast cancer cells via CREB-regulated caspase-3 activation. Biochem. Biophys. Res. Commun. 467, 562–569. doi:10.1016/j.bbrc.2015.09.145
Keywords: breastfeeding, ethnobotanical, galactagogues, Taiwan, traditional Chinese medicine pharmacy
Citation: Chao J, Ko C-Y, Lin C-Y, Tomoji M, Huang C-H, Chiang H-C, Yang J-J, Huang S-S and Su S-Y (2021) Ethnobotanical Survey of Natural Galactagogues Prescribed in Traditional Chinese Medicine Pharmacies in Taiwan. Front. Pharmacol. 11:625869. doi: 10.3389/fphar.2020.625869
Received: 04 November 2020; Accepted: 23 December 2020;
Published: 12 February 2021.
Edited by:
Yue Liu, Xiyuan Hospital, ChinaReviewed by:
Yanming Wei, Gansu Agricultural University, ChinaArmando Caceres, Universidad de San Carlos de Guatemala, Guatemala
Copyright © 2021 Chao, Ko, Lin, Tomoji, Huang, Chiang, Yang, Huang and Su. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Shyh-Shyun Huang, c3NodWFuZ0BtYWlsLmNtdS5lZHUudHc=; Shan-Yu Su, c2hhbnl1c3VAZ21haWwuY29t