Background: According to classical sources of Traditional Mongolian Medicine, the Mana-4 decoction clears internal heat and fever, alleviates febrile and infectious diseases, resolves pale-brown Badgan disorders, and alleviates severe pneumonia. Chimedragchaa.Ch. et al. (2002) demonstrated that Mana-4 possesses heat-clearing, anti-inflammatory, and immunomodulatory effects. Chronic Fatigue Syndrome (CFS) is a disorder characterized by clinical manifestations including physical exhaustion, low-grade fever, headache, mood fluctuations, cognitive impairment, and sleep disturbances. In recent years, as the pace of modern life and workload have increased, physical, psychological, and mental stress have intensified, leading to dysregulation of the nervous and endocrine systems, impaired immune function, and a rising global prevalence of CFS—a trend that has attracted increasing attention from researchers worldwide. However, the etiology and pathogenesis of CFS remain incompletely understood, and effective, evidence-based treatments continue to be sought. Therefore, we developed Immunoflu soluble granules, derived from the constituents of Mana-4, and this study aimed to investigate its anti-fatigue effects, as no such investigation had previously been conducted. Aim: To evaluate the anti-fatigue effect of Immunoflu, a formulation derived from the traditional Mana-4 decoction widely used in Traditional Mongolian Medicine. Materials and Methods: A chronic-fatigue rat model was established by forced-swimming induction, following the method of Jia Wang et al. (2013). The behavioral effects of Immunoflu were assessed using the open-field test (locomotor activity) and the elevated plus-maze test (anxiety-related behavior). Result: Immunoflu was administered at 100, 200, and 400 mg/kg to evaluate its effects in a chronic-fatigue model. In the open-field test, no significant difference (p>0.05) in central-zone entries was observed between Immunoflu and the model control. However, vertical locomotor activity increased significantly: Immunal 50 mg/kg +80.4% (p=0.024), Immunoflu 100 mg/kg +82.6% (p=0.003), and 200 mg/kg +77.4% (p=0.035). From these findings, Immunoflu at 100 and 200 mg/kg clearly enhanced locomotor activity in rats with chronic fatigue. In the elevated plus-maze test, Immunal 50 mg/kg increased the time spent in the central zone (10×10cm) by 53.3% (p=0.021) and in open arms by 61.4% (p=0.032) compared with the model control. Although Immunoflu produced no significant changes (p>0.05) in central-zone entries or time spent in the central zone, the time spent in the open arms increased by 60.6% at 200 mg/kg (p=0.026), indicating a reduction in anxiety and improved behavioral response to stress. Conclusion In a forced-swimming–induced chronic-fatigue model, Immunoflu increased locomotor activity by 77.4–82.6% at 100 and 200 mg/kg, reduced anxiety by 60.6% at 200 mg/kg, and reduced behavioral despair and fatigue by 35.3% at 100 mg/kg.

Background: Diabetes mellitus accounts for 42.9% of endocrine and nutritional metabolic diseases in Mongolia, with a prevalence of 111.4 cases per 10,000 population. This represents a 28.5% increase compared with the previous year (82.9 cases per 10,000 population in 2019), indicating a continuing upward trend in the prevalence of diabetes mellitus. In Mongolian traditional medicine, Sapparin tablets are used to treat blood disorders and liver diseases. The formulation contains four major herbal ingredients: C. jubata, C. sappan, Z. officinale, and H. rhamnoides. Aim: To study the effects of Sapparin in a high-fat diet and low-dose streptozotocin-induced diabetic model in experimental rats. Materials and Methods: We used 40 Wistar rats to establish a type 2 diabetes mellitus (T2DM) model according to the method described by Bailu Duan et al. (2017). The rats were fed a high-fat diet for 28 days, followed by an intraperitoneal injection of streptozotocin (STZ) at 35 mg/kg to induce T2DM. After STZ administration, Sapparin was orally administered to diabetic rats at 89 and 178 mg/kg for 21 days. At the end of the experimental period, insulin, GLUT4, superoxide dismutase (SOD), and glucagon-like peptide-1 (GLP-1) levels were determined using enzyme-linked immunosorbent assay (ELISA) according to the manufacturer’s instructions on days 14 and 21. Result: After 14 and 21 days of treatment, fasting blood glucose levels decreased by 33% and 22.5% in the Sapparin 89 mg/kg and 178 mg/kg groups, respectively, compared with the diabetic control group (p=0.05). In the glucose tolerance test, the 89 mg/kg Sapparin-treated group showed a 31% increase in glucose levels at the initial measurement compared with the diabetic control group, followed by decreases of 10% at 30 min and 30% at 120 min (p=0.04). Serum insulin levels in the 89 mg/kg Sapparin group decreased by 20% on day 14 and 19.8% on day 21 compared with the diabetic control group, while the 178 mg/kg group showed decreases of 15% and 20%, respectively, approaching the levels observed in the healthy control group (p=0.05). Furthermore, HOMA-IR decreased by 42–46% over time in both the 89 and 178 mg/ kg Sapparin-treated groups, with statistically significant differences observed (p=0.05). Conclusion In a rat model of type 2 diabetes mellitus, Sapparin reduced blood glucose levels, serum insulin levels, and insulin resistance (HOMA-IR), and may have a positive effect on lipid metabolism.

Background: Respiratory diseases remain among the top five leading causes of morbidity, with an incidence rate of 788.4 cases per 10,000 population in 2021. Among these, acute bronchitis accounts for 9.3%. According to international clinical guidelines for the diagnosis and treatment of adult acute bronchitis, symptoms usually resolve spontaneously within 1–3 weeks, but they considerably reduce the patient’s quality of life. Therefore, Colsaurin syrup, a new natural formulation with analgesic and anti-inflammatory effects, was clinically investigated to assess its efficacy and safety. The introduction of this domestically produced herbal medicine into clinical practice is expected to have both medical and socioeconomic significance by expanding the range of national pharmaceutical products. Aim: To evaluate the effect of Colsaurin syrup on the quality of life in adults diagnosed with acute bronchitis. Materials and Methods: This study was a randomized, double-blind, placebo-controlled clinical trial conducted among inpatients at Songinokhairkhan District General Hospital, Ulaanbaatar. Adult patients diagnosed with acute bronchitis (J20) who met the inclusion criteria and provided informed consent were enrolled. Participants were randomly assigned to either the Colsaurin or placebo group. Result: In the Bronchitis Severity Score (BBS) assessment, baseline mean scores indicated severe disease: 10.88±2.47 in the Colsaurin group and 10.67±2.16 in the placebo group. After treatment, scores decreased significantly to 3.50±1.41 (p<0.001) in the Colsaurin group and 5.00±2.24 (p=0.006) in the placebo group, indicating greater improvement in the Colsaurin-treated patients. In the Visual Analog Scale (VAS) assessment, the mean pre-treatment score for both groups was 7, corresponding to frequent cough, which decreased to 2 after treatment (p<0.05), representing a 28% reduction in coughing discomfort. In the Cough and Sputum Assessment Questionnaire (CASA-Q), the Colsaurin group showed a 3.25-point reduction after treatment, indicating a significant decrease in cough frequency and triggering factors (p<0.05). Conclusion 1. In patients diagnosed with acute bronchitis (J20), treatment with Colsaurin syrup reduced disease severity by 30% and alleviated cough-related discomfort by 28% compared to baseline. 2. Moreover, patients reported improved sleep quality and work capacity, reflecting an overall enhancement in quality of life. 3. No adverse effects were observed in the Colsaurin treatment group.

Background: Chronic Fatigue Syndrome (CFS) is a poorly understood disorder of unknown etiology, characterized by clinical manifestations including physical exhaustion, low-grade fever, myalgia, dizziness, mood fluctuations, cognitive impairment, and sleep disturbances. CFS is highly prevalent and frequently comorbid with psychiatric conditions, particularly depression and anxiety. Symptoms exacerbate during physical or mental exertion and do not completely resolve with rest. Currently, there is a lack of proven, effective pharmacological treatments for CFS. Therefore, this study aimed to investigate the anti-fatigue effects of Immunoflu. Aim: To evaluate the anti-fatigue effects of Immunoflu, a technologically modernized formulation derived from the traditional Mana-4 decoction. Materials and Methods: A chronic fatigue rat model was established using the forced-swim protocol described by Jia Wang and Chengxin Sun (2013). The pharmacological effects of Immunoflu were evaluated by quantifying serum levels of cytokines (IL-1β, IL-2, IL-5, IL-10, and IL-17a) by ELISA and assessing behavioral despair using the forced swim test (FST). Results: We evaluated how Immunoflu affects the chronic fatigue model at doses of 100, 200, and 400 mg/kg by measuring serum levels of IL-1β, IL-2, IL-5, IL-10, and IL-17a and assessing despair using the “Forced swim test”. In the forced-swimming-induced chronic fatigue model in rats, Immunoflu at a dose of 100 mg/kg increased the serum IL-2 indicator by 23.8%, and Immunal at a dose of 50 mg/kg increased it by 23.3% compared to the model control group, a statistically significant difference (p < 0.05). Furthermore, Immunoflu at 200 mg/kg reduced IL-17a cytokine levels by 23.7% compared with the model control group. When evaluating the swimming state of the animals with the Forced swim test, the group given Immunal 50 mg/kg (52.03±9.3 sec) decreased by 31.6% (*p=0.038), and the group given Immunoflu 100 mg/kg (49.19±8.54 sec) decreased by 35.3% (*p=0.01) respectively compared to the model control group, while no statistically significant difference was observed in other groups. Conclusions 1. Immunoflu at 100 mg/kg demonstrates immunostimulatory effects in a chronic fatigue model by increasing serum IL-2 levels by 23.8%. Additionally, at 200 mg/kg, it exhibits anti-inflammatory properties, reducing IL-17a levels by 23.7%. 2. In the forced-swimming model, Immunoflu at 100 mg/kg effectively reduced behavioral despair and physical fatigue by 35.3%.

Background: Lish-6 has been used for treatment pharyngitis, flu and throat disease. Lish-6 is composed from Eugenia caryophylla. Thumb, Saussurea lappa C.B. Clark, Schizostachoum chinense. Rendle, Glycyrrhiza uralensis. Fisch, Gentiana algida Pall, Terminalia chebula. Retz. Anti-fever properties of these plants and their bio-active compounds have extensively been studied. Aim: To determine the anti-fever effects of Lish-6. Marerials and Methods: Fever was induced by intravenous administration of lipopolysaccharide (LPS) at concentration of 0.5 mg/kg. Lish-6 was given orally at concentration of 92 mg/kg, 1 and 6 hours after the LPS administration. Rectal temperature wa measured 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 hours after the LPS administration. Paracetamoli was given orally at concentration of 50 mg/kg. Blood levels of Prostaglandin E2 (PGE2) and interleukin-6 (IL-6) interleukin-1β (IL-1β) were determined by enzyme linked immune sorbent assay using rat kits. Lung tissue was examined by histopathological analysis. Results: The body temperature of rats in the normal group was 35.0±1.10С, while in the control group, periodic fever was caused by the effect of lipopolysaccharide (p=0.001). But in the Lish-6 drug group, rectal temperature decreased steadily (p=0.05). In addition, the IL-1β cytokine in the normal group was 3.24±0.31 ng/L and increased by 60.5% in the control, indicating the development of the pathological model, while this parameter decreased by 31% in the Lish-6 drug group (p=0.05). IL-6 cytokine in the normal animals was 21.1±0.2 pg/L and increased by 19.04% in the control, indicating the development of the pathological model, while this parameter decreased by 8.3% in the Lish-6 drug group (p =0.05). PGE2 in the normal group was 43.2±0.3 ng/L, and it increased by 62.7% in the control group, indicating the development of a pathological model, while this parameter decreased by 53.3% in the Lish-6 drug group (p=0.05). Conclusion Lish-6 traditional drug has the effect of reducing rectal temperature, IL-1β, PGE2 and IL-6 cytokines during lipopolysaccharide-induced febrile pathology model.

Background: Erkhem-8 medicine is a composed Crocus Sativus L, Lagotis integrifolia, Gentiana barbata froel etc, used for the treatment of respiratory diseases, specially pneumonia and fever or hot disease in Mongolian Traditional Medicine. Aim: The effects of Erkhem-8 medicine to determine the some sourcebook study results. Materials and Methods: An evaluation of its effects on wind, bile, and phlegm was conducted using Traditional Mongolian Medicine methods (Dagvatseren B, 1996). In order to clarify the structure and composition of Erkhem-8 traditional medicines, and the treatment of lung fever from traditional medical sources. Text and source-study and comparison method were used in the study. Results: The study found that Erkhem-8 medicine demonstrated a varying capacity to suppress wind, bile, and phlegm, with bile suppression being the most significant at 0.68, followed by wind suppression at 0.58, and phlegm suppression at 0.16. Erkhem-8 is composed of 8 ingredients, which are safflower Carthamus tinctorius L, gmeline Bostaurus domesticus, Schizostachoum chinense Rendle, wood Santalum album L, Odontitis rubra Baung.Opiz, flora Gentiana decumbens L, herba Lagoti sintegrifolia Schischk, flora Aconitum Kusnezoffii Reichenb. These herbs themselves have a variety of biological activities, including reduce heat, pain relief, anti-oxidant and anti-tumor, anti-inflammation activity. Conclusions 1. The study found that Erkhem-8 exhibited the highest suppression of bile (0.68), followed by wind (0.58), and phlegm (0.16), indicating its effectiveness in modulating these elements. 2. Most of the raw materials included in the composition of Erkhem-8 medicine have a bitter and sweet taste and have the ability to remove heat, especially heat of the solid organs, i.e. heat of the lungs, liver, blood, specially pneumonia and fever or hot disease in Traditional Mongolian Medicine.

Background: Lish-6 has been used for treatment pharyngitis, flu and throat disease. Lish-6 is composed from Eugenia caryophylla Thumb, Saussurea lappa C.B.Clark, Schizostachoum chinense Rendle, Glycyrrhiza uralensis Fisch, Gentiana algida Pall, Terminalia chebula Retz. Anti-fever properties of these plants and their bio-active compounds have extensively been studied. Aim: To determine the pain relief and antibacterial effects of Lish-6. Materials and Methods: To conduct acute toxicity study using V.B. Prozorovsk method. Average lethal dose, lethal and maximum nonlethal doses were determined. Acetic acid (1%-0.1 ml) was injected into the rat abdominal cavity to induce pain. Wistar rat of either sex (n = 6) weighing 18–22g were used. All animals were withdrawn from food 2h before the start of experiment and were divided in five groups. Group I was injected with normal saline (10ml/kg) as control, Diclodenk was given orally at concentration of 25 mg/kg. Group II III, IV, V and VI were injected with Lish-6 was given orally at concentrations of 9.2, 18, 36, 92, 184 mg/kg injection of acetic acid. The number of abdominal constrictions (writhes) were counted of acetic acid injection for the period of 20 min. To determine the antibacterial effect by dilution method. Results: Average lethal dose of Lish-6 was found to be LD50=0.92 (0.6-1.04) g/kg suggesting that it is slightly toxic animals. Control group animals abdominal constrictions 72.4±8.8. Lish-6 concentrations of 9.2, 18, 36, 92, 184 mg/kg group animal reduced acitic acid induced pain by 41.9-78.7% suggesting that it is pain relief effect (p<0.001). 4 g of Lish-6 medicine is active against gram-positive bacteria (S.aureus, Streptococcus pneumonia). However, it is inactive against gram-negative bacteria. In other words, Lish-6 medicine inhibits the growth of methicillin-resistant and non-resistant S.aureus bacteria at a dose of 500 mg. It was also found to inhibit Streptococcus pneumonia at a dose of 250 mg. Conclusion Average lethal dose of Lish-6 was found to be LD50=0.92 (0.6-1.04) g/kg suggesting that it is slightly toxic animal. Lish-6 reduced acitic acid induced pain by 41.9-78.7% suggesting that it is pain relief effect. Lish-6 traditional drug has an antibacterial effect.

Background: In traditional medicine, the Shimshin-6 formulation, which consists of Rheum undulatum L., Hippophae rhamnoides L., Zingiber officinalie Roscoe, Saussurea Lappa C.B.Clark, Sal ammoniacum, Tronae veneni, is recommended for women experiencing menstrual retention disorders. In recent years, Shimshin-6 has been widely used to promote postpartum uterine involution for women and our study aimed to evaluate and determine the acute and chronic toxicity effects of Shimshin-6. Aim: To evaluate and substantiate the acute and chronic toxicity effects of Shimshin-6. Materials and Methods: The acute toxicity of Shimshin-6 was evaluated using the rapid method described by V.B. Prozorovsky (1978) by administering intraperitoneal injections of the medicinal extract in white mice to determine the lethal dose. The active dose was determined following the methodology of I.P. Zapadnyuk (1983). Chronic toxicity was evaluated in Wistar rats according to the OECD 407 (2008) guidelines. The test animals were administered Shimshin-6 in tablet form (90 mg/kg and 180 mg/kg) and decoction form (tang) (162 mg/kg) daily for 60 days. At the end of the experiment, biochemical and complete blood analyses were conducted, along with histopathological examination of major organs. The study was conducted with ethical approval granted by the Ethics Committee of the Mongolian National University of Medical Sciences (MNUMS) on October 25, 2024. Results: The LD50 for Shimshin-6 tablets was 4.47 (3.39–5.1) g/kg, indicating low acute toxicity based on the K.K. Sidorov classification. The LD50 for the decoction form was 8.1 (7.1–9.4) g/kg, suggesting it is non-toxic. Regarding chronic toxicity, platelet count was significantly reduced compared to the healthy control group: Shimshin-6 tablet group: 46% reduction at 90 mg/kg and 29.7% reduction at 180 mg/kg. Shimshin-6 decoction group: 60.5% reduction at 162 mg/ kg. Additionally, hemoglobin levels in the decoction group (162 mg/kg) decreased by 15.7% (p<0.05). Biochemical analysis showed a 36.3% reduction in total cholesterol (LDL-C) levels in the tablet group (180 mg/kg) and decoction group (162 mg/kg) compared to the control (p<0.05). Conclusion Shimshin-6 tablets showed low acute toxicity in experimental mice. However, long-term administration may lead to a reduction in platelet count.

Background: The Shimshin-6 formulation, composed of Rheum undulatum L., Hippophae rhamnoides L., Zingiber officinale Roscoe, Saussurea lappa C.B. Clarke, Sal ammoniacum, and Tronae veneni, has traditionally been used in the management of gynecological disorders such as amenorrhea, abnormal blood clot formation, and pelvic pain. It has also been widely applied in postpartum care to promote uterine contractility and to prevent complications, including hemorrhage and inflammation. However, its therapeutic potential in postpartum uterine involution has not been scientifically validated. Aim: To investigate the effects of the Shimshin-6 herbal formulation on postpartum uterine involution in rats Materials and Methods: This experimental study was conducted at the Research Center of the Institute of Traditional Medicine and Technology, following the methodology described by Zheng ZH et al. (2019). Postpartum rats were randomly assigned to four groups and received daily treatments for five consecutive days with either Shimshin-6 tablets at doses of 180 mg/kg and 90 mg/kg, Shimshin-6 decoction at 163 mg/kg, or physiological saline as a control. Serum concentrations of estrogen, progesterone, TNF-α, TGF-β1, and TGF-β3 were measured using commercially available ELISA kits (Shanghai MLBIO Biotechnology Co. Ltd, China). Following ethical euthanasia, uterine tissues were collected for histological examination, which included evaluation of uterine weight, endometrial thickness, myometrial structure, and glandular morphology. Results: Shimshin-6 treatment significantly reduced the uterine index and serum estrogen levels compared with the control group, while no significant difference was observed in progesterone concentration. The treatment also decreased tumor necrosis factor-α (TNF-α) levels and modulated growth factors in postpartum rats. Histological analysis further revealed that Shimshin-6 promoted uterine recovery, despite the presence of inflammatory cell infiltration and hemorrhagic changes in the uterine wall. Conclusion Shimshin-6 preparation exerts a promotive effect on postpartum uterine involution in rats.

: The “Zidraga-6” prescription, which is widely used in traditional medicine, was selected and technologically developed, and formed into capsule medicine. Zidraga-6 capsule was prepared using six different herbal Capsicum annuum L. Holarrhena antidysenterica Wall ex, Atragene sibirica L, Embelia ribes Burm, Terminalia chebula Retz, and Kaempferia galanga L. Goal: This study was conducted to standardize and determine the safety and quality parameters of the Zidraga-6 capsule. Materials and Methods: Quality (moisture, total ash) and safety parameters were determined by Mongolian National First Pharmacopoeia methods. The content of the main biologically active compounds in the Zidraga-6 capsule was identified using TLC. In addition, the content of biologically active compounds is determined by UV spectrophotometer methods. The results were processed using basic biostatistical methods, calculating the arithmetic mean (M), standard deviation (δ), and standard error (m) using the SPSS 20.0 program. The ethical approval for the study was obtained by a decision of the Ministry of Health - Medical Ethics Review Committee on research on May 23, 2023 (23/029). Results: The presence of p-methoxycinnamate, gallic acid, oleanolic acid, and capsaicin in the Zidraga-6 capsule drug was detected by the TLC method, and their Rf values were 0.26, 0.24, 0.82, and 0.45, respectively. The average weight of Zidraga-6 capsules was 0.4±0.019 g, moisture was 9.63±0.09%, disintegration was 6.48±0.37 minutes, dissolution was 94.68±2.85%. The content of methods biologically active compounds in the Zidarga-6 capsule was determined total triterpene saponins as 1.89±0.19% by UV spectrophotometric methods. Conclusion We determined quality and safety parameters of the Zidraga-6 capsule were defined and the Mongolian National Pharmacopoeia monograph’s draft for the Zidraga-6 capsule was developed.