Jujube

BACKGROUND: PCOS is a common condition among women of reproductive age, marked by irregular menstrual cycles, hyperandrogenism, and ultrasound abnormalities. Infertility treatments such as metformin and myoinositol often have side effects and low adherence. Ziziphus jujuba has the potential in improving PCOS outcomes, prompting this study to compare its effect on pregnancy rates with conventional therapies. METHODS: This double-blind, randomized trial involved 196 infertile PCOS patients (ages 18-45), with 49 participants in each group. Participants were randomly assigned to four groups: metformin (500 mg daily), myoinositol (2000 mg daily), Ziziphus jujuba hydroalcoholic extract (15 g daily), or placebo (sachet/pill) for 12 weeks. Biochemical (FBG, lipid profile, ALT, AST, ESR, CRP, TyG index) and anthropometric (weight, BMI, waist circumference) measurements were taken pre- and post-study. Ovulation induction with letrozole was performed, and pregnancy occurrence was the primary endpoint, assessed via Beta hCG and ultrasound 6-7 weeks after treatment. RESULTS: No significant differences in pregnancy as primary outcome were found (Ziziphus jujuba: 10, Metformin: 7, Myoinositol: 5, Placebo: 4; p > 0.05). However, significant improvements in cholesterol, TG, HDL cholesterol, and FBG were observed in the Ziziphus jujuba compared to other groups (p < 0.05). CONCLUSION: The Ziziphus jujuba extract demonstrated significant improvements in FBG levels, lipid profiles, and insulin resistance; however, it did not significantly increase pregnancy occurrence compared to metformin, and myoinositol. No serious adverse effects were observed, with only one participant reporting mild constipation. These findings suggest that while Ziziphus jujuba shows promise in metabolic management of PCOS, its efficacy in enhancing fertility outcomes requires further investigation or consideration in combination therapies. TRIAL REGISTRATION: Registered at the Mashhad Medical University of Medical Science: IR.MUMS.MEDICAL.REC.1402.191. The date of enrolment of the first patient into the trial is January 21, 2023. © 2025. The Author(s).

Functional constipation is a common disorder of the gastrointestinal tract in children without specific treatment. Ziziphus jujuba has been used in traditional medicine for various diseases such as constipation. A safe and inexpensive treatment with few side effects can be used as an effective alternative to current medications. In this study, we sought to compare Ziziphus jujuba syrup (ZS) with polyethylene glycol (PEG) for the treatment of pediatric functional constipation. A double-blind, randomized clinical trial was performed on children aged 2-10 years with functional constipation who were referred to the gastroenterology clinic of the 17-Shahrivar Hospital in Rasht, Iran. Eligible patients were randomized into two groups: PEG group; 1-5 cc/kg/day (40% w/v solution without electrolytes; average dose: 0.2-1 g/kg), and ZS group; 1-5 cc/kg/day (average dose: 5-25 mg/kg). All patients were followed up for three months, every 2 weeks in the first month, and then monthly for 2 months. At the beginning and end of the study, liver and kidney function tests and blood sugar levels were checked. Data were analyzed using SPSS software version 19 at a significance level of 0.05. Out of 90 eligible children, 32 patients in the PEG group and 30 patients in the ZS group completed the follow-up visits. The mean age of the subjects was 4.31 ± 1.97 years. There was no significant difference between the two groups in terms of age (P = 0.181), gender (P = 0.218), age at onset of constipation (P = 0.083), and weight (P = 0.199). The average therapeutic response score in the ZS group improved prominently compared to the PEG group (P < 0.05). The average number of encopresis and visual analog scale pain scores significantly decreased in the ZS group compared to the PEG group (P < 0.05). Other indices, including frequency of defecation, and medication adherence in the ZS group were significantly improved compared to the PEG group (P < 0.05). Only in the PEG group, a few cases reported self-limiting side effects. ZS can be a treatment choice for functional constipation without any adverse events or liver or kidney injury in children. However, further studies are necessary to find p

OBJECTIVES: The effects of jujube (Ziziphus jujube) consumption on metabolic and mental health outcomes in subjects diagnosed with metabolic syndrome (MetS) is unknown and remains to be examined. Hence, we carried out a parallel-group, randomized controlled trial to investigate this issue. METHODS: Eligible participants were randomly assigned to the intervention (n = 30) or the control (n = 30) groups to receive either jujube or a placebo for eight weeks. Subjects were provided with 30 g dried jujube powder or placebo and were asked to consume half of the powder at 10 a.m. and the rest at 4 p.m. Lipid profile, fasting blood glucose (FBG), waist circumference (WC), and blood pressure were evaluated as primary outcomes. Secondary outcomes collected were mental health measures (e.g., depression, anxiety, and stress). RESULTS: Jujube consumption failed to decrease FBG, total cholesterol, low-density lipoprotein cholesterol, and blood pressure, as well as depression and anxiety scores (P > 0.05). However, the between-group comparison revealed a significant improvement in WC (- 3.98 vs. - 0.51, P = 0.01), triglyceride (TG) (- 24.96 vs. - 0.73, P = 0.03), and high-density lipoprotein cholesterol (HDL-C) (2.83 vs. 0.40, P = 0.01) in the jujube group compared to the placebo. In addition, compared to the control group, jujube consumption led to a significant improvement in the score of stress (- 5.80 vs. - 2.86, P = 0.01). CONCLUSION: Jujube consumption only had beneficial effects on WC, TG, and HDL-C in subjects with MetS. However, the current study has methodological weaknesses in blinding and herb purity/potency testing, which should be addressed in future studies. Nomogram for Predicting the Risk of Complications after Endoscopic Foreign Body Removal from the Adult Upper Gastrointestinal Tract. Chen Z(1), Yin M(2), Xia P(2), Han X(2), Zhu H(3). Author information: (1)Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong, 226000, China. (2)Department of Gastroenterology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210000, Jiangsu Province, China. (3)

4. Dig Dis Sci. 2024 Apr;69(4):1361-1371. doi: 10.1007/s10620-024-08343-7. Epub 2024 Feb 28. Nomogram for Predicting the Risk of Complications after Endoscopic Foreign Body Removal from the Adult Upper Gastrointestinal Tract. Chen Z(1), Yin M(2), Xia P(2), Han X(2), Zhu H(3). Author information

BACKGROUND: Although antihistamines are the first-line treatment for chronic spontaneous urticaria (CSU), 50% of patients don't respond to standard doses. In this study, the effectiveness of Ziziphus jujube fruit syrup in combination with antihistamines was assessed in patients with CSU. METHODS: This double-blind randomized clinical trial was conducted in Shiraz between December 2019 and December 2020. 64 patients with CSU who had experienced hives for at least six weeks and did not respond to the usual treatments were enrolled in the study. They were randomly assigned to intervention and control groups using permuted block random allocation. For four weeks, the intervention group received 7.5 mL Ziziphus jujube syrup twice a day, while the control group received 7.5 mL simple jujube syrup twice a day. Both groups received cetirizine 10 mg every night. Urticaria activity score (UAS) and CU-Q2oL questionnaires were used to assess urticaria state and sleep quality before and after each week for four consecutive weeks. Data were analyzed using SPSS software version 18, and P<0.05 was considered statistically significant. RESULTS: Before the intervention, there was no statistically significant difference between the two groups' mean of UAS (P=0.490) and sleep quality (P=0.423). During the follow-up, UAS in the intervention group was significantly lower (P=0.001). Moreover, this difference was significant on the day 28 (P=0.046). During the follow-up, the quality of sleep in both groups improved significantly, and this improvement was more significant in the intervention group. CONCLUSION: Ziziphus jujube syrup could be an effective adjuvant treatment for CSU.Trial Registration Number: IRCT20190304042916N1. Copyright: © Iranian Journal of Medical Sciences.

BACKGROUND & AIMS: In the current study, we aimed to assess the effect of dried Ziziphus jujube on blood glucose, lipid profiles, anthropometric indices, and inflammatory factors in type 2 diabetic(T2D) patients. METHODS: In this randomized controlled clinical trial, 48 patients, aged 30-65 years, were randomly assigned to two intervention(n = 24) and control(n = 24) groups. The subjects in the intervention group received 30 g Ziziphus jujube daily for 12 weeks. At baseline and the end of the 12th week, 10 ml of blood was taken from each patient after a 12- to 14-h overnight fasting. Plasma levels of fasting plasma glucose (FPG), triglycerides(TGs), total cholesterol(TC), high-density lipoprotein-cholesterol(HDL-C), low-density lipoprotein-cholesterol(LDL-C), high-sensitivity C-reactive protein(hs-CRP), and interleukin-6(IL-6) were measured. Anthropometric indices were determined. RESULTS: Plasma FPG, TG, TC, and LDL-C decreased significantly up to -11.36%, -13.59%, -7.46%, -7.65% in the Ziziphus jujube group at the end of week 12 compared to baseline, respectively (P < 0.05), and this reduction was significant in comparison with the control group (P < 0.05). The plasma hs-CRP reduced significantly up to -24.46% in the Ziziphus jujube group at the end of week 12 compared to baseline (P < 0.05), however, this reduction was not significant in comparison with the control group (P < 0.05). Also, there were no significant differences between the two groups in mean changes of body mass index, plasma HDL-C, and IL-6. CONCLUSIONS: The current study showed that daily consumption of Ziziphus jujube may have beneficial effects on the lipid profiles and blood glucose levels in T2D. CLINICAL TRIAL REGISTRATION NUMBER: T his clinical trial was registered at the Iranian registry of clinical trials (IRCT registration number: IRCT20181210041913N1).

Ziziphus jujuba Mill. (jujube) is an invaluable medicinal plant in traditional and modern medicine. Jujube syrup is a complex of herbal extracts including Z. jujuba, Berberis vulgaris, Rhus coriaria, Prunus domestica, and Rosa damascene. The purpose of the present study was to formulate and investigate the efficacy and safety of jujube syrup on brightening of facial skin. In this randomized, double-blind, controlled clinical study, 46 participants consumed jujube syrup or placebo (23 in each group) twice a day for 8 weeks. The number of pigments, area of pigmentation, and physician's global assessment score (PGAS) were evaluated at baseline and after 8 weeks. The results showed the amounts of total phenolics and flavonoids were 81.97 ± 0.25 and 4.98 ± 1.04 mg/ml, respectively. The amounts of organic acids (gallic acid and chlorogenic acid) were quantified at 1140 ± 17.65 and 1520 ± 25.77 μg/ml, respectively. The amounts of total phenolic and flavonoids were stable under accelerated conditions. Eight weeks after treatment, the number of pigment counts reduced to 0.545 ± 0.307 compared to the placebo group. Moreover, the pigmented area and its percentages were significantly reduced to 0.556 ± 0.285 and 0.561 ± 0.288 in jujube syrup compared with placebo, respectively. Jujube syrup is efficient and safe for treating hyperpigmentation of the face. © 2022 Wiley Periodicals LLC.

Liver injury is the most common complication of anti-tuberculosis drugs that can cause significant problems. The study aimed to determine the effectiveness of Jujube syrup on the prevention of antituberculosis drug-induced hepatotoxicity (DIH). This pilot randomized double-blind study was conducted based on a placebo-controlled design in patients with tuberculosis (TB). The patients were divided into two groups based on the block random allocation method and received 10 cc of jujube or placebo syrup per day. The liver enzyme levels were assessed as primary outcomes, and the severity of cough, anorexia, and nausea along with the quality of life (QOL) was assessed as secondary outcomes. Finally, eight and nine patients in the jujube and placebo groups completed the study, respectively. In the second week of the study, 27.3% of the patients in the placebo group developed hepatotoxicity. Moreover, there was no liver toxicity in the jujube group. This difference between the two groups was statistically significant (p = .037). Furthermore, the severity of cough in patients in the jujube group decreased significantly during weeks 2 and 4. The QOL significantly improved in the jujube group, compared to the placebo group. This study suggested that Jujube syrup could prevent anti-TB DIH. It can also improve the severity of cough and the QOL in pulmonary TB patients. © 2021 The Authors. Pharmacology Research & Perspectives published by John Wiley & Sons Ltd, British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics.

Coronavirus disease 2019 (COVID-19) pandemic has caused an urgent need for investigating potential treatments. Traditional medicine offers many potential remedies that have been historically used and have the advantage of bypassing the cultural obstacles in the practice of medicine. We aimed to investigate the efficacy of Zufa syrup in the treatment of suspected patients with mild to moderate symptoms of COVID-19. This triple-blind randomized controlled trial recruited patients with evidence of COVID-19 on chest computed tomography without an indication of hospital admission from March 2020 until April 2020. Participants were assessed by a physician and completed a pre-specified form to assess the duration and severity of symptoms. Patients were randomized to receive Zufa syrup (a combination of herbal medicines: Nepetabracteata, Ziziphus jujube, Glycyrrhizaglabra, Ficuscarica, Cordia myxa, Papaver somniferum, Fennel, Adiantumcapillus-veneris, Viola, Viper's-buglosses, Lavender, Iris, and sugar) or identical-looking placebo syrup at a dose of 7.5 mL (one tablespoon) every 4 hours for 10 days. After applying the eligibility criteria, 116 patients (49.1% male) were randomized to trial arms with a mean age of 44.3. During the follow-up, Cough, dyspnea, headache, myalgia, anorexia, anxiety, and insomnia improved gradually in both groups, and showed no difference between Zufa syrup and placebo. Oxygen saturation and pulse rate had stable trends throughout the follow-up and were similar between study arms. No patient required hospital admission or supplemental oxygen therapy during the study period. To conclude, in patients with mild to moderate symptoms of COVID-19, Zufa syrup did not show any difference in symptomatology over a 10 days' period when compared with placebo. Due to potential effects of medicinal plants in the treatment of respiratory infections, further studies are warranted to clarify their role in COVID-19. The study was approved by the Ethics Committee of the Qom University of Medical Science (Ethics committee reference number IR.MUQ.REC.1398.165) on March 10, 2020 and was registered in Iranian Clinical Trial Center (approval ID: IRCT20200404046934N1

Physiologic changes due to aging, pregnancy, nutritional status, drug interactions, and can affect pharmacokinetics and pharmacodynamics of antiepileptic drugs. In this review article, the interactions between phenytoin and herbs recorded in the literature were summarized according to the Medline database (via PubMed). Our results revealed that, changes in phenytoin's bioavailability were reported for co-administration of herbs or herbal extracts. An increase in phenytoin blood levels was established with Piper nigrum, Mentat, and Lipidum sativum in in vitro and/or in vivo studies. In contrast, herbphenytoin interactions led to sub-therapeutic levels of phenytoin in other cases with herbs such as Cannabis, Ginkgo biloba, Morinda citrifolia, Nigella sativa, and Trigonella foenum graceum. In addition, the findings of other pharmcodynamic experiments showed that various herbs, including Zizyphus jujube, Terminalia chebula, Curcuma longa L, and Centella asiatica, improved the pharmacological impact of phenytoin. To reduce the patients' health risks, health professionals involved in their treatment are expected to be thoroughly educated about the interactions between phenytoin and medicinal plants.

Reverse transcriptase inhibitors (RTIs), including nucleoside RTIs (NRTIs) and non-nucleoside RTIs (NNRTIs), are critical antiretroviral drugs for the treatment of human immunodeficiency virus (HIV) infection. Emergence of multi-RTI resistance calls for the development of more potent therapeutics or regimens against RTI-resistant strains. Here, we demonstrated that combining azidothymidine (AZT) with a new NNRTIs under development, diarylpyridine (DAPA)-2e, diarylanilin (DAAN)-14h, or DAAN-15h, resulted in strong synergism against infection by divergent HIV-1 strains, including those resistant to NRTIs and NNRTIs, suggesting the potential for developing these novel NNRTIs as salvage therapy for HIV/acquired immune deficiency syndrome (AIDS) patients.

The synergistic effects of biocontrol yeasts Cryptococcus laurentii and Rhodotorula glutinis combined with silicon (Si) against Alternaria alternata and Penicillium expansum molds were investigated in jujube fruit (Chinese date, Zizyphus jujuba) stored at 20 and 0 degrees C, respectively. Combinations of C. laurentii and R. glutinis at 5 x 10(7) cells/ml with 2% Si was most effective in controlling the diseases caused by A. alternata and P. expansum on jujube fruit stored at 20 degrees C. When fruits were stored at 0 degrees C, combining C. laurentii and R. glutinis with Si was as effective against P. expansum as was Si or the yeasts applied alone and was more effective in controlling A. alternata. Si may have a fungistatic effect by directly inhibiting pathogen growth, but it did not greatly influence the growth of the antagonists.

Fifty-nine species of extracts of Chinese herbal medicinal prescription were tested for inhibitory activity of adenosine 3',5'-cyclic monophosphate (cAMP) phosphodiesterase (PDE). Kanzo-shashin-to showed the highest activity in these prescriptions. Kanzo-shashin-to, Hange-shashin-to and Shokyo-shashin-to, whose contracting crude drugs were very similar, were especially studied among these prescriptions. Pinellia tuber acted as an ascent component for Scutellaria root and a mitigatory component for Giycyrrhiza. Jujube acted as a mitigatory component for Glycyrrhiza. Ginger acted as an additional component for Scutellaria root in cAMP PDE test. This additional effect of 6-gingerol, 6-shogaol from Ginger and baicalin from Scutellaria root were investigated.

As the treatment of nonspecific chronic cough with conventional medications that treat cough according to the cause is limited, Maekmundong-tang (comprising Liriopis seu Ophiopogonis Tuber, Pinelliae Tuber, Oryzae Semen, Zizyphi Fructus, Ginseng Radix, and Glycyrrhizae Radix et Rhizoma) has been used empirically in the clinical setting of East Asian traditional medicine. This study is the first to explore the feasibility, preliminary effect, safety, and cost-effectiveness of Maekmundong-tang for nonspecific chronic cough. This study protocol is that of a double-blind, randomized, active-controlled, parallel-group clinical trial for comparing Maekmundong-tang with Saengmaek-san (comprising Liriopis seu Ophiopogonis Tuber, Ginseng Radix, and Schisandrae Fructus), a Korean national health insurance-covered herbal medicine for cough. A total of 30 nonspecific chronic cough patients will participate and receive the assigned herbal medicine for 6 weeks, and clinical parameters will be assessed at weeks 0 (baseline), 3 (midterm assessment), 6 (primary endpoint), 9, and 24 (follow-up). Study feasibility outcomes, including recruitment, adherence, and completion rates, will be assessed. Preliminary effects on cough severity, frequency, and quality of life will be evaluated using outcome measures, such as the Cough Symptom Score, Cough Visual Analog Scale, and the Leicester Cough Questionnaire. Adverse events and laboratory tests will be monitored for safety evaluation, and exploratory economic evaluations will be conducted. The results will provide evidence of Maekmundong-tang in the treatment of nonspecific chronic cough.

OBJECTIVES: Ziziphus jujuba var. spinosa, commonly known as sour jujube, has been utilized for millennia in traditional Chinese medicine and functional foods. This review comprehensively summarizes the phytochemistry, pharmacology, and resource utilization of its multiple medicinal-edible parts, aiming to bridge research gaps and promote integrated applications. METHODS: A systematic literature search was conducted across PubMed, Web of Science, Google Scholar, and CNKI, using keywords such as "Sour jujube" and "Z. jujuba var. spinosa," covering publications up to December 2024. KEY FINDINGS: Phytochemical analysis identified 354 bioactive compounds, including 164 flavonoids and 74 triterpenoids, underlying the plant's broad-spectrum pharmacological activity. The seeds, a well-documented herbal medicine, are used alone, in polyherbal formulations, or as an adjuvant to acupuncture, with sedative-hypnotic effects extensively studied via neurotransmitter regulation, specifically by upregulating GABA receptor expression and inhibiting 5-HT degradation and signaling pathway modulation. Nonseed tissues, such as fruits, leaves, and roots, exhibit underutilized potential due to their high content of antioxidants and nutrients, yet remain understudied, leading to resource waste. CONCLUSIONS: This review highlights the need to prioritize research on nonseed parts to maximize their medicinal and nutritional value. The findings provide a scientific basis for advancing sour jujube's applications in healthcare and functional food industries. © The Author(s) 2026. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

Jujube is a widely consumed fruit with a long history in traditional medicine. Numerous studies have explored its potential effects on various health parameters. However, the overall quality of this evidence and the specific impact of jujube on metabolic syndrome remain unclear. This meta-analysis investigates the effect of jujube on body mass index, serum lipid profile, blood sugar levels, and other metabolic factors and blood indicators. The databases Web of Science, Scopus, PubMed, Google Scholar, and SID were searched up to September 2023. Our review included various clinical studies written in English and Persian that focused on the effect of jujube on lipid profiles. In vivo, in vitro, review studies, book chapters, observational studies, and low-quality studies based on critical appraisal tools were excluded from the analysis. A total of seven studies involving 483 participants were included in this review. Jujube significantly reduced BMI and TG, and also markedly decreased FBS in subjects with type 2 diabetes. Furthermore, the results varied significantly based on subgroups defined by dosage, treatment duration, and disease type. Notably, LDL and total cholesterol levels showed a significant decrease within some of these subgroups. However, HDL, AST, and ALT did not have significant changes. The findings suggest that jujube may exert beneficial effects on metabolic diseases, particularly in patients with hyperlipidemia and type 2 diabetes. However, the overall quality of the evidence is limited, and further research is needed to confirm these findings and elucidate the mechanisms underlying jujube's effects. Impact of jujube fruit on serum lipid profile, glycemic index, and liver function: a systematic review and meta-analysis. © 2025. The Author(s).

OBJECTIVES: This study sought to determine the most common oral herbal formula for menopausal symptoms in classical Chinese medicine textbooks and investigate its clinical effectiveness and potential mechanisms of action. METHODS: The most common formula used for menopause-like symptoms in past eras was identified from the Encyclopedia of Traditional Chinese Medicine. A systematic review of randomized controlled trials (RCTs) was undertaken and findings from relevant experimental studies were summarized. RESULTS: Licorice (Glycyrrhiza spp.) and jujube (Ziziphus jujuba Mill.) formula (LJF) was used in 63 of the 175 citations (36%) in the classical literature. Evidence from four RCTs showed that while LJF may improve sleep symptoms, there is insufficient evidence to provide recommendations for clinical practice. Experimental studies showed sedative, antidepressant-like, estrogenic and antiprogestogenic actions. CONCLUSIONS: LJF has a long history of use for menopause-like symptoms, but further research is needed to confirm its clinical effects and guide clinical decision-making.

OBJECTIVE: To assess the effectiveness and safety of Zao Ren An Shen (ZRAS), a Chinese herbal medicine formula, for the treatment of insomnia. METHODS: Seven databases (ie, EMBASE, PubMed, the Cochrane library, and PsycINFO, Chinese National Knowledge Infrastructure, Wanfang and Chongqing VIP) were searched from their inception to 6 November 2018. Controlled trials comparing the effectiveness or safety of ZRAS to conventional treatments, a placebo or no-treatment in an insomnia population were selected. Primary outcomes were: sleep quality (assessed with the Pittsburgh Sleep Quality Index, PSQI), and the number of adverse events at post-treatment. The risk of bias was assessed with the Cochrane Collaboration's tool and meta-analyses were performed using RevMan 5.3. RESULTS: A total of 19 studies (1780 participants) were included. The effect of ZRAS on sleep quality (mean difference) was found to be superior compared to placebo in the sole placebo-controlled study located [-0.90 (-1.56, -0.24; 95% CI), p = 0.007] and similar to Benzodiazepine Receptor Agonists (BzRAs) [0.17 (-0.29, 0.64); 95% CI, p = 0.46]. The number of adverse events (relative risk) was lower for ZRAS than BzRAs [0.16 (0.12, 0.23; 95% CI), p < 0.001]. An overall high risk of bias was found in the selected studies. CONCLUSIONS: The results favor ZRAS against BzRAs and placebo for the treatment of insomnia. However, the poor methodology of the studies prevents strong recommendations for ZRAS. Clinical trials with higher quality designs are required.