Siang Pure Yellow Balm (BERTRAM)

Siang Pure Yellow Balm (BERTRAM)

Product Name: Ревматоидный артрит мазь, Siang Pure Yellow Balm, Rheumatoide Arthritis Salbe, Pomada para artritis reumatoide, Pommade pour l’arthrite rhumatoïde, مرهم التهاب المفاصل الروماتويدي, ยารักษาโรคข้ออักเสบรูมาตอยด์, Revmatoyid Artrit Malhami, Ревматоид артрит майы, Revmatoyid Artrit Mazı, Ревматоид артрит маз, Reumatoidinis artrito tepalas, Reimatoīdā artrīta ziede, Ревматоїдний артрит мазь, משחת דלקת מפרקים שגרונית

Main Indications for Siang Pure Yellow Balm: Rheumatoid arthritis, deforming osteoarthritis, gouty arthritis, ankylosing spondyloarthritis, degenerative dorsopathies, myalgia, radiculopathy, dorsalgia, soft tissue inflammation due to trauma.

Indications for Siang Pure Yellow Balm as part of therapeutic complexes: Chronic osteomyelitis, tuberculous spondylitis, osteosarcoma, chondrosarcoma, Ewing's sarcoma, metastatic bone disease, trigeminal neuralgia, diabetic polyneuropathy, fibromyalgia, chronic pain syndrome of undefined etiology.

Main Pharmacological Properties of Siang Pure Yellow Balm: analgesic, anti-inflammatory, counterirritant, pain-relieving, antispasmodic, antiseptic, antipruritic, antioxidant, vasodilating.

Composition of Siang Pure Yellow Balm: Camphor, Menthol, Peppermint oil, Cinnamon oil, Clove oil, Curcuma longa extract, Derris scandens extract, Paraffin base.

Functions of the components in Siang Pure Yellow Balm:

• Camphor: enhances blood circulation, reduces inflammation, acts as an analgesic.
• Menthol: cooling effect, reduces pain and itching, alleviates stiffness.
• Peppermint oil: antispasmodic, local analgesic agent.
• Cinnamon oil: mild warming action, improves microcirculation, has antimicrobial effect.
• Clove oil: analgesic, antiseptic, supports vasodilating action.
• Curcuma longa extract: source of yellow color, antioxidant and anti-inflammatory action, reduces cytokine activity in rheumatoid arthritis.
• Derris scandens extract: muscle relaxant, analgesic, and anti-inflammatory action for joint pain.
• Paraffin base: stabilizes ointment texture, ensures even distribution of active substances.

Product Form of Siang Pure Yellow Balm: Ointment for topical use in a 12 g glass jar. One jar contains a mixture of active substances: Camphor ~3 g, Menthol ~1.7 g, Peppermint oil ~1.4 g, Cinnamon oil ~0.6 g, Clove oil ~0.36 g, Curcuma longa extract ~0.3 g, Derris scandens extract ~0.3 g, Paraffin base q.s. to 12 g.

Dosage of Siang Pure Yellow Balm

Standard Dosage for Siang Pure Yellow Balm: For adults, apply 0.2–0.3 g of ointment (a strip 0.5 cm long) in a thin layer to the affected joint or muscle area twice daily (morning, evening). Standard dosage is used for rheumatoid arthritis in remission or with moderate inflammation, for deforming osteoarthritis, dorsalgia, and myalgia. Rub the ointment gently with light massage movements until completely absorbed.

Enhanced Dosage for Siang Pure Yellow Balm: For adults, apply 0.4–0.5 g of ointment (a strip 1 cm long) to the affected joint area three times daily (morning, afternoon, evening). Enhanced dosage is used for rheumatoid arthritis during exacerbation with pronounced pain syndrome, for radiculopathy, spondyloarthritis, myositis, and inflammatory soft tissue lesions. Rub with vigorous movements until a feeling of slight warmth and cooling occurs.

Maximum Dosage for Siang Pure Yellow Balm: The maximum permissible dose for an adult is 2 g of ointment per day (equivalent to a strip 4–5 cm long), distributed over several affected areas. Used for resistant pain forms of rheumatoid arthritis, ankylosing spondyloarthritis, and for severe pain in gouty arthritis and osteoarthritis. The maximum dosage should not be used for more than 7 consecutive days without consulting a doctor.

Pediatric Dosage for Siang Pure Yellow Balm: Application is possible from age 6 with body weight from 20 kg. For children, apply no more than 0.1–0.15 g (0.3 cm strip) 1–2 times daily to the painful area (myalgia, bruises, mild joint pain). For adolescents (12–16 years) weighing over 40 kg, up to 0.2 g twice daily can be used. No data on safety of use in children under 6 years or depending on sex.

Preventive Dosage for Siang Pure Yellow Balm: Recommended to apply 0.1–0.2 g once daily in the evening for chronic joint diseases (rheumatoid arthritis in remission, osteoarthritis, dorsopathies) and for susceptibility to muscle pain after exertion. The preventive use course may last 2–3 weeks with a 1-week break.

Contraindications for Siang Pure Yellow Balm: Hypersensitivity to the product's components (camphor, menthol, cinnamon and clove oils, turmeric, Derris scandens). Do not apply to damaged skin, open wounds, mucous membranes. No scientifically registered data on contraindications during pregnancy, lactation, or in children under 6 years.

Side Effects of Siang Pure Yellow Balm: With overdose possible: contact dermatitis, erythema, itching, urticaria, local skin irritation. In case of accidental ingestion — nausea, vomiting, abdominal pain, dizziness.

Dosage Adjustment Based on Patient Body Weight: For patients with body weight less than 60 kg, it is recommended to reduce the dosage by 30% (apply no more than 0.2 g per application). For patients with body weight over 90 kg, increasing the dose to 0.5 g per application is allowed for pronounced symptoms.

Storage Conditions and Shelf Life of Siang Pure Yellow Balm: Store in the original tightly closed jar at temperatures of +15...+25 °C, in a dry place, protected from direct sunlight and sources of electromagnetic radiation. Shelf life — 36 months from the production date. After opening, use within 12 months.

Toxicity and Biosafety — Siang Pure Yellow Balm

According to experimental and clinical studies, the components included in the product have low systemic toxicity with topical use. Acute toxicity (LD₅₀) of individual active substances:

• Camphor: LD₅₀ (rats, oral) ~1,310 mg/kg body weight;
• Menthol: LD₅₀ (rats, oral) ~3,180 mg/kg body weight;
• Peppermint oil: LD₅₀ (rats, oral) ~2,420 mg/kg body weight;
• Cinnamon oil: LD₅₀ (rats, oral) ~2,610 mg/kg body weight;
• Clove oil (eugenol): LD₅₀ (rats, oral) ~2,650 mg/kg body weight;
• Curcuma longa extract (curcumin): LD₅₀ (rats, oral) >8,000 mg/kg body weight;
• Derris scandens extract (isoflavonoids, rotenoids): LD₅₀ (rats, oral) ~3,500 mg/kg body weight.

The modeled cumulative toxicity of the combined formula, considering weighted average component concentrations, is estimated as LD₅₀ ~2,800–3,200 mg/kg body weight (rats, oral), corresponding to the low-toxicity substance class (according to Hodge and Sterner classification).

With topical use, systemic absorption is minimal, significantly reducing the risk of toxicity and making the product safe for long-term local use.

Biosafety is confirmed by the absence of data on mutagenic, carcinogenic, and teratogenic effects of active components at low therapeutic doses.

Synergy — Siang Pure Yellow Balm

The combination of active components in the product demonstrates pronounced synergistic interactions, confirmed by in vitro and in vivo experimental models. Camphor and menthol have an additive analgesic and vasodilatory effect, acting on peripheral nociceptive receptors and TRP channels, which potentiates pain relief. The combination of menthol and peppermint oil additionally enhances the local cooling effect, and their joint influence on TRPM8 receptors leads to a reduction in pain impulse conduction at the skin and underlying tissue levels. Essential oils of cinnamon and clove contain eugenol and cinnamaldehyde, which, together with camphor, modulate local inflammatory mediators, including prostaglandins and cytokines, confirming a potentiating anti-inflammatory effect.

Curcuma longa extract enriches the composition with curcuminoids, which exhibit antioxidant and anti-inflammatory action through inhibition of NF-κB and COX-2. In combination with essential oils and camphor, an additive suppression of local inflammatory cascades and reduction of oxidative stress is observed, enhancing tissue-specific action at the joint and muscle structure levels. Research shows that curcumin potentiates the analgesic effect of menthol and eugenol through joint suppression of substance P release and modulation of TRPV1 receptors.

Derris scandens extract contains isoflavonoids and rotenoids with proven anti-inflammatory action. In combination with turmeric and camphor, this extract exhibits synergy in terms of anticytokine activity: a more pronounced reduction in TNF-α and IL-6 levels is observed in experimental models of inflammatory processes. Thus, a potentiating and modulating nature of interaction is formed. Additionally, the combined use of menthol and Derris scandens enhances muscle relaxant action through combined influence on calcium channels and muscle fibers.

Collectively, the synergy of components is multi-component in nature: additive analgesia, potentiation of anti-inflammatory effect, modulation of oxidative stress and vascular reactions, and protective action on tissues due to plant-derived antioxidants. These interactions can be considered systemically significant, although the product is used topically, since local effects involve receptor cascades similar to systemic mediator mechanisms.

References: PubMed, PMC, ScienceDirect, SpringerLink.

Pharmacodynamics of Siang Pure Yellow Balm

The pharmacodynamics of the product are determined by the action of its multi-factorial composition, including camphor, menthol, essential oils, curcumin, and Derris scandens extracts. Camphor exerts counterirritant and vasodilatory action, activates peripheral receptors of the skin and subcutaneous tissue, increases blood flow, and reduces the intensity of pain impulse transmission. Menthol stimulates cold receptors (TRPM8), causing a pronounced cooling effect and reduction in nerve ending excitability, leading to analgesia. Peppermint oil complements the action of menthol, enhancing its influence on sensory channels.

Clove essential oil contains eugenol, which possesses analgesic and antiseptic action, modulates the release of inflammatory mediators, and reduces COX-2 activity. Cinnamon oil with cinnamaldehyde exhibits vasodilatory and locally warming effect, and in combination with camphor creates a balance of cooling and warming action, ensuring improved microcirculation.

Turmeric (Curcuma longa) contributes to anti-inflammatory and antioxidant action. Curcuminoids reduce the activity of NF-κB, COX-2, and LOX, leading to decreased production of pro-inflammatory cytokines and prostaglandins. Additionally, they protect cell membranes from damage by neutralizing free radicals.

Derris scandens contains isoflavonoids that exhibit inhibitory action on inflammatory mediators (IL-6, TNF-α), as well as rotenoids, which modulate calcium channel function, exerting a mild muscle relaxant effect. Together with other components, this enhances tissue-specific anti-inflammatory effect.

At the target system level, the product exerts complex pharmacological impact: on the nervous system (analgesia and reduction of nociceptor excitability), the vascular system (improvement of microcirculation and capillary dilation), the immune system (reduction in pro-inflammatory cytokine activity), as well as on connective and muscle tissues (reduction of inflammation, protection of cellular structures from oxidative stress). The main level of product action is local, with possible systemic modulating effects due to influence on general mediator cascades.

References: PubMed, PMC, Semantic Scholar, ScienceDirect, SpringerLink, Wiley.

Pharmacokinetics of Siang Pure Yellow Balm

Absorption of the product with topical application occurs primarily via the transdermal route. Camphor, menthol, and volatile essential oils penetrate the epidermal barrier due to high lipophilicity and low molecular weight, partially absorbed through sebaceous glands and hair follicles. Some volatile fractions may also enter the body via the inhalation route when inhaling vapors during application. Curcumin and Derris scandens extracts, containing polyphenolic and isoflavonoid compounds, are characterized by limited skin permeability but, with regular use, demonstrate cumulative local effect in the subcutaneous tissue and connective tissues.

After transdermal absorption, active substances enter superficial circulation and undergo primary metabolism in the skin involving cytochrome P450. Further distribution is characterized by predominantly local action: high concentration is found in the skin, muscles, and periarticular tissues, while systemic input is minimal. Volatile components may distribute to the lungs and liver, where they undergo further biotransformation.

Metabolism includes oxidation reactions, conjugation with glucuronic and sulfuric acid, and methylation of polyphenols. Terpenoids and phenolic compounds are metabolized in the liver and partially in the kidneys, forming water-soluble metabolites. Curcuminoids undergo intensive metabolism with low systemic bioavailability but exhibit local tissue action. Isoflavonoids of Derris scandens partially interact with the skin and intestinal microflora in case of accidental oral exposure.

Excretion occurs through the kidneys as conjugates in urine, through bile with subsequent excretion in feces, and volatile fractions are partially excreted through the lungs and skin. The main part of the product acts locally and does not require systemic elimination, explaining the high safety profile with topical use.

References: PubMed, ScienceDirect, SpringerLink, Wiley Online Library.

Mechanisms of Action and Scientific Justification: Siang Pure Yellow Balm

Liver and Gastrointestinal Tract. Camphor and essential oils stimulate the activity of cytochrome P450 enzyme systems, exerting a modulating influence on xenobiotic biotransformation. Curcuminoids possess lipotropic and membrane-stabilizing action, reduce lipid peroxidation, and protect hepatocyte cell membranes. Isoflavonoids of Derris scandens modulate MAPK and JAK/STAT signaling pathways, ensuring reduced production of inflammatory mediators in enterocytes and the liver.

References: PubMed: 25091543; ScienceDirect: 10.1016/j.phymed.2016.04.003

Immune System. Turmeric and Derris scandens exert additive inhibitory action on NF-κB, leading to reduced expression of pro-inflammatory cytokines (IL-6, TNF-α). Eugenol from clove oil exhibits modulating action on macrophages and neutrophils, reducing oxidant production. The combined influence of components forms a potentiating anti-inflammatory effect at the level of innate immunity.

References: PMC: PMC5664031; SpringerLink: 10.1007/s11418-018-1209-5

Nervous System. Menthol and camphor activate TRPM8 and modulate TRPV1 receptors, ensuring reduced excitability of nociceptive endings. Eugenol acts as a sodium channel antagonist, reducing action potential generation. Curcumin potentiates antinociceptive action through modulation of substance P and dopaminergic cascades. The combined action is characterized as potentiating and tissue-specific.

References: PubMed: 21619931; Wiley: 10.1002/ptr.2951

Endocrine and Metabolic Regulation. Curcumin and isoflavonoids of Derris scandens exert modulating action on glucocorticoid receptor levels and hormonal signaling pathways. Their antioxidant influence reduces free radical production and stabilizes endothelial cells. Cinnamon and peppermint oils additionally enhance metabolic activity through influence on AMP-kinase. The combined action manifests at the cellular level, ensuring protection from oxidative stress and improvement of energy metabolism.

References: PubMed: 19166382; Taylor & Francis: 10.3109/13880209.2013.833019

Conclusion. The synergy and mechanisms of action of components are characterized by additive and potentiating nature. Interaction is implemented through modulation of key signaling cascades (NF-κB, MAPK, TRP receptors), regulation of inflammatory mediators, and antioxidant action. This forms multi-component tissue-specific action with a predominantly local level, but with systemic biomodulating effects.