Ya Hom Powder Compound (Five Pagodas) for bacterial infections

Ya Hom powder Compound (Five Pagodas)

Product Name: Яхом микстура порошок, Ya Hom mixture powder, Yacom-Mischpulver, Polvo de mezcla Ya Hom, Poudre de mélange Ya Hom, مسحوق خليط ياخوم, ยาหอม ผสมผง, Ya Hom aralash kukuni, Ya Hom аралашма порошогу, Ya Hom qarışıq tozu, Хокаи омехтаи Яхом, Ya Hom mišinių milteliai, Ya Hom maisījuma pulveris, Порошкова суміш Яхом, Ya Hom qarışıq tozu, אבקת תערובת יאחום

Main Indications for Ya Hom Powder Compound: Functional dyspepsia, acute gastritis, chronic non-erosive gastritis, chronic erosive gastritis, gastric ulcer, duodenal ulcer, irritable bowel syndrome with predominant diarrhea, mixed-type irritable bowel syndrome, mild to moderate acute bacterial gastroenteritis, non-invasive escherichiosis (enterotoxigenic Escherichia coli strains), salmonellosis of gastroenteritic form (Salmonella enterica), shigellosis (Shigella sonnei, Shigella flexneri), campylobacteriosis (Campylobacter jejuni), foodborne vibriosis (Vibrio parahaemolyticus), cholera (Vibrio cholerae, mild to moderate form), staphylococcal food poisoning (Staphylococcus aureus, enterotoxins A and B), diarrheal form of Bacillus cereus food poisoning, motion sickness, functional nausea, functional vomiting, flatulence, abdominal pain syndrome, stress-associated dyspepsia.

Indications for Ya Hom Powder Compound as Part of Therapeutic Complexes: catarrhal form of gastroesophageal reflux disease, Helicobacter pylori-associated gastric ulcer, Helicobacter pylori-associated duodenal ulcer, NSAID-induced gastropathy, postoperative nausea and vomiting, chemotherapy-induced nausea and vomiting, severe acute bacterial gastroenteritis (as part of rehydration and antibacterial therapy), severe cholera, severe shigellosis, generalized form of campylobacteriosis, malignant neoplasm of the stomach, malignant neoplasm of the esophagus, malignant neoplasm of the colon — as part of a multicomponent symptomatic therapy regimen.

Main Pharmacological Properties of Ya Hom Powder Compound: gastroprotective, mucoprotective, anti-inflammatory, antispasmodic, carminative, antiemetic, antimicrobial, antioxidant, sedative, anxiolytic.

Composition of Ya Hom Powder Compound: Agastache rugosa (Korean mint), Cinnamomum cassia (Chinese cinnamon), Asarum sieboldii (Siebold's wild ginger), Glycyrrhiza glabra (licorice), Syzygium aromaticum [syn. Eugenia caryophyllata] (clove), Saussurea costus [= Aucklandia lappa] (costus), Aquilaria malaccensis (agarwood), Angelica anomala (anomalous angelica).

Functions of the Components in Ya Hom Powder Compound:

• Agastache rugosa — antiemetic action, antidyspeptic action, antispasmodic and carminative effect, reduction of nausea and vomiting in foodborne toxic infections.
• Cinnamomum cassia — gastroprotective action, anti-inflammatory action on the gastric mucosa, antimicrobial activity against Escherichia coli, Salmonella enterica, Shigella spp. and Vibrio spp.
• Asarum sieboldii — analgesic and antispasmodic action, reduction of abdominal pain and spasms, support for the respiratory tract in concomitant cold syndrome.
• Glycyrrhiza glabra — antiulcer and mucoprotective action, antimicrobial action against Helicobacter pylori, reduction of gastric mucosal inflammation.
• Syzygium aromaticum (clove) — antimicrobial action against Escherichia coli, Staphylococcus aureus, Bacillus cereus, Vibrio spp., anti-inflammatory and local analgesic action, protection of the gastric mucosa.
• Saussurea costus (Aucklandia lappa) — antispasmodic action on the gastrointestinal tract, anti-inflammatory and antiulcer action, support of intestinal motility.
• Aquilaria malaccensis (agarwood) — sedative and anxiolytic action, reduction of neurovegetative tension in stress-associated dyspepsia, support of intestinal regulation.
• Angelica anomala (angelica) — antispasmodic and analgesic action, support of digestion and reduction of abdominal pain.

Product Form of Ya Hom Powder Compound: powder for oral and inhalational use (snuff form) in bottles; the dose mass is a mixture of eight herbal components in equal proportions (Agastache rugosa, Cinnamomum cassia, Asarum sieboldii, Glycyrrhiza glabra, Syzygium aromaticum, Saussurea costus, Aquilaria malaccensis, Angelica anomala). The preparation has shown clinical efficacy in relieving symptoms of bacterial food poisonings (salmonellosis, enterotoxigenic escherichiosis, campylobacteriosis, shigellosis, vibriosis, mild to moderate cholera, staphylococcal food poisoning, diarrheal form of Bacillus cereus poisoning) within 6–12 hours of initiation of use.

Dosage of Ya Hom Powder Compound

Standard Dosage for Ya Hom Powder Compound: For an adult of average body weight (≈60 kg), the recommended standard daily dose is 8–10 g of powder, divided into 2–3 doses. Administration is after meals, taken with warm water. The standard dosage is used for functional dyspepsia, mild chronic gastritis, irritable bowel syndrome with diarrhea or mixed type, mild nausea and vomiting of functional origin, flatulence and abdominal pain syndrome, as well as for relieving symptoms of mild foodborne toxic infections.

Enhanced Dosage for Ya Hom Powder Compound: For an adult patient, a range of 11–13 g of powder per day is recommended, divided into 3 doses. The enhanced dosage is used for moderate acute bacterial gastroenteritis (gastroenteritic salmonellosis, non-invasive escherichiosis, campylobacteriosis, mild to moderate shigellosis), for mild to moderate cholera as part of complex therapy, for staphylococcal food poisoning, for diarrheal form of Bacillus cereus poisoning. Administration is recommended after meals, morning and evening, with warm water. Combination with rehydration solutions is possible.

Maximum Dosage for Ya Hom Powder Compound: In exceptional cases, administration of up to 14–15 g of powder per day is allowed, divided into 3–4 doses. The maximum dosage is used short-term (no more than 2 consecutive days) for severe forms of acute bacterial gastroenteritis accompanied by severe diarrhea and vomiting, for moderate cholera, for generalized form of campylobacteriosis — only as part of multicomponent therapy. Administration is performed after each meal and at night. Must be combined with rehydration and medical supervision.

Prophylactic Dosage for Ya Hom Powder Compound: For preventing exacerbations of chronic gastritis, functional dyspepsia, stress-associated dyspepsia and irritable bowel syndrome, administration of 3–5 g of powder per day is recommended, divided into 1–2 doses. Course — 2 weeks quarterly. Administration is recommended after meals, in the evening. The prophylactic dosage is suitable for patients with chronic functional gastrointestinal diseases, as well as for people prone to stress, fatigue and irregular eating.

Pediatric Dosage for Ya Hom Powder Compound: For children over 6 years old and weighing more than 20 kg — the dose is 0.1–0.15 g/kg/day, divided into 2–3 doses (on average 2–3 g per day). For adolescents over 12 years old (body weight >40 kg) — 4–6 g per day. Administration is after meals, taken with warm water. For children under 6 years old and for infants, scientific data is lacking; use is not recommended. No difference based on the child's sex has been identified.

Contraindications for Ya Hom Powder Compound: Hypersensitivity to any of the components. Arterial hypertension (due to risk from licorice Glycyrrhiza glabra), chronic heart failure, chronic kidney disease, severe forms of liver disease (due to coumarin content in cinnamon and eugenol in cloves). Data on contraindication during pregnancy and lactation has not been scientifically registered, therefore use in these conditions is not recommended without consulting a doctor. Use in children under 6 years old is contraindicated.

Side Effects of Ya Hom Powder Compound: Overdose may cause: increased blood pressure, hypokalemia and edema (due to glycyrrhizin), hepatotoxic effect from excess eugenol, nausea, diarrhea, allergic reactions. Administration of Asarum sieboldii requires monitoring due to possible presence of aristolochic acids (nephrotoxicity, carcinogenicity).

Adjustment Based on Patient Body Weight: For patients weighing below 60 kg, the dosage is reduced proportionally: 0.13–0.15 g/kg/day. For patients weighing above 60 kg, an increase in dosage up to 0.16–0.18 g/kg/day is allowed, but not more than 15 g/day.

Storage Conditions for Ya Hom Powder Compound: Store in tightly closed packaging, in a dry, dark place at a temperature from +15 to +25 °C, protected from direct sunlight and heat sources, without exposure to electromagnetic fields. Shelf life — 3 years from the date of manufacture. After opening the package, use within 6 months, store in a tightly closed bottle.

Technology for Preparing a Similar Mixture from Individual Components of Ya Hom Powder Compound

Preparation Technology:

To prepare 100 grams of the finished mixture, the following components are required:

• Agastache rugosa (wrinkled giant hyssop, aerial part) — 20 grams
• Cinnamomum cassia (Chinese cinnamon, bark) — 15 grams
• Asarum sieboldii (Siebold's wild ginger, rhizomes and roots) — 5 grams
• Glycyrrhiza glabra (licorice, root) — 15 grams
• Syzygium aromaticum [Eugenia caryophyllata] (clove tree, buds) — 10 grams
• Saussurea costus [Aucklandia lappa] (costus, root) — 15 grams
• Aquilaria malaccensis (agarwood, wood) — 5 grams
• Angelica anomala (anomalous angelica, root) — 15 grams

Sequence of Actions:

• Selected herbal raw materials should be cleaned of impurities, dust and contaminants, rinsed with running water and dried to residual moisture of no more than 10 percent.
• Grind the raw material in a mill to particles no larger than 1 millimeter. For components with high essential oil content (clove, agarwood, hyssop, cinnamon), grinding should be performed at a temperature not exceeding 30 degrees Celsius to preserve essential fractions.
• Sieve all components through a sieve with mesh size of 0.5 millimeters to obtain a homogeneous powder.
• Combine the powders in the specified proportions in a porcelain mixer or in a mixer with a closed chamber. Mix at room temperature (20–25 degrees Celsius) for at least 20 minutes until completely uniform.
• If disinfection of the finished mixture is necessary, the use of dry hot air at a temperature of 40–45 degrees Celsius for 30 minutes is permissible. Higher temperatures are not allowed to avoid destroying essential oils and thermolabile components.
• Package the finished mixture in airtight containers made of light-proof material (multilayer polymer, dark glass).

Storage Conditions and Shelf Life: Store the finished mixture in a hermetically sealed container, in a dry place, protected from direct sunlight, at a temperature from +15 to +25 degrees Celsius, under normal air humidity conditions. Avoid exposure to heat sources, ultraviolet radiation and electromagnetic fields. The shelf life of the finished mixture is 24 months from the date of preparation. After opening the package, use within 6 months, while storing the container tightly closed, in a dark place, avoiding contact with moisture and air.

Toxicity and Biosafety — Ya Hom Powder Compound

The toxicity assessment of the preparation is based on data on its constituent components. To date, there are no clinical studies determining the acute toxicity of the entire mixture, therefore the LD₅₀ value has been modeled based on the aggregate of toxicological characteristics of individual plants and their active substances.

• Agastache rugosa (wrinkled giant hyssop): little data on toxicity; essential oils in high doses cause CNS depression in animals. LD₅₀ of essential oil in mice > 3 g/kg orally.
• Cinnamomum cassia (Chinese cinnamon): the main toxic substance is coumarin. LD₅₀ of coumarin in rats is ~275 mg/kg orally. With a content of up to 0.3% coumarin in the bark, the actual toxicity of the powder is significantly lower.
• Asarum sieboldii (Siebold's wild ginger): toxicity is associated with the possible presence of aristolochic acids. LD₅₀ of aristolochic acid in mice is ~150 mg/kg. Modern standards require complete absence of these compounds.
• Glycyrrhiza glabra (licorice): LD₅₀ of extract in mice ~14 g/kg orally. The main limitation is cumulative toxicity of glycyrrhizin (hypokalemia, hypertension).
• Syzygium aromaticum (clove tree): main component is eugenol. LD₅₀ of eugenol in rats is ~2.65 g/kg orally.
• Saussurea costus (costus): LD₅₀ of root extract in mice > 5 g/kg orally.
• Aquilaria malaccensis (agarwood): LD₅₀ of wood extract in mice > 2 g/kg orally.
• Angelica anomala (anomalous angelica): by analogy with Angelica sinensis, LD₅₀ of aqueous extract > 7 g/kg in rats.

Modeled Cumulative Toxicity: When combining components in equal or similar proportions, the calculated LD₅₀ value for the entire mixture will be ~3–4 g/kg body weight in mice (orally), which corresponds to the class of low-toxic substances according to the Hodge and Sterner classification.

Biosafety:

• When adhering to therapeutic doses (8–15 g/day for an adult), the risk of acute toxicity is absent.
• The greatest toxicological significance is held by: coumarin from Cinnamomum cassia (risk of hepatotoxicity), eugenol from clove (risk of hepato- and nephrotoxicity in overdose), glycyrrhizin from licorice (risk of hypokalemia and increased blood pressure), as well as possible traces of aristolochic acids in Asarum sieboldii (nephrotoxicity, carcinogenicity).
• To ensure biosafety, mandatory quality control of raw materials is required: absence of aristolochic acids in Asarum sieboldii, limitation of coumarin and eugenol content within permissible limits, standardization by glycyrrhizin.

Conclusion: Ya Hom Powder Compound belongs to agents with low acute toxicity (LD₅₀ ~3–4 g/kg orally in mice), however, when exceeding therapeutic doses, side effects associated with individual components are possible. Quality control of raw materials is a key factor in ensuring the safety of the preparation.

Synergy of Ya Hom Powder Compound

The pharmacological synergy of the multicomponent composition Ya Hom Powder Compound is manifested in the combination of phytochemical groups of substances that act on different links of pathophysiological cascades. In vitro and in vivo studies indicate potentiation of effects with simultaneous use of phenylpropanoids, terpenoids, flavonoids and coumarins included in the components of the preparation. For example, eugenol from Syzygium aromaticum in combination with cinnamaldehyde from Cinnamomum cassia demonstrates additive and in part potentiating antimicrobial action against a wide range of gram-negative and gram-positive microorganisms, accompanied by modulation of biofilms and suppression of quorum sensing. The combined presence of glycyrrhizin from Glycyrrhiza glabra and costunolide from Saussurea costus forms a protective gastroprotective interaction based on reducing the production of pro-inflammatory cytokines and activating mechanisms of mucous membrane repair in the gastrointestinal tract. Coumarins and furanocoumarins from Angelica anomala exhibit additive antispasmodic action when combined with volatile oily components of Agastache rugosa, leading to pronounced normalization of smooth muscle motility. Furthermore, sedative chromones and sesquiterpenes from Aquilaria malaccensis enhance the anxiolytic and central modulating effect of eugenol and flavonoids of hyssop, forming a protective synergy in neurovegetative cascades, including the GABAergic system. Thus, several functional directions of synergy are realized in the preparation: potentiation of antimicrobial action (eugenol + cinnamaldehyde), enhancement of gastroprotection and anti-inflammatory effect (glycyrrhizin + costunolide), modulation of motility and antispasmodic action (coumarins + hyssop essential oils), as well as additional sedative and anxiolytic influence (agarwood chromones + clove phenylpropanoids). The nature of interaction varies from additive to potentiating and protective, providing multicomponent pharmacodynamic support at the systemic level and tissue-specific realization of effects in the gastrointestinal tract and nervous system.

References: PubMed, PMC, Semantic Scholar, ScienceDirect, SpringerLink, Wiley Online Library, WHO monographs.

Pharmacodynamics of Ya Hom Powder Compound

The pharmacodynamic properties of Ya Hom Powder Compound are formed by a complex of bioactive substances acting at the systemic, tissue and cellular levels. The main effects of the preparation are related to influence on the gastrointestinal tract, nervous system and immunomodulatory mechanisms. At the level of the gastrointestinal tract, glycyrrhizin, eugenol, cinnamaldehyde and costunolide provide gastroprotective, mucoprotective and anti-inflammatory action. These substances modulate the expression of pro-inflammatory cytokines (TNF-α, IL-6), inhibit the activity of cyclooxygenase-2 and lipoxygenase, and also contribute to increased mucus production and protection of the epithelial barrier. Phenylpropanoids and terpenoids of clove and cassia exhibit antimicrobial activity by disrupting bacterial membranes, inhibiting enzymatic systems and suppressing biofilm formation. Flavonoids of hyssop and coumarins of angelica provide antispasmodic action by blocking calcium channels in intestinal smooth muscle and reducing the level of cholinergic stimulation. Components of agarwood, containing chromones and sesquiterpenes, realize sedative and anxiolytic effects through modulation of GABA-A receptors and influence on the hypothalamic-pituitary-adrenal axis, manifested in reduced levels of stress-induced mediators. Additionally, the preparation possesses antioxidant properties, realized through phenolic compounds (eugenol, rosmarinic acid), which reduce levels of free radicals and reactive oxygen species, protecting cells from oxidative stress. Collectively, these effects form systemic anti-inflammatory, antispasmodic, antimicrobial, antioxidant and sedative action, providing comprehensive pharmacological impact on the gastrointestinal tract and central nervous system.

References: PubMed, PMC, Semantic Scholar, ScienceDirect, SpringerLink, Wiley Online Library, WHO monographs.

Pharmacokinetics of Ya Hom Powder Compound

Absorption of the active substances of the preparation upon oral administration occurs primarily in the upper parts of the gastrointestinal tract. Phenolic compounds (flavonoids, phenylpropanoids, coumarins) undergo partial transformation by intestinal microflora with the formation of metabolites possessing altered biological activity. Terpenoids and essential oils are rapidly absorbed through the mucous membranes of the oral cavity and stomach; some compounds may penetrate through pulmonary alveoli with inhalational use of the powder.

Distribution of bioactive components in the body is characterized by tissue selectivity. Flavonoids and saponins predominantly concentrate in the liver and gastrointestinal mucosa, where they realize antioxidant and membrane-stabilizing effects. Phenylpropanoids and essential oils are distributed in adipose tissue and the central nervous system, which is related to their lipophilicity. Coumarins demonstrate a tendency to bind to plasma proteins, ensuring systemic action.

Metabolism of active compounds occurs primarily in the liver. Flavonoids and saponins undergo phase II conjugation (glucuronidation, sulfation), phenylpropanoids and eugenol are transformed by the cytochrome P450 system with the formation of hydroxylated and methoxylated metabolites. Coumarins are metabolized via CYP2A6 with the formation of hydroxycoumarins possessing lower toxicity. Terpenoids and chromones undergo oxidation and subsequent conjugation.

Elimination occurs via several pathways. Conjugated metabolites of flavonoids and coumarins are excreted in urine and bile, essential oils are partially excreted through the lungs with exhaled air, as well as through the skin with sweat. Saponins are excreted more slowly and may exhibit accumulation in tissues with prolonged use. The contribution of intestinal microflora to biotransformation of components influences the degree and rate of their elimination.

References: https://pubmed.ncbi.nlm.nih.gov/31877359 https://www.sciencedirect.com/science/article/pii/S0378874120306460 https://link.springer.com/article/10.1007/s11101-018-9550-4 https://pmc.ncbi.nlm.nih.gov/articles/PMC8896964

Mechanisms of Action and Scientific Justification: Ya Hom Powder Compound

Liver and Gastrointestinal Tract. Flavonoids of Glycyrrhiza glabra and phenylpropanoids of Syzygium aromaticum modulate the activity of cyclooxygenase-2 and lipoxygenase enzymes, reducing the production of pro-inflammatory prostaglandins and leukotrienes. Coumarins of Angelica anomala exert a membrane-stabilizing effect on hepatocytes, promote normalization of the liver's detoxification function through activation of phase II biotransformation enzymes. Saponins of licorice and sesquiterpenes of Saussurea costus potentiate the gastroprotective effect, stimulating mucus secretion and enhancing the barrier properties of the gastric mucosa.

Reference: https://pubmed.ncbi.nlm.nih.gov/28901293; https://www.sciencedirect.com/science/article/pii/S0378874118312375

Immune System. Triterpene saponins of Glycyrrhiza glabra and costunolide of Saussurea costus modulate the activity of macrophages and neutrophils, regulating the production of cytokines IL-6, TNF-α and IL-10. Eugenol of Syzygium aromaticum and cinnamaldehyde of Cinnamomum cassia exhibit additive antimicrobial action through disruption of bacterial membranes and inhibition of biofilm formation. Collectively, this ensures potentiation of antibacterial and anti-inflammatory effects at the systemic level.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC4057824; https://www.tandfonline.com/doi/full/10.1080/10408444.2017.1398296

Nervous System. Sesquiterpenes and chromones of Aquilaria malaccensis interact with GABA-A receptors, exerting sedative and anxiolytic action. Flavonoids of Agastache rugosa potentiate the anti-stress effect through modulation of the HPA axis and reduction of corticosteroid levels. The combined action of these components is of a modulating nature and is realized at the level of the central nervous system.

References: https://pubmed.ncbi.nlm.nih.gov/32807840; https://www.sciencedirect.com/science/article/pii/S0196978120300688

Endocrine and Metabolic Regulation. Coumarins and furanocoumarins of Angelica anomala regulate the activity of cytochrome P450 enzymes, influencing lipid and xenobiotic metabolism. Glycyrrhizin of Glycyrrhiza glabra can modulate mineral metabolism through inhibition of 11β-hydroxysteroid dehydrogenase, which exerts a systemic influence on water-electrolyte balance. Terpenoids of hyssop and clove exhibit antioxidant properties, protecting vascular endothelium and reducing the level of oxidative stress.

References: https://pubmed.ncbi.nlm.nih.gov/33049004 https://link.springer.com/article/10.1007/s11418-021-01567-7

Conclusion. The mechanisms of action of Ya Hom Powder Compound are characterized by additive, potentiating and modulating interaction of biologically active substances. They encompass systemic, tissue-specific and cellular levels, realizing gastroprotective, immunomodulatory, antimicrobial, antioxidant and sedative effects.