34 Integrat ive Medic ine • Vo l . 8, No. 2 • Ap r /May 2009 Yanii'll Ulla .'\hiimil—Pcindeliofi

REVIEW ARTICLE

Dandelion [Taraxacum officinale and T mongolicum)¡irk Yarnell. NÜ. RH(AHG). and Kathy AbascalJD, Rll(AHC)

Abstract

Dandelion {Taraxacum spp) is used in many traditionaland modern herbal medical systems, as partictilarly has beendocumented in Asia, Europe, and North Atnerica. I he root isprimarily considered a gastrointestinal remedy supportingdigestion and liver function, while the leaf is used as a diureticand bilter digestive stimulant.

I'reclinical research on dandelion has revealed numerousproperties, including its actions as an inflammation modula-tor, ditiretic, digestive .stimulant, insulin stimulant, demul-cent, prebiotic, immunomodulator, antiangiogenic, and anti-

neoplastic, although not all studies agree.There are very limited numbers of clinical trials involving

dandelion, and almost all oí these involve complex herbal for-mulas containing dandelion as only 1 part. The.se formulashave been shown to counter indigestion, mildly help metabo-lize androgenic hormones, counter hepatitis B infection, reverseH('//íVí/;í)í/(T/Jv/<'n-related gastritis, and reverse intestinal meta-plasia. Overall, dandelion is very safe, although it may aggra-vate acute ga.strointestinal inflammation. I'urlher re.search iswarranted on this widely-used, intriguing herbal medicine.

Dandelion {Taraxacum spp) is used in many traditional andmodern herbal medical systems, as has been documentedparticularly in Asia, Europe, and North America. The root

is primarily considered a gastrointestinal remedy, supportingdigestion and liver function, while the leaf is used as a diuretic andbitter digestive stimulant.

Common NamesI he Hngli.sh name ilamietion is a corruption ofthe French

dent de kon. meaning "lion's tooth." The herb is similarly namedin many Indo-European tongues, also being called "lion's tooth"in Clerman {l.öwvniahn) and Spanish {diente de kon). The namerefers to the toothed margins ofthe leaves.

In both modern French and English, the name for dandeli-on reflects its diuretic nature—being called pissenlit ("pee thebed") and pis.sabeds. respectively. It has also been calledyà/rvclock in English, though the reason for this name is unknown.

Dandelion is called/;H2 _I¡ÍÍÍ( '1 yingl in Chinese (the num-bers depict tone), hokmei in Japanese, -anap'ogon^vongln Korean.No translations other than dandelion are given for the names.

The latin name Taraxacum is from the Greek and means"disease remedy,"

History and Folk UseUandeliuns are among the most recognizable weeds in the

world. Traditional use goes so far back as to predate writtenrecords. The leaf of Chinese dandelion {T mongolicum) was firstmentioned in writing in the Tang Materia Medica (659 AD) andis classically considered a valuable remedy in Chinese medicine,hoth topically and internally, for treating abscesses, reducing eyeinflammation, and provoking diuresis. '

Opposite: Dandelion (Taraxacum sppj is used in many traditional

and modern herbal medical systems. The root is primarily considered

a gastrointestinal remedy supporting digestion and liver ßinction.

while the leafLs used as a diuretic and bitter digestive stimulant.

Despite its probable botanical origins in Asia, there arem\ths and traditional medicinal uses for dandelion across Europe''and the herb is possibly mentioned in Dioscorides' famous DeMateria Medica—Dioscorides used ancient Greek names for theplants and gave a description that sounds very much like dandeli-on.' These traditional sources consistently referred to the roots ashelpful for the li\'er, while the leaves and flowers were regarded asuseful diuretics and bitter digestive stimulants,'

Throughout its enormous growing range, all parts of thedandelion were eaten as food.

Chemical CompositionAmong the most important comixnmds in dandelion are

sesquiterpene lactones (believed to have antiinilammatory and anti-cancer effects), pheiiylpropanoids (Mieveci to have inflammation-modulating efiects), triterpenoid saponins (effects unkiiown forthis herb; well known for many others: eg, the adaptogenic effectsfound in plants such as Panaxginseng), and polysaccharides (com-plex carbohydrates). Major sesquiterpene lactones, generallyoccurring as glycosides (sugars), include taraxacosides. taraxa-colides, dihydrolactucin, ixerin, taraxinic acids, and ainslioside.^Phenylpropanoids (cinnamic acid derivatives) are plentifullypresent and include cichoric acid, monocaffeoyltartaric acid,4-cafîbeylquinic acid, chlorogenic acid, catïeic acid, and relatedcompounds. Inulin (a class of fibers known as fructans) is alsopresent in large amounts in dandelion root.''

Dandelion leaf is a good source of potassium; 1 analysisfound that 100 g (just over ?> oz) of leaf contained 297 mg potas-sium, putting it in a league with other high potassium-sourcefoods.' This means that, by dry weight, up to 4% of dandelionleaf is potassium. However, it should l)e pointed out that food-level doses (not the smaller medicinal doses) of leaf must beingested to obtain potassium. AS mL(l tsp) dose of leaf tincturewith a 1:2 (\veight:volume) ratio containing 4% potassium wouldprovide just 100 mg of potassium, approximately one-fifteenththe dose necessary to be clinically relevant.

Yamell and Abascal—Dandelion In tegrat ive tVledicine • Vo l . 8, No. 2 • Ap r /May 2009 35

PharmacologyDandcliim lent" and root have both been studied for their

effects on digestion, mostly as bitter digestive stimulants. Daiideiionroot has been investigated tor demulcent, prebiotic, hypoglycémie,and immune-modulating etiects. Dandelion leaf lias also beeninvestigated as a diuretic and intlammation modulator.

Demulcent and Prebiotic Acti\ity: Dandelion roots have adistinct demulcent action and prebiotic properties due to their con-tent of inulin**: tall-harvested roots have the highest inulin content.^

Digestion, Inflammation, and Angiogenesis: Sesquiterpenelactones impart a bitter taste to the plant, which is especially nota-ble in the leaf but also in the root (particularly when spring-harvest-ed).'' These compounds also likely explain the increase in bile pro-duction seen in animal studies with dandelion,'" with the studiesthemselves lending support to the traditional use of dandelion as abitter digestive stimulant. One study showed that sesquiterpenelactones contributed to the inflammation-modulating properties ofdandelion root. ^

Other studies showed that crude extracts of both root andflower modulated inflammation, and some evidence suggeststhat phenylpropanoids might be key to this activit)'.''^'^'' Ethanolextracts ofthe dried aerial parts have been shown in rodent stud-ies to reduce intlammation and inhibit angiogenesis. thoughwhich constituents were responsible for these etiects were notinvestigated.'^

Hypoglycémie Effects: Dandelion root and leaf repeatedlyhave been shov\'n to have hypoglycémie properties, though theexact mechanisms of action are poorly understood. ^•''' Of concern,at least 1 report attributes this property to an insulin seeretagogueeiieet (ie, stimulating pancreatic beta-cell release of insulin).'^ Thismechanism could lead to further insulin resistance and contributeto beta-eell burnout in patients with diabetes. This said, however, atleast 1 mouse study has failed to confirm any hypoglycémie effectsof dandelion."* Human trials are necessary to elariiy dandelion'sefieets on blood sugar and determine if the herb may be helpful orharmful for people with diabetes.

Immunity: Studies on the effects of various dandelionextracts and compounds on the immune system are contradic-tory, some showing inhibition and some stimulation of tumornecrosis factor, for example.'^''^" This may suggest that dandeli-on extract has various effects on dlfFerent lymphocyte popula-tions or body tissues, or it may indicate that dandelion canmodulate immune reactions. The polysaecharides in dandelion,of which there are many, are often credited with being key inter-mediaries in immune interactions.*^' More in-depth research isneeded on dandelion s immune-system efieets.

Miscellaneous PrecUnical Studies: In vitro and rodentstudies consistently show that various parts of dandelion haveantineoplastie activity. • • • The leaf was more antioxidant thanthe root in vitro.'''* Dandelion leaf has proven diuretic in rats,though at fairly high doses in 1 study and only to a modestdegree in another.-^"** Another study failed to fmd a diureticaction of oral or intraperitoneal dandelion extracts.'^' Recently.an animal study showed that a dandelion extract upregulatedestrogen, progesterone, and follicle-stimulating hormone reeep-tors in miee.- ^ Other effects of dandelion appear to be the result

of multiple constituents acting in concert, although lack ofresearch makes it difficult to draw conclusions.

Clinical Applications, Western StudiesBitter and Diuretic Principles: l-or most clinical uses, dan-

delion has not been scrutinized rigorously aceording to modernscientific methods. Traditionally, the leaf is regarded as a usefulbitter and moderately potent diuretic. Tbougli no study has yetbeen published to support these uses, a preliminary trial docu-menting dandelion leaf's diuretic aetivity was in press at the limeof writing this article (Spelman K, et nl.J Altern Complemen Med.2008). The German Commission E approves the use of dandeli-on as a diuretic and also for use in anorexia, dyspepsia, and bil-iary abnormalities.^''

Detoxifieation: Dandelion root has a long history of use forsupporting liver function and treating various dermatologie andsystemic disorders, based on the theory that the herb improvesthe liver's ability to detoxify. These ideas have received littlereseareh attention.

In regard to hormone detoxification, a recent study eom-pared tbe efïeets of an herbal formula containing dandelion(specifically, T officinalis). turmeric (Curcutna longa). artichoke{Cvnnra seolymus), rosemary (Rosmnrinus offkitinlis). sehisandra{Schisandra chinensis), and milk thistle {^iiyhum nmrianuni). ahealthy diet, and plaeebo on hormone levels in 40 premeno-pausal women. '*'The study ran for 4 menstrual cycles. Comparedwith the other 2 treatments, the herbal formula eaused signifi-eant declines in early follieular-phase androgens with no eflFeeton levels of any other sex steroid hormone. The implications ofthis study are hard to determine, but it does suggest that dande-lion and other herbs may have some role in enhancing detoxifica-tion of androgens.

Gastrointestinal Complaints: The use of dandelion leaf forindigestion or other atonie gastrointestinal complaints is alsolargely unverified by modern studies. However, a case series of24 patients with nonspecific, chronic colitis treated with a for-mula consisting of dandelion (specifically. T ojfieiriaf). St John'swort (Hyperiaim perforatum), lemon balm {Melism offieinalis),calendula {Calenàula ojßeirialis). and fennel (I'oenieulum vulgäre)demonstrated remarkable symptomatic improvement in termsof stool normalization and pain reduction.''

Warts: The traditional use of fresh dandelion stem latex totreat warts has not been evaluated.

Clinical Applications, Chinese StudiesSeveral Chinese-language studies have reported on the

effeets of various formulas containing T mongolieutn.Unfortunately, full text translations of these studies are notavailable, and the information provided here is based solelyon English-language abstracts. Therefore interpretation ofthese studies must be undertaken cautiously.

Antibiotic Actions: An herbal formula known as/i/ zheng(]uxie* was just as effective as the antibiotic gentamycin in 75 eases

' listed ii^redienls cXfu zheng qu dr. Astragalus rnentbmnacats, Atractylmics macnKephata.

Paeonia lactpiora. Taraxacam monogolieum. Olihnkndia liißiaa

36 Integrative Medicine • Vol. 8, No. 2 • Apr/May 2009 Yarnell and Aba.mil—Danädion

of gastric disease caused by Hclicoboclcr pylori (formerly' knownas Campylolmclcrpytoridis or CP).'*^ This study found that in theChinese herbal medicine group, clinical symptoms obviouslyimproved—with the curative effective rate for CP at 80% (24 of30 patients), the death rate for CP at 30% (9/30), and the effec-tive rate for pathohistologicalchangesat50%(15/30). Differencesof curative effective rate between the two groups were statisti-cally insignificant (/'>.O5).

Hepatitis B: A formula calledy/e duyanggan gao* (JY) wassignificantly more effective than another botanical formulation(the main ingredients of which were charred havAihorn [FruetusCniliicgi], charred germinated barley [fructrus HordeiGcrminatus], and wheat bran) in lowering elevated liver enzymesand curing patients with hepatitis B in a 96-person. double-blind trial." i'un' meant that serum hepatitis B virus (liBV)-DNA become negative. According to the abstract, 27% ofJY-group patients had normalization of serum alanine amin-otransferase levels (ALT. chemicals that liver cells release whenthey are damaged or sick) and 32% became HBV-DNA negativecompared to just 9% and 18% (respectively) ofthe other group.

Intestinal Metaplasia: The herbal formula xiao wei \anpowderf was quite effective at reversing intestinal metaplasia in120 patients (91%-92% of patients normalized), compared with120 untreated controls (only 14%-21% normalized).'''

Dosage and SustainabilityKt'conniiended doses oí the crude dried root or leaf

Taraxacum spp range fi^om 4 to 10 g daily in divided doses. Freshroot or leaf can be consumed as food at levels of 50 g or greaterper day according to traditional knowledge. Based on our experi-ence, typical doses of root or leaf tinctures in the United Statesare 3 to 5 mL 3 times/day.

The British Herbal Pharmacopoeia (BPH) recommends 0.5 to2 g of root or 4 to 8 mL of root tincture, both 3 times/day.-^'' TheGerman Commission E Monographs recommend doses of 3 to 4 gof root twice daily or 10 to 15 drops of tincture 3 times/day.^''

BPH recommends 3 to 5 g of leaf or 5 to 10 mL of leaf tinc-ture, both 2 times/day."^^ Commission E recommends 4 to 10 gof leaf or 2 to 5 mL of tincture, both 3 times/day. "^

Dandelion is a prolific weed that has naturalized in temper-ate regions around tbe globe. As a result, it is not environmentall)'threatened in any way. The widespread use of herbicides to killdandelions sugge.sts that they should not be harvested from urbansettings without first determining if they have been sprayed.

Safety and Drug InteractionsDandelion is a commonly available food with a long history

of human use and as such poses little risk of harm. Dandelionextracts are listed on the US Food and Drug Administration's"generally recognized as safe" (GRAS) list for foods and supple-ments. Allergy to dandelion can occur but is rare. Patients sensi-

tized to other members ofthe Asleraceae plant family are some-times cross-sensitized to dandelion.'^

Dandelion doses up to 6 g/kg in rabbits have shown notoxicity.'''' Consumption of diets containing 33% dandelion formonths produced no toxic effects in rats. *" No negati\'e effects inhumans have been reported during pregnancy or lactation, inchildren, or in combination with pharmaceutical drugs. Onestudy in rats found that 2 g/kg body weight taken with the drugciprofioxacin greatly impaired absorption of this antibiotic,presumably due to the mineral content of dandelion leaf,'-' asminerals are known to chelate ciprofioxacin and block itsabsorption and activity.

Because it is a bitter, dandelion should be used with cautionin patients with acute gastrointestinal inflammation or obstruc-tion or in those with nonatonic reflux esophagitis. Bitters canpotentially stimulate or aggravate these conditions.

ConclusionDandelion is widely used in traditional and natural medi-

cine systems around the world yet has received surprisingly littleresearch attention. Given that some preclinical and ciinicairesearch has suggested this gentle, safe remedy may have signifi-cant activity, further research is clearly essential.

o:Artemisiacapilkris. Taraxacum mon^licum. PlanUifto

seed. ( ephiitaiiaphK seifiuni. HeJyotis Jißu.ia, Chrysanthrmi inditam. Sinitay glabra. Äxlragalu!^

iiiembranaiï'u.i. Sdh'iui- miltiorrhiui, Poty^mum orienlalis. Paeonia alba, Pt^matum sibiricum

tUslcd ingredienls of xiao weiyaii powder. Smilax glabra. ¡Ifdyotis d\§iaae, Taraxacum mangali-

mm. Ciiestúpittia sappan. Paeonia alba. Cypfras wtumiu.1. Blttiüa striata. Glycyrrhiia uraknm

Eric Yamell, ND. R» (AH(;). is assistanl prot'csNor ot liotaiiical nH'dkine at BastyrUniversity in Kenmore, Wasliingtoii. ynd prcsiclcdl iiflhe iiiH;ini<;(l MedicineAcailt'iiiy in Seattle. In his private practice, Dr Varnell lixuses on men's healtli,urolt>gy, ;ind rie]iiiriili)gy. Me is yiitlmr nl \'íiliirii¡>iithii Urology iitiil Mcii'.\ ¡Imllli

(ik'alinpMounlainPubiishiiig, 2001) und iVii/nrii/w;/iii{.<i.ïir(ii'n/<T(»/rt_qi'(HealingMiHiiilairi Puhlishiiiji, 200(1), and C(iauth(irot[/;>(/Víí//í(i/<f7;(rij/AÍ<'í/(i;>n'(MaryAnne Lieltert, 2004). among other works. He is chief financial officer oí I iealingMountain Publishing in Wenatchee. Washington, and vice president of HeronBotanicals in Poulsbo, Washington. Dr Yarnell is former chair of botanicalmedicine at ihe Southwest College of Naturopathic Metiicine in Teriipc. Arizona,and former edit or oft heyiií/ríi(i/()/íViiíur(>^(i//(i( Mviliciih:

Kathy Abascal, JD, RH (AIK.J, is a professional herbalist and the executive director of

ihe Botanical Medicine Acaiiemy in \'ashon, VVashiiijihui, a nonprofii orgiinizatioii

dedicated lo supporting and prùinoting excellence in the practice of herbal medi-

cine. She is the author of Ilirbs & liißueiiztt (Tigana Press, 2001)), coauthor of

Clinical Bolanical Mediane (Mary ,\nn Liebert Inc. 2(K)l-t), a contributor of several

herb monographs to ihe Tatbimk it/'j\Vf/«rii/Mí'i/(í7>/('(Cburcliill Livingston, 2006),

;md bas written numerous articles on the clinical use of medicinal plants. She also

feaches an annual Intensive Seminar in Botanical Medicine, sponsored by the

University of Maryland School of Medicine, with Lric Yamell, Mt, and James Duke

at the Green Pharmacy Garden in Fulton, Maryland.

References1, Bcnsky D, Clavcy S, Stoger E, Gamble A. Chmist Ih-rbal Mtihaiie Materia Medica.

iíÁ ed. Seattle, WA: Eastland Press; 21M)4,

2, MacKilliipJ. .4 Diilitmar/of Celtic Mytkilany. Oxfoni. VK: Oxford Lltiiveriiiy Presu: 21X)4,S, Dioscorides, De Maleria Medica. Translalion by üsbaldrstoii T, Wood R.

lohaiiiiesbiirg, South Africa: IBIDIS Press, 2001),4, Orieve M, ,4 Moilem llirhal. New YoA: Duver Publicatiocis; 1931,5, Schiitï K, C arle R, Schieber A. Tiinixaciiin—a re\'iew on ils phylochemiral and phar-

niarologicalprofile.yi'fAmi/iÍKírmrtrii/, 2006:107(3):313-323.

t), Schulz K. Muks E, Carle ß. Schieber A. Séparation and quantiiitation of inuliii inselecied artichoke iCymira sei'lyinus l.,l culiivars ainl dandelion [Tarii.xtitum oßkinalrWEB, e\ WIGÜ,) roots by hinh-peribmiatice anión exchaiigi' ciir(niiatography withpulsi.'daiii|K'ri)iTielricdeIerlioii,/ííiiniíi7(7m)mii/íii;r. 2(Klli;2<K 12):1295-1303,

7, Hook I, ,McGee A, Henman M, el al, Evaluation of dandelion tor diuretic activity andvariation in potassium conieni. IntJPIiarmucog. 1993:HUI):29-3'1.

8, Trojanová 1. Rada \', Kokoska L, VIková E. The biiidogenir effect of Taraxucum offm-mile Toox. Fitoterapia. 2004;75:760-763,

YitrneU and Aba.scal—Dandelion Integrative Medicine • Vol. 8, No, 2 • Apr/May 2009 37

9. Kuusi T, Pyysalo H, Aulio K. The bitterness properties of" dandelion II, Chemicalinvestigations. Lvhensm Wi.w Techno!. 1985; 18;347-349.

10. Faber W. The dandelion-7iirajMra;n officinale Weber ¡article in German]. Phannaiie.

23

24

11, Kashiwada V, Takanaka K, Tsukada H, et a!. Sestjuiterpene glucosides from anti-ieu-kotriene B4 release fraction of Tiiraxiieum njficimúe. J Asian Nat Prod RM.

12. Hu C, Kitts DD. Dandelion {Taraxacum ojfiàmile) flower extract supprf^se.s boilireaetive oxygen species and nilric oxide and prevents lipid oxidalion in vilrn.

13. Yasukawa K, Akihisa T, Inoue Y, Tamura T, Yamanimchi S, Takido M. [Ilhibi ( r>•effect of t he m p t h a n o l exLracts from coi i ipa-s i ia t p l a n t s mi12-0-telradecanoylpliorboi-13-aceiaTf-induccd ear oedema in aiice. Phytother Ri i1998;12(7);484-487.

14. Jeon HJ, Kang JH, lung IIJ, et al. Anti-inflammatorj- activity of Turnxmuin offkiiialc. !Ethnopharmaiol. 2008:115(1 );82-8 8.

15. Akhtar MS, Khan (iM, Khaliq T. Effects o\ Porlu!iica uliraaie (Kulla) and Taraxacumoffiànak (Dliudhal) in nonnoglycaemit and alloxan-ireated hyperglycaeniic rabbits.JPakMedAiSiK. 1985:35(7): 207-210.

16. Petlevski R, Hadzija M, Slijepcevic M, Juredc D. Effect of antidiabetis' herbal prepa-ration on serum glucose and fruclusamine in NOD mice../ Ethnopharmmol.2001 ;75(2-3): 181-184.

17. Hussain Z, Waheed A, QureshiRA, et al. The effect ofmedicinal plants of Islamabadand Murree region of Pakistan on insulin secretion from INS-1 celLs. Phytuther Res.2O04;18(l):73-77,

18. Swaiistoii-Flatt SK, Day C, Flatt PR, Gould BJ, Bailey CJ. Glycaemic effects of tradi-tional r.uropean plant treatments for diabetes. Studies in normal and streptozotocindiabetic imcr.Üií(/'t7i-,vKii. 198í!:L0(2):tí9-73.

19. Koci UN, HongSH, SongBK, et al, 7Íiriiíin"um ii^anaic induces cytotoxicily throughTNF-alpha and IL-lalpha secretion in Hep G2 cells. Íj/;-Sn.2004;74<9):1149-U57,

20. Kim HM, Shin HY, Lim KH, et a!. Taraxacum íiffirí/iale inhibils tumor necrosis iac-tor-alpha protiuclion from rat astrotytes. Immumipharmaco! Immunnloxicoi

38

21. Jeong JY, Chung YB, Lee CC, Park SW, Lee CK, Studies on immunopotentlatingactivities of antitimmr polysa echa ride from aerial parts of Taraxacum plalycarpum.AràiPharmRes. lí)91;!4(I):H8-72.

22. Sigstedt SC, Hooten C.I, Caliewaert MC, ei al. Evaluation of aqueous extracts ofTaraxacum officinale on groMih and invasion of breasi and prostate cancer cells. IntjOncol. 2008;.12(5):1085-'l(l90.Baba K, Abe S, Mizund D. Antitumor activity of hot water extract of dandelion,Taraxacum p/iiVim'/f-correiation between antitumor activity and timing of adminis-tration larticle in Japanesel. Yakugaku Ztixshi. 1981:101(6):538-543.Hagymasi K, Blaïovio A, Fehér ) . lugasi A, Kristó .ST. Kêr>' A. The in vitro effect ofdandelion's antioxidant.s on the microsomal lipid peroxidation. PhyhUher Kes.2000;I4(l):43-44.

25. Rácü-Kotilla E. Racï G, Solomon A. The action of Turaxatum officinale extracts onthe body weight and diuresis of laboratory aninials. Planta Med. 1974;26{3):212-217

26. Grase.s F. Mi-ieroG. Co.sta-Bauza A. Prieio H. .March}G. Urolithiasis and phytothera-py.MiWMyj/im/. 1994;2ii(5):507-511.

27. Tita B. Bello L', Faccendini P, et al. TaraxacamojpeinaleW: Pharmacological effect ofetbanol extract, Pharmacol Res. 1993:27(Suppl l):23-24.

28. Zhi X, Honda K, Oiaki K. Misugi T, Sumi T, Ishiko O. Dandelion T-1 extract up-reg-ulates reproductive hormone receptor expression in mice, liil J Mol Med.20<)7;20(:i):2M7-292.

29. Blumenthal M, Basse WR, Goldberg A, et al. (eds). Vie Complete German Commissionf. Monographs: Tlwrupeulic Guide to Herbal Medicines. Austin: American BotanicalCouncil and Boston: Integrative Medicine Communications, 1998.

30. Greenlee H. Atkinson C, StanC7yk TZ, i^impelW. Apilot and feasibility study on tbeeifei ts of naturopathic botanical and dietary interventions on sex steroid hormonemetabolism in premenopausal women. Ciiiieer Epidemiol Biomarkers Prev2007:10(8): 16ÜI-1609.

31. Chakurski 1. Matev M, Kolchev A. Angelova 1, Siefanov G, Treatment of chronic coli-tis with an herbal combination of Taraxacum officinale, ¡lypericum perforatum,Melissa iißicinaHs. Calriiiiiila officinaHs and Foeiiiculum ¡'ulgare (article in Bulgarian],Vu(rfli>/n. 1981:20(ti):51-54.

32. Fang JY. Effect of fii-zheng qu-xie on gastric disease infected with Campylohaeicrpv!i>-/•/•/w larticle in aiinese|.2'/Mni;,Y;IVy/f//cZ(iZ/i/.1991;lL(3): 150-152,133.

33. Chen Z. Clinical study of 9f¡ cases with chriuiic hepatitis R treated with jiedu yang-gan gao by a doulile-blind method [article in Chinese). Zhong Xi Yi jie He Za Zhi.199O:lO(2);71-74.f)7.

34. i.lu XR, Han WCi Sun DR. Treatment of intestinal meiaplasia and atypical hyperpla-sia of gastric tnucosa with xiao wei yan powder lariicle in Chinesel. ¿iun,ççi/o 2Ä0BgXiYijieHeZaZhi. 1992:12(10):602-'603,580,

35. Hoffmann D. Méditai Herbali.im: The Seience iiml Practice of Herbal Medieine.Rochester. \ T : Healing Arts Press: 2003.

36. Wumenthal M, Croldberg A. Rrinckmann J, eds. Herbal Medicine: Expanded Commission EMonoaraplii. Newton, .MA:Integrative MedicineCommunications; 2000.

37. Lee Y'W, Choi SY, Lee EK, Sohn JH, ParkJVV, Hong CS. Cross-allergenicity of pollensfrom the Compositae fannly: Artemisia vulgaris. Dendranlhema grandißorum. andTanaucum officinale. Mn Allergy Asthmu ¡miiiuno!. 20O7;99(6):526-533.

38. Hirono I. \ iori H, Kato K, Ushimaru Y, Kato T, Haga M. Safetj' examination of someedible plants. Pan 2.! Environ Palhol Toximl 1978:l(l}:7I-74.

39. Zhu M, Wong PY, Li RC. Eflects ol" Taraxacum mongolieum on the bioavailability anddisposition of ciprofloxacin in rais. / Pharm Sri. 1999:88(6):632-634.

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