Systematic Reviews
Copyright ©The Author(s) 2022.
World J Methodol. May 20, 2022; 12(3): 132-147
Published online May 20, 2022. doi: 10.5662/wjm.v12.i3.132
Table 1 Baseline study characteristics, and summary of risk of bias assessment
Country of 1st author
Type of randomized controlled trial
Patient profile
Overall risk of bias as per RoB-2 tool2
Sample size
Mean age
Male (N, %)
Sample size
Mean age
Male (N, %)
1Enesel et al[18], 2005RomaniaParallel groupPatients undergoing surgery for GIT cancer4062 (range 37-87)23 (57.5)30NANA-
2Ishikawa et al[21], 2006JapanParallel groupPatients with inoperable colon/liver/pancreatic cancer2563.6 ± 8.321 (84)2565.8 ± 6.318 (72%)?
3Brush et al[22], 2006United StatesParallel groupHealthy adult volunteers3NANA2NANA-
4Schink et al[27], 2007GermanyParallel groupPrimary/locally relapsed colorectal carcinoma patients undergoing open (complete/partial) tumour resection1172 ± 8.27 (63.6)1169 ± 10.45 (45.5)?
5Purandare et al[33], 2007IndiaParallel groupPatients with diabetic foot ulcer2356.2617 (73.9)2256.3219 (86.4)?
6Uebaba et al[29], 2008JapanCrossoverHealthy adult female volunteers1639 ± 90 (0)1639 ± 90 (0)?
7Bhat et al[28], 2010IndiaParallel group (I) Healthy adult volunteers13NANA13NANA?
Crossover (II)Healthy adult volunteers110NANA110NANA-
8Işik et al[23], 2010TurkeyParallel groupAllergic rhinitis patients with house dust mite sensitivity12NANA12NANA-
9Kianbakht et al[30], 2011IranParallel groupHealthy adult male volunteers4522.5 ± 0.645 (100)4421.1 ± 0.544 (100)?
10Mondal et al[24], 2011IndiaCrossoverHealthy adult volunteers22NANA22NANA?
11Nantz et al[26], 2012United StatesParallel groupHealthy adult volunteers5625.4 ± 5.723 (41.1)5626.9 ± 7.126 (46.4)?
12Suprabha et al[32], 2017IndiaParallel groupUncomplicated pregnant women in 20-24 wk of pregnancy15NANA15NANA?
13Gupta et al[34], 2017IndiaParallel groupHealthy children aged 5-12 yr3137.3 ± 1.8161 (51.4)3147.4 ± 1.8164 (52.2)?
14Rais et al[36], 2021IndiaParallel group25-60 yr, asymptomatic/ uncomplicated COVID-19 RTPCR +ve, mild symptoms80NA57 (71.3)40NA30 (75)-
15Bhaskaran et al[31], 2019IndiaParallel groupHealthy full-term infants (< 12 mo age), > 2.5 kg birth weight, with normal growth and development47NANA34NANA-
16Kumar et al[35], 2014IndiaParallel groupAdult patients with T2DM of any stage56NANA28NANA-
17Ravindran et al[25], 2014IndiaParallel groupPatients with head & neck cancer in complete remission following primary treatment37NANA38NANA?
18Somarathna et al[20], 2010IndiaParallel groupHIV +ve patients without AIDS surveillance signs as per WHO, and no concurrent illness21NANA6NANA-
19Gupta et al[19], 2010IndiaParallel groupNew HIV +ve patients with CD4 count not < 150/microliter and no complications or comorbidities12NANA8NANA-
Table 2 Details of intervention and comparators
Intervention: Ayurvedic name1
Intervention: Scientific name
Intervention: Route; dose, frequency, duration2
Comparator: Description; route, dose, frequency, duration2
1Enesel et al[18], 2005Isorel® (Mistletoe, firtree)Bandaaka, Suvarna-bandaaka etc.Viscum albumSubcutaneous; 2 wk pre-operatively, 2 wk post-operatively; dose details not clearStandard care
2Ishikawa et al[21], 2006Aged garlic extractLashuna, Rasona etc.Allium sativumOral; 125 mg, 4 capsules daily, 12 wkMatching placebo
3Brush et al[22], 2006Glycyrrhizia glabra tinctureYashtimadhu, Madhuyashtyaahvaa etc.Glycyrrhiza glabraOral; 0.44 g/7.5 mL, twice daily, 7 dMatching placebo tincture
4Schink et al[27], 2007Standard care + Iscador® (Standardized mistletoe extract)Bandaaka, Suvarna-bandaaka etc.Viscum albumIV infusion; 5 mg, single doseStandard care
5Purandare et al[33], 2007Standard care + Tinospora cordifoliaGuduuchi, Guduuchikaa etc.Tinospora cordifoliaDetails not availableStandard care + matching Placebo
6Uebaba et al[29], 2008Shirodhara oil-dripping treatment using sesame oilShirodhara; Tila, SnehphalaSesamum indicumOil dripping on forehead; single sittingControl supine position; single sitting
7Bhat et al[28], 2010Fortified tea with Withania somnifera, Glycyrrhzia glabra, Zingiber officinale, Ocimum sanctum & Elettaria cardamomumAshwagandha; Yashtimadhu; Aardraka, Shunthi; Tulasi; ElaaWithania somnifera, Glycyrrhzia glabra, Zingiber officinale, Ocimum sanctum, Elettaria cardamomumOral; 2.06 g, thrice daily, 2 moRegular tea; Oral; 2 g, thrice daily, 2 mo
8Işik et al[23], 2010Specific immunotherapy + Nigella sativaKaalaajaaji, Kalikaa etc.Nigella sativaOral; 2 g daily, 1 moSpecific immunotherapy alone
9Kianbakht et al[30], 2011Saffron tabletKumkuma, Rudhira, Kaashmiraka etc.Crocus sativusOral; 100 mg daily, 6 wkMatching placebo
10Mondal et al[24], 2011Tulsi capsulesTulasi, Surasa, Suravalli etc.Ocimum sanctumOral; 300 mg daily, 4 wkMatching placebo
11Nantz et al[26], 2012Aged garlic extractLashuna, Rasona etc.Allium sativumOral; 640 mg, 4 capsules daily, 90 dMatching placebo
12Suprabha et al[32], 2017Rasayana Avaleha with milkComposite4Composite4Oral; 12 g, twice daily, 2 moCalcium carbonate (500 mg) with ferrous sulfate (200 mg); Oral; daily, 2 mo
13Gupta et al[34], 2017Cyavanaprasa (Dabur) with milkComposite4Composite4Oral; 6 g, twice daily, 6 moMilk; Oral, 100-200 mL, twice daily, 6 mo
14Rais et al[36], 2021Intervention 1: Vyaghryadi Kashaya (50 mL) + Pippali (250 mg) + Samshamani vati (500 mg)Vyaghryadi Kashaya: Kantakari, Shunthi, Guduchi; Pippali; Samshamani vati: GuduchiSolanum xanthocarpum, Zingiber officinale, Tinospora cordifolia, Piper longumOral; twice daily, 10 dVitamin C (500 mg) twice daily, Paracetamol (500 mg) as needed
Intervention 2: Shunthi churna (2 g) + Rasona kalka (1 g)Shunthi; Rasona, LasunaZingiber officinale, Allium sativumOral; Shunti churna: Twice daily, Rasona: once daily; 10 d
15Bhaskaran et al[31], 2019Swarna Bhasma (Calcined powder of gold), honey, ghritaSwarna prashana, madhu, ghritaNAOral; Swarna bhasma: 0.2-2.4 mg3; once daily, 4 wkOral Honey + ghrita; dose details not available
16Kumar et al[35], 2014Intervention 1: Mamajjaka capsulesMaamajjaka, Naagjhvaa etc.Enicostemma littoraleOral; 500 mg, twice daily, 3 moControl; no details available
Intervention 2: Shilajatu capsulesShilajatuAsphaltum punjabinumOral; 500 mg, twice daily, 3 mo
17Ravindran et al[25], 2014Varunadi Ghrita + Standard careComposite4Composite4Oral; 5 g, twice daily, 1 yStandard care
18Somarathna et al[20], 2010Ranahamsa RasayanaComposite4Composite4Oral; 5 g, twice daily, 90 dStandard care
19Gupta et al[19], 2010Shilajatu RasayanaComposite4Composite4Oral; 95 g over first 15 d, later 6 g per day for 75 dStandard care
Table 3 Results from the included studies: Impact of Ayurvedic medication on components of the immune system
T Helper cells
T cytotoxic cells
T cells: Other results
NK cell count/ activity
B lymphocyte count
WBC count/ activity
Other variables
Indirect evidence
1Enesel et al, 2005Isorel® (Mistletoe, firtree)+-++-++NA++NA
2Ishikawa et al, 2006Aged garlic extract--NA+NANANANA-NANA
3Brush et al, 20061Glycyrrhizia glabra tincture+/-+/-NA+/-+/-NANANANANANA
4Schink et al, 2007Iscador® (Standardized mistletoe extract)NANANA+NANANANANA-NA
5Purandare et al, 2007Tinospora cordifoliaNANANANANANANANA+NANA
6Uebaba et al, 20082Shirodhara oil-dripping (sesame oil)NANANA+/-NANANANANANANA
7Bhat et al, 20103Fortified tea with multiple Ayurvedic ingredientsNANANA+/-NANANANANANANA
8Işik et al, 2010Specific immunotherapy + Nigella sativa+/-+/-+/-+/-+/-NANANA+NANA
9Kianbakht et al, 2011Saffron tabletNANANANANA--NA-NANA
10Mondal et al, 20114Tulsi capsules+/-+/-NA+/-+/-NANA+/-NANANA
11Nantz et al, 20125Aged garlic extractNANA+/-+/-NANANA+/-NANA+
12Suprabha et al, 2017Rasayana Avaleha with milkNANANANANA-NANANANANA
13Gupta et al, 2017Cyavanaprasa (Dabur) with milkNANANANANANANANANANA+
14Rais et al, 2021Intervention 1: Vyaghryadi Kashaya + Pippali + Samshamani vati NANANANANANANANANANA-
Intervention 2: Shunthi churna + Rasona kalkaNANANANANANANANANANA-
15Bhaskaran et al, 20196Swarna Bhasma, honey, ghritaNANANANANA+/-NANA+/-NANA
16Kumar et al, 2014Intervention 1: Mamajjaka capsulesNANANANANANANANANANA+
Intervention 2: Shilajatu capsulesNANANANANANANANANANA+
17Ravindran et al, 2014Varunadi Ghrita + Standard careNANA+++NANANANANANA
18Somarathna et al, 2010Ranahamsa Rasayana+NANANANANANANA-NANA
19Gupta et al, 2010Shilajatu Rasayana+NANANANANANANANANANA