Abstract
Context
Chamomile is a widely recognized medicinal herb, and it has been used for its various medicinal properties. Chamomile’s widespread recognition and application in medicine highlights its significance in herbal therapeutic practices globally.
Objective
To explore chamomile as a low-risk antimicrobial and anti-inflammatory agent, utilizing clinical characteristics derived from the existing body of evidence from randomized clinical trials within the current literature.
Methods
We conducted a systematic review of randomized clinical trials using the search terms ‘chamomile anti-inflammatory antimicrobial randomized clinical trials’ and ‘chamomile anti-inflammatory antimicrobial’. We sourced data from databases including PubMed, Google Scholar, Cochrane Library, and ClinicalTrials.gov. We then performed a meta-analysis using R to assess the efficacy of chamomile as an anti-inflammatory and an antimicrobial agent, and its impact on mucosal recovery in clinical settings.
Results
A total of 11 randomized clinical trials were identified. The mean difference, confidence intervals, and standard error from the extracted means and standard deviations for relevant outcomes were calculated. Statistical tests from the meta-analysis demonstrated that chamomile exhibited statistically significant reductions in mucositis severity and pain level, indicating the anti-inflammatory effects of chamomile.
Conclusion
This study highlights chamomile’s potential as a natural alternative for managing inflammation and microbial infections, offering a promising alternative to standard treatments. Our study suggests chamomile has the potential to act as a natural anti-inflammatory agent. A future study with a larger sample size may provide clinical evidence of this effect.
Systematic review registration number (PROSPERO): CRD42024566615
Keywords: Chamomile, anti-inflammatory, natural herbal plant
Introduction
Chamomile is a widely recognized medicinal herb, according to a report from the World Health Organization (WHO) (WHO 2019). The WHO includes chamomile in its definition of traditional, complementary, and integrative medicine (TCIM) (WHO 2024). This herb belongs to the Asteraceae Family and is primarily represented by two varieties: Matricaria chamomilla (German chamomile) and Anthemis nobilis (Roman or English chamomile) (Singh et al. 2011). Currently, the U.S. Food and Drug Administration (FDA) classifies German chamomile as Generally Recognized As Safe (GRAS) for use in food products (FDA n.d), and the U.S. Pharmacopeia recognizes chamomile as a therapeutic agent (Pharmacopeia US n.d).
Chamomile is native from west Asia and Europe, and found across various continents, including Asia, Europe, and North America, with a significant presence in the United States where traditionally, it has been used for its antiemetic, antispasmodic, and sedative properties (Sharafzadeh and Alizadeh 2011; Weiss 1988). The extensive use of chamomile as a medicinal herb is well-documented throughout various cultures and historical periods (Figure 1).
Figure 1.
Summary of traditional use of chamomile. This figure was created based on the collection of information from the previous reports (Antonielli 1928, Benítez et al. 2010, Carle and Gomma 1991/1992, Malik et al. 2013, McKay and Blumberg 2006, Menale et al. 2022, Mrabti et al. 2019, Naceiri Mrabti et al. 2021, Raal et al. 2013, Savikin et al. 2013, Smitherman et al. 2005, Tabernaemontanus 1664, Ubessi et al. 2019, Zucchi et al. 2013).
In 500 BCE, Hippocrates, the father of medicine described chamomile as a medicinal plant (Carle and Gomma 1991/1992). In 10th-century Uyghur medical texts from China, it is indicated that chamomile helps with swelling, urinary disorders, and soothes pain (Ubessi et al. 2019). During the medieval age, doctors prescribed chamomile for intermittent fevers in the 16th and 17th centuries (Antonielli 1928). In 1644, Tabernaemontanus, a physician and herbalist, reported on the medicinal properties of chamomile (Tabernaemontanus 1664). Chamomile as medicine was continued to be studied in 21 C. Smitherman et al. in 2005 studied the chamomile as folk remedies among African American community in Michigan, USA and found it was used to treat colic (Smitherman et al. 2005). An ethnobotanical survey conducted in Brazil discovered that Chamomile is one of the most commonly used plants for medicinal purposes (Zucchi et al. 2013). Another ethnobotanical study in Serbia identified chamomile as one of the most commonly used plants for medicinal purposes (Savikin et al. 2013). Traditional Moroccan medicine recommends chamomile as a treatment for diabetes (Mrabti et al. 2019; Naceiri Mrabti et al. 2021). In Spain, chamomile is utilized for treating gastralgia, digestive disorders, female genital infections, and kidney stones (Benítez et al. 2010). In traditional Italian medicine, chamomile was used to treat sprains, broken bones, and gastrointestinal pain (Menale et al. 2022). In Estonia, chamomile is commonly used to alleviate symptoms of colds and flu (Raal et al. 2013). In 2013, Malik et al. reported on the use of chamomile in homeopathy in Pakistan (Malik et al. 2013). In Germany, the chamomile flower is officially recognized as a standard medicinal tea (infusion) approved for drinking, as well as for topical use in rinses or gargles, creams and ointments, vapor inhalation, and as an ingredient in sitz or vapor baths (McKay and Blumberg 2006).
Chamomile’s widespread recognition and application in traditional medicine highlights its significance in herbal therapeutic practices globally. Utilizing clinical characteristics from the existing randomized clinical trials within the current literature is an opportunity to enhance our understanding of treatment efficacy and patient outcomes. By systematically analyzing these characteristics, our study contributes to identifying trends, optimizing clinical decision-making, and ultimately improving the quality of care provided to patients.
To the best of our knowledge, the efficacy of chamomiles as an anti-inflammatory agent has not yet been thoroughly evaluated via a comprehensive meta-analysis of randomized clinical trials covering various range of clinical characteristics across multiple countries. In this systematic review and meta-analysis, our objective is to explore chamomile as a low-risk anti-inflammatory agent, utilizing clinical characteristics derived from the existing body of randomized clinical trials within the current literature.
Methods
Systematic review
This systematic review and meta-analysis aimed to evaluate the antimicrobial and anti-inflammatory effects of chamomile. The review followed the PRISMA-P guidelines (Page et al. 2021). To identify relevant studies, we searched the following databases: Google Scholar, PubMed, Cochrane, and ClinicalTrials.gov. The search terms used included ‘chamomile’, anti-inflammatory’, ‘antimicrobial’, and ‘randomized clinical trials’. This search was restricted to studies published in the past 20 years, specifically between 2004 and 2024. We applied filters to exclude studies involving pediatric populations, non-human subjects (such as mice and rats), and review articles. Exclusion criteria were carefully considered to avoid unnecessary large heterogeneity of data included. The studies were screened based on the following inclusion and exclusion criteria.
Inclusion criteria
Randomized clinical trials evaluating chamomile’s anti-inflammatory effects such as pain severity level and bleeding were included. Adult human participants were included. Studies directly assess chamomile’s antimicrobial outcomes were included.
Exclusion criteria
Review articles or editorials were excluded. Studies involving mice, or rat populations were excluded. Publications beyond the past 20 years were excluded. Articles with insufficient data were excluded.
Titles and abstracts were independently reviewed by 2 of our members to assess eligibility based on the inclusion criteria. Full-text articles of potentially relevant studies were then retrieved and further evaluated. Articles were excluded if they lacked sufficient data or involved combinational herbal compounds. This systematic review was registered in PROSPERO (Haby et al. 2016) on July 17, 2024.
Meta-analysis
Data were collected and organized in a manner aiming to capture study characteristics (e.g., country, study design, and agent tested), intervention details (e.g., test and control group characteristics, placebo use), participant demographics (e.g., age, gender, and sample size of test and control groups), and outcome measures (e.g., mean values, standard deviations, and p-values). The outcomes were reviewed independently by two reviewers and categorized by joint consensus into one of six outcome measures: 1) anti-inflammatory effects, 2) pain severity levels, 3) gingival bleeding, 4) microbial load, 5) mucosal inflammation, and 6) gingival index. The meta-analysis was performed using R statistical software utilizing the meta package (Balduzzi et al. 2019). First, the effect size and inverse variance weights for each study were calculated. Next, the pooled effect was calculated using these weights. Finally, forest plots were generated to represent effect size, weight, confidence interval, observed effect and heterogeneity for each included study together. Furthermore, an alluvial diagram was created using the RAWgraphs.
Statistical tests
Statistical analyses evaluated the efficacy of chamomile as an anti-inflammatory agent. Heterogeneity among studies was assessed using the I2 statistic. Effect sizes were reported as weighted mean differences or odds ratios with corresponding 95% confidence intervals (CI). A p-value of <0.05 was considered statistically significant. In the forest plot, statistical significance was presented with vertical line of no significance.
Results
Systematic review
An initial search across Google Scholar, PubMed, Cochrane, and ClinicalTrials.gov yielded 12,000, 31, 3, and 0 studies, respectively, for a total of 12,031 records. After removing review articles, 1,603 studies remained. Further exclusions were applied to studies involving animal models (e.g., mice, rats), pediatric populations, or publications older than 20 years (from 2024), resulting in 653 studies. These remaining studies were manually screened based on titles, abstracts, and full texts for relevance to herbal compounds, narrowing the selection to 9 studies. Additionally, 2 manually identified studies from Google Scholar that met the inclusion criteria were added (Figure 2), resulting in a total of 11 studies included in the final meta-analysis (Table 1).
Figure 2.
Systematic review flow chart based on PRISMA-P guidelines, which outlines the study screening and selection process.
Table 1.
Summary of final selected studies included in the meta-analysis.
| Authors | Year | Country | Agent | Body site | Measurements | Effects (outcome) |
|---|---|---|---|---|---|---|
| AbdElwadoud et al. (2019) | 2020 | Egypt | 1ml of chamomile oral gel 1 h before meal 3 times a day | Oral mucosa | National Cancer Institute Pain Numeric Rating Scale and Patient-Reported Oral Mucositis Symptoms scale | Statistically significant reduction in oral mucositis grade, pain intensity, and patient-reported oral mucositis symptoms using chamomile gel |
| Agarwal and Chaudhary (2020) | 2020 | India | 1% of 50 g/250 ml chamomile mouth wash, to rinse with 15 ml of assigned medication two times a day for 1 min | Subgingival plaque | Probing pocket depth, Clinical attachment level, Gingival index, Plaque index, Gingival bleeding index, Stating index | Statistically significant improvement on clinical characteristics and microbial profile using chamomile in periodontitis |
| Alkasso et al. (2020) | 2020 | Iraq | 5ml of Herbal mouthwash containing chamomile | Salivary pH | Salivary pH | Chamomile mouthwash showed significantly improved salivary buffering capacity 15 mins after carbonated drink intake |
| Al-Kholani (2011) | 2011 | Yemen | Herbal extract dentifrice (Parodontax) including chamomile | Gingiva | Patient Hygiene Performance Index (PHP); the Approximal Plaque Index (API); Gingival Index (GI); Sulcular Bleeding Index (SBI) | Toothpaste containing chamomile usage had a statistically significant clinical improvement in patients with gingivitis |
| Aradmehr et al. (2017) | 2017 | Iran | 0.5 grams of 1.3% chamomile cream twice a day | Skin with episiotomy stitch | Pain tenth day after birth | Chamomile cream significantly reduced episiotomy pain in Primiparous women |
| Batista et al. (2014) | 2014 | Brazil | Herbal mouthwash containing extracts of Matricaria recutita L (chamomile) | Gingiva | Gingival bleeding index | A significant reduction in gingival bleeding using chamomile mouthwash observed |
| Elhadad et al. (2022) | 2020 | Egypt | Chamomile topical oral gel 3% | Oral mucosa | WHO Stomatitis intensity grading system; pain severity | A significant reduction in chemotherapy-induced oral mucositis using chamomile topical gel observed |
| George et al. (2009) | 2009 | India | 150 gm of Colgate herbal-based toothpaste brush twice a day | Gingiva | Gingival Index (GI); Plaque Index, Salivary pH | Statistically significant difference in the plaque and gingival scores |
| Nemati et al. (2021) | 2021 | Iran | 3 drops of chamomile extract | Nasal | Minimal clinically important difference (MCID) | The use of chamomile extracts significantly improved the symptoms of chronic rhinosinusitis |
| Radafshar et al. (2010) | 2010 | Iran | 3 gm Parodontax dentifrice in 10 ml water | Full mouth plaque | Plaque index | Statistically significant difference in the full mouth plaque index using chamomile containing toothpaste observed |
| Shabanloei et al. (2009) | 2009 | Iran | 8gm/5 ml chamomile gargle 4 times a day after chemotherapy treatment | Oral mucosa | WHO Stomatitis intensity grading system; pain | Chamomile was shown to be as effective as conventional treatment against post-chemotherapy stomatitis |
This meta-analysis included 11 studies that examined the anti-inflammatory properties of chamomile. The outcomes were assessed by focusing on the effect of chamomile as 1) anti-inflammatory effects, 2) pain severity levels, 3) gingival bleeding, 4) microbial load, 5) mucosal inflammation, and 6) gingival index. Pain severity levels and gingival bleeding outcomes were sub-analyses of anti-inflammatory effect analysis. The results are presented as pooled mean differences with 95% confidence intervals and assessment of study heterogeneity. Consistently, no known side effects were reported across all 11 studies.
Chamomile significantly reduces pain
Chamomile’s role in pain severity reduction may be attributed to its anti-inflammatory properties, as pain is often a clinical manifestation of underlying inflammation. First, the anti-inflammatory effect of chamomile was tested including gingival bleeding index and pain severity index measured. The meta-analysis of chamomile’s anti-inflammatory effects included seven studies. As shown in Figure 3(A), the pooled mean was −1.57 (95% CI: −4.05 to 0.91) and showed no statistically significant reductions of inflammation using chamomile. The statistical analysis demonstrated large heterogeneity (I2 = 92%, p < 0.01), indicating high variability among the included studies assessing chamomile anti-inflammatory properties. Next, we investigate this further with sub-group analysis to look into more on large heterogeneity. Upon conducting a subgroup analysis of studies with pain severity only, it was observed that the pooled mean was −0.61 (95% CI: −0.76 to −0.46) while there was no heterogeneity present (I2 = 0%, p < 0.95), suggesting consistency across the studies even though pain severity measurements from more than one body site is included in the analysis. Remarkably, the results of the meta-analysis of studies indicated a statistically significant reduction in pain severity associated with the use of chamomile as the pooled effect is distinctively separated from the vertical line of no effect (Figure 3(B)). Although the effect sizes varied across the 4 studies included, each study showed clear mean differences. Furthermore, the subgroup meta-analysis of chamomile’s effect on bleeding was conducted. Three studies that measured bleeding were selected and included. The pooled mean difference was −3.09 (95% CI: −13.55 to 7.37), demonstrating no statistical significance in reduced gingival bleeding associated with chamomile treatment (Figure 3(C)). There was low heterogeneity among the analyzed studies (I2 = 97%, p < 0.01).
Figure 3.
A. Forest Plot for the meta-analysis of chamomile’s anti-inflammatory effects including outcomes of pain severity and bleeding. Seven studies were included. The pooled mean difference was -1.57 (95% CI: -4.05 to 0.91) with no statistically significant effect. High heterogeneity was noted (I2 = 92%, p < 0.01), B. Forest plot for the meta-analysis of chamomile’s reduction of pain severity levels. Four studies were included in the Sub-analysis evaluating chamomile’s effect on pain severity levels. The pooled mean difference was -0.61 (95% CI: -0.76 to -0.46) and showed a statistical significance. No heterogeneity was noted (I² = 0%, p = 0.95) while variation of effect size was observed due to limited number of study available. C. Forest plot for meta-analysis of chamomile’s effect on pain severity levels on oral mucosa included rest of three studies. The pooled mean difference was -3.09 (95% CI: -13.55 to 7.37). Additionally, there was no significant heterogeneity among the studies analyzed (I2 = 97%, p < 0.01). The red diamond shape represents the average effect with confidence intervals as its width while the black vertical line represents no significance.
No significant association between chamomile and dental plaque
Next, the anti-microbial effect of chamomile was tested including the plaque index measured. Five studies with direct measurement of microbial load by plaque index were included. The pooled mean difference was −3.90 (95% CI: −10.94 to 3.13), indicating no significant effect. High heterogeneity was noted (I2 = 95, p < 0.01) (Figure 4).
Figure 4.
Forest Plot for the meta-analysis of chamomile’s antimicrobial effects. For chamomile’s antimicrobial properties, five studies were selected and analyzed. The pooled mean difference was -3.90 (95% CI: -10.94 to 3.13) which indicated no significant antimicrobial effect. High heterogeneity was observed (I2 = 95, p < 0.01). The red diamond shape represents the average effect with confidence intervals as its width while the black vertical line represents no significance.
Chamomile effective on mucosal integrity and recovery from tissue injury
We then performed a meta-analysis specifically focusing on mucosal integrity measured by gingival index and oral mucositis severity. Three studies with direct measurement of gingival index were included and analyzed for chamomile effect. The pool mean difference was −1.25 (95% CI: −3.46 to 0.96), indicating no statistically significant reduction in gingival inflammation. Heterogeneity was high (I2 = 83%, p < 0.01) (Figure 5(A)). Chamomile’s effect on pain severity levels measured specifically on oral mucosa included three studies. The pooled mean difference was −0.70 (95% CI: −1.25 to −0.15), demonstrating a statistically significant reduction of mucosal inflammation (Figure 5(B)). The effect size of one study out of three included was higher, this may have been the driving factor behind statistical significance. Further studies need to be included to draw clinically significant outcomes. Additionally, there was no heterogeneity among the analyzed studies (I2 = 0%, p = 0.58), showing no differences between the studies. The lack of heterogeneity further supports the reliability of chamomile’s effect on pain reduction across diverse studies. Overall, the current meta-analysis revealed that chamomile demonstrated a statistically significant effect in reducing pain and mucosal inflammation. However, the pooled mean difference was not statistically significant with elevated heterogeneity for bleeding, antimicrobial, and gingival index.
Figure 5.
A. Forest Plot for the meta-analysis of chamomiles’ gingival index. Three studies were included. The pooled mean difference was -1.25 (95% CI: -3.46 to 0.96), indicating no significant effect. High heterogeneity was noted (I2 = 83%, p < 0.01). B. Forest plot for the meta-analysis of chamomile’s reduction of mucosal inflammation. Three studies were included. The pooled mean difference was -0.70 (95% CI: -1.25 to -0.15), indicating a significant effect. No heterogeneity was noted (I2 = 0%, p = 0.58) while variation of effect size was observed due to limited number of study available. The red diamond shape represents the average effect with confidence intervals as its width while the black vertical line represents no significance.
Discussion
Approximately 70-80% of the global population is thought to benefit from complementary and alternative medicine, often relying on herbal plants like chamomile, green tea, aloe vera, and propolis to meet their healthcare needs (Seal et al. 2016). Chamomile is well-known for its numerous pharmacological properties, which include anticancer, anti-infective, anti-inflammatory, antioxidant, analgesic, hypoglycemic, antihypertensive, hypolipidemic, antiallergy, antidepressant, and organ-protective effects (Dai et al. 2022; Sah et al. 2022) while tested negative for genotoxicity tests (Rosol et al. 2023). Chamomile is increasingly recognized as a TCIM, particularly beneficial for patients who lack access to standardized healthcare, experience hypersensitivity reactions to synthetic pharmaceuticals, or are dealing with growing multidrug resistance. This study systematically reviewed the literature and conducted a meta-analysis to investigate the overall clinical health effects of chamomile on six specific outcomes: 1) anti-inflammatory effects, 2) levels of pain severity, 3) gingival bleeding, 4) microbial load, 5) mucosal inflammation, and 6) gingival index. This review included all available randomized clinical trials from the past 20 years and up to the present date.
Chamomile has a long history of being used for its anti-inflammatory effects in the treatment of inflammatory skin and mucosal conditions (Colella et al. 2023). Surely, our selected final 11 randomized clinical trial studies included 1 skin and 10 oral applications of chamomile. Chamomile is chemically constituted by more than 120 phytochemicals including 28 terpenoids, 36 flavonoids (Aaqil et al. 2022) and palmitic acid, linoleic acid, oleic acid, and stearic acid as primary metabolites (Zhao et al. 2018). As a drug, the most bioactive component of chamomile is apigenin, one of the flavonoids. It reduces inflammatory mediators by inhibiting inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) expression through nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways (Liang et al. 1999), leading to a decrease in the production of nitric oxide and prostaglandin associated with pain sensitivity. In mice, chamomile has been shown to reduce Th17 cell differentiation signaling pathway, which subsequently inhibits the NF-κB and MAPK signaling pathways and this further decreased pro-inflammatory mediators such as tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) (Wang et al. 2021). To be used as a therapeutic agent, the European and the U.S. Pharmacopoeia suggest that chamomile flowers should contain at least 0.25% apigenin-7-glucoside and 0.3% apigenin-7-glucoside, respectively.
Previously, a reduced level of inflammation was observed upon chamomile treatment (Weber et al. 2020). Specifically, components of chamomile such as α-Bisabolol, β-farnesene, Chamazulene, Apigenin, Geraniol, Herniarin, Umbelliferone, Luteolin, Quercetin, Rutin are considered to have anti-inflammatory effects (Akram et al. 2024) (Figure 6). A decrease in the severity of inflammation from the anti-inflammatory effects of chamomile occur due to the reduction of inflammatory mediators such as interleukin-1β and tumor necrosis factor-α. Although literature supports chamomile’s anti-inflammatory effects, our meta-analysis, which focused solely on the gingival bleeding index, did not yield statistically significant results. Gingival bleeding is a clinical indicator of inflammation in the gums. In contrast, the meta-analysis of subset data that examined pain levels showed a distinct statistical significance regarding chamomile’s analgesic effects. Pain is a clinical symptom of inflammation, and chamomile has previously been shown to reduce neuropathic pain (Forouzanfar and Hosseinzadeh 2018), which is consistent with our findings. Although this subset of meta-analysis did not directly assess inflammatory markers, previous findings, such as the statistically significant reduction in mucosal inflammation suggest a potential connection.
Figure 6.
Summary of chamomile components and medicinal effects displayed by alluvial diagram. Each component of chamomile displays intercalation with multiple medicinal effects. The figure was restructured based on information included in the review article by Akram et al. (2024).
Our meta-analysis found no significant antimicrobial effects, despite most literature validating its effectiveness using various approaches (Saderi et al. 2005; Takada et al. 2024). The findings largely stem from the methods employed in the clinical trials analyzed, which primarily relied on the plaque index. This clinical measurement assesses the area of biofilm on teeth; however, it lacks microbiological measurements that are essential to validate the anti-microbial effects. Standard antimicrobial testing methods, such as the Kirby-Bauer agar diffusion assay and minimum inhibitory concentration test, could have provided more accurate confirmation of these effects.
Interestingly, meta-analysis indicated a statistically significant impact of chamomile on minimizing damage to oral mucosal tissue. This aligns with a double-blind trial focused on wound healing that included 14 patients with tattoo abrasion injuries. In this research, chamomile extract demonstrated effectiveness in promoting wound healing and speeding up the process of epithelialization (Glowania et al. 1987). Another study found that chamomile is more effective than corticosteroids in reaching complete wound healing at a faster rate (Martins et al. 2009).
This study has several limitations, including the small number of qualified studies that met our inclusion and exclusion criteria, which may have affected the statistical power. The phytoconstituents present in chamomiles can also vary from batch to batch, influenced by factors such as soil quality, growth conditions, and the methods used to deliver chamomile components in clinical trials. Additionally, certain phytochemical constituents, such as lipophilic compounds, are more prone to oxidation, while chamazulene and bisabolol are particularly unstable. Moreover, both alcoholic and aqueous extracts of chamomile exhibit poor tissue permeability (Sah et al. 2022). The analysis of the plaque index posed a significant limitation when evaluating chamomile’s antimicrobial effect. This is because the plaque index measures the area of biofilm on teeth, rather than quantifying microbial load, viability, or cell concentration. Additionally, other measurements included in various subsets of selected studies such as probing pocket depth, clinical attachment level, the stating index, and the patient hygiene performance index—could not be used in the current meta-analysis. This was due to an insufficient number of studies available for statistical analysis.
Future perspectives
Regulating and standardizing chamomiles as TCIM, validating their cellular mechanisms for health effects, and conducting clinical trials with more specific and personalized approaches may ensure the effective application of chamomile as TCIM.
Conclusions
In Summary, our meta-analysis confirmed that chamomile is an effective agent for pain relief, promoting better wound healing, and aiding recovery from iatrogenic conditions. Chamomile is significantly effective in reducing pain, maintaining mucosal integrity, and recovery from tissue injury. The exploration of chamomile’s pharmacological properties continues to yield insights that enhance our understanding of its potential benefits and applications. Our findings show the significance of chamomiles in improving human health because it can potentially lead to novel therapeutic strategies. A future study with a larger sample size may provide clinical evidence of this effect.
Funding Statement
The author(s) reported there is no funding associated with the work featured in this article.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
Raw data are available from original articles included in this review
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Data Availability Statement
Raw data are available from original articles included in this review






