A Scoping Review on Medicinal Properties of Piper betle (Sirih) Based on Malay Medical Manuscripts and Scientific Literatures

Background: Malay medical manuscripts have deciphered the medicinal value of Piper betle (sirih) enormously. In this review, an effort was made to explore the medicinal use of P. betle and correlate this information with the scientific evidence. Methods: The information regarding the use of P. betle was retrieved from the books consisting of a Malay medical manuscript with an identification number MSS 2219 from the National Library of Malaysia. PubMed, ScienceDirect and Scopus databases were used to collect information regarding the scientific evidence for the medicinal use of P. betle. This review was written following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines. The keywords used for searching the articles included P. betle, antimicrobial, analgaesic, haepatic and gastric. Results: MSS 2219 showed that P. betle has varied medicinal uses and based on that, it can be grouped into six categories. P. betle application method was different in different conditions. In terms of the literature search, 226 articles were found, 75 articles were extracted for detailed analysis and only 23 met the inclusion criteria. The information was related to the chemical assays, in vivo and in vitro studies. Conclusion: In summary, P. betle has the potential to treat medical conditions in various types of categories as recorded in the Malay medical manuscripts and also based on scientific publications. For clinical purposes, more information is required, such as the specific mechanism involved, the best extraction method and the best dosage for treatment.