A review of the efficacy of traditional Iranian medicine for inflammatory bowel disease

Table 3 Clinical studies on plants used in traditional Iranian medicine for the treatment of inflammatory bowel disease

Study	Study design	No. of patients	Disease	Plant	Part of plant	Control group	Duration of treatment	Result
Kaliora et al[82]	Open, comparing CD patients with healthy volunteers	10 patients and 8 controls	CD	Pistacia lentiscus	Oleogum resin	-	4 wk	↓TNF-α secretion, ↑macrophage migration inhibitory factor release meaning that random migration and chemotaxis of monocytes/macrophages was inhibited
Kaliora et al[83]	Open, comparing CD patients with healthy volunteers	10 patients and 8 controls	CD	Pistacia lentiscus	Oleogum resin	-	4 wk	Significant reduction of CD Activity Index, ↓Plasma IL-6 and C-reactive protein, ↑total antioxidant potential, no side effects observed
Madisch et al[84]	Double-blind, randomized, placebo-controlled, multicenter	31	Collagenous colitis	Boswellia serrata	Gum resin extract	Placebo	6 wk	The proportion of patients in clinical remission was higher in the Boswellia serrata extract group than in the placebo group; Compared to placebo, Boswellia serrata extract treatment had no effect on histology and quality of life
Gupta et al[85]	Randomized	30	Chronic colitis	Boswellia serrata	Gum resin	Sulfasalazine	6 wk	Eighteen out of 20 patients treated with Boswellia gum resin showed an improvement in one or more of the parameters including stool properties, histopathology as well as scanning electron microscopy, hemoglobin, serum iron, calcium, phosphorus, proteins, total leukocytes and eosinophils; In the sulfasalazine group, 6 out of 10 patients showed similar results in the same parameters, 14 out of 20 patients treated with Boswellia gum resin achieved remission, while in the case of sulfasalazine the remission rate was 4 out of 10
Gupta et al[86]	Randomized	30	UC	Boswellia serrata	Gum resin	Sulfasalazine	6 wk	All tested parameters including stool properties, histopathology, scanning microscopy of rectal biopsies, and blood parameters including hemoglobin, serum iron, calcium, phosphorus, proteins, total leukocytes and eosinophils improved after treatment with Boswellia serrata gum resin. The rate of remission was similar in the two studies group (82% in the Boswellia serrata group vs 75% in the sulfasalazine group)
Al-Habbal et al[87]	Double-blind controlled	38	Duodenal ulcer	Pistacia lentiscus	Oleogumresin	Placebo	2 wk	Symptomatic relief in 80% of patients on oleogum resin from P. lentiscus and 50% in patients on placebo, endoscopically proven healing occurred in 70% of patients on oleogum resin from P. lentiscus and 22% of patients on placebo, no side effects observed
Fernández-Bañares et al[88]	Open label, multicenter, randomized	92	UC	Plantago ovata	Seed	Mesalamine	12 mo	40% relapse rate in the P. ovata seed group and 35% in the mesalamine group and 30% in the Plantago ovata plus mesalamine group

UC: Ulcerative colitis; CD: Crohn’s disease; iNOS: Inducible nitric oxide synthase; Cox: Cyclooxygenase.