Herbal medicinal products for inflammatory bowel disease: A focus on those assessed in double‐blind randomised controlled trials

Abstract

Inflammatory bowel disease patients frequently use herbal products as complementary or alternative medicines to current pharmacotherapies and obtain information on them mainly from the internet, social media, or unlicensed practitioners. Clinicians should therefore take a more active role and become knowledgeable of the mechanisms of action and potential drug interactions of herbal medicines for which evidence of efficacy is available. The therapeutic efficacy and safety of several herbal medicines have been studied in double-blind randomised controlled trials (RCTs). Evidence of efficacy is available for Andrographis paniculata extract; curcumin; a combination of myrrh, extract of chamomile flower, and coffee charcoal; and the Chinese herbal medicines Fufangkushen colon-coated capsule and Xilei san in patients with ulcerative colitis; and Artemisia absinthium extract and Boswellia serrata resin extract in patients with Crohn's disease. However, most of this evidence comes from single small RCTs with short follow-up, and the long-term effects and safety of their usehave not yet been established. Thus, our findings indicate that further appropriately sized RCTs are necessary prior to the recommended use of these herbal medicines in therapy. In the meantime, increasing awareness of their use, and potential drug interactions among physicians may help to reduce unwanted effects and adverse disease outcomes.

Efficacy and Safety of Sophora flavescens (Kushen) Based Traditional Chinese Medicine in the Treatment of Ulcerative Colitis: Clinical Evidence and Potential Mechanisms

“…Other experiments have shown that Kushen used in vivo can significantly reduce the number of invasive microbial populations in the intestines of mice, thereby lowering animal mortality caused by E. coli and Clostridium perfringens type B. Besides, Kushen was validated to inhibit NK-1R expression, leading to a reduced secretion of inflammatory cytokines such as IL-1β and IL-8 in cells and the promotion of IFN-γ synthesis (Holleran et al, 2020;Ding et al, 2020). Consequently, this produces certain regulatory effects on abnormal immune responses in the intestinal mucosa.…”

“…Kushen is a kind of Chinese herbal medicine commonly used to treat UC with DHAS that exerts extensive influence in antiinflammatory, immunosuppression, and antibacterial functions (Holleran et al, 2020). Studies have shown that matrine, a major component of Kushen, possesses broad-spectrum antibacterial effects.…”

Patterns of Complementary and Alternative Medicine Use in Saudi Arabian Patients With Inflammatory Bowel Disease: A Cross-Sectional Study

“…As such, patients are usually searching for further effective and safe treatment options and, hence, often turn to CAM. Previous studies have reported a wide range of CAM agents used for IBD [16,17]. A recent study that surveyed 1,286 Austrian patients with IBD reported that 50.7% used CAM at some point during the disease course [18].…”

Uncovering the Mechanism of Ge-Gen-Qin-Lian Decoction for Treating Ulcerative Colitis Based on Network Pharmacology and Molecular Docking Verification

“…Current therapies are limited by increased risks of infection of cancer by loss of clinical bene t. Since the dissatisfaction with conventional medication, complementary and alternative therapies are commonly used in the patient with UC [5,6], including traditional Chinese medicine (TCM), dietary supplements, probiotics, and mind/body interventions [7,8]. Among them, the therapeutic e cacy and safety of several TCM formulas in IBD have been shown in some double-blind randomized controlled trials [9,10].…”