Research Article

Effects of the Pistacia atlantica subsp. kurdica Oleoresin on the Symptoms and Quality of Life in Functional Dyspepsia: A Randomized Controlled Trial

Abstract

The Pistacia atlantica subsp. kurdica oleoresin (OPA) is utilized for the treatment of dyspepsia and other gastrointestinal diseases in the Persian Medicine. Therefore, the therapeutic efficacy and safety of standardized OPA in functional dyspepsia (FD) were evaluated. To standardize OPA, the constituents of the OPA essential oil were determined by gas chromatography-mass spectrometry. Fifty patients were allocated to each of the OPA and placebo groups. The OPA and placebo groups consumed two 200 mg OPA or placebo capsules, respectively, every 12 hours along with one 40 mg famotidine tablet per day for 8 weeks. Dyspepsia severity was the primary outcome measured by the Hong Kong dyspepsia index. The secondary outcomes included quality of life measured by the sf-36 questionnaire, complete blood count, and the blood levels of alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, triglyceride, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. The outcomes were measured at the baseline and endpoint. OPA contained 10% w/w essential oil, and the constituents of the OPA essential oil were α-pinene (96%), β- pinene (2%) and terpinolene (2%). Thirty five patients in each group completed the trial. OPA decreased the Hong Kong score significantly (p = 0.013), but the placebo had no significant effect on the Hong Kong score (p = 0.651), at the endpoint compared to baseline. The sf-36 questionnaire score of the OPA group increased significantly (p = 0.027), but it increased insignificantly in the placebo group (p = 0.078), at the endpoint compared to baseline. There was no significant effect on the blood tests, and also no side effect. Thus, OPA may mitigate the symptoms, and increase the quality of life of the FD patients without side effects. The OPA essential oil and the monoterpenes α-pinene, β- pinene and terpinolene may be responsible for the effects of OPA in FD.

Lee K, Kwon CI, Yeniova AO, Koyanagi A, Jacob L, et al. Global prevalence of functional dyspepsia according to Rome criteria, 1990-2020: a systematic review and meta-analysis. Sci Rep 2024;14:4172.

Cheng J, Guo J, Xu L, Shi Z, Xu F, et al. The overlap subgroup of functional dyspepsia exhibits more severely impaired gastric and autonomic functions. J Clin Gastroenterol 2024;58:31-38.

Hu WHC, Lam KF, Wong YH, Lam CLK, Huii WM, et al. The Hong Kong index of dyspepsia: a validated symptom severity questionnaire for patients with dyspepsia. J Gastroenterol Hepatol 2001;17:545-551.

Wauters L, Talley NJ, Walker MM, Tack J, Vanuytsel T. Novel concepts in the pathophysiology and treatment of functional dyspepsia. Gut 2020;69;591-600.

Lacy BE, Chase RC, Cangemi DJ. The treatment of functional dyspepsia: present and future. Expert Rev Gastroenterol Hepatol 2023;17;9-20.

Broeders BWLCM, Carbone F, Balsiger LM, Schol J, Raymenants K, et al. Review article: functional dyspepsia – a gastric disorder, a duodenal disorder or a combination of both? Aliment Pharmacol Ther 2023;57:851-860.

Oshima T. Functional dyspepsia: current understanding and future perspective. Digestion 2024; 105:26-33.

Boeing T, de Souza P, da Silva LM, Gasparotto Junior A. Herbal medicines in the treatment of dyspepsia: an overview. Planta Med 2022;88:664-677.

Czigle S, Fialova SB, Toth J, Mucaji P, Nagy M. Treatment of gastrointestinal disorders – plants and potential mechanisms of action of their constituents. Molecules 2022;27:2881.

Yoon JY, Ko SJ, Park JW, Cha JM. Complementary and alternative medicine for functional dyspepsia: an Asian perspective. Medicine (Baltimore) 2022;101:e30077.

Voirol-Perrin J, Stamm GM, Nunes LS, Schoepfer A. Functional dyspepsia: update 2023. Rev Med Suisse 2023;19;1554-1557.

Bozorgi M, Memariani Z, Mobli M, Salehi Surmaghi MH, Shams-Ardekani MR, et al. Five Pistacia species (P. vera, P. atlantica, P. terebinthus, P. khinjuk, and P. lentiscus): a review of their traditional uses, phytochemistry, and pharmacology. Sci World J 2013;2013:219815.

Ben Ahmed Z, Yousfi M, Viaene J, Dejaegher B, Demeyer K, et al. Four Pistacia atlantica subspecies (atlantica, cabulica, kurdica and mutica): a review of their botany, ethnobotany, phytochemistry and pharmacology. J Ethnopharmacol 2021;265:113329.

Borhani M, Khoshzaban F, Jodeiri B, Naseri M, Kamalinejad M, et al. Comparison between used herbs for treatment of gastroesophageal reflux disease [GERD] in Iranian traditional medicine [ITM]. Adv Environ Biol 2014;8:773-781.

McHorney CA, Ware Jr JE, Lu JF, Sherbourne CD. The MOS 36 – item Short – Form Health Survey (SF – 36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994;32;40-66.

Dabos KJ, Sfika E, Vlatta LJ, Frantzi D, Amygdalos GI, et al. Is Chios mastic gum effective in the treatment of functional dyspepsia? a prospective randomized double-blind placebo controlled trial. J Ethnopharmacol 2010;127:205-209.

Heiran AR, Bagheri Lankarani K, Bradley Ry, Simab AR, Pasalar M. Efficacy of herbal treatments for functional dyspepsia: A systematic review and meta-analysis of randomized clinical trials. Phytother Res 2022;36:686-704.

Vanuytsel T. Novel insights in the pathophysiology and management of functional dyspepsia. Acta Gastroenterol Belg 2023;86:68-73.

Chaves J, Pita I, Libanio D, Pimentel-Nunes P. Pharmacological treatment of functional dyspepsia: an old story revisited or a new story to be told? a clinical review. GE Port J Gastroenterol 2022;30:86-97.

Tome J, Kamboj AK, Loftus CG. Approach to disorders of gut-brain interaction. Mayo Clin Proc 2023;98:458-467.

Guimaraes AG, Quintans JSS, Quintans Jr LJ. Monoterpenes with analgesic activity - a systematic review. Phytother Res 2013;27:1-15.

Quintans JSS, Shanmugam S, Heimfarth L, Araujo ANS, Almeida JRGDS, et al. Monoterpenes modulating cytokines – a review. Food Chem Toxicol 1019;123:233-257.

Salehi B, Upadhyay S, Orhan IE, Jugran AK, Jayaweera SLD, et al. Therapeutic potential of α – and β – pinene: a miracle gift of nature. Biomolecules 2019;9:738.

Kim T, Song B, Cho KS, Lee IS. Therapeutic potential of volatile terpenes and terpenoids from forests for inflammatory diseases. Int J Mol Sci 2020;21:2187.

Bagheri S, Sarabi MM, Khosravi P, Mohammadrezaei Khorramabadi R, Veiskarami S, et al. Effects of Pistacia atlantica on oxidative stress markers and antioxidant enzymes expression in diabetic rats. J A Coll Nutr 2019;38:267-274.

Saller R, Iten F, Reichling J. Dyspeptic pain and phytotherapy - a review of traditional and modern herbal drugs. Forsch Komplementarmed Klass Naturheilkd 2001;8:263-273.

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IssueVol 10, No 3, 2025 QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/tim.v10i3.19756
Keywords
Wild pistachio Gastrointestinal disease Gastrointestinal system Traditional medicine Integrative medicine Complementary and alternative medicine

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How to Cite
1.
Kianbakht S, Khonche A, Hashem-Dabaghian F, Fallah Huseini H, Nabati F, Mohtashami R. Effects of the Pistacia atlantica subsp. kurdica Oleoresin on the Symptoms and Quality of Life in Functional Dyspepsia: A Randomized Controlled Trial. Trad Integr Med. 2025;10(3):221-227.