Persian Medicine “Sahj” in Ulcerative Colitis Remedy: A before-and-after Clinical Trial
Abstract
Ulcerative colitis (UC) is an inflammatory bowel disease and its etiology has not fully understood in conventional medicine. It also influences the quality of life as a result of its recurrence and progressive clinical course, then, it has been considered an important public health concern. This study aimed to evaluate the impact of prescription therapy based on the Persian Medicine as a complementary treatment for the mitigation of the symptoms of UC as well as improvement in the disease severity. A total of 30 UC patients with an age range of 15-70 years participated in this clinical trial. They were treated with the “Sahj” capsule containing: Curcuma longa L., Punica granatum L., and Terminalia chebula Retz. for 4 weeks. The “Sahj” capsule was prepared based on the Persian Medicine resources. The bowel frequency at day/night, urgency of defecation, general health, and blood in stool were assessed pre/post intervention and the results were compared before and after the clinical trial. The “Sahj” capsule significantly enhanced the clinical findings. There was a significant increase in simple clinical colitis activity index (SCCAI) score in response to the prescription of the “Sahj” capsule (7.73 ± 1.98 before and 4.30 ± 1.12 after the trial) in which general health condition of patients was increased by 50% after the clinical trial. Bowel frequency at day was remarkably decreased by totally 15 patients with the scores of 1, 2 and 3 were enrolled to score 0. Also, bowel frequency at night was not statically significant (p = 0.267) in spite of 7 patients were improved their score (changed their score from 2 to 1). Urgency of defecation (p 0.003) and blood in stool (p 0.0001) were significantly decreased compared with pre-intervention stage. These findings suggest an appropriate complementary treatment to reduce the symptoms of ulcerative colitis. However, further studies with larger sample size are warranted to assess the efficacy and safety of the “Sahj” capsule in the treatment of UC.
Antonelli E, Villanacci V, Bassotti G. Novel oral-targeted therapies for mucosal healing in ulcerative colitis. World J Gastroenterol 2018;24:5322-5330.
Calvet X, Argüelles-Arias F, López-Sanromán A, Cea-Calvo L, Juliá B et al. Patients' perceptions of the impact of ulcerative colitis on social and professional life: results from the UC-LIFE survey of outpatient clinics in Spain. Patient Prefer Adherence 2018;12:1815-1823.
César B, Lyra AC, Rocha R, Santana GO. Epidemiology, demographic characteristics and prognostic predictors of ulcerative colitis. World J Gastroenterol 2014;20:9458-9467.
Naganuma M, Mizuno S, Nanki K, Sugimoto S. Recent trends and future directions for the medical treatment of ulcerative colitis. Clin J Gastroenterol 2016;9:329-336.
Lin SC, Cheifetz AS. The Use of Complementary and Alternative Medicine in Patients with Inflammatory Bowel Disease. Gastroenterol Hepatol (NY) 2018;14:415-425.
Ke F, Yadav PK, Ju LZ. Herbal medicine in the treatment of ulcerative colitis. Saudi J Gastroenterol 2012;18:3-10.
Sałaga M, Zatorski H, Sobczak M, Chen C, Fichna J. Chinese Herbal Medicines in the Treatment of IBD and Colorectal Cancer: A Review. Curr Treat Options Oncol 2014;15:405-420.
Lal UR, Singh IP. Review and Implications of Traditional Indian Medicine for Inflammatory Bowel Disease, Translational Studies on Inflammation. Ane C.F. Nunes 2019; Intech Open.
Kamali M, Tavakoli H, Khodadoost M, Daghaghzadeh H, Kamalinejad M et al. Efficacy of the Punica granatum peels aqueous extract for symptom management in ulcerative colitis patients. A randomized, placebo-controlled, clinical trial. Complement. Ther Clin Pract 2015;21:141-146.
Chandan S, Mohan BP, Chandan OC, Ahmad R, Challa A et al. Curcumin use in ulcerative colitis: is it ready for prime time? A systematic review and meta-analysis of clinical trials. Ann Gastroenterol 2020;33:53-58.
Cunha Neto F, Marton LT, de Marqui SV, Lima TA, Barbalho SM. Curcuminoids from Curcuma Longa: New adjuvants for the treatment of crohn's disease and ulcerative colitis? Crit Rev Food Sci Nutr 2019;59:2136-2143.
Rostamani HR, Semnani S, Yousefi M. Persian traditional medicine in treatment of ulcerative colitis: a case report. Res J Pharm 2021;8:1-6.
Moradi Z, Besharat M, Ghorbanifar Z, Parsa-Yekta Z, Masroorchehr MR. Intestinal Ulcer: Review of Diagnosis and Treatment in Persian Medicine. Sch J App Med Sci 2015;3:460-466.
Sharifi Darani N, Cooper GM, Alizadeh Vaghasloo M. Introduction to the Concept of Crisis in Diseases. Trad Integr Med 2019;4:165-169.
Mosleh G, Nimrouzi M, Badr P, Abolhasanzadeh Z, Azadi A, Mohagheghzadeh A. The Approach of Traditional Persian Medicine to Treatment of Anal Fissure. Trad Integr Med 2019;4:78-83.
Aghili Alavi Khorasani Shirazi MH. Makhzan-Al-Advieh. Kanpur, Bhagwan Dial.
Kamalinejad M, Baghzadeh A, Jafari A, Hasheminejad SA, Davati A et al. Prioritization of medicinal plants affecting ulcerative colitis from the perspective of Iranian medicine. J Islam Iran Trad Med 2020;11.
Shah TA, Parikh M, Patel KV, Patel KG, Joshi CG et al. Evaluation of the effect of Punica granatum juice and punicalagin on NF-κB modulation in inflammatory bowel disease. Mol Cell Biochem 2016;419:65-74.
Gautam MK, Goel S, Ghatule RR, Singh A, Nath G et al. Curative effect of terminalia chebula Retz. extract on acetic acid-induced experimental colitis: role of antioxidants, free radicals and acute inflammatory marker. Inflammopharmacology 2013;21:377-383.
Lee J, Choi HS, Lee J, Park J, Kim SB et al. Preparation of herbal formulation for inflammatory bowel disease based on in vitro screening and in vivo evaluation in a mouse model of experimental colitis. Molecules 2019;24:464.
Sabir SM, Abbas SR, Shahida S, Khan MF. In-Vitro antioxidant, anti-lipid peroxidative activities and In-Silico study of Terminalia chebula bioactive compounds. Clin Phytosci 2020;6:1-9.
Sadeghi N, Mansoori A, Shayesteh A, Hashemi SJ. The effect of curcumin supplementation on clinical outcomes and inflammatory markers in patients with ulcerative colitis. Phytother Res 2020;34:1123-1133.
Kamali M, Khodadoost M, Heydari M, Tavakoli H, Hajimehdipoor H et al. The role of syndrome differentiation in the clinical efficacy of Punica granatum on patients with ulcerative colitis. Iran Red Crescent Med J. 2017;19.
Rezayat F, Hashempur MH, Tavahen H, Salmanroghani H, Emtiazy M. The efficacy of Ramak (a traditional herbal medicine preparation) for patients with ulcerative colitis: A pilot, randomized, triple-blinded, placebo-controlled clinical trial. Eur J Integr Med 2020; 39:101209.
Rahimi R, Baghaei A, Baeeri M, Amin G, Shams-Ardekani MR et al. Promising effect of Magliasa, a traditional Iranian formula, on experimental colitis on the basis of biochemical and cellular findings. World J Gastroenterol 2013;19:1901.
Kamali M, Tavakoli H, Khodadoost M, Daghaghzadeh H, Kamalinejad M et al. Efficacy of the Punica granatum peels aqueous extract for symptom management in ulcerative colitis patients. A randomized, placebo-controlled, clinical trial. Complement. Ther Clin Pract 2015;21:141-146.
Walmsley RS, Ayres RC, Pounder RE, Allan RN. A simple clinical colitis activity index. Gut 1998;43:29-32.
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Issue | Vol 6, No 2, 2021 | |
Section | Research Article(s) | |
DOI | https://doi.org/10.18502/tim.v6i2.6778 | |
Keywords | ||
Persian medicine Ulcerative colitis Inflammatory bowel disease Herbal medicine |
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