Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis

Abstract

Herbal medicines are used by patients with IBD despite limited evidence. We present a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating treatment with herbal medicines in active ulcerative colitis (UC). A search query designed by a library informationist was used to identify potential articles for inclusion. Articles were screened and data were extracted by at least two investigators. Outcomes of interest included clinical response, clinical remission, endoscopic response, endoscopic remission, and safety. We identified 28 RCTs for 18 herbs. In pooled analyses, when compared with placebo, clinical response rates were significantly higher for Indigo naturalis (IN) (RR 3.70, 95% CI 1.97–6.95), but not for Curcuma longa (CL) (RR 1.60, 95% CI 0.99–2.58) or Andrographis paniculata (AP) (RR 0.95, 95% CI 0.71–1.26). There was a significantly higher rate of clinical remission for CL (RR 2.58, 95% CI 1.18–5.63), but not for AP (RR 1.31, 95% CI 0.86–2.01). Higher rates of endoscopic response (RR 1.56, 95% CI 1.08–2.26) and remission (RR 19.37, 95% CI 2.71–138.42) were significant for CL. CL has evidence supporting its use as an adjuvant therapy in active UC. Research with larger scale and well-designed RCTs, manufacturing regulations, and education are needed.

Yerba Mate (Ilex paraguariensis) Reduces Colitis Severity by Promoting Anti-Inflammatory Macrophage Polarization

“…The use of medicinal plants for the treatment of IBD, particularly ulcerative colitis, has been growing worldwide during the last few decades, despite the limited evidence and lack of knowledge about the mechanism of action of several of the plants used [ 50 ]. Accordingly, recent efforts have been focused on the analysis of different bioactive compounds found in medicinal plants and their therapeutic targets [ 51 ].…”