7 mei 2016: Bron: Ann Gastroenterol. 2015 Apr-Jun; 28(2): 210–220

Wat al heel lang bekend is en is ook al wel vaker gepubliceerd dat planten en kruiden, ook wel fytotherapie genoemd, een grote rol kunnen spelen in het voorkomen en bestrijden van chronische darm- en maagontstekingen. Op onze website staan vele voorbeelden hiervan, zie ook de lijsten per vorm van kanker voor effecten van gebruik van individuele planten en kruiden (in extracten soms ook).

Hier een meta analyse van gerandomiseerde studies over de werking van voornamelijk deze planten en kruiden op chronische ontstekingen van darmen en maag: mastic gum, tormentil extracts, wormwood herb, aloe vera, triticum aestivum, germinated barley foodstuff, en boswellia serrata.

boswellia-serrata
Foto: Boswellia serrata

Het is toch echt belachelijk gezien de positieve resultaten dat deze onderzoekers maar 27 gerandomiseerde studies konden vinden in de laatste 20 jaar (van april 1993 tot april 2014) naar het voorkomen en bestrijden van chronische ontstekingen in darmen en maag door planten en kruiden.

Een citaat uit de conclusies: 

In chronische ontstekingen (ulcerative colitis), aloe vera gel, triticum aestivum, andrographis paniculata extract en topical Xilei-san waren superieur aan placebo in het bewerkstelligen van een complete remissie of klinische respons en curcumin (curcuma) was superieur aan placebo in het in stand houden van een totale remissie; boswellia serrata gum resin en plantago ovata zaden waren even effectief dan het chemische medicijn mesalazine. Oenothera biennis had dezelfde cijfers van een respons dan omega-3 vetzuren in de behandeling van chronische darmontstekingen (ulcerative colitis). In de ziekte van Crohn, mastic gum, Artemisia absinthium, en Tripterygium wilfordii waren superieur aan placebo in het bewerkstelligen van een totale remissie en in het voorkomen van een recidief na operatie. Fytotherapie (planten en kruiden therapie) bewerkstelligt hun therapeutische effecten door verschillende mechanismen, waaronder immuunregulatie, antioxydante activiteit, remming en stoppen van leukotriene B4 en nuclear factor-kappa B, en voorkomt ontstaan van bloedproppen.

Het volledige studierapport: Herbal and plant therapy in patients with inflammatory bowel disease is gratis in te zien of te downloaden.

Hier het abstract:

Herbal therapies exert their therapeutic benefit by different mechanisms including immune regulation, antioxidant activity, inhibition of leukotriene B4 and nuclear factor-kappa B, and antiplatelet activity. Large, double-blind clinical studies assessing the most commonly used natural substances should urgently be conducted.

Ann Gastroenterol. 2015 Apr-Jun; 28(2): 210–220.
PMCID: PMC4367210

Herbal and plant therapy in patients with inflammatory bowel disease

Abstract

The use of herbal therapy in inflammatory bowel disease (IBD) is increasing worldwide. The aim of this study was to review the literature on the efficacy of herbal therapy in IBD patients. Studies on herbal therapy for IBD published in Medline and Embase were reviewed, and response to treatment and remission rates were recorded. Although the number of the relevant clinical studies is relatively small, it can be assumed that the efficacy of herbal therapies in IBD is promising. The most important clinical trials conducted so far refer to the use of mastic gum, tormentil extracts, wormwood herb, aloe vera, triticum aestivum, germinated barley foodstuff, and boswellia serrata. In ulcerative colitis, aloe vera gel, triticum aestivum, andrographis paniculata extract and topical Xilei-san were superior to placebo in inducing remission or clinical response, and curcumin was superior to placebo in maintaining remission; boswellia serrata gum resin and plantago ovata seeds were as effective as mesalazine, whereas oenothera biennis had similar relapse rates as ω-3 fatty acids in the treatment of ulcerative colitis. In Crohn’s disease, mastic gum, Artemisia absinthium, and Tripterygium wilfordii were superior to placebo in inducing remission and preventing clinical postoperative recurrence, respectively. Herbal therapies exert their therapeutic benefit by different mechanisms including immune regulation, antioxidant activity, inhibition of leukotriene B4 and nuclear factor-kappa B, and antiplatelet activity. Large, double-blind clinical studies assessing the most commonly used natural substances should urgently be conducted.

References

1. Triantafillidis JK, Stanciu C, editors. 4th Edition. Athens, Greece: “Technogramma”; 2012. Inflammatory bowel disease: etiopathogenesis, diagnosis, treatment.
2. Zollman C, Vickers A. What is complementary medicine? BMJ. 1999;19:693–696. [PMC free article] [PubMed]
3. Langmead L, Feakins RM, Goldthorpe S, et al. Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis. Aliment Pharmacol Ther. 2004;19:739–747. [PubMed]
4. Ben-Arye E, Goldin E, Wengrower D, Stamper A, Kohn R, Berry E. Wheat grass juice in the treatment of active distal ulcerative colitis: a randomized double-blind placebo-controlled trial. Scand J Gastroenterol. 2002;37:444–449. [PubMed]
5. Sandborn WJ, Targan SR, Byers VS, et al. Andrographis paniculata extract (HMPL-004) for active ulcerative colitis. Am J Gastroenterol. 2013;108:90–98. [PMC free article] [PubMed]
6. Tang T, Targan SR, Li ZS, Xu C, Byers VS, Sandborn WJ. Randomised clinical trial: herbal extract HMPL-004 in active ulcerative colitis - a double-blind comparison with sustained release mesalazine. Aliment Pharmacol Ther. 2010;33:194–202. [PubMed]
7. Abdel-Tawab M, Werz O, Schubert-Zsilavecz M. Boswellia serrata: an overall assessment of in vitro, preclinical, pharmacokinetic and clinical data. Clin Pharmacokinet. 2011;50:349–369. [PubMed]
8. Gupta I, Parihar A, Malhotra P, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med. 2001;67:391–395. [PubMed]
9. Chen ZS, Nie ZW, Sun QL. Clinical study in treating intractable ulcerative colitis with traditional Chinese medicine. Zhongguo Zhong Xi Yi Jie HeZa Zhi. 1994;14:400–402. [PubMed]
10. Huber R, Ditfurth AV, Amann F, et al. Tormentil for active ulcerative colitis: an open-label, dose-escalating study. J Clin Gastroenterol. 2007;41:834–838. [PubMed]
11. Zhang F, Li Y, Xu F, Chu Y, Zhao W. Comparison of Xilei-san, a chinese herbal medicine, and dexamethasone in mild/moderate ulcerative proctitis: a double-blind randomized clinical trial. J Altern Complement Med. 2013;19:838–842. [PubMed]
12. Fukunaga K, Ohda Y, Hida N, et al. Placebo controlled evaluation of Xilei San, a herbal preparation in patients with intractable ulcerative proctitis. J Gastroenterol Hepatol. 2012;27:1808–1815. [PubMed]
13. Biedermann L, Mwinyi J, Scharl M, et al. Bilberry ingestion improves disease activity in mild to moderate ulcerative colitis - an open pilot study. J Crohns Colitis. 2013;7:271–279. [PubMed]
14. Gong Y, Zha Q, Li L, et al. Efficacy and safety of Fufangkushen colon-coated capsule in the treatment of ulcerative colitis compared with mesalazine: a double-blinded and randomized study. J Ethnopharmacol. 2012;141:592–598. [PubMed]
15. Hanai H, Iida T, Takeuchi K, et al. Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial. Clin Gastroenterol Hepatol. 2006;4:1502–1506. [PubMed]
16. Fernandez-Banares F, Hinojosa J, Sanchez-Lombrana JL, et al. Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish group for the study of Crohn's disease and ulcerative colitis (GETECCU) Am J Gastroenterol. 1999;94:427–433. [PubMed]
17. Greenfield SM, Green AT, Teare JP, et al. A randomized controlled study of evening primrose oil and fish oil in ulcerative colitis. Aliment Pharmacol Ther. 1993;7:159–166. [PubMed]
18. Hanai H, Kanauchi O, Mitsuyama K, et al. Germinated barley foodstuff prolongs remission in patients with ulcerative colitis. Int J Mol Med. 2004;13:643–647. [PubMed]
19. Kanauchi O, Mitsuyama K, Homma T, et al. Treatment of ulcerative colitis patients by long-term administration of germinated barley foodstuff: multi-center open trial. Int J Mol Med. 2003;12:701–704. [PubMed]
20. Langhorst J, Varnhagen I, Schneider SB, et al. Randomised clinical trial: a herbal preparation of myrrh, chamomile and coffee charcoal compared with mesalazine in maintaining remission in ulcerative colitis--a double-blind, double-dummy study. Aliment Pharmacol Ther. 2013;38:490–500. [PubMed]
21. Kaliora AC, Stathopoulou MG, Triantafillidis JK, Dedoussis GV, Andrikopoulos NK. Chios mastic treatment of patients with active Crohn's disease. World J Gastroenterol. 2007;13:748–753. [PMC free article] [PubMed]
22. Kaliora AC, Stathopoulou MG, Triantafillidis JK, Dedoussis GV, Andrikopoulos NK. Alterations in the function of circulating mononuclear cells derived from patients with Crohn's disease treated with mastic. World J Gastroenterol. 2007;13:6031–6036. [PMC free article] [PubMed]
23. Omer B, Krebs S, Omer H, Noor TO. Steroid-sparing effect of wormwood (Artemisia absinthium) in Crohn's disease: a double-blind placebo-controlled study. Phytomedicine. 2007;14:87–95. [PubMed]
24. Krebs S, Omer TN, Omer B. Wormwood (Artemisia absinthium) suppresses tumour necrosis factor alpha and accelerates healing in patients with Crohn's disease - a controlled clinical trial. Phytomedicine. 2010;17:305–309. [PubMed]
25. Naftali T, Lev LB, Yablecovitch D, Half E, Konikoff FM. Treatment of Crohn's disease with cannabis: an observational study. Isr Med Assoc J. 2011;13:455–458. [PubMed]
26. Lal S, Prasad N, Ryan M, et al. Cannabis use amongst patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2011;23:891–896. [PubMed]
27. Gerhardt H, Seifert F, Buvari P, Vogelsang H, Repges R. Therapy of active Crohn disease with Boswellia serrata extract H15. Z Gastroenterol. 2001;39:11–17. [PubMed]
28. Ren J, Tao Q, Wang X, Wang Z, Li J. Efficacy of T2 in active Crohn's disease: a prospective study report. Dig Dis Sci. 2007;52:1790–1797. [PubMed]
29. Holtmeier W, Zeuzem S, Preibeta J, et al. Randomized, placebo-controlled, double-blind trial of Boswellia serrata in maintaining remission of Crohn's disease: good safety profile but lack of efficacy. Inflamm Bowel Dis. 2010;17:573–582. [PubMed]
30. Tao QS, Ren JA, Ji ZL, Li JS, Wang XB, Jiang XH. Maintenance effect of polyglycosides of Tripterygium wilfordii on remission in postoperative Crohn disease. Zhonghua Wei Chang Wai KeZa Zhi. 2009;12:491–493. [PubMed]
31. Liao NS, Ren JA, Fan CG, Wang GF, Zhao YZ, Li JS. Efficacy of polyglycosides of Tripterygium wilfordii in preventing postoperative recurrence of Crohn disease. Zhonghua Wei ChangWai Ke Za Zhi. 2009;12:167–169. [PubMed]
32. Ren J, Wu X, Liao N, et al. Prevention of postoperative recurrence of Crohn's disease: Tripterygium wilfordii polyglycoside versus mesalazine. J Int Med Res. 2013;41:176–187. [PubMed]
33. Langhorst J, Anthonisen IB, Steder-Neukamm U, et al. Amount of systemic steroid medication is a strong predictor for the use of complementary and alternative medicine in patients with inflammatory bowel disease: results from a German national survey. Inflamm Bowel Dis. 2005;11:287–295. [PubMed]
34. Langmead L, Chitnis M, Rampton DS. Use of complementary therapies by patients with IBD may indicate psychosocial distress. Inflamm Bowel Dis. 2002;8:174–179. [PubMed]
35. Rahimi R, Mozaffari S, Abdollahi M. On the use of herbal medicines in management of inflammatory bowel diseases: a systematic review of animal and human studies. Dig Dis Sci. 2009;54:471–480. [PubMed]
36. Ali T, Shakir F, Morton J. Curcumin and inflammatory bowel disease: biological mechanisms and clinical implication. Digestion. 2012;85:249–255. [PubMed]
37. Dahmen U, Gu YL, Dirsch O, et al. Boswellic acid, a potent antiinflammatory drug, inhibits rejection to the same extent as high dose steroids. Transplant Proc. 2001;33:539–541. [PubMed]
38. Singh P, Chacko KM, Aggarwal ML, et al. A-90 day gavage safety assessment of Boswellia serrata in rats. Toxicol Int. 2012;19:273–278. [PMC free article] [PubMed]
39. Bamba T, Kanauchi O, Andoh A, Fujiyama Y. A new prebiotic from germinated barley for nutraceutical treatment of ulcerative colitis. J Gastroenterol Hepatol. 2002;17:818–824. [PubMed]
40. Cheng AL, Hsu CH, Lin JK, et al. Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res. 2001;21:2895–2900. [PubMed]
41. Anonymous. Safety of traditional Chinese medicines and herbal remedies. Curr Probl Pharmacovigilance. 2004;30:10–11.
42. Triantafillidis JK. The use of natural products in the treatment of inflammatory bowel disease (Editorial) Ann Gastroenterol. 2008;21:41–43.
43. Joos S. Review on efficacy and health services research studies of complementary and alternative medicine in inflammatory bowel disease. Chin J Integr Med. 2011;17:403–409. [PubMed]

Articles from Annals of Gastroenterology : Quarterly Publication of the Hellenic Society of Gastroenterology are provided here courtesy of The Hellenic Society of Gastroenterology

Plaats een reactie ...

Reageer op "Fytotherapie: Planten en kruiden voorkomen en verminderen chronische darm- en maagontstekingen - o.a. ziekte van Crohn - veel beter dan placebo of chemische medicijnen"


Gerelateerde artikelen