title: Systematic review: the efficacy of herbal therapy in inflammatory bowel disease.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM), particularly herbal therapy, is widely used by patients with inflammatory bowel disease (IBD) but controlled data are limited.
  
  
  OBJECTIVE
  To systematically review the literature on the efficacy of herbal therapy in the treatment of ulcerative colitis (UC) and Crohn's disease (CD).
  
  
  METHODS
  Publications in English and non-English literatures (MEDLINE, EMBASE, EBM Reviews, AMED, Global Health) were searched from 1947 to 2013 for controlled clinical studies of herbal therapy in IBD. Outcome measures included response and remission rates.
  
  
  RESULTS
  Twenty-one randomised controlled trials (14 UC; 7 CD) including a total of 1484 subjects (mean age 41, 50% female) were analysed. In UC, aloe vera gel, Triticum aestivum (wheat grass juice), Andrographis paniculata extract (HMPL-004) and topical Xilei-san were superior to placebo in inducing remission or 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 (evening primrose oil) had similar relapse rates as omega-3 fatty acids in the treatment of UC. In CD, Artemisia absinthium (wormwood) and Tripterygium wilfordii were superior to placebo in inducing remission, and preventing clinical recurrence of post-operative CD respectively.
  
  
  CONCLUSIONS
  Randomised controlled trials of herbal therapy for the treatment of IBD show encouraging results but studies remain limited and heterogenous. Larger controlled studies with stricter endpoints and better-defined patient groups are required to obtain more conclusive results on the use of CAM therapies in IBD.
authors: Department of Medicine and Therapeutics, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Chinese University of Hong Kong, Shatin, Hong Kong.
authors: S C
authors: SC
authors: Ng
authors: Y T
authors: YT
authors: Lam
authors: K K F
authors: KK
authors: Tsoi
authors: F K L
authors: FK
authors: Chan
authors: J J Y
authors: JJ
authors: Sung
authors: J C Y
authors: JC
authors: Wu
mesh_terms: D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D006801:Humans; D008517:Phytotherapy; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D055502:Secondary Prevention; D016896:Treatment Outcome