Health benefits of pendant from the viewpoint of Persian medicine

Background:Reviewing historical evidence in the various schools of traditional medicine shows that numerous methods have been used to maintain human good health and treatment of diseases.Persian medicine(PM)scholars have been employed different methods to prescribe medications,which can be classified into two main groups:internal uses,including oral,parenteral,and anal,and also external uses such as topical,transdermal,and applying pendants.In this study,we aim to introduce some of the therapeutic pendants.Methods:We reviewed the most famous PM textbooks and current evidence in relevant databases such as PubMed,Science Direct,Scopus,Google scholar and SID related to the topic.Results:In this study,about 100 traditional therapeutic substances were found and finally,thirty-two of them were represented.They were often stones,and some of them were other materials such as metals,gums,and herbs.According to the PM,the utilization of pendants,in addition to cosmetic purposes,has been considered to maintain the health and treatment of some diseases.Therapeutic pendants can be considered as a kind of external medication use in which therapeutic materials are hung on the body surface.The external use of pendants could have curative effects with their close contact to the body surface.Conclusion:Pendant therapy may probably be considered as a non-invasive and easy-to-use treatment with unnoticeable side effects that can be utilized along with other therapies.

Evaluation of scientific evidence for abortifacient medicinal plants mentioned in traditional Persian medicine

Background:Miscarriage or spontaneous ending to a pregnancy takes place at the early stages of pregnancy without intervention.Pregnant women may use medicinal herbs to relieve some of the symptoms of pregnancy as they believe that all herbs are safe.Some abortion-inducing herbs were mentioned by the famous Iranian philosophers,Avicenna and Aghili,in documents of traditional Persian medicine titled Al-Qanun Fi Al-Tibb(The Canon of Medicine,written by Avicenna in the 11th century)and Makhzan Al-adviyah(The Storehouse of Medicaments,written by Aghili in the 18th century).Methods:Electronic databases such as PubMed,Scopus,Google Scholar,Cochrane Library and Web of Science were searched to find new scientific evidence that these plants are toxic during pregnancy.Data was collected from 1831 to 2019.Results:Twenty-one plants were found to be abortive according to Al-Qanun Fi Al-Tibb(The Canon of Medicine)and Makhzan Al-adviyah(The Storehouse of Medicaments).Scientific research has shown that these plants possess abortifacient effects by the mechanisms of toxic alkaloids,uterine stimulants,and emmenagogue that interferes with implantation and results in fetus toxicity.These studies included in vivo or in vitro studies.Some of these plants showed abortifacient effects by more than one mechanism.Ruta graveolens,Nigella sativa,Curcuma longa,Lupinus termis,Apium graveolens,Mentha longifolia,and Peganum harmala possess uterine stimulant properties.Ruta graveolens,Juniperus sabina,Cicer arietinum,Piper longum,Artemisia absinthium,and Citrullus colocynthis interfere with implantation.Ruta graveolens,Nigella sativa,Curcuma longa,Tanacetum parthenium,Piper longum,Laurus nobilis,Apium graveolens,Mentha longifolia,and Cinnamomum iners exhibit emmenagogue effects.Lupinus termis,Delphinium staphisagria,Laurus nobilis,Trigonella foenum-graecum,Zataria multiflora,and Artemisia absinthium contain toxic alkaloids and possess teratogenic effects.Conclusion:The results of this study of traditional Persian medicine resources have been confirmed with new scientific evidence.Therefore,pregnant women should avoid consuming herbs without knowledge of their safety.

Light and color therapy: the role of light and color in architecture from the perspective of traditional Persian medicine

Some of the most important elements of healing architecture are light and color,which have been considered in diverse studies of environmental design for treatment and an effect on health.However,there is a lack of research in the field of the proportion of light and color with human differences.The goal of the present research is to provide a new perspective regarding the correlation between humans and the environment based on the philosophy of natural sciences in Iranian traditional medicine,with a focus on color and light to contrive an all-out balance of humans.The present article establishes a connection between traditional and modern medicine;it also indicates medical and health activists to draw their attention to the need for basic researches in traditional Iranian medicine to improve it based on scientific evidence as well as change the attitude of architects to design places based on people’s temperament(in traditional Persian medicine,temperament implies the same and new quality that results from the combination of the four elements(fire,air,water,and earth are four essential constituents of human and non-human beings)with each other and with their interaction in a composite body).This article is a descriptive method in a qualitative study that discuss elements of light and color from the perspective of traditional Persian medicine,after reviewing the history of color and light therapy.From the perspective of modern research,the study additionally discusses the effect of light and color on humans,the relationship of light and color with the temperament of people,and the effect of environmental color and light on people’s temperament.Notably,humans differ with regard to their characteristics and thus have different temperaments,which causes them to have different tendencies toward environmental factors.Qualitative data indicate the difference in the propensity of individuals to color and light according to a physical and psychological condition,and the effect of color and light on human temperament.Thus,the recommendations of traditional medicine can help present a proper pattern of design.

Gastrointestinal effects of Artemisia absinthium Linn. based on traditional Persian medicine and new studies

One of the most extensively used herbs in traditional Persian medicine (TPM) used in the treatment ofgastrointestinal (GI) disorders, is the plant Artemisia absinthium Linn. (AAL). It also has a wide range of activitiessuch as analgesic and anti-inflammatory, anti-oxidant, anti-fungal, and anti-bacterial activities, hepatoprotective,and neuroprotective activities in addition to having gastroprotective effects. This article is a review comparingTPM resources with new medicines. This review investigates this herb in major TPM sources and strives toextrapolate the exact function it serves in the digestive tract and compares the collected information on the functionof AAL with information found in new medical resource databases such as ISI, Pubmed, Scopus, Google Scholar,and Scientific Information Database. AAL from the Asteraceae family of TPM, known as Afsentin, was used in thetreatment of GI weaknesses, stomach pains, swellings, intestinal parasites, diarrhea, and vomiting. AAL increasedappetite, so it was used for insect repellents and insecticide. Recent studies have indicated that the effects of thisplant improved the symptoms of Crohn's disease and played a role in reducing inflammatory factors. It also hasstrong anti-parasitic, anti-insect, hepatoprotective, and antioxidant effects. Given the widespread use of AAL as atraditional medicine currently in use in different countries, particularly in the treatment of GI diseases, furtherclinical studies that focus on the therapeutic qualities of this plant are required in the future.

Methods of preparation of egg and therapeutic uses:a review perspective of Persian Medicine

Background:The nutrients in eggs play an important role in the health of different body organs like the brain,cardiometabolic system,musculoskeletal system,skin and eyes and so the eggs can be considered as functional foods.In order to maintain the highest nutrient content of an egg,it is recommended to cook it properly,but no specific clinical research has been carried out yet on the role that the cooking of an egg plays in its food and health properties.For this reason,this study has collected and discussed the topics related to a variety of methods of cooking eggs,based on the texts of Persian Medicine,and conducted a comparison with modern sources of nutrition.Methods:The present study is a review in which sources of Persian Medicine(PM)were searched in software JamiTib(Version 1.5)and Persian electronic banks,sites of PubMed,Google Scholar,ScienceDirect,and Embase and websites of health reference of American food and water.Finally,the results obtained were classified and a content analysis was carried out.Results:In the PM books,in addition to referring to the different properties of eggs,different effects of different egg preparation have been investigated.The wise men of the school of medicine have proposed at least five methods of egg preparation,including very soft boiled,soft-boiled,hardboiled,fried,and omelet.In the texts,the healing properties of each case and the quality of digestion in the body were separately investigated.Among the five main methods of preparation eggs,the therapeutic and digestive effects of soft-boiled eggs are emphasized to a greater extent,because easy digestion leads to more beneficial effects of the yolk of the eggs.Conclusion:Though the wise men of Persian Medicine have proposed a variety of methods to cook eggs,ease of digestion is one of the most important factors in their decision-making while proposing the type of cooking method for therapeutic prescriptions.In contrast,in modern nutrition research,regardless of the method of cooking eggs,the effect of its use on diseases like heart disease or diabetes has been studied.Owing to the fact that many cases of eggs,as mentioned,have been confirmed in PM texts during modern scientific surveys,it appears that clinical studies on the relevant issues of eggs in this context are useful in better understanding therapeutic effects.

Developing evidence-based medicine in Persian medicine: obstacles, challenges, and solutions andsolutions

Introduction:Considering the importance of evidence-based medicine(EBM)and the emphasis of Persian medicine(PM)experts on its use,this study was designed;to investigate the practice of PM specialists,the obstacles,challenges,and solutions of developing and using EBM in PM were also the aims of the present study.Method:In the present study,98 PM specialists,who work in Iran completed the electronic Persian version of the evidence-based medicine.The effective factors in the practice of specialists were assessed by Spearman correlation and Mann-Whitney U tests.Results:The mean±standard deviation of age,graduation time,and clinical experience were 44.52±6.45,3.26±2.28,and 6.76±5.27 years,respectively.Evaluating the data showed,that 52 participants(53.1%)had not passed any EBM training courses.Social media,general and medical databases,textbooks,colleagues,and journal articles were used frequently in clinical practices,but the specific EBM-specific resources were neglected.Conclusions:More attention must be paid to produce scientific evidence,improving the infrastructures and health policies,and empowering PM specialists to apply EBM in their clinical practices.

Etiologies of heavy menstrual bleeding: a comparison between current and Persian Medicine

Purpose:Heavy menstrual bleeding(HMB)is one of the common causes of women in reproductive age referring to gynecology centers.Methods:In this review study,the causes of HMB were assembled from reliable books of Persian Medicine(PM).To compare with new scientific evidence,the HMB characteristics were searched using databases including PubMed,Google Scholar and Scopus as well as valid references of current medicine books.Results:The causes of HMB in PM,similar to current medicine,are divided into three categories including functional,structural and drugs.Functional and drug causes in both schools of medicine are almost concordant.In the structural category,we can consider the presence of a mass in uterus,cervix,and vagina,as mentioned in PM,equivalent with polyps and leiomyomas.Also in PM,mucosal disturbances in this tissues match cervicitis and vaginitis properties.For some causes mentioned in PM such as Akele,Hekke,and weakness of uterus and its tissues,no equivalent was available in current medicine.Conclusions:There are more similarities in menstrual bleeding in both current and Persian Medicine.In some cases,patients present with HMB for which there is no known cause in current medicine.In these cases,the etiologies mentioned in Persian Medicine and their treatment can be used.

Introduction to the book of"Atamat al-Marza":a manuscript about the role of food in Persian medicine

Nutrition is one of the most important principles in Persian medicine,and Persian scholars have written various books and treatises on this subject.Atamat al-Marza by Hakim Roshan Zamir is one of these books.Hakim Roshan Zamir was a wise Persian scholar who lived in 12th-13th centuries AH(18th-19th centuries AD).He described the details of food-based treatment carefully in his book,Atamat al-Marza.This article tries to introduce this book and the role of foods in Persian medicine and represent recommendations and viewpoints of Hakim Roshan Zamir in this field.

Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine

Kaiy(medieval cautery)is an ancient method of heat therapy in traditional Persian medicine(TPM).Some of its important applications have been neglected during the medical revolution.Meanwhile,different treatment modalities that incorporate heat,including moxibustion,have progressed in traditional Chinese medicine.In this study,we reviewed the main TPM textbooks that were written specifically in the field of kaiy.We considered the traditional teachings in the context of contemporary information,gathered from the scientific literature about moxibustion and modern cauterization.Some surgical therapeutic indications of kaiy(e.g.,debridement and coagulative procedures)have been advanced by the innovation of electro-cauterization.However,those therapeutic applications that were based on the TPM humoral theory for relieving body coldness or myofascial pains—which are similar to moxibustion usages—have not received the same attention.Apart from the broad similarities of kaiy and moxibustion as thermal therapies with similar indications,there is a striking correspondence between kaiy point mapping and acupoints.Therefore,further research on different kaiy aspects is recommended.

Role of dietary and lifestyle modifications in reflex epilepsy based on traditional Persian medicine

1 Introduction Epilepsy is a disease prevalent on a global scale. Reflex seizure, a part of this disorder, is categorized into two subtypes- ＂generalized＂ and ＂partial＂ reflex seizuresWe know that complementary and alternative medicine （CAM） modalities play a considerable role in health systems： their use is on the rise Although the paucity of evidence on CAM medicaments and recommendations is a real problem, separating the facts from fiction is certainly important when it comes to current scientific publications. While, modem medicine has specifically focused on treatments, holistic methods such as traditional Persian medicine （TPM） have paid more attention to prevention and removing causes. For instance, Jorjani （1042-1137 anno Domini）, the great Iranian physician, ordered his epileptic patients to avoid standing on high grounds or performing stressful tasks,These preventive measures have been supported in the recent literature,

The role of selected medicinal plants from Iranian traditional medicine for the treatment of fatigue in metabolic syndrome

Background:Fatigue is a symptom of metabolic disorders such as metabolic syndrome,which is currently increasing in the world.There is no specific medication for fatigue,but in many cases,such as in metabolic disorders,it can be relieved by treating the underlying causes.Oxidative stress and inflammation are associated with fatigue and metabolic syndrome.Other mechanisms in metabolic syndrome are also involved in causing fatigue.Objective:The aim of this study was to investigate the role of selected medicinal plants from Iranian traditional medicine(ITM)in improving fatigue in patients with metabolic syndrome.Methods:ITM is one of the most ancient systems of medicine.In this article,we first explained fatigue,its types,and treatment from the perspective of ITM and then introduced a list of medicinal plants used in ITM to treat fatigue.Next,we reviewed the biological effects of these plants effective in treating the manifestations of the metabolic syndrome based on a search of electronic databases.Results:They have antioxidant,anti-inflammatory,and anti-diabetic activities.Among them,Matricaria chamomilla L.,Laurus nobilis L.,Origanum majorana L.,Vitex agnus-castus L.,Lawsonia inermis L.,Anethum graveolens L.,and Pistacia terebinthus L.improve the lipid profile and reduce dyslipidemia.Also,the antihypertensive effects of Matricaria chamomilla,Laurus nobilis,and Origanum majorana have been proven.Conclusion:These plants prevent fatigue and disease progression by countering oxidative stress and inflammation and affecting the properties of the metabolic syndrome.

The origins of Uyghur medicine: Debates and perspectives

Uyghur medicine refers to the traditional medicine of the people residing in the oases of the Taklamakan desert in the North-West corner of modern China.Due to historical and geographical reasons,the ancestors of the modern Uyghurs had extensive contact with Greco-Roman civilization even beginning in the 4th century BCE,and continuing with different extent until the 6th century CE.Thus,the knowledge of Greek humoral medicine spread to the Uyghur regions.When Arab-Persian medicine arrived along with Islam in the 10th century,it met both Buddhist medicine and the developed folk medicine.In this paper,we argue that“Greco-Roman”,“Arab-Persian”and“Uyghur”medicines are all of essentially the same system under holistic humoral medicine.We further assert that“Traditional European Medicine”is based on the same tradition,and,while it was discarded in the West,it has been substantially preserved by the Uyghurs.We also consider the implications of making the two millennial tradition of Uyghur medicine the object of modern scientific research in China.

Umbilical displacement: a mini review

Background:Umbilical displacement is a known disorder in folk medicine of different cultures.The various causes,clinical signs and symptoms are attributed to this disorder and different diagnostic and therapeutic methods are mentioned.Methods:To follow the aim of the study,Persian medicine literature,Google Scholar,Google,PubMed,Scopus and Web of Science were searched with no limit of the publication date and the article type(original papers and literature reviews).The searched terms were Navel,Umbilicus and other synonyms in Persian,Turkish,Russian,German,Chinese and Indian language,Dislocation,Sliding,Displacement,Deviation,Falling,Ptosis,Folk medicine and combination of these words.We also corresponded with several experts in traditional medicine via LinkedIn.All available descriptive evidence related to umbilical displacement was retrieved,and the contents were presented as categories including the disorder name,attributed signs and symptoms,and the diagnostic and therapeutic methods.Results:This disorder is called“Taharok-e-Sorre”in Persian medicine,“Nawikkatin”in Erbil(Iraq),“Dharan or Nabhi Sarakna”in Hindi,“Göbek düşmesi”in Turkish,Bēn tún in Chinese and“Cirro”in the people of Mayan community and Spanish,and“смещенпупок”in the folk medicine of the Kurgan Bashqir.Hard work,pregnancy,childbirth,fear,lifting heavy objects,rapid and sudden movements,trauma or fall and slipping of the foot are said to be causes of umbilical displacement.Umbilical displacement is associated with several symptoms such as diarrhea,constipation,abdominal pain,anorexia,anxiety,and depression.Conclusion:In this mini-review,umbilical displacement was expressed from the viewpoint of different cultures.New cases of umbilical displacement has been reported in new articles,and the pathology of umbilical displacement has been explained from the perspective of Persian medicine.

The protective effect of a standardized hydroalcoholic extract of Prosopis farcta (Banks & Sol.) J.F.Macbr. fruit in a rat model for experimental ulcerative colitis

Background:Investigating new therapies for inflammatory bowel disease among natural products has recently been gaining attention.Although Prosopis farcta has repeatedly been mentioned in traditional Persian medicine as a therapeutic option for inflammatory bowel disease,no evidence-based investigations have been conducted on this topic.The aim of this study was to assess the impact of P.farcta on acetic acid-induced colitis in rats.Methods:A hydroalcoholic extract of P.farcta fruits was prepared.Thirty-six adult Wistar rats were divided into six groups,and colitis was induced in five groups,except the sham group,using acetic acid solution.The animals received distinctive daily doses of P.farcta(50,75,and 100 mg/kg/day,p.o.)and dexamethasone(1 mg/kg/day,i.p.)as standard treatment for two progressive days,starting from colitis induction.Microscopic and histopathological examinations were performed on inflamed colonic tissue.Tissue concentrations of interleukin-1βand tumor necrosis factor-αwere assessed using enzyme-linked immunosorbent assay kits.To identify the role of oxidative stress in ulcerative colitis,the levels of malondialdehyde and myeloperoxidase were measured in colon tissues.Results:Treatment with all concentrations of P.farcta attenuated inflammation and ulcers compared with saline treatment in the control group(P<0.01 for 50 mg/kg;P<0.001 for 75 and 100 mg/kg/day).The best suppression of tumor necrosis factor-αand interleukin-1βwas observed at a dose of 100 mg/kg P.farcta(P<0.001).This dose showed the best effect in reducing myeloperoxidase and malondialdehyde in ulcerative colitis-induced rats(P<0.001).Conclusion:P.farcta can be considered a promising candidate for treating ulcerative colitis;thus,it requires further confirmation by clinical trials.

Jadwar(Delphinium denudatum Wall.):a medicinal plant

Delphinium denudatum Wall.is one of the important medicinal herbs of traditional Persian medicine and is known as Jadwar.Medicinal plants are the most widely used drugs in traditional Persian medicine and has been used for various diseases since earlier times.The medicinal uses of Delphinium denudatum Wall.date back to over 1,000 years ago.Rhazes(845–925 C.E.)was the first Persian physician and scientist who reported the use of Delphinium denudatum Wall.as a herbal remedy.During the following centuries,the usages of Delphinium denudatum Wall.in the treatment of various diseases has been mentioned in the books and references of traditional Persian medicine for cures to various diseases such as neurologic and psychiatric disease,gastrointestinal disease,fever,pain,and poisoning.According to modern studies,the dried roots of Delphinium denudatum Wall.have antipyretic,antimicrobial,anticonvulsant,hepatoprotective,antioxidant,and pain-relieving properties.Biomolecules from roots of Delphinium denudatum Wall.were also identified as potential cures for central nervous system diseases as well as for the amelioration of morphine addiction.Delphinium denudatum Wall.,with its properties involving the prevention of mitochondrial dysfunction,reduction of oxidative stress,and inflammation and immune dysregulation,can be utilized in curing inflammatory disorders.The effective therapeutic influence of root extract of Delphinium denudatum Wall.against several diseases needs to be confirmed through controlled clinical trials.This article reviews the different features of Delphinium denudatum Wall.and focuses on the well-known therapeutic effects of this herbal drug on various human disorders and animal disease models.

The potential effects of Caper (Capparis spinosa L.) in the treatment of diabetic neuropathy

Diabetic neuropathy(DN)is the most common form of neuropathy worldwide,with its prevalence rising alongside diabetes,and being characterized by sensory,motor or autonomic symptoms.DN is considered to be an incurable complication of diabetes,the management of which mainly consists of improving glycemic control,managing pain relief and ensuring continuous foot care.Although gabapentin,duloxetine and tricyclic antidepressants are commonly used to reduce patient symptoms,they do not affect the pathophysiology and progression of neuropathy.Furthermore,these drugs can have various side effects including insomnia,decreased appetite,arrhythmia,heart failure,and suicidal behavior.According to traditional Persian medicine,DN is recognized as a type of“Khadar”or“Esterkha”(a sensory or motor disorder,respectively)that occurs due to the accumulation of sugars in the peripheral nerves.Capparis spinosa L.,commonly known as the caper plant,has been recommended in authentic sources of traditional Persian medicine to treat such disorders.In this study,we reviewed the pharmacological properties of C.spinosa using the Web of Science,PubMed,Scopus and Google Scholar databases,and found that Capparis spinosa L.could affect several pathways involved in DN pathogenesis,including aldose reductase activity,the secretion of inflammatory mediators(IL-17,TNF-α,IL-1β,IL-6),oxidative stress,hyperlipidemia,hyperglycemia and advanced glycation end product formation.Based on these findings,we hypothesize that Capparis spinosa L.,may prevent the progression and reduce the symptoms of diabetic neuropathy,and so can be considered as a complementary treatment in this disorder.This hypothesis should be evaluated in well-designed in vitro and in vivo studies,and through clinical trials.

Rhazes’concepts on medical ethics

Ethics in any industry and profession,especially in medicine,is a matter of great concern and debatable.Ancient Persian Muslim doctors also did not neglect this issue,as they mentioned some points regarding the observance of medical ethics in most of their books.Rhazes'"Akhlaq al-Tabib"treatise is one of the most important manuscripts on medical ethics.Abu Bakr Muhammad ibn Zakariyya Razi,known in the west as Rhazes,was a great Persian scientist and physician who lived in the 9th and 10th centuries AD.In the"Akhlaq al-Tabib"treatise,he wrote a collection of his guidelines and ideas about medical ethics.In this manuscript,Rhazes first mentioned the ethical qualities that the physician must admire,and then pointed out the ethical standards regarding treatment and patient's rights.The study found that the principles of tenth-century medical ethics are very similar to what is being said today.

The medieval Persian manuscript of Afyunieh:the first individual treatise on the opium and addiction in history

According to historical evidence, the abuse of opium has been reported all over the globe-specifically throughout Eastern nations-since the sixteenth century. Before that, opium had mostly been applied as medication. Reference has been made in traditional Persian medical literature to the method of cultivation, properties, side effects and toxicity. In sixteenth century Iran, during the reign of the Safavids, opium abuse began. It was from then that prominent Persian scholars started to think of solutions to this societal problem. One of the most famous scholars was Imad al-Din Mahmud ibn Mas＇ud Shirazi, who composed a book concerning addiction-Afyunieh, a comprehensive book on the topic of opium and all issues of opium. Furthermore, he recommended methods for reducing opium dose as well as substitution with other medications that had a narrower range of side effects, in order to eradicate dependency upon opium and opium-derived materials. This is most likely the first book that comprehensively addressed opium and discussed drug rehabilitation methodology, in traditional Persian medical literature. In this historical review, the authors have introduced the book Afyunieh, which presents methods for treating addiction to and giving up opium; the text comprises a synthesis of the author＇s opinions, professional experience and references to the work of other famous physicians.

Anti-irritable Bowel Syndrome Syrup Improves Constipation-Predominant Irritable Bowel Syndrome:A Randomized,Placebo-Controlled Trial

Objective To evaluate the efficacy and safety of administration of the formulated Persian herbal syrup on improving the symptoms of patients with constipation-predominant irritable bowel syndrome(IBS-C).Methods This study was conducted in 70 patients with IBS-C,who were recruited from 3 medical centers in Mashhad,Iran,from November 2017 to August 2018.Seventy patients were randomly assigned to 2 groups including treatment and placebo groups by block randomization,35 cases in each group.Patients in the treatment group received 15 mL of anti-IBS syrup,thrice daily for 6 weeks and followed up for 4 weeks.Placebo syrup was also prepared through similar instruction,BP syrup without plant extract was used.Primary outcome induding IBS Symptom Severity Scale(IBS-SSS)questionnaire and secondary outcomes in terms of Hospital Anxiety and Depression(HADS)questionnaires,the Bristol Stool Form Scale(BSFS)were completed and evaluated at weeks 6 and 10,respectively.Safety indices were collected at the end of the treatment and Common Terminology Criteria for Adverse Events v4.0(CTCAE)was used to evaluate the adverse events.Results The response to treatment was 84.4%(27/32)in the treatment group and 46.4%(13/28)in the placebo group,respectively(P=0.002).Compared with pre-treatment,a significant decrease was found on the IBS-SSS and BSFS scores after 6-week intervention in both groups(P<0.001).Moreover,IBS-SSS and BSFS scores in the treatment group were lower than the placebo group after the intervention(P=0.041).There was no significant difference in the anxiety and depression scores after treatment in both groups(P>0.05).Side effects reported in the treatment group included 2 cases of headache during the first week of the onset of the treatment,1 case of drowsiness,1 case of increase in menstrual bleeding,which did not result in discontinuation of the treatment.In the placebo group,1 case of exacerbation of the disease was reported.Conclusions Anti-IBS syrup significantly reduced the severity of IBS symptoms compared to placebo.However,there was a need for further investigation regarding the anxiety and depression scores.(Registration No.IRCT2017061034446N1).

Effects of rhubarb(Rheum ribes L.)syrup on dysenteric diarrhea in children:a randomized,double-blind,placebo-controlled trial

BACKGROUND：Rheum ribes L.is a plant native to China,Iran,Turkey,India,and a few other countries.Antidiarrheal activity is considered to be one of its important properties according to various systems of traditional medicine.An increasing rate of bacterial resistance to antibiotics has led to treatment failure in some cases of shigellosis in children,and underlines a need for safe,efficient and valid options.OBJECTIVE：The purpose of this study is to evaluate the efficacy of R.ribes syrup as a complementary medicine for treatment of shigellosis in children.DESIGN,SETTING,PARTICIPANTS AND INTERVENTIONS：This randomized,doubleblind,placebocontrolled trial started with a group of 150 children aged between 12–72 months with suspected Shigella dysentery.R.ribes syrup or placebo syrup was administered to the intervention and control groups,respectively for 5 days.In addition,the standard antibiotic treatment（ceftriaxone for the first 3 days and cefixime syrup for 2 further days）was administered to both groups.MAIN OUTCOME MEASURES：Body temperature,abdominal pain,need for antipyretics,defecation frequency,stool volume and consistency and microscopic stool examination were recorded as outcome measures.Any observed adverse effects were also recorded.RESULTS：Mean duration of fever and diarrhea in the R.ribes group was significantly lower than that in the placebo group（P=0.016 and 0.001,respectively）.In addition,patients in the R.ribes group showed shorter duration of need for antipyretics and shorter duration of abdominal pain（P=0.012 and 0.001,respectively）.However,there were no significant differences between the two groups regarding the microscopic stool analyses.Furthermore,no adverse effect was reported.CONCLUSION：R.ribes syrup can be recommended as a complementary treatment for children with Shigella dysentery.