Table 3 Clinical trials of Rhubarb and the active constituents
From: What we already know about rhubarb: a comprehensive review
No. | Drugs | Species | Subjects | Study design | Outcome | Mechanism | Quality of evidence | Refs. |
|---|---|---|---|---|---|---|---|---|
1 | Crude rhubarb | – | 368 critically ill patients with Grade I–III AGI | Retrospective study based on propensity score matching | Rhubarb significantly improve feeding tolerance and relieve gastrointestinal dysfunction in critically ill patients without serious adverse reactions | CRP ↓ | III | [19] |
2 | Rhubarb powder | – | 112 critically ill patients with IAH and AGI stage I-III | Randomized trial | Rhubarb enema had a protective effect against IAH and may be more effective compared with glycerin enema | PCT ↓, CRP ↓, TNF-α ↓, IL-6 ↓, ventilation function ↑ | IIa | [145] |
3 | Rhubarb decoction (50 g rhubarb slice plus 100 ml water) | – | 94 Chinese patients who required jejunal feeding tube insertion | Randomized trial | Significantly shorter insertion time in the rhubarb group | – | IIa | [146] |
4 | Rhubarb syrup | R. ribes L. | 150 Iranian children aged between 12-72 months with suspected Shigella dysentery | Randomized, double-blind, placebo-controlled trial | Significant improvement of symptom and shorter duration of need for antipyretics | – | Ib | [147] |
5 | Rhubarb | – | 912 participants with SAP | Meta-analysis for a total of 16 randomized controlled trials | Rhubarb plus trypsin inhibitor group showed lower mortality, length of hospitalization, abdominal pain relief time, and serum amylase level | – | Ia | [148] |
6 | Rhubarb combined with early EN | – | 126 patients with SAP | A randomized controlled trial | Significant improvement of symptom, renal function and shorter periods of hospital stays in the EEN/rhubarb group | – | Ib | [149] |
7 | Rhubarb combined with mirabilite | – | 96 patients with SAP | A randomized controlled trial | The times taken for abdominal distension, abdominal pain, blood and urinary amylase values to normalize were significantly shorter | WBC count ↓, CRP ↓, IL-6 ↓ | IIa | [80] |
8 | Crude rhubarb combined with somatost-atin | – | 1161 patients with acute pancreatitis | Meta-analysis of 19 randomized controlled trials | Adjuvant treatment with crude rhubarb appears to have additional benefits. Reduced the total complications and duration of hospital stay | Improve the gastrointestinal function | Ia | [150] |
9 | Raw Rhubarb Solution | – | 500 Chinese patients with high-risk factors of pancreatitis after post-ERCP | Predictive random compared research in one center | Raw rhubarb significantly reduced the incidence of post-ERCP pancreatitis in high-risk patients | – | IIa | [151] |
10 | Crude rhubarb | R. palmatum L. | 869 patients with systemic inflammation reaction syndrome/sepsis | Meta-analysis of 15 randomized controlled trials | Crude rhubarb has additional benefits in the treatment of sepsis; improve the gastrointestinal function | IL-6 ↓, TNF-α ↓, prothrombin time ↓ platelet number ↑ | Ia | [152] |
11 | Crude rhubarb | – | 40 septic patients with APACHE II score of above 12 | A randomized controlled trial | Crude rhubarb can improve intestinal permeability in patients with sepsis | Procalcitonin level ↓ | Ib | [84] |
12 | Rhubarb capsule | – | Patients with chronic kidney disease (stages 3 & 4) of age 20–60 years | A prospective comparative study | Significantly improve the clinical features and biochemical parameters | – | Ib | [153] |
13. | Capsules of Rhubarb stem extract | – | 80 Iranian patients with type II diabetes mellitus aged 30–60 years old with fasting blood glucose greater than 140 mg/dl | Randomized, double-blind, placebo-controlled trial | Significant reduction of HbA1C and fasting blood glucose with rhubarb intervention | – | Ib | [154] |
14 | Rhubarb powder (Yalan Pharmaceutical Co., Ltd., Lanzhou, China) | – | 85 patients with heat stroke | Randomized controlled trials | Significant improvemen of liver and kidney function, shorter ICU and hospital stays, and a lower APACHE II score in the rhubarb group | WBC ↓, CRP ↓, PCT ↓, IL-6 ↓ | IIa | [155] |
15 | Rhubarb extract | – | 125 patients with minor aphthae | Randomized, placebo-controlled trial | Symptom resolution time: rhubarb (1.84 days), placebo (4.64 days) | – | IIa | [156] |
16 | Rhubarb leachate (extracted with 30 mL of boiling water) | – | 80 Chinese patients aged 22–79 years with ARDS | Randomized, controlled trial | Rhubarb can decrease EVLWI and PVPI, and improve oxygenation in patients | – | IIa | [157] |
17 | R. emodi powder capsule (420 mg of powdered drug per capsule) | R. Emodi L. | 45 unmarried participants aged 15–25 years having regular menstrual cycles with dysmenorrhoea | Randomized, single-blind, standard controlled trial | Improve in dysmenorrhoea quality of life | – | IIa | [158] |
18 | Crude rhubarb | R. palmatum L | 886 Chinese patients with AOPP | Meta-analysis of a total of 12 randomized controlled trials | Reduce the incidence of intermediate syndrome and MODS, total dose of pralidoxime or atropine | Restore cholinesterase function and purgative | Ia | [159] |
19 | Rhubarb extract (extracted with water at 100 °C for 4.5 h) | – | A total of 80 patients with lung cancer | A randomized, double-blind, placebo-controlled trial | Rhubarb extract significantly decrease attenuated radiation induced lung toxicity (RILT) and improve pulmonary function | TGF-β1 ↓, IL-6 ↓ | Ib | [160] |
20 | R. Officinalis Baill (extracted with water) | R. Officinalis Bail. | 103 patients with athero- sclerosis aged from 45 to 65 years | A randomized, double-blind, placebo-controlled clinical trial | Significantly improves endothelial function in patients with atherosclerosis | TC ↓, LDL-C ↓, FMD ↑ | Ib | [161] |
21 | Prepared rhubarb | – | 92 patients with PIH | A randomized controlled trial | Improve IR of PIH | Regulation of GLUT1 | Ib | [162] |