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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]