Overview of the phytomedicine approaches against Helicobacter pylori

Table 1 Examples of clinical trials using herbal medicines

Herb	Study design	Sample	Experimental intervention	Control	Outcome	Difference between experimental and control group		Ref.
Garlic oil	Blind non-randomized trial	20 dyspeptic patients	275 mg garlic oil 3 times a day for 14 d	Same plus 20 mg omeprazole	Negative for histology and urease test	No	Symptom score (8.7 ± 1.70 vs 8.5 ± 1.51) and H. pylori density (2.0 ± 0.82 vs 2.1 ± 0.74) did not significantly changed	[111]
Fresh garlic or jalapeno peppers	Open non-randomized trial	12 healthy patients with H. pylori	10 cloves fresh garlic or 6 jalapeno peppers with 3 meals per test day	Bismuth subsalicylate with 3 meals per test day or no intervention	Reduction in urea breath test counts		Garlic and jalapeno add no effect (P > 0.8), but significant reduction after bismuth (P < 0.001)	[112]
Cinnamon	Blinding placebo-controlled	23 patients undergoing gastroscopy	40 mg cinnamon extract twice a day for 4 wk	Placebo	Reduction in urea breath test counts	No	Mean urea breath test reading (23.9 vs 25.9) did not significantly changed	[109]
Lycopene	Quasi-control trial	54 patients with H. pylori	Metronidazole 500 mg/bd, amoxicillin 1g/bd, omeprazole 20 mg/bd, bismuth 240 mg/bd, and lycopene 30 mg/daily	Metronidazole 500 mg/bd, Amoxicillin 1 g/bd, Omeprazole 20 mg/bd, Bismuth 240 mg/bd	Slight increased eradication rate with lycopene (no statistical difference) evaluated by urease rapid test	No statistical difference		[113]
Nigella sativa (N. sativa)	Randomized trial	88 dyspeptic patients	Triple therapy (TT: clarithromycin 500 mg twice daily, amoxicillin 1g twice daily, omeprazole 40 mg once daily) and 1, 2 or 3 g N. sativa	Clarithromycin 500 mg twice daily, amoxicillin 1g twice daily, omeprazole 40 mg once daily	2 g/d and TT no statistical difference 1 g/d and 3 g/d significantly less effective than TT by stool antigen test	No	Eradication rates with 2 g N. sativa and TT with no statistical difference; eradication rate with 1g or 3 g N. sativa was significantly less than that with TT (P < 0.05)	[89]
Green propolis	Non-randomized clinical trial	18 patients infected with H. pylori	20 drops of alcoholic preparation of Brazilian green propolis 3 times a day for 7 d	No	One patient negative for H. pylori 40 d after treatment	Not applicable		[108]
Glycyrrhizaglabra	Randomized double blind placebo controlled trial	107 patients infected with H. pylori	55 patients - 150 mg of GutGard (root extract of G. glabra) once daily for 60 d	52 patients - placebo once daily for 60 d	56% of patients receiving GutGard eradicate H. pylori vs 4% on placebo	Yes	A significant interaction effect between group and time (P = 0.00)	[88]
Chinese patent medicine wenweishu /yangweishu	Randomized, controlled and multicenter trial	642 patients infected with H. pylori	PCM plus wenweishu group (n = 196); and PCM plus yangweishu group (n = 224)	PCM group (n = 222, pantoprazole 40 mg twice a day, clarithromycin 500 mg twice a day, metronidazole 400 mg twice a day, for 7 d)	Higher healing rate in PCM plus wenweishu; Higher rates of symptom relief in PCM plus wenweishu and PCM plus yangweishu; Eradication rate between PMC group and PMC plus wenweishu or PMC plus yangweishu group was not significantly different (P = 0.108, 0.532, respectively)	Yes	Healing rate in PCM plus wenweishu groups was significantly higher than the rate in PCM group (P = 0.004) Symptom relief rates in PCM plus wenweishu groups and PCM plus yangweishu were significantly higher than the rate in PCM group (both P < 0.01)	[110]

PCM: Pantoprazole, clarithromycin, metronidazole; H. pylori: Helicobacter pylori.