Efficacy of a combination of herbal gel versus topical diltiazem (2) in chronic anal fissure healing: A randomized double-blind clinical trial

Tavakoli-Dastjerdi, S. and Motavasselian, M. and Emami, S. A. and Mansourian, M. and Sahebkar, A. and Teimouri, A. (2019) Efficacy of a combination of herbal gel versus topical diltiazem (2) in chronic anal fissure healing: A randomized double-blind clinical trial. Journal of HerbMed Pharmacology, 8 (2). pp. 139-145.

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Abstract

Introduction: Chronic anal fissure (CAF) is a common painful ailment that adversely affects quality of life. Nonsurgical treatments such as topical diltiazem are routinely administered to patients with CAF. However, diltiazem is associated with side effects such as headache and allergic reactions, which often lead to discontinuation of the treatment. The aim of this study was to determine the efficacy and safety of a topical Persian herbal remedy with analgesic, anti-inflammatory and antiseptic properties versus topical diltiazem (2) in CAF healing. Methods: In this randomized double-blind clinical trial, 70 patients with CAF were randomly divided into an intervention group receiving topical herbal medicine and control group receiving topical diltiazem (2) for 6 weeks. Both groups were given lifestyle and dietary advice including adherence to a high-fiber diet, avoidance of spicy foods, use of a laxative (psyllium powder) in case of constipation, and taking sitz baths. Severity of pain, bleeding, and itching were measured at the firstvisitaswellasthefirst,third,andsixthweeksoftreatment.Woundhealingandepithelialization were evaluated by anal examination. The treatment and follow-up period was 12 weeks; 6 weeks for assessing the effect of treatment and 6 weeks for examining treatment maintenance and evaluating the percentage of recurrence. Results: The herbal medicine caused significant reduction in pain compared with diltiazem (P<0.001). The herbal medicine had a significant effect in terms of wound healing at the end of the period (P<0.001). Recurrence rate was lower in the intervention group (32) than the control group (56), though this difference was not significant (P=0.323) Conclusion: Findings of this clinical trial suggest a higher efficacy of the combination herbal remedy versus topical diltiazem 2 in the management of pain and wound associated with CAF. © 2019 Nickan Research Institute. All rights reserved.

Item Type: Article
Additional Information: Cited By :1 Export Date: 16 February 2020 Correspondence Address: Teimouri, A.; Gastroenterology Department, Isfahan University of Medical SciencesIran; email: ateimouri@med.mui.com
Uncontrolled Keywords: Allium ampeloprasum Aloe vera Anal fissure Astragalus sarcocolla Commiphora mukul Syzygium aromaticum Traditional medicine Allium ampeloprasum extract Astragalus sarcocolla extract Commiphora mukul extract diltiazem Syzygium aromaticum extract unclassified drug adult analgesia anus fissure Article colonoscopy controlled study double blind procedure human irritable colon major clinical study quality of life questionnaire randomized controlled trial wound healing
Subjects: QV pharmacology
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib1 lib1
Date Deposited: 27 Jun 2020 05:59
Last Modified: 27 Jun 2020 05:59
URI: http://eprints.mums.ac.ir/id/eprint/18677

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