Study: Berber improves the symptoms of irritable bowel syndrome

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Cover Chen C, Tao C, Liu Z, et al. A randomized clinical study with Berberinhydrochloride in patients with diarrhea-forheld irritable bowel syndrome. Phytother res. 2015; 29 (11): 1822-1817. Design in this 14-week monocentric, double-blind, placebo-controlled clinical study, the patients were randomized into 2 groups after a 2-week start-up phase, in order to receive either the study medication or placebo twice a day for 8 weeks. The treatments were canceled after 8 weeks and the patients were watched for another 4 weeks. Participants all participants met the inclusion criteria based on the Rome III classification system for irritable bowel syndrome with predominant diarrhea (IBS-D). Between May 2011 and January 2015, 196 patients with IBS-D were in ...
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reference

chen C, Tao C, Liu Z, et al. A randomized clinical study with Berberinhydrochloride in patients with diarrhea-forheld irritable bowel syndrome. Phytother-Res . 2015; 29 (11): 1822-1817.

Design

In this 14-week monocentric, double-blind, placebo-controlled clinical study, the patients were randomized into 2 groups after a 2-week start-up phase, in order to receive either the study medication or placebo twice a day for 8 weeks. The treatments were canceled after 8 weeks and the patients were watched for another 4 weeks.

participant

All participants met the inclusion criteria based on the Rome III classification system for irritable bowel syndrome with predominant diarrhea (IBS-D). Between May 2011 and January 2015, 196 patients with IBS-D aged 18 to 65 years were recruited for this study by the Tenth People’s Hospital of Shanghai, Tongji University School of Medicine, Shanghai, China. Some of these patients were either excluded or could not complete the study. In the end, 70 patients ended the study in the Berberin Group and 62 in the placebo group. The age of the patients was between 19 and 61 in the Berberin group and between 18 and 65 years in the placebo group.

medication and dosage study

Berberinhydrochloride 200 mg twice a day was the active medication. Vitamin C, 200 mg twice a day, was used as placebo. Both products were made by Shanghai Sine Tianping Pharmaceutical Co., Ltd. made.

target parameter

diarrhea, abdominal pain, urgent bowel movements, frequency and any side effects were recorded on the basis of daily questionnaires. Before administering the medication and after the treatment has been completed, IBS symptom values, depression and anxiety scales and the IBS scale for quality of life (QOL) were assessed.

important knowledge

Both the Berberin and the placebo group reported on a reduction in symptoms during the 8 weeks in which they took the medication, even though the placebo group reported a lower benefit. In week 8, the diarrhea frequency in the Berberin group was significantly lower than in the placebo group ( p = 0.032).
The Berberin group, but not the placebo group, reported a lower urgency and frequency of bowel movements from week 4 to week 8 ( p <0.01).
Both groups reported less abdominal pain during the 8-week treatment. In the Berberin group 3 of the study from week 3 and a significant reduction in pain relief was observed by week 8. The pain relief scores for week 8 represented a reduction of 64.6 % (1.54 ± 0.26 vs. 4.35 ± 0.58) compared to the initial values. In the placebo group, the end value was a reduction of 29.4 % (2.88 ± 0.37 vs. 4.08 ± 0.23). The pain reduction was in the week 6 Berberin Group significantly larger than in the placebo group ( p <0.01) and week 8 ( p <0.01).
Berberin significantly reduced the overall IBS symptom score, the fear score and the depression score ( p <0.01). Treatment with Berber was also associated with an increased QOL score ( p <0.05). In the placebo group, no significant changes were found in these values ​​( p 0.05).
The total value of the IBS symptoms, the fear value and the depression value were significantly lower in the Berberin group compared to the placebo group ( p <0.05).

practice implications

Berberin can be an effective means of treating the symptoms of IBS-D.
IBS is a common illness that affects the quality of life of the patient. It is a chronic state that is characterized by abdominal pain or complaints in connection with a disturbed defecation, but the lack of identifiable structural or biochemical anomalies. Changes in neurohumoral mechanisms and psychological factors, bacterial overgrowth, genetic factors, intestinalism, visceral hypersensitivity and factors of the immune system are based on theory, but a clear understanding of etiology is still evident. At this point, the IBS treatment is determined by the most annoying symptoms of the patient.
The total value of the IBS symptoms, the fear value and the depression value were significantly lower in the Berberin group compared to the placebo.
This clinical study shows 2 things. First, and most importantly, Berber is effective when treating IBS if the prevailing symptom is diarrhea. Second, many patients can also benefit from the easy take of placebo.
The advantageous effects of Berber are more complex and far more than previously assumed. In the past, we have only taken into account its antibiotic properties and used it closely to treat infectious gastritis. In this study by Chen et al. experienced patients who berberin revenue, not only a reduced frequency, urgency, diarrhea and abdominal complaints, but also a significant reduction in anxiety and depression.
The Berber used in this study became the rhizome of the Chinese gold thread ( Coptis chinensis ). In North America, commercial sources are generally made of Oregon grapes ( mahonia aquifolium ).
Berber herself has an antimicrobial effect, but it also increases the effect of some antibiotics against frequent oral streptococcal species. 2 It also has an antifungal effect and a synergistic effect if it is administered in combination with antiMyotics. It partially restricts secretaric diarrhea by improving the absorption of sodium and water from the intestinal lumen. 4 Berber significantly increases the pain tolerance in rats by influencing the nitrogen oxide pathways. Opioid paths, 6 A campaign that may also be responsible for the increased pain tolerance.
While the advantages of Berberin exceeded those reported in the vitamin C group, the placebo had a significant benefit at least for a few weeks. Placebo benefit is common in IBS studies. A meta -analysis by Ford and Moayyedi from 2010 identified 73 randomized controlled studies (RCTS), which included 8,364 patients with irritable bowel syndrome who have been assigned placebo. The pooled placebo response rate was 37.5 %. [95%Confidence interval (CI): 34.4%-40.6%]. The response rates were higher in European RCTs, RCTs, which used the doctor used, and RCTs that used a shorter therapy duration. 7 Although this study was carried out in China, the placebo reaction of 29.4 % is remarkably close to the result of Ford. This placebo effect must be taken into account when treating patients with irritable bowel syndrome; About a third even speaks to a placebo for some time.
Berber also has many parallel uses to the Metformin drug. Both increase insulin sensitivity and are used to treat diabetes mellitus type 2 and the polycystic ovarial syndrome (PCOS). 8-9 Both have similar effects on the intestinal microbioma, reduce the variety of bacteria and increase the production of short-chain fatty acids. However, they seem different effects to have gastric motility. In many patients, metformin causes diarrhea and even vomiting by unknown mechanisms.
These current results on irritable bowel syndrome raise the question - could Berber help reduce some of the intestinal side effects of metformin? At this point there are no reports in medical literature that could inform us; However, it is certainly tempting to prescribe berberin patients who take metformin, especially those with digestive disorders that they attribute to the medication. Of course, potentiation of the effects can be expected and a close -meshed monitoring of serum glucose would be justified.
There are some warning information related to Berber, who have been published in the literature. In August 2015, Zhi et al. becomes. Berber in combination with Clarithromycin also inhibits significant cytochrome p450 3a (Cyp3a). 12 Although this was a preliminary study, she should warn us about the use of Berber in combination with one of these antibiotics or with medicinal products that are dependent on the effect of Cyp3a.

  1. Lazaraki G, Chatzimavroudis G, Katsinelos P. recent progress in the pharmacological treatment of irritable bowel syndrome. world J Gastroenterol . 2014; 20 (27): 8867-8885.
  2. dziedzic a, wojtyczka rd, kubina R. inhibition of oral streptococcal growth, which is induced by the complementary effect of Berberinchloride and antibacterial compounds. molecules . 2015; 20 (8): 13705-13724.
  3. Liu H., Wang L., Li Y. et al. Structural optimization by Berberin as a synergist to restore the antifungal activity of fluconazole against drug -resistant Candida Albicans. chemmedchem . 2014; 9 (1): 207-216.
  4. y. Zhang, X. Wang, S. Sha et al. Berberin increases the expression of NHE3 and AQP4 in Sennosida-induced diarrhea. fitoterapie . 2012; 83 (6): 1014–1022.
  5. Tang Ql, Lai Nl, Zhong Yf, Wang am, Su JK, Zhang MQ. Antinaoceptive effect of Berber on visceral hypersensitivity to rats. world J Gastroenterol . 2013; 19 (28): 4582–4589.
  6. y. Feng, Y. Li, C. Chen et al. The inhibitory role of Berber in the intestinal movement of rodents is related to the activation of the endogenous opioid system. Phytother-Res . 2013; 27 (10): 1564–1571.
  7. Ford AC, Moayyedi P. Meta-Analysis: Factors that influence the placebo response rate in irritable bowel syndrome. food pharmacol. Ther . 2010; 32 (2): 144-158.
  8. h. Zhang, J. Wei, R. XUE et al. Berber reduces blood sugar in patients with type 2 diabetes mellitus by increasing the insulin receptor expression. metabolism . 2010; 59 (2): 285-292.
  9. w. Wei, H. Zhao, A. Wang et al. A clinical study on the short -term effects of Berber in comparison to metformin on the metabolic properties of women with polycystic ovarian syndrome. EUR J ENDOCRINOL . 2012; 166 (1): 99-105.
  10. Zhang X, Zhao Y, XU J, et al. Modulation of the intestinal microbiota by Berberin and Metformin during the treatment of obesity caused by fat -rich nutrition in the case of rats. Scientific Rep . 2015; 5: 14405.
  11. Bouchoucha M, Uzzan B, Cohen R. Metformin and digestive disorders. diabetes metab . 2011; 37 (2): 90-96.
  12. Zhi D, Feng Pf, Sun Jl, et al. The strengthening of heart toxicity through simultaneous administration of Berber and macrolids. EUR. J. Pharm. Sci . 2015; 76: 149-155.