Table 1.
Summary of clinical trials of vegetable extracts in Helicobacter pylori infection.
| Study Design | Study Sample | Experimental Intervention | Control Intervention | Main Outcomes | References |
|---|---|---|---|---|---|
| RCT | 32 patients underwent gastroscopy (23 patients completed trial) | Cinnamon extract (40 mg twice daily) for 4 weeks | Placebo | Slight and non-significant improvement in urea breath counts. | [62] |
| RCT | 86 diabetic patients with positive H. pylori stool antigen test (77 patients completed trial) | Broccoli sprouts powder (6 g/day) alone or in combination with standard triple therapy for 4 weeks | Standard triple therapy (omeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1000 mg) | H. pylori eradication rates with Broccoli sprouts powder, standard triple therapy, and combination of both were 56%, 89.3% and 91.7%, respectively. | [63] |
| RCT | 89 volunteer subjects randomized in group A (H. pylori positive, broccoli sprout extract containing sulforaphane), group B (placebo) and group C (H. pylori negative, broccoli sprout extract containing sulforaphane). | One capsule containing 250 mg broccoli sprout extract yielding 1000 μg sulforaphane. | Placebo | No significant effect was found in treatment group regards to H. pylori infection density. MDA concentration was significantly reduced in groups A and C with broccoli sprout treatment. | [64] |
| Controlled clinical trial | 25 H. pylori positive patients (mean age: 50 ± 12 years) with functional dyspepsia | Curcumin 30 mg, bovine lactoferrin 100 mg, N-acetylcysteine 600 mg, and pantoprazole 20 mg twice daily for 7 days | - | Significant improvement of the severity of symptoms and serologic signs of gastric inflammation. 12% H. pylori eradication rate. | [65] |
| RCT | 68 H. pylori positive patients aged 20–50 years with peptic ulcer (60 patients, 30 in each group completed study) | Curcumin 500 mg/day, as adjunct to standard triple therapy (clarithromycin 500 mg, amoxicillin 1000 mg, and pantoprazole 40 mg twice daily) | Placebo | Improvement of dyspepsia in curcumin group was significantly higher (27.6%) vs. placebo (6.7%). H. pylori eradication rate was 73.3% in both groups. | [66] |
| RCT | H. pylori patients were randomized in two groups, 50 patients each, with mean age of 54.65 ± 16.54 in triple therapy group, and 53.65 ± 15.65 in triple therapy + curcumin group. | Triple therapy twice a day for one week + turmeric tablets (700 mg) thrice a day for 28 days. | Triple therapy (omeprazole, amoxicillin, and metronidazole) twice a day for one week. | Significantly decrease in MDA levels and increase in TAC of the gastric mucosa in triple therapy + curcumin treated patients. | [67] |
| RCT | 36 patients (47% males and 53% females) with mean age of 40.87 ± 16.45 years in the treatment group and 35.40 ± 11.26 years in the control group | 2 tablets of garlic powder daily (2 g each) for 8 weeks. | Placebo | 87% H. pylori negative cases in Garlic treated group and 73% H. pylori negative cases in placebo group, as confirmed by UBT. | [68] |
| Pilot study | 20 dyspeptic patients aged 18–75 years with positive H. pylori (5 patients completed study) | Garlic oil capsule (4 mg) four times daily for 14 days | - | No improvement in H. pylori symptoms or eradication | [69] |
| Single-center, prospective crossover study | 12 healthy H. pylori infected adults (average age: 41.4 years) |
|
Bismuth subsalicylate (2 tablets) with 3 meals per test day | No beneficial effects by garlic or capsaicin on H. pylori. Median urease activity before and after therapy for garlic was 28.5 vs. 39.8, for capsaicin was 43.7 vs. 46.6, and for bismuth was 55.8 vs. 14.3. | [70] |
| RCT | 40 volunteers with H. pylori infection | Burdock complex (Arctium lappa, Angelica sinensis, Lithospermum erythrorhizon, and Sesamum indicum oil) 2 bottles (2 × 10 mL) every day after breakfast and dinner, for 8 weeks. | Placebo | A significant decrease in urea breath counts and inflammatory markers (TNF-α and IL-8), and improved antioxidant capacity, with Burdock complex | [71] |
| RCT | 107 participants with H. pylori infection, aged 18–45 years | GutGard (Root extract of Glycyrrhiza glabra) 150 mg for 60 days | Placebo | H. pylori stool antigen (HpSA) was negative in 56% and 4% of patients treated with GutGard or placebo, respectively | [72] |
| RCT | 88 H. pylori patients, with non-ulcer dyspepsia (age range of 18–65 years) | 1-, 2- or 3-g Nigella sativa + 40 mg omeprazole | Standard triple therapy (clarithromycin, amoxicillin, and omeprazole) | No significant difference in H. pylori eradication rate between triple therapy (82.6%) and 2-g N. sativa (66.7%). Effect on dyspeptic symptoms was similar in all groups. | [73] |
| RCT | 142 patients aged 19–70 years were enrolled in the trial. | Fermented milk containing 1.0 × 106 CFU/mL L. paracasei HP7 and 100 mg G. glabra. | Placebo | Significant improvement in GI symptoms, 13C-UBT scores, and chronic inflammation was observed in treatment group. | [74] |
| RCT | 120 patients suffering from non-ulcer dyspepsia or peptic ulcer disease randomized into treatment group (mean age: 38.8 years) or control group (mean age: 40.1 years). | Clarithromycin based triple regimen + G. glabra 380 mg twice daily, for 2 weeks. | Clarithromycin based triple regimen (clarithromycin twice daily, amoxicillin once daily, omeprazole twice daily), for 2 weeks. | H. pylori eradication rate for treatment and control groups was found as 83.3% and 62.5%, respectively. | [75] |
| RCT | 70 patients were randomized in treatment (mean age: 42.31713.85) and control (mean age: 36.31713.64) groups. | Anti-secretory agent 1 + honey-based formulation of N. sativa (5 mL N. sativa) once daily, for 8 weeks. | Placebo | The mean Hong Kong index of dyspepsia scores and H. pylori infection rates were significantly lower in treatment group. | [76] |
| RCT | 52 H. pylori positive patients were randomized in group A (low dose mastic gum), group B (high dose mastic gum), group C (pantoprazole), and group D (standard therapy). | Pure mastic gum [350 mg (group A) or 1 g (group B) thrice daily] or combination of pure mastic gum (350 mg thrice daily) and pantoprazole (20 mg twice daily) (group C). | Standard therapy (pantoprazole 20 mg, amoxicillin 1 g and clarithromycin 500 mg) for 10 days (group D). | H. pylori eradication was observed in 4/13 patients in group A, 5/13 patients in group B, none of the patients in group C, and 10/13 patients in group D. No significant differences were found in mean UBT values in groups A, B and C. | [77] |
1 Famotidine. RCT, randomized clinical trial; MDA, malondialdehyde; TAC, total antioxidant capacity; UBT, urea breath test.