## 3 Results
### Phytochemical or Plant Extract Effectiveness on IBD Patients

Table 2: _Cont._disease activity was reduced in the resveratrol group of UC patients with mild-to-moderate disease. Resveratrol increased the antioxidant capacity and reduced the oxidative stress in this group of patients [40; 41]. The main polyphenolic compound of green tea, namely (-)-epigallocatechin-3-gallate (EGCG), was administered as oral Polyphenon E in 19 patients with mild-to-moderate UC. The study was completed by 16 patients, and the remission rate was 53.3% with a drop in the disease activity index after 56 days of therapy. This rate was the same for the low or high dosage groups (400 or 800 mg EGCG daily). Quality of life and endoscopic scores also improved while no serious adverse effects were noted [24]. Pycnogenol(r) is an extract from the French maritime pine (_Pinus pinaster_) bark that is rich in polyphenols, specifically 70 \(\pm\) 5% procyanidins. The effect of Pycnogenol(r) on oxidative stress in pediatric CD patients in remission was studied by measuring several potentially interesting biomarkers such as enzyme diamine oxidase (DAO) and calprotectin. Fourteen CD patients and 15 healthy children completed the study. Pycnogenol(r) had no effect on markers of inflammation (CRP, calprotectin) or disease activity index, but it reduced oxidative stress. It also increased DAO which could be beneficial to these patients [51]. Silymarin, a phytochemical isolated from an extract of _Silybum marianum_ seeds, demonstrated anti-inflammatory effects in experimental studies. It was investigated in an RCT of 80 UC patients. Only 70 patients completed the study, and 38 of them in the silymarin group showed an improvement in disease activity index and erythrocyte sedimentation rate. In the same group, 33 of the 38 patients also had increased hemoglobin levels after 6 months of treatment. In contrast, the placebo group did not have significant alterations of these parameters. Thus, silymarin supplements were recommended to maintain UC in remission [38]. Tormenttil (_Tormentilla erecta_) belongs to the _Rosacea_ family of plants and contains high amounts of tannins. A tormentil extract was used in a controlled trial to verify its safety, side effects and potential impact in 16 UC patients. The trial was completed by 15 patients whose disease activity was reduced. These patients were also able to lower steroid dosages. Safety and tolerability of tormentil extract was also verified [46]. An extract of _Triptergbium wilfordii Hook F_. called T2 was administered to 20 CD patients for 3 months to conduct a clinical trial. Biopsies were taken before and after the intervention, but no other clinical data was provided. Treatment with T2 seemingly ameliorated mucosal inflammation and promoted mucosal healing. Histology also showed upregulation of Foxp3+ protein expressing regulatory T-cells and interleukin(IL) 10 with lowered levels of proinflammatory Tumor Necrosis Factor alpha (TNF-a) [52]. Pine resin was applied as an herbal remedy in ancient China. Ecabet sodium has been isolated from it and used for gastritis and gastric ulcer. Seven patients with mild-to-moderate UC were recruited, with 6 of them completing a trial of ecabet sodium enemas administered twice per day for two weeks. Statistically significant improvements were reported in disease activity index and endoscopy. However, this trial had no control group or blinding, thus limiting its power [53]. A herbal combination of myrrh, chamomile flowers and coffee charcoal was compared with mesalazine. This RCT was conducted for 12 months, and the ability to maintain remission in UC patients was studied. Initially, 97 patients were recruited and 82 completed the study. Non-inferiority for the use of this herbal combination was proven in comparison to mesalazine, with a safe and tolerable profile warranting further investigation [32]. A systematic review and meta-analysis reviewed 5 RCTs and 15 non-randomized clinical trials. These RCTs have been meta-analyzed by this review [29; 34; 35; 36; 37].