Traditional Persian medicine,Herbal medicine,Rheum ribes L,Rhubarb,Dysentery,Shigellosis,Diarrhea," /> Traditional Persian medicine,Herbal medicine,Rheum ribes L,Rhubarb,Dysentery,Shigellosis,Diarrhea,"/> Effects of rhubarb (<em>Rheum ribes</em> L.) syrup on dysenteric diarrhea in children: A randomized, double-blind, placebo-controlled trial
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Journal of Integrative Medicine ›› 2017, Vol. 15 ›› Issue (5): 365-372.doi: 10.1016/S2095-4964(17)60344-3

Special Issue: Natural Drug

• Research Article • Previous Articles     Next Articles

Effects of rhubarb (Rheum ribes L.) syrup on dysenteric diarrhea in children: A randomized, double-blind, placebo-controlled trial

Ali Khiveha, Mohammad Hashem Hashempurb, Mehrdad Shakibac, Mohammad Hassan Lotfid, Afsaneh Shakerie, SeidKazem Kazemeinia, Zohre Mousavia, Marzie Jabbaria, Mohammad Kamalinejadf, Majid Emtiazya,g   

  1. a Department of Traditional Medicine, Faculty of Iranian Traditional Medicine, Shahid Sadoughi University of Medical Sciences, Ardakan, Yazd 8951737915, Iran 
    b Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa 7461781189, Iran 
    c Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd 8951737915, Iran 
    d Department of Biostatistics and Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd 8951737915, Iran 
    e Department of Traditional Medicine, School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran 3439123900, Iran 
    f Department of Pharmacognosy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran 
    g Research Center of the Iranian Traditional Medicine, Shahid Sadoughi University of Medical Sciences, Yazd 8951737915, Iran
  • Received:2017-02-13 Accepted:2017-04-14 Online:2017-09-15 Published:2017-09-15
  • Contact: Majid Emtiazy; E-mail: Mohammad Kamalinejad; E-mail:


Rheum ribes L. is a plant native to China, Iran, Turkey, India, and a few other countries. Antidiarrheal activity is considered to be one of its important properties according to various systems of traditional medicine. An increasing rate of bacterial resistance to antibiotics has led to treatment failure in some cases of shigellosis in children, and underlines a need for safe, efficient and valid options.


The purpose of this study is to evaluate the efficacy of R. ribes syrup as a complementary medicine for treatment of shigellosis in children.

Design, Setting, Participants and Interventions

This randomized, double-blind, placebo-controlled trial started with a group of 150 children aged between 12-72 months with suspected Shigella dysentery. R. ribes syrup or placebo syrup was administered to the intervention and control groups, respectively for 5 days. In addition, the standard antibiotic treatment (ceftriaxone for the first 3 days and cefixime syrup for 2 further days) was administered to both groups.

Main Outcome Measures

Body temperature, abdominal pain, need for antipyretics, defecation frequency, stool volume and consistency and microscopic stool examination were recorded as outcome measures. Any observed adverse effects were also recorded.


Mean duration of fever and diarrhea in the R. ribes group was significantly lower than that in the placebo group (P = 0.016 and 0.001, respectively). In addition, patients in the R. ribes group showed shorter duration of need for antipyretics and shorter duration of abdominal pain (P = 0.012 and 0.001, respectively). However, there were no significant differences between the two groups regarding the microscopic stool analyses. Furthermore, no adverse effect was reported.


R. ribes syrup can be recommended as a complementary treatment for children with Shigella dysentery.

Trial Registration

Iranian Registry of Clinical Trial: IRCT2014070518356N1.

Key words: Traditional Persian medicine, Herbal medicine, Rheum ribes L, Rhubarb, Dysentery, Shigellosis, Diarrhea

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