ResearchArticle
Clinical Pilot Study of Rectal Suppository Containing Combined
Extract of Cissus quadrangularis Linn. and Acmella paniculata
(Wall ex. DC.) R. K. Jansen in Acute Hemorrhoids
Kanokporn Niwatananun,
1
Wirat Niwatananun,
1
Sirivipa Piyamongkol,
2
Darunee Hongwiset,
2
Chidchanok Ruengorn,
1,3
Kiatkriangkrai Koyratkoson,
1
Panee Sirisa-ard,
2
Sunee Chansakaow,
2
Songwut Yotsawimonwat,
2
Chalermpong Saenjum ,
2,4
Ampai Phrutivorapongkul,
2
and Suporn Charumanee
2
1
DepartmentofPharmaceuticalCare,FacultyofPharmacy,ChiangMaiUniversity,ChiangMai50200,ailand
2
DepartmentofPharmaceuticalSciences,FacultyofPharmacy,ChiangMaiUniversity,ChiangMai50200,ailand
3
PharmacoepidemiologyandStatisticsResearchCenter(PESRC),FacultyofPharmacy,ChiangMaiUniversity,
ChiangMai50200,ailand
4
ClusterofExcellenceonBiodiversity-basedEconomicsandSociety(B.BES-CMU),ChiangMaiUniversity,
ChiangMai50200,ailand
CorrespondenceshouldbeaddressedtoSupornCharumanee;chsuporn@gmail.com
Received 18 June 2021; Accepted 9 October 2021; Published 2 November 2021
AcademicEditor:GioacchinoCalapai
Copyright © 2021 Kanokporn Niwatananun et al. is is an open access article distributed under the Creative Commons
AttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkis
properly cited.
Background. Cissusquadrangularis Linn.(CQ)isamedicinalplantwithgoodevidenceforthetreatmentofhemorrhoids,listedintheai
NationalListofHerbalProductsintheoraldosageform. Acmellapaniculata (Wallex.DC.)R.K.Jansen.(AP)isamedicinalplantwitha
localanestheticeffect. Objective.ToinvestigatethepotentialofrectalsuppositoriescontainingCQandAPextractstoalleviatesymptomsof
hemorrhoidscomparedwiththecommercializedrectalsuppositorycontaininghydrocortisoneandcinchocaine. MaterialsandMethods.
Hemorrhoidoutpatients(n � 105)withdifferentseveritygrades(I,II,orIII)fromeighthospitalsinnorthernailandwereincludedin
thisstudy.Hemorrhoidseveritywasgradedbyproctoscopyassociatedwitheitheranalpainorbleedingrelatedtohemorrhoidsorboth.
epatientswererandomlyallocatedtotwogroups:CQ-APgroup(n � 52)orthecommercializedrectalsuppositorygroup(n � 53).One
suppositorywasrectallyadministeredtwicedailyinthemorningandatbedtimeforsevendays.Evaluationswereperformedbyphysicians
on days 1, 4, and 8 of the study. e primary endpoints were bleeding and prolapse size, while the secondary endpoint was anal pain.
Results. Baseline demographics, lifestyle, constipation, number of prolapses, grade of hemorrhoid severity, and duration of experiencing
hemorrhoidswerecomparableinbothgroupsofpatients.eeffectsofCQ-APandthecommercializedrectalsuppositoryonbleeding,
prolapse size, and anal pain were comparable. e patients in both groups were satisfied with both products at comparable levels and
stated a preference for further use in the case of hemorrhoids recurrence. In terms of safety, the patients in the commercialized rectal
suppository group experienced a higher incidence of adverse events, including anal pain and bleeding. Conclusion. Rectal suppositories
containing a combined extract of CQ and AP show potential in alleviating hemorrhoidal symptoms with a good safety profile.
1. Introduction
Hemorrhoid is an anorectal disease caused by venous di-
latationintherectumandanus.Clinicalmanifestationsof
hemorrhoids commonly found in the early phase include
bleeding during or after defecation. Pain, itching, and/or
prolapse in the anus can sometimes be found [1]. e
prevalenceofhemorrhoidsinvestigatedinthemonksliving
inBangkokwas4%[2].InSouthKorea,14.4%oftheadult
population suffers from hemorrhoids-related symptoms
Hindawi
Evidence-Based Complementary and Alternative Medicine
Volume 2021, Article ID 5605323, 6 pages
https://doi.org/10.1155/2021/5605323