The Role of Syndrome Differentiation in the Clinical Efficacy of Punica granatum on Patients with Ulcerative Colitis

Background Tendency of patients toward diseases and their therapeutic responses are different based on their own temperament according to traditional Persian medicine. Objectives The aim of this study is to investigate the difference between therapeutic responses of hot and cold temperament patients (based on traditional Persian medicine) with ulcerative colitis to pomegranate peel extract. Methods Seventy-eight patients with moderate ulcerative colitis based on the Lichtiger colitis activity index (LCAI) criteria were randomized to receive an aqueous extract of the Punica granatum peel (6 grams per day) or placebo for four weeks. They were assessed before and after the intervention, in terms of symptoms, by the LCAI scoring system. The results were compared in two therapeutic groups based on the patients’ temperament (cold and hot), which were diagnosed based on a previous validated questionnaire. Results Therapeutic response was significantly higher in patients with hot temperament compared to patients with cold temperament in the P. granatum group (1.916 ± 0.492 versus -0.500 ± 0.500, P = 0.029). Conclusions This study showed the importance of considering syndrome differentiation and temperaments in interpreting the effect of P. granatum peels extract on ulcerative colitis.