Synergistic Effect of Cumin (Cuminum cyminum L.) Decoction Alongside with Three-drug and Four-drug Treatment Protocols on Helicobacter pylori Eradication

Background: Helicobacter pylori is a major cause of peptic ulcer. On the other hand, cumin (Cuminum cyminum L.) is an effective medicinal plant for the treatment of gastrointestinal disease in traditional Persian medicine. This study aimed at investigating the synergistic effect of the decoction of cumin with the three- and four-drug protocols against H. pylori in patients with peptic ulcer. Patients with peptic ulcer infected with H. pylori were treated with cumin decoction, three- and four-drug protocols, and their co-administration to eradicate H. pylori. 
Materials and Methods: Patients were randomly divided into five groups, including group (1) omeprazole with cumin decoction, (2) cumin decoction with the threeprotocol treatment, (3) cumin decoction with the four-drug protocol treatment, and (4 and 5) three- and four-drug protocols alone. The cumin fruit powder was given to patients in 3-g packages and decoction was prepared according to the traditional Iranian medicine guidelines. H. pylori eradication was measured by the 14C–urea breath test (14C-UBT) after 4 weeks of intervention. The Kolmogorov–Smirnov test, χ2 test, logistic regression, and ANOVA (SPSS, 11.5) were used for data analyses. 
Results: In total, 75 patients (48 male and 27 female patients) participated in this study. The results showed that eradication of H. pylori was observed in all five study groups. Eradication of H. pylori in cumin decoction with the three-drug protocol group was more than the other groups (85.72%), although this difference was not statistically significant. In addition, this eradication was 61.5% in the cumin + omeprazole group, while the H. pylori eradication rates for the three-drug and four-drug protocols were 77.8% and 58.33%, respectively. 
Conclusions: The results showed that decoction of cumin could be used as a complementary treatment alongside conventional medicine therapy to increase the H. pylori eradication.