The role and efficacy of medical herbal therapy preparations

The core value of medical herbal therapy preparations is to purify active polysaccharides, flavonoids, alkaloids and other effective components in herbal plants, and play a role in four clinical scenarios: anti-infection, anti-inflammatory soothing, tissue repair, and metabolic regulation. Compared with traditional chemical drugs, it has the advantages of lower toxic and side effects and multi-target synergy. However, there is still a big controversy in the academic community about the standardization of its mechanism of action and the level of evidence-based evidence.

I was rotating in the dermatology clinic in the past two years and met an aunt who had suffered from chronic eczema for 6 years. The red rash on her calves came back again and again. After using hormone ointments for several years, the skin in the affected area shrank and became thinner. Once the medication was stopped, the eruptions became more severe. Later, she was prescribed a Class II medical device herbal gel containing purslane and flavescens extracts, which was used intermittently with weak hormones. A follow-up check after three weeks showed that 80% of the rash had disappeared. The recurrence rate during the six-month follow-up was 32% lower than the previous use of hormones alone.

Don’t think this is an isolated case. Many departments are now trying this kind of preparations, but the controversy has indeed never stopped. Many researchers in the clinical system of Western medicine have always had reservations. The core reason is that the quantification standards for the active ingredients of most herbal preparations are not uniform. For the same astragalus extract, the content of astragalus polysaccharide can vary by more than 2 times in different origins and extraction processes. The clinical effects fluctuate greatly. Most of the existing clinical data are small sample single-center trials, which are not as solid as the large sample multi-center evidence-based evidence of chemical drugs. Researchers in the field of traditional Chinese medicine believe that it is unreasonable to use single-component content standards for compound herbal preparations: for example, the commonly used compound herbal oils containing turmeric, Phellodendron, and Sanguisorba have the triple effects of antibacterial, eliminating edema, and promoting mucosal healing. Compared with the combined use of antibiotics, anti-swelling drugs, and mucosal protective agents, the metabolic burden on the liver and kidneys is reduced by nearly 40% in treating intestinal mucosal damage in patients with radiation enteritis. The advantages of multi-target synergy are difficult to compare with single-target chemical drugs.

Take the most commonly used anti-infection function as an example. In the summer, endocrinology departments often encounter wound ulcers caused by diabetic patients wearing their feet. Many times, after a round of conventional antibiotics, Pseudomonas aeruginosa and Staphylococcus aureus have become resistant, and the wound pus will not heal for half a month. Using honeysuckle and dandelion extracts as a wet compress can reduce the load of pathogenic bacteria on the wound by more than 90% in about a week. It’s not that herbal medicine kills bacteria more powerfully than antibiotics, but its active ingredients work by destroying the cell membrane of pathogenic bacteria and inhibiting protein synthesis. It basically does not induce drug resistance. In the past two years, many ICUs have even tried to use herbal preparations combined with antibiotics to deal with multi-drug-resistant bacteria, and a lot of positive data have been released.

There are also anti-inflammatory and soothing scenarios. Many children with allergies suffer from atopic dermatitis. Parents are afraid that using hormones will affect their children's development. Apply herbal cream containing chamomile and calendula extracts. Most of the itching can be relieved in two or three days, and there is no risk of hormone dependence. Oh, by the way, there is also postpartum episiotomy care. Nowadays, many obstetrics and gynecology hospitals will prescribe herbal ointments containing comfrey and angelica, which heal about 2 days faster than conventional iodine care. It can also reduce scar hyperplasia and does not affect breastfeeding.

But there are many pitfalls. Last year, I treated a patient with contact dermatitis. I bought an eczema ointment online that was claimed to be "pure herbal and hormone-free". After using it for three days, my face became red, swollen and hot. It was only after I submitted it for testing that I found out that it contained powerful hormones that were illegally added. There are also many people who are allergic to herbal ingredients such as mugwort and nepeta, and casual use of herbal preparations without allergen warnings will aggravate the symptoms. This is also another core point of controversy in the industry today: many unscrupulous businesses collect IQ taxes under the banner of "herbal medicine", but instead ruin the reputation of regular medical herbal preparations.

In the final analysis, medical herbal preparations are neither a magic medicine that can cure all diseases, nor are they the ineffective IQ tax that some people talk about. They are essentially the product of a combination of traditional herbal medicine experience and modern pharmaceutical extraction technology. Choosing compliant products and using them in appropriate scenarios can indeed solve many problems that chemical medicines cannot solve. If the quantitative standards for active ingredients and large-scale evidence-based evidence can be completed in the future, it may be able to play a greater role in the fields of chronic disease management and postoperative rehabilitation.