Validating herbal medicines

The double-blind, placebo-controlled clinical trial is regarded as the gold standard for medicinal research, enabling unbiased statistical analysis of the safety and efficacy of medicines. As more and more herbs are subjected to clinical trials and proven to have therapeutic benefit, their credibility in the medical world increases, and doctors become more open to the idea of prescribing them for their

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patients. Of course, clinical trials sometimes produce negative results, bringing the use of particular remedies into question.

Using clinical trials to verify herbal therapeutics provides researchers and clinicians alike with a great deal of valuable information, but there are some unique challenges involved in testing herbal medicines in this way.

The first hurdle to be overcome is that all the patients in the study should take exactly the same medicine; however, as they are natural substances, herbs can contain chemical variations from batch to batch.

Thus, the herbal products used in many studies are standardized, and we now possess a significant body of evidence supporting the use of standardized herbal products (commonly single herbs dispensed as tablets or capsules), but far less evidence of the effectiveness of more traditional preparations, such as homemade infusions and decoctions and compound medicines made up of several herbs.

The processes involved in creating standardized herbal products provide companies with a level of ownership of the research results, giving them more leeway to recoup their investment funds by claiming that their specific product has been clinically proven, while other non-standardized products have not.

These issues have major implications for the way herbal medicine is practiced in the future, and have already strongly influenced the prescribing habits of many doctors and herbalists, who prefer

Qing hao - changing iho future of malaria

The story of qing hao (Artemisia annua), or Chinese wormwood, provides a snapshot of ihe way medicines derived from herbs may have a dramatic Impact on the future or healthcare. In the 1970s. Chinese researchers seeking herbal remedies against malaria rediscovered its potential. Subsequent research revealed that the active constituent artemesinin is extremely effective against Ihe malaria parasite, which is spread from person to person by mosquitoes, killing millions every year.

Today, malaria treatment has been revolutionised by artemesinin-based combination therapy (ACT), which pairs artemesinin derivatives with pharmaceutical agents into a single drug. As ACT safely treats malaria in just three days. WHO has endorsed it as the preferred approach for malaria treatment: thus far. it has saved millions of lives around the world. However, it is expensive, costing as much as 1 5 times more than Ihe previous generation of anti-malarial drugs.

But economically, ariemesinin has also proved revolutionary. In 2003. the medical charity Médecins Sans Frontières teamed wilh research Institutes from Africa. Asia. F,urope and South America U> form the Drugs for Neglected Diseases Initiative, known as DNDi.

To date, this collaboration has developed two forms of ACT that are now in use in Asia. Africa and Soulh and Central America, where, as the world's first patent-free medicines, they are changing not only the health outlook of communities affected by malaria, but also their economic prognosis.



A Chinese farmer carries stalks of qing hao, which contains the constituent artemisinin.

A Chinese farmer carries stalks of qing hao, which contains the constituent artemisinin.

to focus on prescribing standardized remedies that have been clinically trialed.

It's also worth pointing out that the economics of scientific research are such that the herbs most likely to be investigated and "proven" to be effective are those for which there is the largest potential market. We therefore have a good understanding of the way the most popular herbs work, and the roles that herbs can play in extremely common conditions, such as arthritis and heart disease. However, this focus on financially lucrative remedies may mean that our knowledge of more obscure herbs, and the herbal methods for treating less prevalent conditions, could languish in the future.

Continue reading here: Using herbs safely

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