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Challenges and Future Directions of Herbal Medicine Research

An overview of selected pieces in the current literature concerning herbal research and development.

Although approximately 80 percent of people today depend upon herbal medication as a component of their primary healthcare according to the World Health Organization, there is still great concern about the safety and efficacy of herbal use [1]. While herbal medicine can potentially contribute to the advancement of healthcare, many major challenges must be overcome prior to the successful integration of herbal remedies into mainstream medicine. One of the major barriers is the current lack of accurate translations and interpretations of Chinese herbal texts and research by Western scientists. Indeed, for the incorporation of safe and effective herbs into the medical system to become a reality, more researchers and doctors need to be trained in both modern medicine and herbal compendium that has been accumulated since ancient times. Additionally, to establish credibility for herbal use in the modern settings, experience-based claims from Chinese herbal medical doctors must be transformed into evidence-based claims. Finally, the question of how to address the need for both individualizing (the basis of TCM) and standardizing (the basis of modern pharmacology) treatment with herbs must be settled. Once these issues are resolved, the prospect exists for widespread use of herbal medicine as a safe, effective, and affordable form of healthcare [2].

The following articles provides an overview of selected pieces in the current literature concerning herbal research and development:

 

Herbal Medicine Today: Clinical and Research Issues

Evidence-based Complementary and Alternative Medicine

This 2007 article from Evidence-based Complementary and Alternative Medicine provides the history behind herbal medicine and the current challenges with the use of herbal remedies. The paper also provides a side-by-side comparison between the traditional use and scientific use of herbs, a list of factors that are essential in determining the efficacy and effectiveness of herbal treatments, an overview of pragmatic trials (PT) in traditional medicine, and a look into the future directions of herbal research, including high-throughput analysis combining genomic, proteomic and chemical data.

 

Herbal Medicine in the United States: Review of Efficacy, Safety, and Regulation

Journal of General Internal Medicine

This 2008 review article from the Ground Rounds at the University of California, San Francisco Medical Center provides an introduction to herbs, an overview of their regulation in the United States through the Dietary Supplement Health and Education Act (DSHEA), and the evidence for efficacy of commonly used herbs. Additionally, the paper includes a discussion of the concerns of safety, toxicity, and side effects associated with herbal medicine and the future changes that experts have proposed to increase the safety and efficacy of herbal medicine use.

 

Herbal Medicine Research and Global Health: An Ethical Analysis

Bulletin of the World Health Organization

Although governments, international agencies, and corporations are increasingly investing in herbal medicine research, numerous challenges remain unaddressed in this field. In this 2008 publication, the World Health Organization examines the “underappreciated dimensions of the ethical framework in which particularly difficult questions arise for international herbal medicine research: social value, scientific validity and favorable risk-benefit ratio.”

 

Research Methodological Issues in Evaluating Herbal Interventions

Dove Press Journal: Open Access Journal of Clinical Trials

While randomized control trials (RTCs) are considered the “gold standard” of allopathic research, RTCs are not the appropriate methodology for herbal research. This 2010 Dove Press Journal review article explains why and describes some possible research designs to overcome these challenges.

 

New Perspective on Chinese Herbal Medicine (Zhong-Yao) Research and Development

Evidence-based Complementary and Alternative Medicine

This 2011 review article published in Evidence-based Complementary and Alternative Medicine provides the approaches to research and drug discovery in Chinese herbal medicine and highlights key points of discussion, including the fact that “an herbal remedy cannot be substituted by a single compound.”

 

Perspective: The Clinical Trial Barriers

Nature: Outlook

In this 2011 perspectives article, medical treatments are illustrated as both an art and a science and emphasis is placed upon the need for more appropriate methods to test traditional Asian medicines. The necessity for incorporating personalized medicine into randomized controlled clinical trials to demonstrate the safety and efficacy of traditional treatments is the central message of this outlook.

 

Omic Techniques in Systems Biology Approaches to Traditional Chinese Medicine Research: Present and Future

Journal of Ethnopharmacology

While there are many challenges associated with the successful integration of Traditional Chinese Medicine (TCM) into Western medical practices, the advent of omic techniques in systems biology provides a promising route for the modernization and standardization of TCM research while maintaining the holistic and personalized qualities of TCM. Because Chinese herbal remedies are often complex mixtures of numerous phytocomplexes, it had previous been difficult to analyze the role different molecules played in the overall effect. Now, with high-throughput information-rich techniques, tools are available to generate a large amount of raw information and use factorial analytical models to generate a global view of the biological system. These methods are particularly appropriate for TCM research because they are non-reductive (allowing researchers to analyze multiple components at once rather than studying a single compound in isolation) and holistic (consistent with the foundational principles of TCM).

References

  1. Herbal Medicine. University of Maryland Medical Center.
    Available:
    http://www.umm.edu/altmed/articles/herbal-medicine-000351.htm#ixzz1i9ZzqMkX
  2. Cheng YC. Why and how to globalize Traditional Chinese Medicine. Journal of Traditional Chinese Medicine 2011; 1(1): 1-4. doi:10.6219/jtcm.2011.008-P  http://www.jtcm.org/jtcm_n/manager_admin/upload_file/81/13179623781.pdf

By Shannon Wongvibulsin, BS Candidate, UCLA 2014
UCLA Center East-West Medicine, Staff Writer


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