Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-10T16:59:39.751Z Has data issue: false hasContentIssue false

Herbal medicine: the science of the art

Published online by Cambridge University Press:  07 March 2007

Ann F. Walker*
Affiliation:
Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, University of Reading, Reading RG6 6AP, UK
*
Corresponding author: Dr Ann Walker, fax +44 118 966 6930; e-mail a.f.walker@reading.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

In the last 50 years science has provided new perspectives on the ancient art of herbal medicine. The present article discusses ways in which the evidence base for the professional use of 'Western' herbal medicine, as therapy to treat disease, known as phytotherapy, can be strengthened and developed. The evidence base for phytotherapy is small and lags behind that for the nutritional sciences, mainly because phytochemicals are ingested as complex mixtures that are incompletely characterised and have only relatively recently been subject to scientific scrutiny. While some methodologies developed for the nutritional sciences can inform phytotherapy research, opportunities for observational studies are more limited, although greater use could be made of patient case notes. Randomised clinical trials of single-herb interventions are relatively easy to undertake and increasing numbers of such studies are being published. Indeed, enough data are available on three herbs (ginkgo (Ginkgo biloba), St John's wort (Hypericum perforatum) and saw palmetto (Serenoa repens)) for meta-analyses to have been undertaken. However, phytotherapy is holistic therapy, using lifestyle advice, nutrition and individually-prescribed mixtures of herbs aimed at reinstating homeostasis. While clinical experience shows that this approach is applicable to a wide range of conditions, including chronic disease, evidence of its efficacy is scarce. Strategies for investigating the full holistic approach of phytotherapy and its main elements are discussed and illustrated through the author's studies at the University of Reading.

Type
Plenary Lecture
Copyright
Copyright © The Nutrition Society 2006

References

Bellamy, N Buchanan, WW Goldsmith, CH, Campbell, J Stitt, LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Journal of Rheumatology 15 18331840.Google ScholarPubMed
Bensoussan, A Talley, NJ Hing, M Menzies, R, Guo, A Ngu, M (1998) Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. Journal of the American Medical Association 280 15851589.CrossRefGoogle ScholarPubMed
Birks, J, Grimley, EV & Van Dongen, M (2002) Ginkgo Biloba for Cognitive Impairment and Dementia. The Cochrane Database of Systematic Reviews 2002, issue 4, art. no. CD003120. Chichester, West Sussex: John Wiley & Sons Ltd.Google Scholar
Bone, K (2003) A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient. Edinburgh: Churchill Livingstone.Google Scholar
Boyle, P Robertson, C Lowe, F & Roehrborn, C (2004) Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. British Journal of Urology International 93 751756.CrossRefGoogle ScholarPubMed
Drossman, DA, Richter, JE, Talley, NJ, Thompson, WG, Corazziari, E & Whitehead, WE (editors) (1994) The Functional Gastrointestinal Disorders: Diagnosis, Pathophysiology, and Treatment – A Multinational Consensus. Boston, MA: Little, Brown & Co.Google Scholar
European Commission (2004) Directive 2004/24/EC of the European Parliament and of the Council of 31 March 2004, amending, as regards traditional herbal medicinal products, Directive 2001/83/EC on the Community code relating to medicinal products for human use. Official Journal of the European Union L136 8590.Google Scholar
European Scientific Cooperative on Phytotherapy (2003) Monographs: The Scientific Foundation for Herbal Medicinal Products, 2nd ed. New York: Thieme.Google Scholar
Fukuda, K Straus, SE Hickie, I Sharpe, MC Dobbins, JG, Komaroff, A (1994) The chronic fatigue syndrome: a comprehensive approach to its definition and study. Annals of Internal Medicine 121 953959.CrossRefGoogle ScholarPubMed
Griggs, B (1997) New Green Pharmacy: Story of Western Herbal Medicine. London: Vermilion.Google Scholar
Jouad, H Lemhadri, A Maghrani, M, Burcelin, R Eddouks, M (2003) Hawthorn evokes a potent anti-hyperglycemic capacity in streptozotocin-induced diabetic rats. Journal of Herbal Pharmacotherapy 3 1929.CrossRefGoogle ScholarPubMed
Kasper, S Dienel, A (2002) Cluster analysis of symptoms during antidepressant treatment with Hypericum extract in mildly to moderately depressed out-patients. A meta-analysis of data from three randomized, placebo-controlled trials Psychopharmacology 164 301308.Google ScholarPubMed
Linde, K Berner, M Egger, M, Mulrow, C (2005) St John's wort for depression: meta-analysis of randomised controlled trials British Journal of Psychiatry 186 99107.CrossRefGoogle ScholarPubMed
Mills, S & Bone, K (2000) Principles and Practice of Phytother-apy. Edinburgh: Churchill Livingstone.Google Scholar
Nicolaou, N Johnston, GA (2004) The use of complementary medicine by patients referred to a contact dermatitis clinic Contact Dermatitis 51 3033.CrossRefGoogle ScholarPubMed
Paterson, C (1996) Measuring outcomes in primary care: a patient generated measure, MYMOP, compared with the SF-36 health survey British Medical Journal 312 10161020.CrossRefGoogle ScholarPubMed
Rigelsky, JM Sweet, BV (2002) Hawthorn: pharmacology and therapeutic uses American Journal of Health-System Pharmacy 59 417422.CrossRefGoogle ScholarPubMed
Sacks, FM Appel, LJ Moore, TJ, Obarzanek, E Vollmer, WM Svetkey, LP et al. (1999) A dietary approach to prevent hypertension: a review of the Dietary Approaches to Stop Hypertension (DASH) Study Clinical Cardiology 22 Suppl. 1116–1110.CrossRefGoogle ScholarPubMed
Tankanow, R Tamer, HR Streetman, DS, Smith, SG Welton, JL, Annesley, T Aaronson, KD Bleske, BE (2003) Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). Journal of Clinical Pharmacology 43 637642.Google Scholar
Tubach, F Ravaud, P Baron, G, Falissard, B Logeart, I, Bellamy, N Bombardier, C, Felson, D Hochberg, M, van der Heijde, D Dougados, M (2005) Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: the minimal clinically important improvement Annals of Rheumatic Diseases 64 2933.CrossRefGoogle ScholarPubMed
UK Parliament (1977) The Medicines Act 1968. Order 1977. Statutory Instrument 1977 No. 2128 (C. 71). London: H. M. Stationery Office.Google Scholar
Walker, AF Marakis, G Morris, AP Robinson, PA (2002) Promising hypotensive effect of hawthorn extract: a randomized double-blind pilot study of mild, essential hypertension Phytotherapy Research 16 4854.CrossRefGoogle ScholarPubMed
Walker, AF, Marakis, G, Simpson, E, Hope, JL, Robinson, PA, Hassanein, M & Simpson, HCR (2006) Hypotensive effects of hawthorn for diabetic subjects taking prescription drugs: a RCT. British Journal of General Practice (In the Press).Google Scholar
Williamson, EM (2001) Synergy and other interactions in phytomedicines Phytomedicine 8 401409.CrossRefGoogle ScholarPubMed
Williamson, EM (2003) Potter's Herbal Cyclopaedia. Saffron Walden, Essex: C W Daniel Co Ltd.Google Scholar
Wilt, T, Ishani, A, MacDonald, R, Stark, G, Mulrow, C & Lau, J (2000) Beta-Sitosterols for Benign Prostatic Hyperplasia. Cochrane Database of Systematic Reviews 1999, issue 3, art. no. CD001043. Chichester, West Sussex: John Wiley & Sons Ltd.Google Scholar