The role of medical herbal therapeutic preparations

The core role of medical herbal therapy preparations is to rely on natural plant active ingredients that have been approved by the Food and Drug Administration and have clear evidence-based medical evidence. As an effective supplement to chemical drugs and biological agents, they play a unique value in four scenarios: auxiliary treatment of diseases, long-term management and control of chronic diseases, reduction of treatment-related adverse reactions, and full-cycle recovery. They can neither replace conventional treatment options, nor are they an "IQ tax" placebo.

This is not what I thought while sitting in the laboratory patting my head. Xiaoyu, a 12-year-old child with atopic dermatitis who just completed a follow-up visit at the dermatology department last month, is the most direct example. He used a medium-effect glucocorticoid ointment for 3 months. The skin lesions on his elbows disappeared but the local skin showed mild atrophy. His parents refused to take hormones anymore. We changed him to an approved medical gel containing active extracts of purslane and artemisia annua. We applied it in the morning and evening together with low-dose tacrolimus. In two months, the recurrence rate of skin lesions dropped by 62%, and the thinned skin barrier gradually recovered.

But if you throw this case into our hospital's interdisciplinary discussion group, it's guaranteed to be a quarrel for half an hour. Zhang Bo, who works in natural medicinal chemistry, was the first to jump out and say that the active components of this type of herbal preparation are too complex. Currently, we only know that the polysaccharides in purslane can fight inflammation and artemisinin can suppress immune hyperactivity. However, it is not yet clear whether the remaining dozens of components have potential sensitization and whether long-term use will burden the liver and kidney metabolism. The evidence-based level is at best Level 2B and cannot be promoted as a routine plan. Director Li of the Department of Traditional Chinese Medicine was dissatisfied on the spot, saying that this type of formula has been used clinically for thousands of years, and the effectiveness rate in the 300 controlled experiments we have done can reach 78%. It is better than letting the child wait for recurrence, and there is no need to focus on the action path of a single component. In fact, there is nothing wrong with what both sides say. Originally, the application boundaries of medical herbal preparations are still being explored, so there is no need to argue about right and wrong.

It is not only used in dermatology, but also in respiratory departments. Elderly people with COPD in winter and spring are most afraid of cold attacks, so they need antibiotics and hormones for each attack. Last year, their department added approved medical aerosol preparations containing astragalus and root extract to 60 elderly people with COPD in the stable stage, once a day. After six months of follow-up, the number of acute attacks was reduced by an average of 2.3 times, and the length of hospitalization was shortened by 3 days. My own father suffers from chronic obstructive pulmonary disease. He also took it last winter. He didn’t go to the hospital all winter. He had to be hospitalized at least twice a year before. Even he thought it was amazing.

Oh, by the way, there is a misunderstanding that needs to be clarified. Not all preparations with the word "herbal" in them are considered medical. Last month, I received a girl in her 20s from the emergency department. She bought an anti-acne cream online that was claimed to be "pure herbal and hormone-free." After using it for half a month, her face was swollen like a pig's head. The glucocorticoid content in it was measured to be dozens of times higher than the standard. That kind of Sanwu product that doesn't even have a mechanical brand name is not considered a medical herbal preparation at all. Don’t think that herbal medicine is safe. Substandard products are more deceptive than regular chemical medicines.

The Department of Gastroenterology has recently been conducting related controlled experiments on gastric mucosal repair after eradication of Helicobacter pylori. Nowadays, many people still have acid reflux and gastric bloating after sterilization, and they do not feel better after taking proton pump inhibitors for a long time. They added a compound preparation of medical Hericium polysaccharide and dandelion extract to half of the subjects, and took it for 8 weeks. During the reexamination, the rate of gastric mucosal inflammation subsided was 17% higher than that of those who simply used gastric mucosal protectants. My mother suffered from acid reflux after killing Helicobacter pylori last year. She took omeprazole for two months and it still hurts when she ate it cold. I prescribed this preparation for her and she was fine after taking it for three weeks. Now she has no reaction to ice watermelon.

There are also uses in the rehabilitation department that I had never thought of before. Patients with postoperative lymphedema usually rely on elastic stockings and air pressure pumps to physically reduce the swelling. Some severe cases disappear very slowly. Now they use medical ointments containing aescin and turmeric extracts for external application and massage. The swelling is reduced by nearly 30% faster than using physical methods alone. Many patients have reported that the swelling and pain are particularly relieved.

After all, the role of medical herbal preparations is actually not that mysterious, it is to fill the gaps in existing treatment plans. If you expect it to cure cancer and replace antihypertensive and hypoglycemic drugs, you are definitely being deceived. However, if used symptomatically under the guidance of a doctor, it can indeed solve many minor problems that cannot be solved with conventional solutions. After all, medicine is only as effective as it is. There is no need to hold a black and white view, right?