How medical herbal therapy preparations work

The core principle of action of medical herbal therapy preparations is essentially based on the dual framework of the traditional compatibility logic of traditional Chinese medicine and the verification of modern pharmaceutical active ingredients. Through the synergistic effect of a variety of naturally occurring active ingredients in herbs, the therapeutic effect is achieved through three pathways: interfering with the process of pathogenic factors, regulating the physiological state of the human body, and activating autoimmune repair capabilities. This is essentially different from the single-target logic of chemical drugs.

When I was rotating at the Provincial Traditional Chinese Medicine Preparation Center a few years ago, I followed a master to prepare compound lithospermum oil for mild burns and scalds. When I first came across it, I still thought it was strange: isn’t it just boiled comfrey, angelica root, borneol and sesame oil? How come it heals faster than many external chemical burn ointments and has a lower probability of leaving scars? After testing the ingredients, I found out that the shikonin in it can inhibit the reproduction of Staphylococcus aureus and Pseudomonas aeruginosa in the burn area, the ferulic acid in angelica can improve local microcirculation and reduce tissue fluid leakage, and borneol can not only relieve pain, but also promote the penetration of active ingredients into the subcutaneous tissue through the damaged skin barrier. Together, the three are equivalent to sterilizing and preventing infection while supplying nutrients to damaged skin tissue to promote growth. It can also relieve pain and reduce inflammatory exudation. Naturally, it has a more comprehensive effect than a single antibacterial chemical burn ointment.

Speaking of which, there have been two factions in the industry arguing over the working principles of herbal preparations. Old experts from the traditional school have always believed that the core of herbal preparations is the compatibility logic of "monarchs, ministers, and envoys", and it is impossible to separate a single active ingredient. They often use ephedra soup as an example: using ephedra alone can indeed induce sweating and relieve asthma, but it can easily cause heart palpitations and increase blood pressure. When combined with cinnamon twigs, almonds, and licorice, not only the sweating effect is milder, but the side effects are also greatly reduced. If only ephedrine is extracted, it is no different from chemical drugs, and it is not considered herbal therapy at all. Researchers working on natural medicine believe that the uncertainty of traditional compatibility is too high. For the same honeysuckle, the chlorogenic acid content of Henan and Yunnan products can differ by 2 times. Without standardized extraction and dosage calibration, the efficacy of the drug is fundamentally unstable, and it cannot pass the requirements of international clinical trials. Artemisinin is the most typical example. Only by purifying a single active ingredient from Artemisia annua can precise dosage control be achieved to achieve global anti-malarial applications.

I have been conducting clinical research on herbal preparations for nearly 8 years, and I feel that the views of both schools are actually reasonable, and there is no need to argue about right or wrong. For example, to treat acute diarrhea, use purified berberine hydrochloride (which is what we often call berberine). It has a fast onset of action and is accurate in dosage. It can stop diarrhea in two or three hours after taking it. It is much more convenient than boiling berberine hydrochloride and drinking it; but if you want to deal with chronic atrophic gastritis, a chronic disease caused by multiple factors, It is more suitable to use compound herbal preparations like Morodan. Some of the dozens of herbs in it inhibit Helicobacter pylori, some repair the gastric mucosa, and some regulate the secretion of digestive juices. They act on multiple targets at the same time, and the long-term recurrence rate is much lower than using proton pump inhibitors alone.

Oh, by the way, many people think that herbal preparations are "purely natural and have no side effects." This is really a huge misunderstanding. Medical herbal preparations are processed through strict toxicology tests and processing techniques. For example, aconite must be boiled for a long time to destroy the toxicity of aconitine before it can be used as medicine. If you randomly pick herbs at home and boil them in water to drink, or buy "ancestral secret recipes" without batch numbers, it is easy to cause problems. In the past two years, I encountered a patient who drank raw polygonum multiflorum mixed with medicinal wine and caused liver damage. I must remind everyone of this.

In fact, up to now, the mechanism of action of many herbal preparations has not been fully understood. For example, there are dozens of active ingredients in Compound Danshen Dropping Pills. There is no 100% clear conclusion yet on which ones play the main role and which ones are auxiliary and synergistic. But this does not prevent it from being used clinically for more than 20 years and helping tens of millions of patients with coronary heart disease. In the final analysis, the core logic of herbal therapy is never to "kill all sources of disease", but to help the human body find a healthy balance - just like if there is a mouse in your home, the chemical medicine will directly poison the mouse with rat poison, and may accidentally injure the cat at home. The herbal preparation will help you fill the leaked hole, remove the food residue, and then feed the cat so that it can catch the mouse on its own. Naturally, it is more stable and less likely to relapse.