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Synergistic Effects of Chinese Herbal Medicine: A Comprehensive Review of Methodology and Current Research.

Zhou X, Seto SW, Chang D, Kiat H, Razmovski-Naumovski V, Chan K, Bensoussan A - Front Pharmacol (2016)

Bottom Line: However, evidence to support these synergistic effects remains weak and controversial due to several reasons, including the very complex nature of CHM, misconceptions about synergy and methodological challenges to study design.Despite the availability of some scientific data to support the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low, and the clinical relevancy of most of these findings is undetermined.There remain significant challenges in the development of suitable methods for synergistic studies of complex herbal combinations.

View Article: PubMed Central - PubMed

Affiliation: School of Science and Health, National Institute of Complementary Medicine, Western Sydney University Penrith, NSW, Australia.

ABSTRACT
Traditional Chinese medicine (TCM) is an important part of primary health care in Asian countries that has utilized complex herbal formulations (consisting 2 or more medicinal herbs) for treating diseases over thousands of years. There seems to be a general assumption that the synergistic therapeutic effects of Chinese herbal medicine (CHM) derive from the complex interactions between the multiple bioactive components within the herbs and/or herbal formulations. However, evidence to support these synergistic effects remains weak and controversial due to several reasons, including the very complex nature of CHM, misconceptions about synergy and methodological challenges to study design. In this review, we clarify the definition of synergy, identify common errors in synergy research and describe current methodological approaches to test for synergistic interaction. We discuss the strengths and weaknesses of these models in the context of CHM and summarize the current status of synergy research in CHM. Despite the availability of some scientific data to support the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low, and the clinical relevancy of most of these findings is undetermined. There remain significant challenges in the development of suitable methods for synergistic studies of complex herbal combinations.

No MeSH data available.


Related in: MedlinePlus

Histogram showing the general increase in synergy of Chinese herbal medicine related publications in the years 1999–2015 (up to June only for 2015) from a bibliographic search in PubMed and Google Scholar database carried out in June 2015.
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Figure 3: Histogram showing the general increase in synergy of Chinese herbal medicine related publications in the years 1999–2015 (up to June only for 2015) from a bibliographic search in PubMed and Google Scholar database carried out in June 2015.

Mentions: In contrast to western style combined drug therapies where chemical properties and pharmacological effects of individual compounds are well-defined, Chinese herbal formulations are constructed according to TCM theories (“Peiwu” and “Jun-Chen-Zuo-Shi”). Despite the long history of clinical use and a solid theoretical basis, the multi-component and multi-target nature of CHM poses a huge challenge to the study of the mechanisms of action, including synergistic effects underpinning the complex herbal formulations (Wang et al., 2009). With the advance in mathematic modeling (e.g., CI, isobologram) and computer technology (e.g., systems biology analysis), there has been a growing number of systemic and mechanistic studies over the past two decades aiming to provide better scientific evidence and understanding of synergistic effects of Chinese herbal formulation. In this study, we conducted a thorough literature search (keywords used: “Synergism” or “Synergy” or “Synergistic” and “Chinese herbal medicine” or “Chinese medicinal herbs”) in PubMed and Google scholar from the period of 1990 to 2015. The numbers of studies using proper synergy models are shown in Figure 3. Key studies identified are summarized in Table 2.


Synergistic Effects of Chinese Herbal Medicine: A Comprehensive Review of Methodology and Current Research.

Zhou X, Seto SW, Chang D, Kiat H, Razmovski-Naumovski V, Chan K, Bensoussan A - Front Pharmacol (2016)

Histogram showing the general increase in synergy of Chinese herbal medicine related publications in the years 1999–2015 (up to June only for 2015) from a bibliographic search in PubMed and Google Scholar database carried out in June 2015.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940614&req=5

Figure 3: Histogram showing the general increase in synergy of Chinese herbal medicine related publications in the years 1999–2015 (up to June only for 2015) from a bibliographic search in PubMed and Google Scholar database carried out in June 2015.
Mentions: In contrast to western style combined drug therapies where chemical properties and pharmacological effects of individual compounds are well-defined, Chinese herbal formulations are constructed according to TCM theories (“Peiwu” and “Jun-Chen-Zuo-Shi”). Despite the long history of clinical use and a solid theoretical basis, the multi-component and multi-target nature of CHM poses a huge challenge to the study of the mechanisms of action, including synergistic effects underpinning the complex herbal formulations (Wang et al., 2009). With the advance in mathematic modeling (e.g., CI, isobologram) and computer technology (e.g., systems biology analysis), there has been a growing number of systemic and mechanistic studies over the past two decades aiming to provide better scientific evidence and understanding of synergistic effects of Chinese herbal formulation. In this study, we conducted a thorough literature search (keywords used: “Synergism” or “Synergy” or “Synergistic” and “Chinese herbal medicine” or “Chinese medicinal herbs”) in PubMed and Google scholar from the period of 1990 to 2015. The numbers of studies using proper synergy models are shown in Figure 3. Key studies identified are summarized in Table 2.

Bottom Line: However, evidence to support these synergistic effects remains weak and controversial due to several reasons, including the very complex nature of CHM, misconceptions about synergy and methodological challenges to study design.Despite the availability of some scientific data to support the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low, and the clinical relevancy of most of these findings is undetermined.There remain significant challenges in the development of suitable methods for synergistic studies of complex herbal combinations.

View Article: PubMed Central - PubMed

Affiliation: School of Science and Health, National Institute of Complementary Medicine, Western Sydney University Penrith, NSW, Australia.

ABSTRACT
Traditional Chinese medicine (TCM) is an important part of primary health care in Asian countries that has utilized complex herbal formulations (consisting 2 or more medicinal herbs) for treating diseases over thousands of years. There seems to be a general assumption that the synergistic therapeutic effects of Chinese herbal medicine (CHM) derive from the complex interactions between the multiple bioactive components within the herbs and/or herbal formulations. However, evidence to support these synergistic effects remains weak and controversial due to several reasons, including the very complex nature of CHM, misconceptions about synergy and methodological challenges to study design. In this review, we clarify the definition of synergy, identify common errors in synergy research and describe current methodological approaches to test for synergistic interaction. We discuss the strengths and weaknesses of these models in the context of CHM and summarize the current status of synergy research in CHM. Despite the availability of some scientific data to support the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low, and the clinical relevancy of most of these findings is undetermined. There remain significant challenges in the development of suitable methods for synergistic studies of complex herbal combinations.

No MeSH data available.


Related in: MedlinePlus