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Herbal medicine has ancient roots: the first collections of medicinal herbs appeared in China, according to legend, several thousand years ago.
Now some traditional medicine recipes are scientifically confirmed - for example, scientists recently discovered
compounds in ginseng that can inhibit the development of osteoporosis.
In general, oriental traditional medicine is famous throughout the world.
What traditions of herbal medicine are there in Russia?
— Treatment with various medicinal herbs has been practiced in Rus' for many centuries.
In the XII-XVIII centuries, the so-called monastic herbal medicine developed.
At the same time, there was a continuous accumulation and preservation of knowledge about herbalism within the framework of traditional medicine.
In the 18th century, professional educational institutions for doctors began to appear in Russia.
Herbal medicines accounted for the lion's share of medicines, this can be seen in the example of the first Russian national pharmacopoeias - lists of officially recognized medicines and requirements for their quality.
This is no longer folk medicine, but rather official medicine.
For example, in the 19th century, “Russian medicinal herbalist, or Description of domestic medicinal plants” was published, its author was the famous doctor and surgeon Ivan Kashinsky.
The 19th century is the century of the birth of scientific herbal medicine, phytopharmacology, and clinical research into the properties of medicinal plants.
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Around the second half of the 17th century, recipes for traditional medicine, primarily herbal medicine, began to be collected by natural scientists.
Scientists went on expeditions to remote villages across the country and wrote down herbal recipes that had previously been passed down from generation to generation.
Each region, each geographical zone has its own plants, and therefore the traditions of herbal medicine are different.
It has still not been possible to fully accumulate this knowledge, since each village had its own herbalists with their own traditions of treating ailments.
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Please tell us why biologically active substances are so often found in plants?
Is it true that they often serve plants to protect themselves from herbivores?
— Biologically active substances in plants are very diverse and perform a huge number of functions.
In general, all living organisms are characterized by reactions of primary metabolism associated with energy exchange - the synthesis of proteins, fats, carbohydrates, etc.
Secondary metabolism, or synthesis, is characteristic mainly of plants and fungi - these reactions lead to the formation of a number of biologically active compounds.
These are organic acids, glycosides, phenolic compounds, alkaloids, antibiotics and phytoncides, terpenes and terpenoids, essential oils.
In addition, plants are capable of producing hormone-like compounds: phytoestrogens, phytoecdysteroids.
They play an important role in plant physiology, regulating their growth and reproduction, and protection from insects.
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Biologically active substances, in addition to protecting against herbivores, protect plants from adverse environmental factors.
Amazingly, the chemical composition of different parts of plants changes throughout the entire growing season, and various substances accumulate during the period of budding, flowering, and fruiting, which also depends on environmental conditions.
Throughout this time, the plant represents a unique living chemical factory.
There is even a separate scientific field for the study of these processes - comparative phytochemistry.
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their pure form, medicinal plants belong to biologically active additives, and not to drugs.
What place do they find in clinical practice today?
- Medicinal plants are, in essence, raw materials, starting material from which a drug can be produced - crushed herbal collection, extract, individual components.
Of course, there are much more herbal dietary supplements on the market than herbal medicines.
The fact is that dietary supplements are much faster and cheaper to register and bring to market than medications.
In order for a medicine to receive registration, it must undergo serious clinical trials that will prove the effectiveness of the drug.
And for dietary supplements, by and large, the same requirements apply as for food products.
Currently, doctors in Russia do not have the right to prescribe dietary supplements in clinical practice.
In October 2023, a legislative initiative was put forward according to which such a practice could appear, but so far this law has not been adopted.
Allowing doctors to prescribe dietary supplements is proposed to reduce their use as part of self-medication.
Because there are cases when patients with oncology and endocrine diseases try to cure themselves with dietary supplements.
This could end badly.
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As a rule, people without medical education who take herbal medicines without a systematic approach, a deep understanding of the pathogenesis of diseases, are not aware of the possible side effects of such supplements.
Therefore, it would be correct if doctors still prescribe dietary supplements.
At the same time, we are aware that future doctors need to be taught the basics of herbal medicine.
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The other, dangerous side of this phenomenon is when some specialists promise to cure such serious illnesses as cancer, for example, with herbs.
At the same time, dietary supplements often have very aggressive marketing.
What can you say about this phenomenon?
— Such cases and dishonest marketing of dietary supplements, of course, cast a shadow on scientific herbal medicine.
The consumer should not be misled about the real effectiveness of dietary supplements.
As for oncological diseases, the entire medical community has an absolutely clear position: such a patient should be observed by an oncologist and receive treatment in accordance with the diagnosis.
In the case of such serious illnesses, experiments cannot be carried out; cancer is very dangerous and can progress quickly.
Herbal medicine in this case cannot replace chemotherapy, radiation therapy and other methods from the arsenal of oncologists.
Herbal medicines can help reduce intoxication and provide a restorative and stress-protective effect only in addition to the main therapy.
For example, to support the gastrointestinal tract, you can prescribe herbal preparations with anti-inflammatory, regenerating effects or herbal hepatoprotectors to facilitate liver function.
But nothing more than that; under no circumstances should antitumor therapy be replaced with herbs.
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— In what cases can herbal medicine act independently, and not as an addition to the main treatment?
— The main purpose of herbal medicine is primary and secondary prevention, as well as rehabilitation.
Primary prevention is aimed at preventing diseases in the presence of risk factors - for example, genetic condition, in unfavorable climatic conditions.
Secondary prevention is used already in the presence of a chronic disease in order to prevent its relapse.
It complements therapy and is designed to improve the condition of the patient’s organs and systems.
For example, herbal medicine can help recover after a course of antibiotics - many antifungal, gastroprotective, hepatoprotective, nephroprotective plants are known.
But we do not use herbal medicine without basic treatment.
The patient should still be seen by a specialist.
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What can you say about phytoestrogens, which are now offered by dietary supplement manufacturers as a safer replacement for synthesized human hormones in endocrinology?
— It is impossible to replace human hormones with plant ones.
However, it is possible to reduce certain manifestations of the menopausal period with such means.
For example, Salvia officinalis leaves are effective against vegetative manifestations during this period, improve memory and cognitive functions, and support the formation of estradiol in the adrenal glands.
By the age when a person is prescribed to take synthetic estrogens, he usually accumulates many concomitant diseases, and herbal medicines can be used to correct the side effects of such problems.
So, with increased irritability, herbal preparations will help stabilize the nervous system.
And some herbal remedies help prevent the development of osteoporosis.
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Often the attitude towards herbs is quite light, it is believed that they cannot harm the body.
Are there really contraindications in this case, and is it possible to overdose with herbal tinctures and decoctions?
- Of course, it’s possible.
At the Department of Herbal Medicine, we teach to treat medicinal plants as seriously as medicines.
It is imperative to take into account the effect of herbal remedies on the mucous membrane of the gastrointestinal tract; there are a number of herbal remedies that contain bitterness and have a soporific and (in case of inflammation of the gastric mucosa) irritating effect.
It is also possible that there is an individual intolerance to some components of the herbal medicine, for example, individual plants in herbal teas.
And all this, of course, is taken into account when prescribing by herbalists who evaluate the effectiveness of plants and eliminate possible risks from their use.
Safety in herbal medicine is no less important than effectiveness.
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Why do doctors, at least in Russia, not often prescribe herbal medicines?
Maybe it makes sense to expand the use of such drugs as part of complex therapy?
— So far in Russia there are very few doctors who use the herbal medicine method in their work.
At the course of clinical herbal medicine at RUDN, we improve the qualifications of doctors in the field of clinical herbal medicine as part of postgraduate education.
However, we believe that herbal medicine should be taught to medical students and future doctors.
Moreover, there must be a system of state support for the development of herbal medicines, their production and implementation.
There is all the necessary scientific basis for the development of this area.
In research organizations, scientists select plants and study their properties, determine and study the optimal dosage form, develop drug production technology, and conduct preclinical studies on experimental animals.
Unfortunately, only a few herbal medicines make it to the clinical trial stage, as this is a very complex and expensive procedure.
As a result, new science-based herbal products do not reach the manufacturing plant, pharmacy shelves, and ultimately, patients.
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Today, medicinal herbal raw materials are mainly taken from the population; people collect wild plants in the forest or grow them in plots.
Is it possible to simplify the process of producing herbal medicines by establishing the production of chemical analogues of substances that are responsible for the medicinal effects of plants?
— In recent years, against the backdrop of growing demand for high-quality plant raw materials, industrial medicinal plant production has been revived.
As for chemical analogues, the effectiveness of herbal medicine is largely associated with an integrated, systematic approach to the prescription of medicinal plants.
As a rule, a herbalist forms a certain complex of individual plants and/or ready-made herbal preparations.
For example, to maintain the functioning of the gastrointestinal tract during chronic gastritis, it is necessary to use enveloping, anti-inflammatory, vitamin, and, in some cases, sap plants.
As well as plants that support the functions of the liver and pancreas, blood supply and regeneration of the mucous membrane.
If we use a herbal medicine based on an isolated substance of plant origin, then it may turn out to be ineffective in solving a complex problem.
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To summarize...
What are the main pros and cons of herbal medicine, how can a person approach it competently?
— As for the advantages, this is the availability and, as a rule, low cost of such drugs.
Medicinal plants have enormous potential, a large, especially preclinical, scientific base, and the mechanisms of action of plants are well studied.
But questions remain regarding the individual approach when prescribing herbal medicines, the choice of dose, and the quality of plants in the case of medicinal herbal collections.
Unfortunately, medicinal herbs are most often used as part of self-medication.
This is a big risk, especially when it comes to serious illnesses.
In general, in order to correctly use herbal medicine, you need to learn this and, of course, have a basic medical education.
In this case, herbal medicine can benefit patients.