Why is herbal research important?

rusty_blackhaw(6a)August 10, 2014

A viewpoint sometimes seen in this forum is that traditional uses and anecdotes involving herbs are all-important, and that rigorous research into safety and efficacy of herbal products is unnecessary or even undesirable.

The authors of this article in a complementary medicine journal feel research is vital, especially if herbal medicinal products (HMPs) are to be used to tackle chronic diseases.

"Thus far, clinical trials on HMPs have provided a rather indefinite and even bleak view about their therapeutic benefits. However, it is quite possible that the current gold standard, a placebo-controlled randomized double-blinded trial, is unable to provide a relevant outcome about medicines that are primarily intended for personalized and holistic use, as is the case with Chinese herbal medicines. Nonetheless, the FP7 GP-TCM project has agreed on a guideline on randomized controlled clinical trials of Chinese herbal medicines, which should serve as a plausible starting point for further development."

The authors don't explain just why they think herbal drugs might be exempt from established guidelines for drug development, and gloss over problems associated with complex herbal mixtures (they describe chemical compounds with opposing actions in a single herbal drug, for instance). But at least they do recognize that research will be vital in finding out just which products may be beneficial.

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"medicines that are primarily intended for personalized and holistic use,"

In other words ... the results aren't predictable or reliable and we haven't a clue what they are really doing.

If it is going to be called "medicine" the action has to be predictable ... otherwise you are rolling dice with your patients.

    Bookmark   August 10, 2014 at 11:48AM
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I'm not sure what the authors meant by "personalized" use, unless they were referring to a process of evaluating each recipient (by genetic testing, for instance) to determine what herbal drug(s) would be effective. That process hasn't even gotten off the ground yet in alt med, and it would still be necessary to validate such testing in controlled studies.

Declaring that placebo-controlled double-blind studies of herbal meds may be "unable to provide a relevant outcome" comes across as a form of special pleading.

This post was edited by eric_oh on Sun, Aug 10, 14 at 15:12

    Bookmark   August 10, 2014 at 3:11PM
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It's strange how often these topics turn to the usage of Latin rhetoric. It's almost as if there was no ability to debate based on the knowledge of the topic and focus in on context.

In any case, to call that a form of [special pleading], you would be avoiding the fact that expecting a researcher who is experienced in only mainstream medicine to conduct a study on herbals, or worse, an expert in allopathic medicine to properly deal with homeopathic medicine, is the usage of an [argument from misleading authority] since they're both completely out of their respective fields.

This is why people often consider the anecdotes of those more or less new to alternative medicine to be much more useful than those biased towards modern medicine.

    Bookmark   September 4, 2014 at 8:44PM
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"Latin rhetoric"? What on earth does that mean?

I think you misunderstand what "special pleading" is. Despite claims to the contrary, there is no form of alt med that cannot be researched using tools similar to those employed in studying mainstream medicine. Acupuncture, for instance, has been studied using retractible needles that touch but do not actually puncture the skin, though the patient can't tell the difference. It's been shown that "sham" acupuncture works as well as the "real" thing, signifying that any positive results are likely due to placebo effects.

Bottom line is that no one is exempted from the rules of scientific inquiry on the basis that their woo is not subject to real world measurements.

Nothing in alt med is so mysterious that mainstream researchers are unqualified to study it. Scientific research is open to (and used/misused by) practitioners and advocates of various kinds of alt med, including homeopaths, acupuncturists, naturopaths and so on. A lot of these people take refuge in limited and poorly conducted research that purports to show a remedy works. When the flaws of such research are challenged, these practitioners often try to have it both ways, arguing that their methods cannot be accurately studied and appreciated by conventional means.

That's special pleading.

    Bookmark   September 6, 2014 at 1:39PM
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What I mean is that people seem to frequently resort to trying to find flaws in someone's argument(often with Latin names), because they lack the ability to appropriately reason, and so attempt to evade it by trying to apply whichever one of the 200+ logical fallacies that they can remember.

That statement only shows your lack on knowledge on the many differences in types of medicine. I'm not claiming that the rules of scientific inquiry somehow don't apply, but that it would be foolish to treat medicine styles with completely different rules, main concepts, and treatments, as similar.

To say that "sham" acupuncture works as well as the "real" thing means you must have some way of measuring the effects. Because acupuncture and acupressure is based on releasing the flow of "qi" in the human body, there is no way you can reliably measure it's effects beyond anecdotal responses. The closest thing I have heard to this are the machines used in biophoton therapy, and even that is questionable as to whether it's the same thing as what Chinese medicine considers "life force".

I didn't say they were unqualified to study it, I said they shouldn't form theories on it, trying to make all forms of alternative medicine fit the same confines of mainstream medicine. Anyone who knows what they're talking about(at least in their respective field of therapy) should be able to easily take a challenge against the research they provide with a proper response. But it also goes the other way around as well, since just because a person isn't able to argue their research accordingly, doesn't mean the research is always wrong, even though some people may attempt to construe some points as flawed.

    Bookmark   September 17, 2014 at 8:22AM
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I said they shouldn't form theories on it, trying to make all forms of alternative medicine fit the same confines of mainstream medicine.

Here's the major problem with "alternative" medicine ... IF any of it it worked the way it is claimed to work, huge sections of science would not work the way we can observe them working. And within the different areas, there are widely divergent claims about what works, some of it contradictory.

Homeopathy, for example, claims to work even though none of the active ingredient is in the higher, supposedly more powerful dilutions ... which means chemistry and toxicology can't work if homeopathy does.

And if it really worked, beyond placebo response, you could predictably apply it. It would have gone from a fringe practice to being used systematically.

Chiropractors? Shown the same set of x-rays, they can't identify the same subluxations.

Reiki? A girl's science fair project showed that self-proclaimed "energy healers" couldn't detect whether there was a hand near theirs, although they claimed to be able to diagnose from the "energy fields" of their clients.

Reflexology? There are widely divergent charts out there showing the supposed correspondences ... they can't ALL be right.

Acupuncture? Also widely differing charts and insertion points ... they can't ALL be right.

    Bookmark   September 17, 2014 at 10:08AM
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"it would be foolish to treat medicine styles with completely different rules, main concepts, and treatments, as similar."

Why? Shouldn't the end point be whether it works, alternative treatment or not?

Acupuncture is often used to treat pain, and there's obviously a subjective impression involved, for instance asking study participants to estimate pain on a graded scale. But it surely has meaning if "sham" acupuncture that doesn't involve penetrating the skin generates the same "benefits" as actual skin puncture, or if penetrating the skin at random points works as well as hitting the "correct" ones - it then boils down to placebo effects. And we can decide at that point if the placebo effect is sufficient and how (and when) to administer it in the cheapest, safest and most ethical manner possible.

Of course, acupuncture is touted for many different conditions besides pain relief, and objective measurements of its effects are certainly possible.

If palt med advocates want to reject science altogether and depend on anecdotes and testimonials, they're free to do so. What generally happens though is they cite limited and cherry-picked studies in support of their claims (since having some degree of research support is seen as very desirable, at least for marketing purposes). And when those are critiqued, they tell us that scientific studies are corrupt and often wrong, citing a scientific study in support of their argument. ;)

    Bookmark   September 18, 2014 at 9:01AM
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