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Use Plant Extract As Medicine
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Herbal medicines – also known as phytopharmaca – enjoy a considerable importance, be it in the medical treatment of patients or in self-medication. Phytopharma-ca are defined according to German laws regulating the use of drugs as being sub-stances derived from plants or parts thereof, whether processed or unprocessed.
They are mixtures of several substances and are therefore fundamentally different from drugs based on active substances in the pure state; their medical activity de-rives from the mixture that is used in the therapy (phytotherapy). Phytotherapy has a long tradition that can be traced back into antiquity.
It is puzzling at first sight why one should use a plant extract as a medicine rather than identifying, isolating and using the active constituents from the mixture. The use of the mixture can however have many advantages, for instance if the active constituent is unknown but the mixture has a proven clinical effectiveness.
Difficulties in identifying the active components can have many causes. Often, several components of the extract are responsible for the medical effect, whereas the ...
... isolated pure substances show little or no activity this phenomenon is known as synergic activity. Furthermore, biologically active compounds are often represented in nature by inactive precursors, which are only converted into their active forms by enzymatic activation or chemical modification in the alimentary canal after oral administration. This is the case for many glycosides; such compounds are therefore almost impossible to detect by the usual biochemical in vitro methods.
Even if one or more active components of an extract are known, further substances may be responsible for an optimal effect. One example is the increased tolerance that many phytopharmaca displays compared with chemically synthesized drugs. However, such phytopharmaca are not always free from side-effects or interactions with other drugs. Because of their natural sources, phytopharmaca have the advantage of being well accepted by the public; one consequence of this is the readiness of patients to take the medicines regularly, which is important for the success of the treatment.
Despite the established advantages of many phytopharmaca, the use of mixtures of several substances raises fundamental questions and in turn gives rise to criticism. One problem is the uniformity of extracts. How can one rely on the quality of an extract that is not only dependent on the quality of the plant material (drug) used, but also on the method of preparation (the extraction process and the nature and quantity of the extracting agent)?
Can extracts whose active constituents are not even known be regarded as meaningful and up-to-date medicines? Moreover, might not substances that are present in the extract together with the actual active agents have a negative influence on the main medical activity? Who can guarantee that the alleged effect of a plant extract is genuine and is not simply based on vague historical tradition?
Such criticisms are often encountered. For this reason, it is important to establish that plant extracts are subject to the same strict regulations as are all other medicines. This means that phytopharmaca should only be licensed as medicines if their efficacy, harmlessness and pharmacological properties (such as shelf life) have been established in clinical studies. It is of course an intrinsic property of a plant extract that not all components are always present in the same concentrations, but constant quality is assured by standardization and normalization.
The use of phytopharmaca that fulfils these strict requirements is described as rational phytotherapy and should be clearly distinguished from the broad use of remedies of plant origin that are not supported by any scientific investigations.
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