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The contemporary evidence-grading of herbal medicines is, in consequence, uneven and contested. Several herbal preparations have substantial controlled-trial evidence for specific clinical effect: [[wikipedia:Silymarin|silymarin]] (milk thistle) for selected hepatic indications; [[wikipedia:Ginger|ginger]] (''Zingiber officinale'') for nausea of pregnancy and chemotherapy-induced nausea; [[wikipedia:Peppermint oil|peppermint oil]] for irritable bowel syndrome; [[wikipedia:St John's wort|St John's wort]] (''Hypericum perforatum'') for mild-to-moderate depression (with substantial CYP3A4-induction-mediated interaction liability that is now a routine clinical concern); [[wikipedia:Saw palmetto|saw palmetto]] for symptomatic benign prostatic hyperplasia (the controlled-trial evidence, the CAMUS and STEP trials, has been less favourable than the marketing). Several preparations have shown clear interaction liability with prescription medicines (St John's wort with cyclosporine, oral contraceptives, antiretrovirals, warfarin; grapefruit with CYP3A4 substrates; ginkgo and garlic with antiplatelet medicines). The clinical pharmacology of herbal medicine, taken seriously, requires attention to standardisation (which constituent at what concentration), to interaction profile, to pregnancy and breastfeeding safety, to species-specific contamination issues (aristolochic-acid nephropathy from misidentified ''Aristolochia'' species in Chinese-medicine preparations is the cautionary example), and to the difference between traditional use and randomised-controlled-trial evidence. | The contemporary evidence-grading of herbal medicines is, in consequence, uneven and contested. Several herbal preparations have substantial controlled-trial evidence for specific clinical effect: [[wikipedia:Silymarin|silymarin]] (milk thistle) for selected hepatic indications; [[wikipedia:Ginger|ginger]] (''Zingiber officinale'') for nausea of pregnancy and chemotherapy-induced nausea; [[wikipedia:Peppermint oil|peppermint oil]] for irritable bowel syndrome; [[wikipedia:St John's wort|St John's wort]] (''Hypericum perforatum'') for mild-to-moderate depression (with substantial CYP3A4-induction-mediated interaction liability that is now a routine clinical concern); [[wikipedia:Saw palmetto|saw palmetto]] for symptomatic benign prostatic hyperplasia (the controlled-trial evidence, the CAMUS and STEP trials, has been less favourable than the marketing). Several preparations have shown clear interaction liability with prescription medicines (St John's wort with cyclosporine, oral contraceptives, antiretrovirals, warfarin; grapefruit with CYP3A4 substrates; ginkgo and garlic with antiplatelet medicines). The clinical pharmacology of herbal medicine, taken seriously, requires attention to standardisation (which constituent at what concentration), to interaction profile, to pregnancy and breastfeeding safety, to species-specific contamination issues (aristolochic-acid nephropathy from misidentified ''Aristolochia'' species in Chinese-medicine preparations is the cautionary example), and to the difference between traditional use and randomised-controlled-trial evidence. | ||
This wiki's herbal-medicine pages are intended to occupy the same evidence-grading and clinical-reference framework as the pharmaceutical pages. Each monograph is structured by the same [[wikipedia:Phytotherapy|phytotherapy]] template (the PlantMedTemplate), with sections for botanical identity (binomial, family, common names, native range, parts used), traditional use (the spine of the page, history-first, geographic and cultural context), active constituents, preparations (in cultural-historical and contemporary clinical terms), indications and dosing, pharmacokinetics and pharmacodynamics where the data exist, | This wiki's herbal-medicine pages are intended to occupy the same evidence-grading and clinical-reference framework as the pharmaceutical pages. Each monograph is structured by the same [[wikipedia:Phytotherapy|phytotherapy]] template (the PlantMedTemplate), with sections for botanical identity (binomial, family, common names, native range, parts used), traditional use (the spine of the page, history-first, geographic and cultural context), active constituents, preparations (in cultural-historical and contemporary clinical terms), indications and dosing, pharmacokinetics and pharmacodynamics where the data exist, medicine-interaction profile (cross-linked to the wiki's pharmacogenomic interaction layer), pregnancy and lactation, and references. Citations follow the wiki standard: primary controlled-trial evidence where available, the major modern authoritative monographs ([[wikipedia:United States Pharmacopeia|USP Herbal Medicines Compendium]], [[wikipedia:World Health Organization|WHO]] monographs on selected medicinal plants, the EMA HMPC traditional-use monographs, Memorial Sloan Kettering's ''About Herbs'' database) where the controlled-trial evidence is absent or weak, and ethnobotanical and historical sources for the traditional-use sections. | ||
== Members indexed == | == Members indexed == | ||