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      Current state of research on the clinical benefits of herbal medicines for non-life-threatening ailments

      systematic-review

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          Abstract

          Herbal medicines are becoming increasingly popular among patients because they are well tolerated and do not exert severe side effects. Nevertheless, they receive little consideration in therapeutic settings. The present article reviews the current state of research on the clinical benefits of herbal medicines on five indication groups, psychosomatic disorders, gynecological complaints, gastrointestinal disorders, urinary and upper respiratory tract infections. The study search was based on the database PubMed and concentrated on herbal medicines legally approved in Europe. After applying defined inclusion and exclusion criteria, 141 articles were selected: 59 for psychosomatic disorders (100% randomized controlled trials; RCTs), 20 for gynecological complaints (56% RCTs), 19 for gastrointestinal disorders (68% RCTs), 16 for urinary tract infections (UTI, 63% RCTs) and 24 for upper respiratory tract infections (URTI) (79% RCTs). For the majority of the studies, therapeutic benefits were evaluated by patient reported outcome measures (PROs). For psychosomatic disorders, gynecological complaints and URTI more than 80% of the study outcomes were positive, whereas the clinical benefit of herbal medicines for the treatment of UTI and gastrointestinal disorders was lower with 55%. The critical appraisal of the articles shows that there is a lack of high-quality studies and, with regard to gastrointestinal disorders, the clinical benefits of herbal medicines as a stand-alone form of therapy are unclear. According to the current state of knowledge, scientific evidence has still to be improved to allow integration of herbal medicines into guidelines and standard treatment regimens for the indications reviewed here. In addition to clinical data, real world data and outcome measures can add significant value to pave the way for herbal medicines into future therapeutic applications.

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          The Traditional Medicine and Modern Medicine from Natural Products

          Natural products and traditional medicines are of great importance. Such forms of medicine as traditional Chinese medicine, Ayurveda, Kampo, traditional Korean medicine, and Unani have been practiced in some areas of the world and have blossomed into orderly-regulated systems of medicine. This study aims to review the literature on the relationship among natural products, traditional medicines, and modern medicine, and to explore the possible concepts and methodologies from natural products and traditional medicines to further develop drug discovery. The unique characteristics of theory, application, current role or status, and modern research of eight kinds of traditional medicine systems are summarized in this study. Although only a tiny fraction of the existing plant species have been scientifically researched for bioactivities since 1805, when the first pharmacologically-active compound morphine was isolated from opium, natural products and traditional medicines have already made fruitful contributions for modern medicine. When used to develop new drugs, natural products and traditional medicines have their incomparable advantages, such as abundant clinical experiences, and their unique diversity of chemical structures and biological activities.
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            Irritable bowel syndrome: a clinical review.

            Irritable bowel syndrome (IBS) affects 7% to 21% of the general population. It is a chronic condition that can substantially reduce quality of life and work productivity.
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              ACG Clinical Guideline: Management of Irritable Bowel Syndrome

              Irritable bowel syndrome (IBS) is a highly prevalent, chronic disorder that significantly reduces patients' quality of life. Advances in diagnostic testing and in therapeutic options for patients with IBS led to the development of this first-ever American College of Gastroenterology clinical guideline for the management of IBS using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Twenty-five clinically important questions were assessed after a comprehensive literature search; 9 questions focused on diagnostic testing; 16 questions focused on therapeutic options. Consensus was obtained using a modified Delphi approach, and based on GRADE methodology, we endorse the following: We suggest that a positive diagnostic strategy as compared to a diagnostic strategy of exclusion be used to improve time to initiating appropriate therapy. We suggest that serologic testing be performed to rule out celiac disease in patients with IBS and diarrhea symptoms. We suggest that fecal calprotectin be checked in patients with suspected IBS and diarrhea symptoms to rule out inflammatory bowel disease. We recommend a limited trial of a low fermentable oligosaccharides, disacchardies, monosaccharides, polyols (FODMAP) diet in patients with IBS to improve global symptoms. We recommend the use of chloride channel activators and guanylate cyclase activators to treat global IBS with constipation symptoms. We recommend the use of rifaximin to treat global IBS with diarrhea symptoms. We suggest that gut-directed psychotherapy be used to treat global IBS symptoms. Additional statements and information regarding diagnostic strategies, specific drugs, doses, and duration of therapy can be found in the guideline.
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                Author and article information

                Contributors
                Journal
                Front Pharmacol
                Front Pharmacol
                Front. Pharmacol.
                Frontiers in Pharmacology
                Frontiers Media S.A.
                1663-9812
                28 September 2023
                2023
                : 14
                : 1234701
                Affiliations
                [1] 1 Institute of Pharmaceutical Biology , Goethe University , Frankfurt, Germany
                [2] 2 Institute of General Practice , Goethe University , Frankfurt, Germany
                [3] 3 Department of Urology and Pediatric Urology , University Medical Center Mainz , Mainz, Germany
                [4] 4 Department of Family Medicine , Care and Public Health Research Institute , Maastricht University , Maastricht, Netherlands
                [5] 5 Department of Public Health and Primary Care , Academic Centre of General Practice , KU Leuven , Leuven, Belgium
                Author notes

                Edited by: Xuezhong Zhou, Beijing Jiaotong University, China

                Reviewed by: Uroš Branko Pecikoza, University of Belgrade, Serbia

                Marilena Gilca, Carol Davila University of Medicine and Pharmacy, Romania

                *Correspondence: Beatrice E. Bachmeier, b.bachmeier@ 123456em.uni-frankfurt.de
                [ † ]

                These authors have contributed equally to this work and share first authorship

                Article
                1234701
                10.3389/fphar.2023.1234701
                10569491
                37841934
                a6db0280-5846-4812-b0cc-84dc05a7ff73
                Copyright © 2023 Salm, Rutz, van den Akker, Blaheta and Bachmeier.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 05 June 2023
                : 08 September 2023
                Categories
                Pharmacology
                Systematic Review
                Custom metadata
                Ethnopharmacology

                Pharmacology & Pharmaceutical medicine
                herbal medicine,clinical benefits,psychosomatic disorders,gynecological complaints,gastrointestinal disorders,urinary tract infections,upper respiratory tract infections

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