ABSTRACT
The integration of herbal and other forms of traditional medicine (TM) can be done in one of the following three ways: First, it can be incorporated as an integral part of a country’s formal health care system, with each being separately recognized as legitimate forms of health care within the same framework. Second, it can be practice integrated with modern medicine by individual health care practitioners. Third, traditional and modern practices can be integrated as two branches of medical science, with the ultimate incorporation of elements of both to form a new branch (World
22.1 Introduction .......................................................................................................................... 453 22.2 Current Status and Major Issues of Integration of Herbal Medicine in Evidence-Based
Medical Therapy ................................................................................................................... 454 22.3 Factors Relevant to/Affecting Integration of Herbal Medicine into Modern
Medical Practices.................................................................................................................. 455 22.3.1 Herb Quality Issues .................................................................................................. 455 22.3.2 Quality Assurance/Quality Control in Processing and Manufacturing/
Preparation of Herbal Medicines (Good Manufacturing Practices Issues) .............. 456 22.3.3 Herbal Mechanisms of Action, Bioavailability, and Herbs’ Chemical Constituents ...457 22.3.4 Herb-Drug Interactions ............................................................................................ 457 22.3.5 Herb-Herb Interactions ............................................................................................ 458 22.3.6 Ef˜cacy Measurements: Objective Quanti˜able versus Subjective
Quality of Life .......................................................................................................... 458 22.3.7 Other Safety Issues ................................................................................................... 459
22.4 Research Needs..................................................................................................................... 459 22.4.1 Herbal Medicine Quality and Standardization: Quality Assurance and
Quality Control .........................................................................................................460 22.4.2 Preclinical Pharmacological Assessments and Action Mechanisms .......................460 22.4.3 Clinical Ef˜cacy and Safety Assessments ................................................................ 461
22.5 Conclusions ........................................................................................................................... 461 Acknowledgments .......................................................................................................................... 461 References ...................................................................................................................................... 462
Health Organization 2000a). The incorporation of traditional and modern evidence-based medicine (EBM) as integral parts of a country’s formal health care system is most likely to be achieved and has been demonstrated to be practicable in many countries, particularly in Asian countries such as China, Japan, Korea, and India, among others (World Health Organization 2001). On the other hand, the incorporation of traditional medical modalities such as herbal medicine into modern or EBM by either the second or third method of health care integration is not easily achieved for a host of reasons, including scienti˜c, cultural, educational, and legal.
