Getting to Know Herbal Medicines and the Basis of Selection for Consumption

Getting to Know Herbal Medicines and the Basis of Selection for Consumption

by

Prof. Dr dr. I Made Jawi, M.Kes

Dep. Farmakologi FK Unud

madejawi@unud.ac.id

Herbal medicine is defined as raw materials or preparations derived from plants that have therapeutic effects or other effects that are beneficial to health. The composition of herbal medicines can be in the form of crude ingredients, crude extracts or extracts that have been purified, or processed through certain physical methods. Herbal medicines or medicinal ingredients from plants, can be consumed directly or used as raw materials for herbal products, because they contain various types of active ingredients with medicinal properties. Indonesian herbal medicines have been used since ancient times as an effort to maintain health, prevent disease and treat diseases, so their use needs to be encouraged in the community. To ensure this effort, it is very necessary to increase in-depth understanding of the classification of herbal medicines and understand the mechanism by which herbal medicines cause therapeutic effects. The general classification of herbal medicines are herbal medicine, standardized herbal medicine and phytopharmaceuticals, each of which has special characteristics.

Jamu is a medicinal preparation of natural ingredients, the status of safety and efficacy is proven only empirically.

Standardized Herbal Medicines are products containing ingredients or ingredients in the form of plant ingredients, animal ingredients, mineral ingredients, sarian (galenic) preparations or mixtures of these materials which have been used for generations for treatment and can be applied in accordance with the prevailing norms in society. which have been scientifically proven safety and efficacy by preclinical testing and standardized raw materials.

Phytopharmaceuticals are products containing ingredients or ingredients in the form of plant ingredients, animal ingredients, mineral ingredients, extract preparations (galenic) or mixtures of these materials that have been scientifically proven to be safe and effective by means of preclinical and clinical trials as well as raw materials and finished products. has been standardized.

In accordance with the Original Indonesian Herbal Medicine Formulary, the classification of evidence based medicine (EBM) degrees, herbal medicines are divided into several levels of evidence as follows:

Herbal Medicines with strong scientific evidence (Strong Scientific Evidence/Class A).

Evidence of statistically significant benefit from > 2 eligible randomized control trials (RCTs), or evidence from 1 eligible RCT and 1 eligible meta-analysis, or evidence from multiple RCTs with the majority of clinical trials conducted as required , showing evidence of statistically significant benefit with supporting evidence in basic science, animal research, or theory.

Herbal Medicines with Good Scientific Evidence (Group B)

Evidence of statistically significant benefit from 1-2 randomized trials, or evidence of benefit from > 1 eligible meta-analysis or evidence of benefit from > 1 cohort/case-control/non-randomized clinical trial with supporting evidence in science

basis, animal research, or theory. This level applies to situations where a well-designed RCT reports negative results but contrasts the positive efficacy results resulting from many other poorly designed clinical trials or well-designed meta-analyses, pending confirmation of evidence from an additional RCT with good design.

Herbal Medicines with Unclear or Conflicting Scientific Evidence (Class C)

Evidence of benefit from > 1 small RCT without adequate sample size, power, significance, or design quality or contentious evidence from multiple RCTs without the majority of clinical trials meeting requirements, showing evidence of benefit or ineffectiveness, or evidence of benefit from > 1 cohort/case-control/clinical trial that was not randomized, and was not accompanied by supporting evidence in basic science, animal research, or theory, or evidence of efficacy only from basic science, animal research, or theory.

 Herbal Medicines with Negative Scientific Evidence (Fair Negative Scientific Evidence/Group D)

Evidence of no statistically significant benefit (not proven to be useful) from non-randomized cohorts/case-control/clinical trials, and evidence from basic science, animal studies, or theory, suggests no benefit. This level also applies to situations where > 1 well-designed RCT reported negative results, even though positive efficacy results were reported by clinical trials or poorly designed meta-analyses.

Herbal Medicines with Very Negative Scientific Evidence (Strong Negative Scientific Evidence/Class E)

Statistical evidence was not significant (not proven to be useful) from >1 RCTs with objective criteria of adequate power and high quality design.

Herbal Medicines No Evidence (Lack of Evidence / Group F)

Unable to evaluate efficacy because adequate human data are not available

Understanding the grouping of herbal medicines will guide us in selecting rational herbal medicines so that they can produce therapeutic effects as expected. The selection of herbal medicine in the form of herbal medicine Jamu needs to be careful because it has not been supported by scientific research, even though it has been used for generations. Standardized herbal medicine or phytopharmaceuticals are certainly better, especially if there have been good clinical trials or classified as A or B. Good luck.