Evidence-Based Phytotherapy

Rational phytotherapy (modern or scientifically oriented phytotherapy) is based on traditional European phytotherapy. Plants or parts of plants (leaves, roots) are processed using recognized pharmaceutical procedures. It defines the claim to use scientific evaluation standards in addition to existing empirical data (empirical medicine) in order to prove the effectiveness of the plants contained as well as the preparations and combinations on the basis of studies. The active substances contained are extracted, concentrated and, if necessary, individual ingredients of the medicinal plant are separated so that the concentration of the active substances is known and constant.

Rational phytotherapeutics(phytopharmaceuticals) are medicinal products which, in contrast to chemically defined medicinal products and isolated pharmacologically defined pure plant substances (e.g. azelaic acid, penicillins, etc.), contain plant preparations, predominantly standardized and/or normalized extracts, as active ingredients (Loew 1999).

The entire extract (or combination of extracts) and thus a mixture of multiple substances is regarded as the active pharmaceutical ingredient.

It is postulated that each extract contained in a rational phytopharmaceutical has been proven to contribute to clinical efficacy.

If the phytotherapeutic agent contains an extract of one or more drug parts of the same medicinal plant as the active ingredient, it is declared as a monopreparation. The extract is the active substance.

If the phototherapeutic agent in extract form contains several combination partners from different medicinal plants, it is declared as a herbal combination preparation, sample.

Rational phytotherapy thus differs fundamentally from therapy with synthetic active ingredients, which are administered as individual substances and whose singular effects are known. Herbal preparations can be obtained as pressed juices, oil macerates from fresh plants, powders from cut or crushed dried drugs. Extracts are extracts obtained by means of solvents, fractionation or by eliminating undesirable constituents. Phytotherapeutics are offered in conventional dosage forms such as drops, tablets, coated tablets or capsules.

Rational phytotherapy claims to apply the same scientific methods to the phytopharmaceuticals administered as to synthetic medicines. It is based on the guidelines of Good Clinical Practice, with reliable pharmacological and toxicological studies, as well as proof of efficacy in randomized, controlled double-blind studies.

1. Colalto C (2018) What phytotherapy needs: Evidence-based guidelines for better clinical practice. Phytother Res 32: 413-425
2. Fürst R et al. (2015) Evidence-Based Phytotherapy in Europe: Where Do We Stand? Planta Med 81(12-13):962-967.
3. Loew D et al. (1999) Phytopharmacareport. Steinkopff Verlag Darmstadt p 7.