What are the types of medical herbal therapy preparations

The medical herbal therapy preparations currently approved for clinical use in China are mainly divided into two categories: traditional herbal preparations and modern refined herbal preparations based on the preparation process. The applicable scenarios, onset of effect, and regulatory requirements of different categories are significantly different.

I have worked in a traditional Chinese medicine pharmacy in a tertiary hospital for almost eight years. When dispensing medicines to patients, the most common question I am asked is "What is the difference between this Chinese patent medicine and the herbal medicine I brew at home?" This is essentially the difference in the type of preparation.

Traditional herbal preparations basically follow traditional processing standards. The most common ones are the familiar traditional Chinese medicine pieces, which are herbal raw materials such as astragalus, angelica, and honeysuckle that have been cut, fried, and roasted according to the standards. You can take them home and fry them yourself or have them fried in the hospital. There are also ointments, pills, pills, and powders made according to ancient recipes. Many hospitals' special in-hospital preparations also fall into this category. For example, the Huoxue Zhitong Powder made by the Department of Orthopedics of our hospital can be applied to the affected area after a sprain or contusion. It can reduce swelling and blood stasis faster than many Western ointments. However, most of these preparations are made of all ingredients and are relatively complex in composition. At present, most of them can only be used in approved medical institutions and are rarely marketed and circulated on a large scale.

If traditional preparations follow the path of “retaining all ingredients and relying on compatibility to reduce toxicity and increase effectiveness”, modern refined herbal preparations follow the path of “purifying active ingredients and clarifying content standards”. This type is what everyone usually buys in pharmacies, such as Lianhua Qingwen capsules for colds, compound grass coral lozenges for pharyngitis, and ginkgo leaves prescribed for the elderly to improve cardiovascular and cerebrovascular circulation. The active ingredients in the herbs are extracted, compressed into tablets, packed into capsules, or made into granules. They are convenient to eat and the dosage is accurate.

I should also mention here the controversial herbal injections. There have always been two completely different opinions in the industry. One group believes that if the purification process of such preparations is not in place, the residual macromolecular impurities can easily cause allergic reactions. Disasters with Houttuynia cordata injections have indeed occurred before. Regarding adverse reaction events, the other group believes that under the premise of strict control of raw materials and processes, injections have a much faster onset of action than oral preparations and play an irreplaceable role in the treatment of severe cases. Nowadays, the supervision of such preparations is becoming more and more strict, and they can basically only be used by medical staff in hospitals.

Last month, a little girl with acne came to get medicine. The doctor prescribed two kinds of medicine for her. One is a decoction of traditional Chinese medicine soup in a bag, which should be taken internally to regulate endocrine. The other is a compound Pien Tze Huang ointment made with modern technology, which can be applied externally on red and swollen acne to reduce inflammation. The two were used together. When I came back for a review in half a month, most of the acne on my face had disappeared.

In fact, there is no completely unified standard for the classification of herbal preparations in the industry. Many doctors are accustomed to classifying herbal preparations into oral, external, and injection categories according to the route of administration. However, classification according to the preparation process is currently the most commonly used classification method at the regulatory level. The core is to make it easier for doctors to prescribe medicines according to the symptoms, and for patients to feel more confident when using them.