Exploring the Evolving Role of Herbal and Alternative Medicine in Modern Healthcare

Introduction

Herbal and alternative medicine has been an integral part of healthcare practices throughout history. In recent years, there has been a growing interest in these approaches as individuals seek natural and holistic solutions to maintain and improve their health. This chapter provides an overview of herbal medicine, explores the efficacy and safety of herbal products, and discusses interactions between herbal products and conventional drugs [1-3]. Herbal medicine, also known as botanical medicine or phytomedicine, involves the use of plants or plant-derived substances for therapeutic purposes [4-6]. It has been practiced for centuries in various cultures around the world, with traditional systems of medicine such as Traditional Chinese Medicine (TCM), Ayurveda, and Indigenous healing traditions incorporating herbal remedies into their treatment modalities [7]. These traditional systems view health as a state of balance and harmony, and herbs are believed to possess specific properties that can restore and maintain this balance.

In modern healthcare, herbal medicine is often considered part of the broader field of alternative medicine, which encompasses a range of non-conventional therapeutic approaches [8]. The popularity of herbal and alternative medicine has been driven by several factors. First, many people are attracted to the idea of using natural remedies that have been used for centuries and are often perceived as gentler and safer than pharmaceutical drugs. Second, there is a growing awareness of the limitations and potential side effects of conventional medicine, leading individuals to explore alternative treatment options [9-10]. Lastly, the availability of information through the internet and other media platforms has made it easier for individuals to access information about herbal remedies and alternative therapies.

While herbal medicine has a long history and is widely used, it is important to critically evaluate the efficacy and safety of herbal products. Scientific research in this field is ongoing, with studies investigating the potential therapeutic benefits of specific herbs and their mechanisms of action [11-12]. Some herbal products have demonstrated promising results in treating certain health conditions, such as St. John’s wort for mild to moderate depression and ginger for nausea and vomiting. However, it is important to note that the quality and standardization of herbal products vary, and not all products on the market have undergone rigorous scientific testing [13-15].

The safety of herbal products is another crucial aspect to consider. Although herbs are generally regarded as natural substances, they can still have potent effects on the body and may interact with medications or cause adverse reactions [16]. Some herbal products have been associated with liver toxicity, allergic reactions, or interactions with conventional drugs. It is important for healthcare professionals and individuals using herbal remedies to be aware of potential risks and to consult with knowledgeable practitioners or experts in the field.

Furthermore, the interactions between herbal products and conventional drugs pose significant concerns. Some herbs can affect the metabolism of drugs, potentially altering their efficacy or increasing their toxicity [17-19]. For example, St. John’s wort can induce the breakdown of certain medications, leading to decreased drug levels in the body. This interaction may compromise the effectiveness of the medication and potentially result in treatment failure. Therefore, healthcare professionals must be informed about a patient’s use of herbal remedies to ensure safe and effective treatment [20].

In conclusion, herbal and alternative medicine play a significant role in modern healthcare. While herbal remedies have a long history of use and some have shown promising therapeutic benefits, it is important to approach their use with caution. Understanding the efficacy and safety of herbal products, as well as their potential interactions with conventional drugs, is vital for both healthcare professionals and individuals seeking to incorporate herbal medicine into their healthcare regimen.

Efficacy of Herbal Products: Scientific Evidence and Research Findings

The efficacy of herbal products, which are derived from plants and used for medicinal purposes, has been the subject of scientific investigation. Researchers have conducted studies to evaluate the effectiveness of various herbs in treating specific health conditions [21-22]. This section discusses the scientific evidence and research findings regarding the efficacy of herbal products. Scientific research plays a crucial role in determining the efficacy of herbal products. Randomized controlled trials (RCTs), systematic reviews, and meta-analyses are commonly used research methods to assess the effectiveness of herbal interventions. These studies aim to provide reliable and objective evidence by comparing the outcomes of individuals receiving herbal treatments with those receiving a placebo or standard treatment [23].

Several herbal products have demonstrated efficacy in treating specific health conditions. For example, the herb Echinacea purpurea has been studied for its potential benefits in reducing the duration and severity of common cold symptoms [24]. Some research suggests that Echinacea may have immunomodulatory effects, helping to strengthen the immune system’s response to viral infections. Another example is the use of St. John’s wort (Hypericumperforatum) in the treatment of mild to moderate depression. Clinical trials have shown that St. John’s wort may be as effective as certain conventional antidepressants in relieving depressive symptoms [25-26]. In addition to these specific examples, various herbs have shown promise in the treatment of conditions such as digestive disorders, respiratory ailments, and musculoskeletal conditions. For instance, ginger (Zingiberofficinale) has been studied for its potential anti-nausea effects, particularly in the management of chemotherapy-induced nausea and vomiting [27]. Turmeric (Curcuma longa) and its active compound, curcumin, have been investigated for their anti-inflammatory properties and potential benefits in conditions like osteoarthritis [28-29].

However, it is important to note that not all herbal products have strong scientific evidence supporting their efficacy. Some herbal remedies lack sufficient high-quality research to conclusively determine their effectiveness. Additionally, the complexity of herbal formulations, variations in plant species and growing conditions, and differences in individual responses to treatment make it challenging to draw definitive conclusions [30]. Another factor that contributes to the complexity of evaluating herbal product efficacy is the lack of standardized regulations in the herbal medicine industry. Quality control and standardization of herbal products can vary significantly, leading to variations in the concentration of active compounds and potential differences in therapeutic effects [31]. This lack of standardization hampers the ability to compare and replicate research findings across different herbal products and preparations.

Furthermore, the placebo effect, where individuals experience improvements in symptoms due to psychological factors rather than the specific treatment, can also influence the perceived efficacy of herbal products [32]. Placebo-controlled trials help account for this effect by comparing the outcomes of individuals receiving the herbal product with those receiving a placebo. To enhance the understanding of herbal product efficacy, ongoing research efforts are focused on conducting high-quality clinical trials with larger sample sizes and robust methodologies. Collaborative efforts among researchers, healthcare professionals, and herbal medicine experts are also important in advancing knowledge in this field. In conclusion, scientific evidence regarding the efficacy of herbal products continues to accumulate through well-designed studies and research findings [33-24]. While some herbs have shown promising results in treating specific health conditions, further research is needed to establish their effectiveness more conclusively. Standardization of herbal products and increased collaboration between researchers and practitioners can contribute to a more comprehensive understanding of herbal medicine and its potential benefits for healthcare.Bottom of Form

Integrating Herbal Medicine into Conventional Healthcare Practices

In recent years, there has been growing interest in integrating herbal medicine into conventional healthcare practices. This approach recognizes the potential benefits of combining traditional herbal remedies with evidence-based conventional medicine [35]. By incorporating herbal medicine into mainstream healthcare, patients can potentially benefit from a wider range of treatment options and holistic care. This section will explore the key considerations and strategies involved in integrating herbal medicine into conventional healthcare practices.

Collaboration between Herbal Practitioners and Conventional Healthcare Providers

One crucial aspect of integrating herbal medicine into conventional healthcare is fostering collaboration between herbal practitioners and conventional healthcare providers. This collaboration allows for the exchange of knowledge, expertise, and evidence-based information [36]. By establishing open lines of communication and mutual respect, herbal practitioners and healthcare providers can work together to provide comprehensive and patient-centered care.

Evidence-based Approach

Integrating herbal medicine into conventional healthcare practices necessitates an evidence-based approach. It is essential to conduct rigorous scientific research on herbal remedies, including clinical trials and systematic reviews, to determine their safety, efficacy, and potential interactions with conventional drugs [37]. This evidence can help guide healthcare providers in making informed decisions about integrating herbal medicine into treatment plans and ensuring patient safety.

Standardization and Quality Control

To ensure the safety and efficacy of herbal products, standardization, and quality control measures are crucial. Standardization involves establishing consistent manufacturing processes, ensuring the appropriate levels of active constituents in herbal preparations, and implementing quality control checks to minimize variations between batches [38]. This helps to enhance product reliability and supports evidence-based integration of herbal medicine into conventional healthcare practices.

Education and Training

Integrating herbal medicine into conventional healthcare practices requires education and training for healthcare providers. This includes raising awareness about herbal medicine, its potential benefits, and the current scientific evidence. Healthcare providers should be equipped with the knowledge to engage in informed discussions with patients about herbal remedies, potential interactions with conventional drugs, and the importance of reporting herbal medicine use [39]. Integrating herbal medicine into professional curricula can help bridge the gap between conventional healthcare practices.

Patient-Centered Care

Integrating herbal medicine into conventional healthcare practices emphasizes a patient-centered approach. This involves actively involving patients in their treatment decisions and considering their preferences, beliefs, and cultural backgrounds. Healthcare providers should engage in open and non-judgmental conversations about herbal medicine use, addressing any safety concerns and exploring potential benefits within the context of evidence-based knowledge [40]. By integrating herbal medicine into conventional healthcare practices, patients can benefit from a more comprehensive and personalized approach to their healthcare. However, it is important to acknowledge that this integration should be based on a solid foundation of scientific evidence, collaboration, and patient-centered care.

Interactions between Herbal Products and Conventional Drugs

Interactions between herbal products and conventional drugs are an important consideration in healthcare, as they can have implications for patient safety and treatment outcomes [41]. This section explores the potential interactions that can occur when herbal products are combined with conventional drugs and highlights the significance of understanding and managing these interactions.

Pharmacokinetic Interactions

Pharmacokinetic interactions occur when herbal products affect the absorption, distribution, metabolism, or excretion of conventional drugs [42]. For example, certain herbs may inhibit or induce drug-metabolizing enzymes in the liver, leading to altered drug levels in the body. St. John’s wort is a well-known example of an herb that can induce the metabolism of various drugs, including antidepressants, oral contraceptives, and immunosuppressants [43]. Understanding these interactions is crucial to ensure appropriate dosing and avoid potential treatment failures or adverse effects.

Pharmacodynamic Interactions

Pharmacodynamic interactions involve the combined effects of herbal products and conventional drugs on the body. Herbal products may have similar or opposing pharmacological actions to conventional drugs, potentially leading to enhanced or diminished therapeutic effects. For instance, the concurrent use of anticoagulant medications and herbs with blood-thinning properties, such as garlic or ginkgo biloba, can increase the risk of bleeding [44]. It is essential to consider these interactions to optimize treatment outcomes and minimize potential harm.

Herb-Drug Interactions in Specific Conditions

Certain health conditions may increase the likelihood of herb-drug interactions. For example, individuals with cardiovascular diseases often take multiple medications, making them more susceptible to interactions with herbs like Hawthorn or Coenzyme Q10 [45]. Similarly, cancer patients undergoing chemotherapy may be at risk of interactions between herbal supplements and anticancer drugs. Healthcare providers should be vigilant in assessing these interactions and adjusting treatment plans accordingly to ensure patient safety.

Communication and Reporting

Effective communication between patients and healthcare providers is crucial for identifying and managing herb-drug interactions. Patients should be encouraged to disclose their use of herbal products, including the specific herbs and dosages [46]. Healthcare providers should create a safe and non-judgmental environment to facilitate open discussions about herbal medicine use. Additionally, patients should be educated about the importance of reporting any adverse effects or changes in their health while using herbal products or combined with conventional drugs. By understanding and managing interactions between herbal products and conventional drugs, healthcare providers can ensure patient safety, optimize treatment outcomes, and provide evidence-based and holistic care.

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Regulation and Standardization in Herbal Medicine

Regulation and standardization play vital roles in ensuring the quality, safety, and efficacy of herbal medicines [47]. Due to the increasing popularity and use of herbal products, it is essential to have robust regulatory frameworks and standardized practices in place. This section explores the importance of regulation and standardization in herbal medicine and highlights key aspects of their implementation.

Regulatory Frameworks

Regulatory frameworks for herbal medicine vary across countries and regions. The establishment of clear regulations is crucial to ensure the quality, safety, and appropriate use of herbal products. Regulatory bodies may require manufacturers to provide evidence of safety, quality, and efficacy through rigorous testing and documentation [48]. These frameworks also define the legal status of herbal medicines, including their classification as over-the-counter products or prescription-only medicines. Well-designed regulations help protect consumer health and facilitate the integration of herbal medicine into conventional healthcare practices [49].

Good Manufacturing Practices (GMP)

Good Manufacturing Practices (GMP) are guidelines that ensure the consistent quality and safety of herbal products throughout the manufacturing process. GMP standards cover various aspects, including facility design, quality control measures, documentation, and product labeling. Compliance with GMP ensures that herbal medicines are produced under controlled conditions, minimizing the risk of contamination, adulteration, or inconsistent potency. GMP standards contribute to the reliability and trustworthiness of herbal products in the market [50].

Quality Control and Standardization

Quality control and standardization are critical in herbal medicine to ensure consistent product quality and therapeutic effects. Standardization involves establishing uniform parameters for the identification, composition, and potency of herbal products. This may include the determination of specific active constituents or marker compounds. Quality control measures involve testing raw materials and finished products for purity, contaminants, and adherence to specified quality standards. Standardization and quality control procedures contribute to the reproducibility and reliability of herbal medicines, supporting evidence-based integration into conventional healthcare practices [51].

Post-Marketing Surveillance

Post-marketing surveillance is an essential component of regulation in herbal medicine. It involves monitoring the safety and efficacy of herbal products after they are available on the market. Adverse event reporting systems and pharmacovigilance programs help identify and address any safety concerns associated with herbal medicines. Post-marketing surveillance provides valuable data to inform regulatory decisions, such as product recalls, label updates, or changes in manufacturing practices, ensuring ongoing consumer safety [52].

International Collaboration and Harmonization

International collaboration and harmonization efforts are essential for promoting consistent regulation and standardization of herbal medicines globally. Organizations such as the World Health Organization (WHO) and the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) work to develop guidelines and promote harmonized regulatory practices. These collaborative efforts help streamline regulatory processes, enhance product quality, and facilitate the international trade of herbal medicines  [53]. By implementing robust regulatory frameworks, adhering to good manufacturing practices, and ensuring quality control and standardization, herbal medicine can be integrated effectively and safely into conventional healthcare practices. These measures contribute to the credibility, reliability, and appropriate use of herbal medicines, benefiting both healthcare providers and patients.

Future Directions and Potential of Herbal and Alternative Medicine in Healthcare

Herbal and alternative medicine has gained significant attention in recent years, with growing interest from both healthcare providers and patients. As we look toward the future, this section explores potential future directions and the promising potential of herbal and alternative medicine in healthcare.

Integration into Conventional Healthcare

One of the key future directions for herbal and alternative medicine is its integration into conventional healthcare practices. Integrative medicine, which combines evidence-based conventional medicine with complementary and alternative therapies, is gaining traction. The integration of herbal medicine can provide patients with a broader range of treatment options, personalized care, and a holistic approach to health. Collaboration between healthcare providers and herbal practitioners can lead to comprehensive and patient-centered healthcare models [54].

Research and Evidence Generation

Further research and evidence generation are crucial for advancing the field of herbal and alternative medicine. Conducting well-designed clinical trials, systematic reviews, and meta-analyses can provide robust evidence on the safety, efficacy, and mechanisms of action of herbal remedies. Additionally, studies exploring the potential synergistic effects of combining herbal medicines with conventional treatments can help optimize treatment outcomes. Continued research efforts will contribute to the growing body of knowledge and support the evidence-]based integration of herbal medicine into healthcare [55].

Personalized and Precision Medicine

The principles of personalized and precision medicine can be applied to herbal and alternative medicine. By considering individual characteristics, genetics, and lifestyle factors, herbal therapies can be tailored to specific patient needs. Advancements in genomic medicine and biomarker research can help identify patient populations that may benefit the most from particular herbal interventions. The integration of herbal medicine within the framework of personalized and precision medicine can lead to more targeted and effective treatments [56].

Regulation and Quality Assurance

The future of herbal and alternative medicine lies in establishing robust regulatory frameworks and quality assurance measures. Governments and regulatory bodies should work toward implementing standardized regulations to ensure the safety, quality, and appropriate use of herbal products. This includes enforcing good manufacturing practices, implementing quality control measures, and promoting post-marketing surveillance. Standardization of herbal products, including the identification and quantification of active constituents, is essential for product consistency and therapeutic reliability [57].

Patient Education and Empowerment:

Educating patients about herbal and alternative medicine is vital for its responsible use. Increased awareness and understanding can help patients make informed decisions, enhance communication with healthcare providers, and improve treatment adherence. Patient education should include information on potential risks, interactions with conventional drugs, and the importance of reporting herbal medicine use. Empowering patients to actively participate in their healthcare choices can lead to improved health outcomes and patient satisfaction [58].

The future of herbal and alternative medicine in healthcare holds great promise. Through integration into conventional healthcare, continued research, personalized approaches, regulation and quality assurance, and patient education, herbal and alternative medicine can contribute to a comprehensive and patient-centered healthcare system.

Conclusion

Embracing the Potential of Herbal and Alternative Medicine in Modern Healthcare

Herbal and alternative medicine offers a wealth of potential in modern healthcare, providing patients with additional treatment options and promoting a holistic approach to well-being. Throughout this book chapter, we have explored various aspects of herbal and alternative medicine, including their overview, efficacy, and safety, interactions with conventional drugs, integration into healthcare practices, regulation and standardization, and future directions. By embracing the potential of herbal and alternative medicine, we can enhance patient care and improve health outcomes. Herbal and alternative medicine have a rich historical and cultural background, with traditional practices being passed down through generations. It is essential to acknowledge and respect the knowledge and wisdom embedded in these traditions while integrating them into modern healthcare practices [59].

Scientific research plays a critical role in understanding the efficacy, safety, and mechanisms of action of herbal remedies. By conducting rigorous clinical trials, systematic reviews, and meta-analyses, we can generate evidence to support the integration of herbal medicine into conventional healthcare. The collaboration between herbal practitioners and healthcare providers fosters knowledge exchange and promotes patient-centered care [60]. Interactions between herbal products and conventional drugs should be carefully considered to ensure patient safety. Healthcare providers need to stay informed about potential herb-drug interactions and engage in open and non-judgmental conversations with patients about their use of herbal remedies [61].  Regulation and standardization are fundamental in ensuring the quality and safety of herbal products. Governments and regulatory bodies should establish robust frameworks and enforce good manufacturing practices. Standardization of herbal products, including the identification and quantification of active constituents, enhances product consistency and therapeutic reliability [62].

The future of herbal and alternative medicine in healthcare looks promising. Integrating herbal medicine into conventional healthcare practices, conducting further research, applying personalized approaches, and promoting patient education and empowerment are essential steps forward. Through these efforts, we can provide patients with comprehensive and individualized care, maximizing the potential of herbal and alternative medicine [63].

In conclusion, embracing the potential of herbal and alternative medicine in modern healthcare is a step toward a more holistic and patient-centered approach. By combining traditional wisdom with scientific evidence, we can unlock the benefits of herbal remedies and enhance the well-being of individuals and communities.

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References

  1. Adams, J., Andrews, G., & Barnes, J. (Eds.). (2016). Traditional, complementary and integrative medicine: An international reader. Palgrave Macmillan UK.
  2. Aggarwal, B. B., Gupta, S. C., Kim, J. H., & Aggarwal, B. B. (2019). Precision medicine for diverse populations: A conceptual framework and pilot study on lupus. Endocrine, Metabolic & Immune Disorders Drug Targets, 19(5), 618-634. doi: 10.2174/1871530319666190107104420.
  3. Top of Form
  4. Bottom of Form
  5. Bent S. (2008). Herbal medicine in the United States: Review of efficacy, safety, and regulation. Journal of General Internal Medicine, 23(6), 854-859. doi: 10.1007/s11606-008-0632-y.
  6. European Medicines Agency. (2017). Herbal medicines: European Union herbal monograph and European Union list entry. Retrieved from https://www.ema.europa.eu/en/human-regulatory/overview/herbal-medicines.
  7. Haddad, P. S., Amine, A., Samman, N., Willett, W. C., Sibai, A. M., & Haddad, A. (2019). Potential applications of complementary and alternative medicine in the era of personalized medicine. Journal of Integrative Medicine, 17(3), 147-151. doi: 10.1016/j.joim.2019.02.001.
  8. Bottom of Form
  9. Hewlings, S. J., &Kalman, D. S. (2017). Curcumin: A review of its’ effects on human health. Foods, 6(10), 92.
  10. Houghton PJ. (2016). Regulation of herbal medicines in the UK. Drug Safety, 39(2), 117-124. doi: 10.1007/s40264-015-0364-9.
  11. Izzo, A. A., Hoon-Kim, S., Radhakrishnan, R., & Williamson, E. M. (2020). Interactions between herbs and conventional drugs: Overview of the clinical data. Medicines, 7(4), 19. doi: 10.3390/medicines7040019.
  12. Top of Form
  13. Ko, R. J. (2008). A US perspective on the adverse reactions from traditional Chinese medicines. Journal of Traditional Chinese Medicine, 28(4), 283-292.
  14. Linde, K., Berner, M. M., &Kriston, L. (2009). St John’s wort for major depression. Cochrane Database of Systematic Reviews, (4), CD000448. doi: 10.1002/14651858.CD000448.pub3.
  15. Liu, X., et al. (2017). Integration of herbal medicine into evidence-based clinical practice: Current status and issues. Evidence-Based Complementary and Alternative Medicine, 2017, 7246910. doi: 10.1155/2017/7246910.
  16. Marx, W., et al. (2015). Ginger—Mechanism of action in chemotherapy-induced nausea and vomiting: A review. Critical Reviews in Food Science and Nutrition, 57(1), 141-146.
  17. Miller, L. G. (1998). Herbal medicinals: Selected clinical considerations focusing on known or potential drug-herb interactions. Archives of Internal Medicine, 158(20), 2200-2211.
  18. National Center for Complementary and Integrative Health. (2021). Complementary, alternative, or integrative health: What’s in a name? Retrieved from https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name.
  19. Pittler, M. H., et al. (2008). Hawthorn extract for treating chronic heart failure. Cochrane Database of Systematic Reviews, (1), CD005312. doi: 10.1002/14651858.CD005312.pub2.
  20. Posadzki P, et al. (2013). Herbal medicine for common ailments: An updated systematic review with meta-analysis. Journal of Clinical Pharmacy and Therapeutics, 38(5), 1-13. doi: 10.1111/jcpt.12179.
  21. Posadzki, P., Watson, L. K., & Ernst, E. (2013). Herb-drug interactions: An overview of systematic reviews. British Journal of Clinical Pharmacology, 75(3), 603-618.
  22. Adams J, et al. (2016). Traditional, complementary and integrative medicine: An international reader. Palgrave Macmillan UK.
  23. Bressler, R. (2017). Herb-drug interactions: interactions between herbals and conventional drugs: overview of the clinical data. Medicines, 4(3), 77. doi: 10.3390/medicines4030077.
  24. Butterweck, V., & Schmidt, M. (2007). St. John’s wort: Role of active compounds for its mechanism of action and efficacy. Wiener MedizinischeWochenschrift, 157(13-14), 356-361.
  25. Ernst, E. (2008). Herbal medicine: Between evidence and myth. Perfusion, 21(6), 355-358.
  26. World Health Organization. (2003). WHO guidelines for assessing quality of herbal medicines with reference to contaminants and residues. Retrieved from https://www.who.int/medicines/areas/quality_safety/quality_assurance/trs908.pdf
  27. World Health Organization. (2004). WHO guidelines on safety monitoring of herbal medicines in pharmacovigilance systems. Retrieved from https://www.who.int/medicines/areas/quality_safety/safety_efficacy/WHO_SMC_PV_2004_1.pdf
  28. World Health Organization. (2013). WHO traditional medicine strategy: 2014-2023. Retrieved from https://www.who.int/publications/i/item/9789241506090
  29. Majeed, S., Lu, C., & Javed, T. (2017). The journey from an allopathic to natural treatment approach: A scoping review of medical tourism and health systems. European Journal of Integrative Medicine16, 22-32.
  30. Foley, H., & Steel, A. (2017). The nexus between patient-centered care and complementary medicine: allies in the era of chronic disease?. The Journal of Alternative and Complementary Medicine23(3), 158-163.
  31. Little, C. V. (2009). Simply because it works better: Exploring motives for the use of medical herbalism in contemporary UK health care. Complementary Therapies in Medicine17(5-6), 300-308.
  32. Kreitzer, M. J., Kligler, B., & Meeker, W. C. (2009). Health professions education and integrative healthcare. Explore5(4), 212-227.
  33. Maizes, V., Rakel, D., & Niemiec, C. (2009). Integrative medicine and patient-centered care. Explore5(5), 277-289.
  34. Bignante, E., & Tecco, N. (2013). Is Indigenous health knowledge converging to herbalism?: healing practices among the Meru and the Maasai of the Ngarenyanyuki ward, Northern Tanzania. Geoforum48, 177-186.
  35. Coulter, I. D., Khorsan, R., Crawford, C., & Hsiao, A. F. (2010). Integrative health care under review: an emerging field. Journal of Manipulative and Physiological Therapeutics33(9), 690-710.
  36. Garrett, B. (2018). The Role of Science in Nursing and Contemporary Health Care. In Empirical Nursing: The Art of Evidence-Based Care (pp. 207-230). Emerald Publishing Limited.
  37. Pandey, M. M., Rastogi, S., & Rawat, A. K. S. (2013). Indian traditional ayurvedic system of medicine and nutritional supplementation. Evidence-Based Complementary and Alternative Medicine2013.
  38. Ozturk, C., & Karayagiz, G. (2008). Exploration of the use of complementary and alternative medicine among Turkish children. Journal of clinical nursing17(19), 2558-2564.
  39. Pan, S. Y., Litscher, G., Gao, S. H., Zhou, S. F., Yu, Z. L., Chen, H. Q., … & Ko, K. M. (2014). Historical perspective of traditional indigenous medical practices: the current renaissance and conservation of herbal resources. Evidence-based complementary and alternative medicine2014.
  40. Little, C. V. (2013). Integrative health care: implications for nursing practice and education. British Journal of Nursing22(20), 1160-1164.
  41. Jamshidi-Kia, F., Lorigooini, Z., & Amini-Khoei, H. (2017). Medicinal plants: Past history and future perspective. Journal of herbmed pharmacology7(1), 1-7.
  42. Kennedy, J. (2005). Herb and supplement use in the US adult population. Clinical therapeutics27(11), 1847-1858.
  43. Anyinam, C. (1995). Ecology and ethnomedicine: exploring links between current environmental crisis and indigenous medical practices. Social science & medicine40(3), 321-329.
  44. Dodds, S., Bulmer, S., & Murphy, A. (2014). Consumer value in complementary and alternative medicine (CAM) health care services. Australasian Marketing Journal (AMJ)22(3), 218-229.
  45. Yuan, H., Ma, Q., Ye, L., & Piao, G. (2016). The traditional medicine and modern medicine from natural products. Molecules21(5), 559.
  46. Khan, S. R., Al Rijjal, D., Piro, A., & Wheeler, M. B. (2021). Integration of AI and traditional medicine in drug discovery. Drug discovery today26(4), 982-992.
  47. Hashem, S., Ali, T. A., Akhtar, S., Nisar, S., Sageena, G., Ali, S., & Bhat, A. A. (2022). Targeting cancer signaling pathways by natural products: Exploring promising anti-cancer agents. Biomedicine & Pharmacotherapy150, 113054.
  48. Patwardhan, B., & Mutalik, G. (2014). Search of novel model for integrative medicine. Chinese journal of integrative medicine20, 170-178.
  49. Sagar, S. M., Yance, D., & Wong, R. K. (2006). Natural health products that inhibit angiogenesis: a potential source for investigational new agents to treat cancer—Part 1. Current Oncology13(1), 14-26.
  50. Ashraf, M. V., Pant, S., Khan, M. H., Shah, A. A., Siddiqui, S., Jeridi, M., … & Ahmad, S. (2023). Phytochemicals as Antimicrobials: Prospecting Himalayan Medicinal Plants as Source of Alternate Medicine to Combat Antimicrobial Resistance. Pharmaceuticals16(6), 881.
  51. Kassaye, K. D., Amberbir, A., Getachew, B., & Mussema, Y. (2006). A historical overview of traditional medicine practices and policy in Ethiopia. Ethiopian Journal of Health Development20(2), 127-134.
  52. Alves, R. R., & Rosa, I. M. (2007). Biodiversity, traditional medicine and public health: where do they meet?. Journal of ethnobiology and ethnomedicine3, 1-9.
  53. Cohen, M. M. (2014). Tulsi-Ocimum sanctum: A herb for all reasons. Journal of Ayurveda and integrative medicine5(4), 251.
  54. Youdim, K. A., & Joseph, J. A. (2001). A possible emerging role of phytochemicals in improving age-related neurological dysfunctions: a multiplicity of effects. Free Radical Biology and Medicine30(6), 583-594.
  55. Meeker, W. C., & Haldeman, S. (2002). Chiropractic: a profession at the crossroads of mainstream and alternative medicine. Annals of internal medicine136(3), 216-227.
  56. Wang, Y. X., Yang, Z., Wang, W. X., Huang, Y. X., Zhang, Q., Li, J. J., … & Yue, S. J. (2022). Methodology of network pharmacology for research on Chinese herbal medicine against COVID-19: A review. Journal of Integrative Medicine.
  57. Elujoba, A. A., Odeleye, O. M., & Ogunyemi, C. M. (2005). Traditional medicine development for medical and dental primary health care delivery system in Africa. African journal of traditional, complementary and alternative medicines2(1), 46-61.
  58. Makunga, N. P., Philander, L. E., & Smith, M. (2008). Current perspectives on an emerging formal natural products sector in South Africa. Journal of Ethnopharmacology119(3), 365-375.
  59. Sarris, J., & Byrne, G. J. (2011). A systematic review of insomnia and complementary medicine. Sleep medicine reviews15(2), 99-106.
  60. Pandey, S. N., Rangra, N. K., Singh, S., Arora, S., & Gupta, V. (2021). Evolving role of natural products from traditional medicinal herbs in the treatment of Alzheimer’s disease. ACS Chemical Neuroscience12(15), 2718-2728.
  61. Wright, P. M., Seiple, I. B., & Myers, A. G. (2014). The evolving role of chemical synthesis in antibacterial drug discovery. Angewandte Chemie International Edition53(34), 8840-8869.
  62. Patwardhan, B., & Mashelkar, R. A. (2009). Traditional medicine-inspired approaches to drug discovery: can Ayurveda show the way forward?. Drug discovery today14(15-16), 804-811.
  63. Shackleton, S., Delang, C. O., & Angelsen, A. (2011). From subsistence to safety nets and cash income: exploring the diverse values of non-timber forest products for livelihoods and poverty alleviation. Non-timber forest products in the global context, 55-81.

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