Synergistic effects of Chinese herbal medicine: A comprehensive review of methodology and current research

Xian Zhou, Sai Wang Seto, Dennis Chang, Hosen Kiat, Valentina Razmovski-Naumovski, Kelvin Chan, Alan Bensoussan

Research output: Journal article publicationReview articleAcademic researchpeer-review

309 Citations (Scopus)


Traditional Chinese medicine (TCM) is an important part of primary health care in Asian countries that has utilized complex herbal formulations (consisting 2 or more medicinal herbs) for treating diseases over thousands of years. There seems to be a general assumption that the synergistic therapeutic effects of Chinese herbal medicine (CHM) derive from the complex interactions between the multiple bioactive components within the herbs and/or herbal formulations. However, evidence to support these synergistic effects remains weak and controversial due to several reasons, including the very complex nature of CHM, misconceptions about synergy and methodological challenges to study design. In this review, we clarify the definition of synergy, identify common errors in synergy research and describe current methodological approaches to test for synergistic interaction. We discuss the strengths and weaknesses of these models in the context of CHM and summarize the current status of synergy research in CHM. Despite the availability of some scientific data to support the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low, and the clinical relevancy of most of these findings is undetermined. There remain significant challenges in the development of suitable methods for synergistic studies of complex herbal combinations.

Original languageEnglish
Article number201
JournalFrontiers in Pharmacology
Issue numberJUL
Publication statusPublished - 12 Jul 2016
Externally publishedYes


  • Chinese herbal medicine
  • Combination index
  • Interaction
  • Isobologram
  • Synergy
  • System biology

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


Dive into the research topics of 'Synergistic effects of Chinese herbal medicine: A comprehensive review of methodology and current research'. Together they form a unique fingerprint.

Cite this