Optimizing herbal drug use through multivariable standardization and precision approaches

Herbal medicines are widely used globally, but their therapeutic efficacy and safety are often compromised by significant variations in herb quality, disease factors, and patients’ responses. While previous research has attempted to address these challenges through various standardization methods, most studies have focused on single variables, which is insufficient, leading to unreliable treatments and impeding the complete integration of herbal medicine into modern practice. This article introduces a multivariable optimization framework to improve the standardization, effectiveness, and safety of herbal medicine. We conducted a comprehensive literature review across PubMed, Google Scholar, and Science Direct databases to identify key factors affecting herbal medicine use. Based on a synthesis of studies on herb quality, traditional diagnostic criteria, patient variability, and precision medicine, we proposed a conceptual multivariable optimization framework. The framework addresses three key domains: (1) Herb variation, through quality optimization and herbal drug development; (2) Disease variation, by knowledge management and training practitioners; and (3) Patient variation, by tailoring treatments using personalized medicine principles. This multifaceted strategy simultaneously controls multiple sources of variability, may enhance treatment reliability and safety over conventional single-variable methods. The framework is adaptable to various traditional systems. Comprehensive control of herb, disease, and patient factors is crucial for improving herbal therapy outcomes. Implementing this multivariable approach will facilitate the successful integration of herbal medicine into modern evidence-based healthcare. Future efforts should focus on validating this model through clinical studies and leveraging multi-omics tools for personalized treatments.