Drug discovery in traditional Chinese medicine: From herbal fufang to combinatory drugs

Today, drug discovery is a critical issue in the pharmaceutical industry. Although global spending on drug discovery and development has risen sharply in the last decade, the approval rate for new drugs is declining. This situation is mainly due to drug failure caused by lack of efficacy and/ or safety. One important reason for this is that common single-drug therapeutics are rarely able to fully address the complex nature of most human diseases (1). Producing combinatory drugs—combinations of multiple drugs against multiple disease targets—is an appropriate approach to address this issue (2). Traditional Chinese medicine (TCM), a medical system based on natural products, has been widely used in East Asia for thousands of years to provide treatments and cures for disease. The long history and extensive documentation of TCM clinical practices have accumulated a considerable number of fufang (herbal compound prescriptions) that exhibit in vivo efficacy and safety, and provide a unique resource for combinatory drug discovery.