Analysis of the current status of quantitative literature evidence for the prescription of 56 herbal medicines covered by health insurance

Article information

J Korean Med. 2023;44(3):189-200
Publication date (electronic) : 2023 September 1
doi : https://doi.org/10.13048/jkm.23041
1KM Data Division, Korea Institute of Oriental Medicine
2KM Science Research Division, Korea Institute of Oriental Medicine
Correspondence to: Hyeun-kyoo Shin, KM Science Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Daejeon 34054, Republic of Korea, Tel : +82-42-868-9464, E-mail : hkshin@kiom.re.kr
Received 2023 July 24; Revised 2023 August 20; Accepted 2023 August 22.

Abstract

Objectives

The purpose of this study is to analyze the current state of quantitative literature evidence for the prescription of 56 herbal medicines covered by health insurance that have been studied in Korea for the past 30 years, to evaluate the reliability of the evidence, and to find out the research direction of herbal medicine prescription in the future.

Methods

56 kinds of herbal medicine prescriptions were searched in domestic literature search databases OASIS, DBpia, and overseas PubMed, classified into chemistry, toxicity, cells, animals, clinical cases, and clinical trial studies, and built into an EBM pyramid structure.

Results

When classified according to research contents, there were 61 cases (7.5%) of physicochemical analysis to identify constituent substances, 80 cases (9.8%) of toxicity evaluation, and 672 cases (82.7%) of efficacy evaluation. The efficacy evidence was classified according to the evidence-based medical pyramid structure: 196 cell trials (29.1%), 372 animal trials (55.4%), 89 case and case reporting series (13.3%), 7 comparative case studies (1.1%), and 8 randomized control clinical trials (1.2%). In the pyramid composition, the basis for the validity of 56 kinds of herbal medicines prescribed was 568 cases (84.5%) in cell and animal units, which could not be said to be highly reliable. There was no relationship between the ranking of quantitative literature evidence for herbal medicine prescriptions and the ranking of salary administration.

Conclusions

In an era that continues to require scientific evidence for herbal medicine, traditional herbal medicine should secure the basis for safety validity even for the 10th most frequent prescription among 56 herbal medicine prescriptions for consumers. In particular, traditional herbal medicine should increase the quantitative and qualitative level of case reports on related herbal medicine prescriptions, focusing on each clinical society, and move toward comparative case studies and randomized clinical trial so that traditional herbal medicine is positioned as Evidence-based medicine.

Fig. 1

Flowchart of the search selection process with 56 herbal medicine prescriptions

Fig. 2

Confidence in evidence for 56 herbal medicine prescriptions according to EBM pyramid

Number of Studies on the Prescription of 56 Herbal Medicines and the Status of Insurance Benefit Cost

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Article information Continued

Fig. 1

Flowchart of the search selection process with 56 herbal medicine prescriptions

Fig. 2

Confidence in evidence for 56 herbal medicine prescriptions according to EBM pyramid

Table 1

Number of Studies on the Prescription of 56 Herbal Medicines and the Status of Insurance Benefit Cost

Prescriptions Material analysis Safety Evidence Study Efficacy Evidence Study Total Rank


Single dose toxicity Repeated dose toxicity (W) Genotoxicity Cardiotoxic In vitro In vivo Case report Case control studies RCT Number of research Benefit cost
1. Gamisoyo-san 1 1 1 10 13 6 1 33 6 11
2. Galgeun-tang 4 2 1 (13) 1 8 10 1 27 9 12
3. Galgeunhaegi-tang 4 3 3 10
4. Gumiganghwal-tang 2 3 2 (4/13) 1 1 4 6 1 1 21 14 4
5. Kungso-san 1 1 1 3
6. Gungha-tang 1 1 1 1 4 2
7. Naeso-san 1 3 4 8
8. Dangguiyeonkuo-eum 1 1 2
9. Dangguiyukhwang-tang 1 1 2
10. Daeshiho-tang 1 1 3 11 2 1 19 15
11. Daecheongryong-tang 3 3 2 8
12. Daewhajung-eum 1 1 3 5
13. Daewhangmokdanpi-tang 1 2 3
14. Doinseunggi-tang 4 5 1 10
15. Banhabaeckchulchunma-tang 1 1 2 5 6 15 18 10
16. Banhasasim-tang 3 1 1 4 20 5 1 35 5 3
17. Banhahubag-tang 1 2 8 1 12
18. Bakchul-tang 1 1 2
19. Bojungikgi-tang 4 4 2 (4/13) 1 1 16 41 12 81 1 5
20. Boheo-tang 2 6 8
21. Bokryungbosim-tang 1 1 2
22. Bulhwangeum jeonggi-san 2 1 1 3 7 19
23. Samso-eum 1 1 2 6 10 15
24. Samchulkunbi-tang 2 1 3 3 1 10
25. Samhojakyak-tang 1 1 2
26. Samhwangsasim-tang 1 4 14 2 21 13
27. Saengmaek-san 3 1 6 10 4 1 25 10
28. Sosiho-tang 3 2 (4/13) 1 1 2 24 10 43 4 17
29. Socheongyong-tang 2 2 2 (4/13) 1 1 10 18 6 3 3 48 3 9
30. Seungyangbowi-tang 1 1 32
31. Sikyungbanha-tang 3 1 1 36
32. Sihogyeji-tang 2 7 4 45
33. Sihosogan-tang 2 2 37
34. Sihochengan-tang 3 2 39
35. Antae-eum 2 1 38
36. Yeonkyopaedok-san 1 1 2 3 1 44 14
37. Orim-san 1 1 1 40
38. Ojeok-san 5 2 2 (4/13) 1 1 7 10 4 70 8 1
39. Yijung-tang 2 2 1 5 5 1 55 16
40. Yijin-tang 2 1 1 3 17 64 11 6
41. Ikwiseungyang-tang 2 3 46
42. Insampaedok-san 2 2 1 1 3 51
43. Injinho-tang 1 4 9 2 59 16
44. Jaeumganghwa-tang 3 1 1 3 5 1 58 19 20
45. Jowiseunggi-tang 1 1 1 48
46. Chungsanggyuntong-tang 1 3 4 54
47. Chungseoikgi-tang 2 2 51
48. Cheongwi-san 1 1 50
49. Palmul-tang 3 2 1 (4) 1 9 13 4 82 6 16
50. Pyungwi-san 5 2 1 3 10 1 1 73 12 8
51. Haengso-tang 4 2 57
52. Hyangsapyeongwi-san 1 1 3 5 62 7
53. Hyunggyeyungyo-tang 2 1 (4) 1 1 3 6 67 19 18
54. Hwanggeumjakyak-tang 1 3 2 60
55. Hwangryunheadok-tang 4 2 2 (4/13) 1 1 18 29 6 1 119 2 13
56. Hoechunyanggyeok-san 3 2 61

Total 61 30 15 7 28 196 372 89 7 8 813

Benefit cost: review records of benefit cost by 56 herbal medicines prescription, RCT: randomized clinical trial, W: week