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

Chul Kim, Hyeun-kyoo Shin
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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.
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56种医保中草药处方定量文献证据现状分析
目的:本研究的目的是分析韩国近30年来研究的56种健康保险草药处方的定量文献证据现状,评价证据的可靠性,并找出未来草药处方的研究方向。方法:在国内文献检索数据库OASIS、DBpia和国外PubMed中检索56种中药方剂,按化学、毒性、细胞、动物、临床病例和临床试验研究进行分类,构建EBM金字塔结构。结果:按研究内容分类,理化分析鉴定成分61例(7.5%),毒性评价80例(9.8%),疗效评价672例(82.7%)。疗效证据按循证医学金字塔结构分类:细胞试验196项(29.1%),动物试验372项(55.4%),病例和病例报告系列89项(13.3%),比较病例研究7项(1.1%),随机对照临床试验8项(1.2%)。在金字塔构成中,56种中药处方的效度基础在细胞和动物单位为568例(84.5%),不能说是高度可靠。中药处方定量文献证据排名与薪酬管理排名之间不存在相关性。结论:在一个对草药持续要求科学证据的时代,传统草药应该确保安全有效性的基础,即使是消费者在56种草药处方中最常见的第10种处方。特别是,传统草药应提高相关草药处方病例报告的定量和定性水平,以临床各社会为重点,向比较病例研究和随机临床试验方向发展,使传统草药定位为循证医学。
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