The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine Clinics

*Ji Yeon Ryu, Jung Youn Park, Angela Dongmin Sung and Soo Hyun Sung*

### **Abstract**

A cross-sectional study has been conducted to detect the facts about the use of traditional herbal medicines (THMs) in South Korea. The questionnaire has been adopted from the 2017 National Survey for the usage of traditional Korean medicine (TKM) and consumption of THMs. A total number of 1346 participants have been involved in this study. Results showed that the non-decoction types of herbal medicines, which are mostly used for therapeutic purposes (89.0%), and the decoction types of herbal medicines were not only used for the purpose of treatment of diseases (62.5%) but also health improvement purposes (21.9%). Results presented that decoction types of THMs are used for musculoskeletal diseases (56.0%), digestive diseases (21.3%), and respiratory diseases (6.3%), whereas the non-decoction types of THMs are commonly used in musculoskeletal diseases (55.6%), respiratory diseases (20.5%), and digestive diseases (18.1%). Future studies are highly recommended to detect more details about the medical use of THMs in South Korea.

**Keywords:** medicinal herb, herbal medicine, traditional Korean medicine, traditional herbal medicine, medical use of herbal medicine

### **1. Introduction**

#### **1.1 Herbal medicine**

Traditional herbal medicines (THMs) are the most popular and preferred forms of traditional medicines (TMs) [1–3]. The World Health Organization (WHO) estimated that 80% of the population in developing countries rely on traditional herbs for their primary health care [4]. Compared with the developed countries, in the United States of America (USA), 19% of the population uses THMs for their treatment [5].

THMs have gained an increasing popularity in the last two decades in the industrialized countries [6–8]. The Europe market for THMs is estimated to be valued at \$5.18 billion in 2016 [9]. The American botanical council reported that the sales of THMs in the USA reached a total of \$7.45 billion in 2016 [10]. Thus, the global THM market is expected to grow and reach \$129.68 billion by 2023 [11].

TMs, such as traditional Chinese medicines (TCMs), Ayurveda, Kampo, traditional Korean medicines (TKMs), and Unani, have used herbal medicines for hundreds or even thousands of years worldwide [6, 12–15]. Before Western medicine was introduced, TMs, especially herbal medicines, were used for preventing and treating diseases in many nations [16]. The use of THMs is well established, and it is widely known to be safe and effective [17].

TM practitioners in Asian countries, such as China, South Korea, and Taiwan, practice TM treatment in medical clinics as doctors defined by law [18, 19]. South Korea has the highest percentage (15.26%) of TM doctors in medical clinics in East Asia, followed by China (12.63%) and the Taiwan region (9.69%) [18].

#### **1.2 Traditional herbal medicines in Korea**

Koreans have traditionally used herbs for treatment and prevention of diseases. In 1894, Je Ma Lee, a TKM doctor, established the theory of Sasang constitutional medicine (SCM), which is a unique TKM form [14, 20]. Based on the SCM theory, humans are categorized into four constitution types: Taeyangyin (Greater Yang type), Tae-eumin (Greater Yin type), Soyangyin (Lesser Yang type), and Soeumin (Lesser Yin type) [14, 20]. SCM has classified therapeutic THMs according to the four constitutions because THMs that respond to the characteristics of four constitutions are different [14, 20].

In South Korea, TKM is legally institutionalized and covered by national insurance [18]. Since 1987 herbal extracts based on good manufacturing practice (GMP) are covered by health insurance, but the decoction type of traditional herbal medicines (THMs) which is combined with two or more medicinal herbs is still not insured yet [18]. In addition, as a member of the WHO Pharmacovigilance, Korea is monitoring adverse drug reactions, including THMs [21].

#### *1.2.1 Medicinal use of herbs in traditional Korean medicine clinics*

The Korean Ministry of Food and Drug Safety (MFDS) introduced the Good Manufacturing Practice for herbs (hGMP) in 2012 and made it mandatory in 2015 [22]. Thus, medicinal herbs must be manufactured by the hGMP facilities that are licensed by the Korean MFDS [22].

Standards for commonly used herbal materials and preparations are included in the "Korean Pharmacopoeia (KP)" and "Korean Herbal Pharmacopoeia (KHP)" [23]. As of 2019, there are 601 kinds of herbal materials called medicinal herbs listed in the "Korean Pharmacopeia" and "Korean Herbal Pharmacopoeia" [24, 25]. The amount of hazardous substances (e.g., heavy metals, pesticides, aflatoxins, sulfur dioxide, and benzopyrene) in herbal materials is restricted by the "Regulations on Limits and Test Methods for Residues and Contaminants in Herbal Medicines" [26].

According to the Korea medical law, TKM clinics should utilize medicinal herbs certified by the Korean MFDS [22]. Since 2015, TKM clinics have been using THMs composed of medicinal herbs for treating diseases and promoting health.

THMs are the second most commonly used treatment in South Korea, mainly utilized as a combination of two or more medicinal herbs [27, 28]. In addition, they are used in various forms, such as a decoction, powder, tablet, soft extract, paste, and pill [27].

In previous studies related to Korean THMs, Fan [23] reviewed the role of MFDS in THM management: pre-market approval, post-market inspection, and management of the product quality system. Choi [29] reported that THMs are

**113**

**Table 1.**

*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine…*

standardized, regulated, and quality controlled by MFDS guidelines such as KP and KHP. Park [18] investigated the TKM system and summarized development of TM system, policy, education system, medical insurance coverage, and herbal drug monitoring system. Yarnell [30] introduced herbal medicine market and modern-

To the best of our knowledge, this is the first study aims to *shed* some *light on* the overall status of THM usage in South Korea (TKM clinics). The objective of this research was to examine the medical use of THMs, particularly mixtures of THMs, in South Korea, a country with an extensive knowledge and experience in THM use

The cross-sectional study design has been used to address the research goals.

The population of the study included TKM doctors who worked at the TKM

All TKM doctors who used to prescribe THMs and provide their consent form

① Musculoskeletal disease ② Neurological disease ③ Cerebrovascular disease ④ Cardiovascular disease ⑤ Cancer ⑥ Endocrine disease ⑦ Digestive disease ⑧ Respiratory disease ⑨ Mental disease ⑩ Obstetrics and

① Musculoskeletal disease ② Neurological disease ③ Cerebrovascular disease ④ Cardiovascular disease ⑤ Cancer ⑥ Endocrine disease ⑦ Digestive disease ⑧ Respiratory disease ⑨ Mental disease ⑩ Obstetrics and

gynecology disease ⑪ Urogenital disease ⑫ Skin disease ⑬ Disease in eyes and ears ⑭ Others (2) Which disease prescribed non-decoction types of THMs the most when treating the disease?

gynecology disease ⑪ Urogenital disease ⑫ Skin disease ⑬ Disease in eyes and ears ⑭ Others

1.Which disease prescribed decoction types of THMs the most when treating the disease? 2.Which disease prescribed non-decoction types of THMs the most when treating the disease?

2. What is the prescription purpose rate when prescribing herbal medicines? (total 100%)

3. Which disease prescribed herbal medicine the most when treating the disease? (1) Which disease prescribed decoction types of THMs the most when treating the disease?

4. Which disease prescribed herbal medicine the most when treating the disease?

*DOI: http://dx.doi.org/10.5772/intechopen.88714*

ized decoction device of TKM hospitals.

for preventing and treating diseases.

clinics. Inclusion and exclusion criteria are as follows:

1. How many prescription cases are being used in the practice? (1) Decoction types of THMs: \_\_\_\_\_\_\_\_\_\_\_\_\_\_ cases (2) Non-decoction types of THMs: \_\_\_\_\_\_\_\_\_\_\_\_\_\_ cases

**2. Methods**

**2.1 Study design**

**2.2 Study population**

*2.2.1 Inclusion criteria*

have been included.

(1) Diseases treatment \_\_\_\_\_\_\_\_\_% (2) Health improvement \_\_\_\_\_\_\_\_\_%

(3) Beauty \_\_\_\_\_\_\_\_\_% (4) Traffic accident \_\_\_\_\_\_\_\_\_% (5) Others \_\_\_\_\_\_\_\_\_%

*TKM: Traditional Korean medicine THM: Traditional herbal medicine*

*Questionnaire on THM prescriptions of TKM doctors.*

*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine… DOI: http://dx.doi.org/10.5772/intechopen.88714*

standardized, regulated, and quality controlled by MFDS guidelines such as KP and KHP. Park [18] investigated the TKM system and summarized development of TM system, policy, education system, medical insurance coverage, and herbal drug monitoring system. Yarnell [30] introduced herbal medicine market and modernized decoction device of TKM hospitals.

To the best of our knowledge, this is the first study aims to *shed* some *light on* the overall status of THM usage in South Korea (TKM clinics). The objective of this research was to examine the medical use of THMs, particularly mixtures of THMs, in South Korea, a country with an extensive knowledge and experience in THM use for preventing and treating diseases.

### **2. Methods**

*Medicinal Plants - Use in Prevention and Treatment of Diseases*

it is widely known to be safe and effective [17].

**1.2 Traditional herbal medicines in Korea**

monitoring adverse drug reactions, including THMs [21].

*1.2.1 Medicinal use of herbs in traditional Korean medicine clinics*

tutions are different [14, 20].

licensed by the Korean MFDS [22].

Medicines" [26].

and pill [27].

TMs, such as traditional Chinese medicines (TCMs), Ayurveda, Kampo, traditional Korean medicines (TKMs), and Unani, have used herbal medicines for hundreds or even thousands of years worldwide [6, 12–15]. Before Western medicine was introduced, TMs, especially herbal medicines, were used for preventing and treating diseases in many nations [16]. The use of THMs is well established, and

TM practitioners in Asian countries, such as China, South Korea, and Taiwan, practice TM treatment in medical clinics as doctors defined by law [18, 19]. South Korea has the highest percentage (15.26%) of TM doctors in medical clinics in East

Koreans have traditionally used herbs for treatment and prevention of diseases. In 1894, Je Ma Lee, a TKM doctor, established the theory of Sasang constitutional medicine (SCM), which is a unique TKM form [14, 20]. Based on the SCM theory, humans are categorized into four constitution types: Taeyangyin (Greater Yang type), Tae-eumin (Greater Yin type), Soyangyin (Lesser Yang type), and Soeumin (Lesser Yin type) [14, 20]. SCM has classified therapeutic THMs according to the four constitutions because THMs that respond to the characteristics of four consti-

In South Korea, TKM is legally institutionalized and covered by national insurance [18]. Since 1987 herbal extracts based on good manufacturing practice (GMP) are covered by health insurance, but the decoction type of traditional herbal medicines (THMs) which is combined with two or more medicinal herbs is still not insured yet [18]. In addition, as a member of the WHO Pharmacovigilance, Korea is

The Korean Ministry of Food and Drug Safety (MFDS) introduced the Good Manufacturing Practice for herbs (hGMP) in 2012 and made it mandatory in 2015 [22]. Thus, medicinal herbs must be manufactured by the hGMP facilities that are

Standards for commonly used herbal materials and preparations are included in the "Korean Pharmacopoeia (KP)" and "Korean Herbal Pharmacopoeia (KHP)" [23]. As of 2019, there are 601 kinds of herbal materials called medicinal herbs listed in the "Korean Pharmacopeia" and "Korean Herbal Pharmacopoeia" [24, 25]. The amount of hazardous substances (e.g., heavy metals, pesticides, aflatoxins, sulfur dioxide, and benzopyrene) in herbal materials is restricted by the "Regulations on Limits and Test Methods for Residues and Contaminants in Herbal

According to the Korea medical law, TKM clinics should utilize medicinal herbs certified by the Korean MFDS [22]. Since 2015, TKM clinics have been using THMs

THMs are the second most commonly used treatment in South Korea, mainly utilized as a combination of two or more medicinal herbs [27, 28]. In addition, they are used in various forms, such as a decoction, powder, tablet, soft extract, paste,

In previous studies related to Korean THMs, Fan [23] reviewed the role of MFDS in THM management: pre-market approval, post-market inspection, and management of the product quality system. Choi [29] reported that THMs are

composed of medicinal herbs for treating diseases and promoting health.

Asia, followed by China (12.63%) and the Taiwan region (9.69%) [18].

**112**

#### **2.1 Study design**

The cross-sectional study design has been used to address the research goals.

#### **2.2 Study population**

The population of the study included TKM doctors who worked at the TKM clinics. Inclusion and exclusion criteria are as follows:

#### *2.2.1 Inclusion criteria*

All TKM doctors who used to prescribe THMs and provide their consent form have been included.


2.Which disease prescribed non-decoction types of THMs the most when treating the disease?

*TKM: Traditional Korean medicine THM: Traditional herbal medicine*

#### **Table 1.**

*Questionnaire on THM prescriptions of TKM doctors.*

### **2.3 Sample selection**

The survey group of THM consumption included individuals who worked at TKM clinics, hospitals (TKM, long-term care, and general hospitals), traditional herbal medicine pharmacies, and community pharmacies. In the study, 1354 TKM doctors working in TKM clinics were included. Among them, 1346 respondents were selected for the final analysis, excluding 8 who said they do not prescribe THMs.

### **2.4 Questionnaire**

The questionnaire adopted and used in this study has been developed by the Korea Ministry of Health and Welfare (MHW), and the National Statistics of Korea reviewed and approved the questionnaire [27]. The 10-page structured questionnaire contained questions on the use, experience, treatment, management status, preference form, number of prescriptions, prescription purpose, frequently prescribed THMs for treatment, ways to purchase herbs, reasons for difficulty in purchase herbs, and plans to expand the use of THMs [27].

There are four sections used in the analysis: the number of THM prescriptions per year, prescription purpose when prescribing THMs, diseases treated with THMs, and THMs used for the disease [27]. The used questionnaire is shown in **Table 1**.

### **2.5 Data analysis**

Descriptive statistics (mean and proportions) were used to describe the characteristics of the representatives of TKM clinics in the sample. Cross-analysis was used to determine the relationships between the high frequency of disease and prescription. All data analyses were performed using SPSS software (version 21.0 for Windows; IBM cop., Armonk, United States).

### **3. Results**

### **3.1 Basic characteristics of participant TKM doctors**

A total number of 1346 TKM doctors participated in this study, 1204 were men (89.5%) and 142 were women (10.5%). Most of them (73.5%) aged between 41 and 60. Out of the 1346 clinics, 779 (57.9%) were located in the capital area, while the rest 567 (42.1%) were located in the noncapital area. Majority of the participants 882 (65.5%) were with less than 20 years of clinical experience, 417 (31.0%) were with 21–38 years of treatment experience, and 47 (3.5%) of them were with 39–56 years of experience, as shown in **Table 2**.

### **3.2 Types of THMs prescribed in TKM clinics**

### *3.2.1 Dispensing of decoction types of THMs*

Results showed that 1346 of the TKM doctors prescribed an average of 590.4 ± 1105.5 decoction types of THMs/year, and the prescription distribution was as follows: 378 (28.1%) had ≤200 cases, 428 (31.8%) had 201–400 cases, 256 (19.0%) had 401–600 cases, and 284 (21.1%) had ≥601 cases (**Table 3**).

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**Factors** *N* **(%)**

Male 1204 (89.5) Female 142 (10.5)

30–40 191 (14.2) 41–50 550 (40.8) 51–60 440 (32.7) ≥61 165 (12.3)

Capital area 779 (57.9) Chungcheong Province 122 (9.1) Gyeongsang Province 287 (21.3) Jeolla Province 158 (11.7)

≤20 882 (65.5) 21–38 417 (31.0) 39–56 47 (3.5)

**Prescription frequency** *N* **(%) Mean ± SD** ≤200 378 (28.1) 590.4 ± 1105.5

*DOI: http://dx.doi.org/10.5772/intechopen.88714*

Gender

Age (years)

Place of work

Clinical experience

**Table 2.**

**Table 3.**

*TKM: Traditional Korean medicine*

*THM: Traditional herbal medicine TKM: Traditional Korean medicine*

*Demographics of participating TKM doctors.*

*3.2.2 Dispensing of non-decoction types of THMs*

*Decoction types of THMs prescribed in TKM clinics.*

201–400 428 (31.8) 401–600 256 (19.0) ≥601 284 (21.1)

*3.3.1 Purpose of prescribed decoction types of THMs*

(59.4%) had ≥601 cases (**Table 4**).

**3.3 Purpose of prescribed THMs**

Out of the total 1346 respondents, 1070 TKM doctors prescribed non-decoction types of THMs. The average of prescription cases was 1775.9 ± 2349.1 non-decoction types of THMs/year, and prescription distribution was as follows: 222 (20.7%) had ≤200 cases, 120 (11.2%) had 201–400 cases, 92 (8.6%) had 401–600 cases, and 636

Decoction types of THMs have been prescribed in the TKM clinics for various reasons: disease treatment (62.5%), health promotion (21.9%), traffic accidents

*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine… DOI: http://dx.doi.org/10.5772/intechopen.88714*


#### **Table 2.**

*Medicinal Plants - Use in Prevention and Treatment of Diseases*

purchase herbs, and plans to expand the use of THMs [27].

for Windows; IBM cop., Armonk, United States).

**3.1 Basic characteristics of participant TKM doctors**

39–56 years of experience, as shown in **Table 2**.

**3.2 Types of THMs prescribed in TKM clinics**

*3.2.1 Dispensing of decoction types of THMs*

The survey group of THM consumption included individuals who worked at TKM clinics, hospitals (TKM, long-term care, and general hospitals), traditional herbal medicine pharmacies, and community pharmacies. In the study, 1354 TKM doctors working in TKM clinics were included. Among them, 1346 respondents were selected for the final analysis, excluding 8 who said they do not prescribe

The questionnaire adopted and used in this study has been developed by the Korea Ministry of Health and Welfare (MHW), and the National Statistics of Korea reviewed and approved the questionnaire [27]. The 10-page structured questionnaire contained questions on the use, experience, treatment, management status, preference form, number of prescriptions, prescription purpose, frequently prescribed THMs for treatment, ways to purchase herbs, reasons for difficulty in

There are four sections used in the analysis: the number of THM prescriptions

Descriptive statistics (mean and proportions) were used to describe the characteristics of the representatives of TKM clinics in the sample. Cross-analysis was used to determine the relationships between the high frequency of disease and prescription. All data analyses were performed using SPSS software (version 21.0

A total number of 1346 TKM doctors participated in this study, 1204 were men (89.5%) and 142 were women (10.5%). Most of them (73.5%) aged between 41 and 60. Out of the 1346 clinics, 779 (57.9%) were located in the capital area, while the rest 567 (42.1%) were located in the noncapital area. Majority of the participants 882 (65.5%) were with less than 20 years of clinical experience, 417 (31.0%) were with 21–38 years of treatment experience, and 47 (3.5%) of them were with

Results showed that 1346 of the TKM doctors prescribed an average of 590.4 ± 1105.5 decoction types of THMs/year, and the prescription distribution was as follows: 378 (28.1%) had ≤200 cases, 428 (31.8%) had 201–400 cases, 256

(19.0%) had 401–600 cases, and 284 (21.1%) had ≥601 cases (**Table 3**).

per year, prescription purpose when prescribing THMs, diseases treated with THMs, and THMs used for the disease [27]. The used questionnaire is shown in

**2.3 Sample selection**

**2.4 Questionnaire**

THMs.

**Table 1**.

**3. Results**

**2.5 Data analysis**

**114**

*Demographics of participating TKM doctors.*


#### **Table 3.**

*Decoction types of THMs prescribed in TKM clinics.*

### *3.2.2 Dispensing of non-decoction types of THMs*

Out of the total 1346 respondents, 1070 TKM doctors prescribed non-decoction types of THMs. The average of prescription cases was 1775.9 ± 2349.1 non-decoction types of THMs/year, and prescription distribution was as follows: 222 (20.7%) had ≤200 cases, 120 (11.2%) had 201–400 cases, 92 (8.6%) had 401–600 cases, and 636 (59.4%) had ≥601 cases (**Table 4**).

### **3.3 Purpose of prescribed THMs**

#### *3.3.1 Purpose of prescribed decoction types of THMs*

Decoction types of THMs have been prescribed in the TKM clinics for various reasons: disease treatment (62.5%), health promotion (21.9%), traffic accidents


#### **Table 4.**

*Non-decoction types of THMs prescribed in TKM clinics.*

(8.6%), beauty (5.9%), and others (1.1%). It was found that most TKM clinics prescribe decoction of Korean medicine herbs for treatment of diseases, as shown in **Table 5**.

### *3.3.2 Purpose of prescribed non-decoction types of THMs*

Same as above, non-decoction types of THMs have been prescribed for several reasons: disease treatment (89.0%), health promotion (6.0%), car accidents (2.8%), beauty (1.4%), and others (0.9%), as shown in **Table 6**.

#### **3.4 Disease proportions and THMs prescribing pattern**

#### *3.4.1 Decoction types of THMs*

The decoction types of THMs were prescribed for patients suffering from musculoskeletal diseases (56.0%), digestive diseases (21.3%), respiratory diseases (6.3%), and obstetrics and gynecology disease (4.2%).

Results showed that decoction types of THMs frequently used for musculoskeletal diseases were Ojeoksan (22.5%), Bojungikgitang (10.3%), and Sipjeondaebotang (7.5%); for digestive diseases were Bojungikgitang (12.5%), Sipjeondaebotang (8.8%), and Ojeoksan (8.8%); for respiratory diseases were Bojungikgitang (9.9%), Socheongryongtang (9.9%), Sipjeondaebotang (8.6%), and Ojeoksan (8.6%); for obstetrics and gynecology diseases were Jogyeongjongogtang (11.1%), Ojeoksan (9.3%), and Bojungikgitang (7.4%); for skin diseases (*n* = 38) were Ojeoksan (10.5%) and Bojungikgitang (7.9%); for neurological diseases were Ojeoksan (16.7%), Galgeuntang (8.3%), and Yukmijihwangtang (8.3%); for cerebrovascular diseases were Ojeoksan (18.8%), Ganghwangyupungtang (12.5%), and Sipjeondaebotang (9.4%); for mental diseases were Gamiondamtang (11.5%), Kwibitang (7.7%), Bunsimgieum (7.7%), and Ojeoksan (7.7%); for cardiovascular diseases was Gamiondamtang (30.0%); for endocrine diseases was Sipjeondaebotang (25.0%); for urogenital diseases were Ssanghwatang (33.3%), Ojeoksan (33.3%), and Yukmijihwangtang (33.3%); for diseases in eyes and ears was Ojeoksan (100.0%); and for cancer was Banhasasimtang (100.0%), as shown in **Table 7**.

#### *3.4.2 Non-decoction types of THMs*

The non-decoction types of THMs were prescribed for patients suffering from musculoskeletal diseases (55.6%), respiratory diseases (20.5%), and digestive diseases (18.1%).

**117**

*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine…*

**Prescription purpose Mean ± SD** Disease treatment 62.5 ± 24.7 Health improvement 21.9 ± 19.6 Traffic accidents 8.6 ± 12.5 Beauty 5.9 ± 12.5 Others 1.1 ± 4.6

**Purpose of prescription Mean ± SD** Disease treatment 89.0 ± 19.3 Health improvement 6.0 ± 13.3 Beauty 2.8 ± 6.5 Traffic accidents 1.4 ± 9.1 Others 0.9 ± 5.1

**Types of diseases Top 3 used THMs** *N* **(%)** Musculoskeletal disease (*n* = 716) Ojeoksan (五積散) 161 (22.5)

Digestive disease (*n* = 272) Bojungikgitang (補中益氣湯) 34 (12.5)

Obstetrics and gynecology disease (*n* = 54) Jogyeongjongogtang (調經種玉湯) 6 (11.1)

Skin disease (*n* = 38) Ojeoksan (五積散) 4 (10.5)

Neurological disease (*n* = 36) Ojeoksan (五積散) 6 (16.7)

Cerebrovascular disease (*n* = 32) Ojeoksan (五積散) 6 (18.8)

Respiratory disease (*n* = 81) Bojungikgitang (補中益氣湯)

Bojungikgitang (補中益氣湯) 74 (10.3) Sipjeondaebotang (十全大補湯) 54 (7.5)

Ojeoksan (五積散) 5 (9.3) Bojungikgitang (補中益氣湯) 4 (7.4)

Bojungikgitang (補中益氣湯) 3 (7.9)

Ganghwangyupungtang (羌活愈風湯) 4 (12.5) Sipjeondaebotang (十全大補湯) 3 (9.4)

24 (8.8)

8 (9.9)

7 (8.6)

2 (5.3)

3 (8.3)

Sipjeondaebotang (十全大補湯) Ojeoksan (五積散)

Socheongryongtang (小靑龍湯)

Sipjeondaebotang (十全大補湯) Ojeoksan (五積散)

Dangguisusan (當歸鬚散) Wolbitang (越婢湯) Hwangryunhaedoktang (黃蓮解毒湯)

Galgeuntang (葛根湯) Yukmijihwangtang (六味地黃湯)

*DOI: http://dx.doi.org/10.5772/intechopen.88714*

*THM: Traditional herbal medicine*

*THM: Traditional herbal medicine*

*Purpose of prescribed non-decoction types of THMs.*

*Purpose of prescribed decoction types of THMs.*

**Table 5.**

**Table 6.**

*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine… DOI: http://dx.doi.org/10.5772/intechopen.88714*


#### **Table 5.**

*Medicinal Plants - Use in Prevention and Treatment of Diseases*

201–400 120 (11.2) 401–600 92 (8.6) ≥601 636 (59.4)

*Non-decoction types of THMs prescribed in TKM clinics.*

*3.3.2 Purpose of prescribed non-decoction types of THMs*

(8.6%), beauty (5.9%), and others (1.1%). It was found that most TKM clinics prescribe decoction of Korean medicine herbs for treatment of diseases, as shown in

**Prescription frequency** *N* **(%) Mean ± SD** ≤200 222 (20.7) 1775.9 ± 2349.1

reasons: disease treatment (89.0%), health promotion (6.0%), car accidents

The decoction types of THMs were prescribed for patients suffering from musculoskeletal diseases (56.0%), digestive diseases (21.3%), respiratory diseases

Results showed that decoction types of THMs frequently used for musculoskeletal diseases were Ojeoksan (22.5%), Bojungikgitang (10.3%), and Sipjeondaebotang (7.5%); for digestive diseases were Bojungikgitang (12.5%), Sipjeondaebotang (8.8%), and Ojeoksan (8.8%); for respiratory diseases were Bojungikgitang (9.9%), Socheongryongtang (9.9%), Sipjeondaebotang (8.6%), and Ojeoksan (8.6%); for obstetrics and gynecology diseases were Jogyeongjongogtang (11.1%), Ojeoksan (9.3%), and Bojungikgitang (7.4%); for skin diseases (*n* = 38) were Ojeoksan (10.5%) and Bojungikgitang (7.9%); for neurological diseases were Ojeoksan (16.7%), Galgeuntang (8.3%), and Yukmijihwangtang (8.3%); for cerebrovascular diseases were Ojeoksan (18.8%), Ganghwangyupungtang (12.5%), and Sipjeondaebotang (9.4%); for mental diseases were Gamiondamtang (11.5%), Kwibitang (7.7%), Bunsimgieum (7.7%), and Ojeoksan (7.7%); for cardiovascular diseases was Gamiondamtang (30.0%); for endocrine diseases was Sipjeondaebotang (25.0%); for urogenital diseases were Ssanghwatang (33.3%), Ojeoksan (33.3%), and Yukmijihwangtang (33.3%); for diseases in eyes and ears was Ojeoksan (100.0%); and for cancer was Banhasasimtang (100.0%), as shown

The non-decoction types of THMs were prescribed for patients suffering from musculoskeletal diseases (55.6%), respiratory diseases (20.5%), and digestive

(2.8%), beauty (1.4%), and others (0.9%), as shown in **Table 6**.

**3.4 Disease proportions and THMs prescribing pattern**

(6.3%), and obstetrics and gynecology disease (4.2%).

*3.4.1 Decoction types of THMs*

*THM: Traditional herbal medicine TKM: Traditional Korean medicine*

Same as above, non-decoction types of THMs have been prescribed for several

**116**

in **Table 7**.

diseases (18.1%).

*3.4.2 Non-decoction types of THMs*

**Table 5**.

**Table 4.**

*Purpose of prescribed decoction types of THMs.*


#### **Table 6.**

*Purpose of prescribed non-decoction types of THMs.*



#### **Table 7.**

*Disease proportions and pattern of prescribed decoction types of THMs.*


**119**

**Table 8.**

*THM: Traditional herbal medicine*

*Disease proportions and pattern of prescribed non-decoction types of THMs.*

*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine…*

**Types of diseases Top 3 used THMs** *N* **(%)** Cerebrovascular disease (*n* = 11) Ojeoksan (五積散) 3 (27.3)

Cardiovascular disease (*n* = 9) Banhabackchulchunmatang (半夏白朮天麻湯) 2 (22.2)

Skin disease (*n* = 5) Gamisoyosan (加味逍遙散) 1 (20.0)

Mental disease (*n* = 5) Ojeoksan (五積散) 2 (40.0)

Urogenital disease (*n* = 3) Ojeoksan (五積散) 2 (66.7)

Endocrine disease (*n* = 2) Gumiganghwaltang (九味羌活湯) 1 (50.0)

Disease in eyes and ears (*n* = 1) Ojeoksan (五積散) 1 (100.0) Cancer (*n* = 1) Gunghatang (芎夏湯) 1 (100.0)

Yeongyopaedoksan (蓮翹敗毒散) 2 (18.2) Gunghatang (芎夏湯) 1 (9.1)

Gumiganghwaltang (九味羌活湯) 1 (11.1)

Ojeoksan (五積散) 2 (25.0) Gamisoyosan (加味逍遙散) 1 (12.5)

Gamisoyosan (加味逍遙散) 1 (20.0)

Pyeongwisan (平胃散) 1 (33.3)

Bojungikgi-tang (補中益氣湯) Socheongryongtang (小靑龍湯) Ijintang (二陳湯) Jaeumganghwatang (滋陰降火湯) Pyeongwisan (平胃散)

Gunghatang (芎夏湯) Bojungikgitang (補中益氣湯) Sosihotang (小柴胡湯) Ijungtang (理中湯) Ijintang (二陳湯) Pyeongwisan (平胃散)

Gunghatang (芎夏湯) Bulhwangeumjeonggisan (不換金正氣散) Samsoeum (蔘蘇飮) Ijintang (二陳湯) Pyeongwisan (平胃散)

> Gunghatang (芎夏湯) Ojeoksan (五積散) Insampaedoksan (人蔘敗毒散) Pyeongwisan (平胃散)

Gumiganghwaltang (九味羌活湯) Daecheongnyongtang (大靑龍湯)

Pyeongwisan (平胃散)

*DOI: http://dx.doi.org/10.5772/intechopen.88714*

Obstetrics and gynecology disease

(*n* = 8)


*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine… DOI: http://dx.doi.org/10.5772/intechopen.88714*

#### **Table 8.**

*Medicinal Plants - Use in Prevention and Treatment of Diseases*

**Types of diseases Top 3 used THMs** *N* **(%)** Mental disease (*n* = 26) Gamiondamtang (加味溫膽湯) 3 (11.5)

Cardiovascular disease (*n* = 10) Gamiondamtang (加味溫膽湯) 3 (30.0)

Endocrine disease (*n* = 8) Sipjeondaebotang (十全大補湯) 2 (25.0)

Disease in eyes and ears (*n* = 1) Ojeoksan (五積散) 1 (100.0) Cancer (*n* = 1) Banhasasimtang (半夏瀉心湯) 1 (100.0)

**Types of diseases Top 3 used THMs** *N* **(%)** Musculoskeletal disease (*n* = 591) Ojeoksan (五積散) 216 (36.5)

Respiratory disease (*n* = 218) Ojeoksan (五積散) 35 (16.1)

Digestive disease (*n* = 192) Pyeongwisan (平胃散) 38 (19.8)

Neurological disease (*n* = 16) Socheongryongtang (小靑龍湯) 3 (18.8)

Urogenital disease (*n* = 3) Ssanghwatang (雙和湯)

*Disease proportions and pattern of prescribed decoction types of THMs.*

*THM: Traditional herbal medicine*

**Table 7.**

Kwibitang (歸脾湯) Bunsimgieum (分心氣飮) Ojeoksan (五積散)

Ganghwangyupungtang (羌活愈風湯) Bojungikgitang (補中益氣湯) Sipjeondaebotang (十全大補湯) Ojeoksan (五積散) Yukmijihwangtang (六味地黃湯) Insamnyangyeongtang (人蔘養榮湯) Galgeuntang (葛根湯)

Gwakhyangjunggisan (藿香正氣散) Banhasasimtang (半夏瀉心湯) Bangpungtongseongsan (防風通聖散) Yukgunjatang (六君子湯) Yukmijihwangtang (六味地黃湯) Palmultang (八物湯)

Ojeoksan (五積散) Yukmijihwangtang (六味地黃湯)

Gunghatang (芎夏湯) 92 (15.6) Ijintang (二陳湯) 45 (7.6)

Samsoeum (蔘蘇飮) 30 (13.8)

Ojeoksan (五積散) 37 (19.3)

Galgeuntang (葛根湯) 2 (12.5)

Hyangsapyungwisan (香砂平胃散) 21 (10.9)

Socheongryongtang (小靑龍湯)

Ojeoksan (五積散) Gumiganghwaltang (九味羌活湯) Samsoeum (蔘蘇飮) Pyeongwisan (平胃散)

2 (7.7)

1 (10.0)

1 (12.5)

1 (33.3)

**118**

*Disease proportions and pattern of prescribed non-decoction types of THMs.*

Results showed that decoction types of THMs frequently used for musculoskeletal diseases were Ojeoksan (36.5%), Gunghatang (15.6%), and Ijintang (7.6%); for respiratory diseases were Ojeoksan (16.1%), Samsoeum (13.8%), and Socheongryongtang (13.8%); for digestive diseases were Pyeongwisan (19.8%), Ojeoksan (19.3%), and Hyangsapyungwisan (10.9%); for neurological diseases was Socheongryongtang (18.8%); for cerebrovascular diseases were Ojeoksan (27.3%) and Yeongyopaedoksan (18.2%); for cardiovascular diseases was Banhabackchulchunmatang (22.2%); for obstetrics and gynecology diseases was Ojeoksan (25.0%); for skin diseases were Gamisoyosan (20.0%), Gunghatang (20.0%), Ojeoksan (20.0%), Insampaedoksan (20.0%), and Pyeongwisan (20.0%); for mental diseases was Ojeoksan (40.0%); for urogenital diseases were Ojeoksan (66.7%) and Pyeongwisan (33.3%); for endocrine diseases were Gumiganghwaltang (50.0%) and Pyeongwisan (50.0%); for diseases in eyes and ears was Ojeoksan (100.0%); and for cancer (*n* = 1) was Gunghatang (100.0%), as shown in **Table 8**.

### **4. Discussion**

This study investigated the use of THMs in TKM clinics in South Korea.

Results showed that average prescription cases of 590.4 ± 1105.5 decoction types of THMs and 1775.9 ± 2349.1 non-decoction types of THMs had been prescribed by doctors per year in the TKM clinics. According to the Korean national survey [27], the use of decoction types of THMs was 54.8%, and non-decoction types of THMs with the exception of insurance herbal extracts was 45.2% [27].

The reason for the preference for decoction types of THMs in South Korea is that the traditional way to boil herbs is familiar to the people, and it is possible to prescribe customized prescription according to the symptoms of the patients [31]. Non-decoction types of THMs such as granule, pill, tablet, soft extract, paste, and powder are convenient to store and carry because it is smaller in size than the decoction types of THMs [27]. In the case of the same prescription, the non-decoction types of THMs found to be cheaper than decoction types of THMs, so that patients may prefer non-decoction types of THMs for economic reason [27].

According to the 2017 national survey, Koreans responded that decoction types of THMs were too expensive (44.3%) and required health insurance coverage with a top priority (55.2%) [27]. This point will be solved soon since the Korean MHW has a plan to conduct a pilot program for insurance coverage expansion to the THMs in the latter half of 2019 [32].

The Korean MHW has a plan to conduct a pilot program for insurance coverage expansion to the THMs in the latter half of 2019 [32]. This point will make decoction types of THMs more affordable; this is mainly because the decoction type is found to be more potent and used in a wide range than the non-decoction type. As mentioned by Yoo and Son [33], unlike the non-decoction types of THMs, which were mostly used for therapeutic purposes (89.0%), the decoction types of THMs were not only used for the purpose of treatment of diseases (62.5%) but also for health improvement purposes (21.9%). THMs, especially decoction types of THMs, have played an important role in the prevention of diseases and health promotion in people in South Korea [33]. It is related to the viewpoint of TKM, which improves the vitality by correcting the imbalance of the human body, and the traditional way of boiling herbs reflects this [33].

In respiratory diseases, non-decoction types of THMs (20.5%) were more frequently prescribed than decoction types of THMs (6.3%). It is important to take the medication early during a cold, because of the need to combat the virus. It relieves

**121**

*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine…*

symptoms such as cough, nasal congestion, and rhinorrhea [34]. The decoction types of THMs require about 1 day of preparation time because it takes time to boil the mixed herbs. In the case of non-decoction types of THMs, it is presumed that it is used in respiratory diseases such as cold, because it can be prepared in advance, or ready-made products (pharmaceutical products) can be prescribed immediately. Koreans suffer from digestive diseases due to the preference of spicy and salty Foods, and frequent use of antibiotics [35, 36]. In general, decoction types of THMs are used for treating digestive diseases [27]. The reason for using decoction types of THMs for treating digestive diseases is related to drug manufacturing method and patient's digestive condition [37]. As a result of that, decoction types of THMs seem

There are several limitations in this study. First, some data were limited or deficient due to their limited sources, and the information may be biased despite our efforts to obtain objective data. Since this study was particularly purposed to identify the prescription of THMs for each disease, there is a limitation to the

Second, we could not analyze the results of the use of all Korean THMs because the questionnaire was designed specifically for decoction types of THMs. In addition, we could not assess the utilization status of different THM forms (e.g., granule, pill, tablet, soft extract, paste, and powder) and their target diseases, except for the decoction types of THMs. The dosage has an important influence on the treatment [38]. In order to examine the whole use and status of dosage forms of THMs,

Third, we investigated the disease categories, not the specific diseases that THMs were prescribed for. In the 2020 national survey, the questionnaire needs to be cor-

Our study, based on a national survey of TKM doctors, presented the overall status of medical use of THMs in South Korea. However, the 2017 national survey was conducted separately for decoction and non-decoction types of THMs. Therefore, we could not assess the whole status of THM usage and therapeutic effects of each THM formulation. In future survey, we hope to be able to assess the details of medi-

This work was supported by the Policy Support Project for the Development of

Traditional Korean Medicine funded by the Ministry of Health and Welfare.

to be more preferable and suitable for digestive diseases [27, 37].

the questionnaire needs to be revised in a future survey.

rected so that the respondents can reply in regard to specific diseases.

*DOI: http://dx.doi.org/10.5772/intechopen.88714*

analysis by excluding "other" diseases.

**5. Conclusions**

cal use of THMs in South Korea.

**Acknowledgements**

**Conflict of interest**

**Abbreviations**

The authors declare no conflict of interest.

THM Traditional herbal medicine TM Traditional medicine

#### *The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine… DOI: http://dx.doi.org/10.5772/intechopen.88714*

symptoms such as cough, nasal congestion, and rhinorrhea [34]. The decoction types of THMs require about 1 day of preparation time because it takes time to boil the mixed herbs. In the case of non-decoction types of THMs, it is presumed that it is used in respiratory diseases such as cold, because it can be prepared in advance, or ready-made products (pharmaceutical products) can be prescribed immediately.

Koreans suffer from digestive diseases due to the preference of spicy and salty Foods, and frequent use of antibiotics [35, 36]. In general, decoction types of THMs are used for treating digestive diseases [27]. The reason for using decoction types of THMs for treating digestive diseases is related to drug manufacturing method and patient's digestive condition [37]. As a result of that, decoction types of THMs seem to be more preferable and suitable for digestive diseases [27, 37].

There are several limitations in this study. First, some data were limited or deficient due to their limited sources, and the information may be biased despite our efforts to obtain objective data. Since this study was particularly purposed to identify the prescription of THMs for each disease, there is a limitation to the analysis by excluding "other" diseases.

Second, we could not analyze the results of the use of all Korean THMs because the questionnaire was designed specifically for decoction types of THMs. In addition, we could not assess the utilization status of different THM forms (e.g., granule, pill, tablet, soft extract, paste, and powder) and their target diseases, except for the decoction types of THMs. The dosage has an important influence on the treatment [38]. In order to examine the whole use and status of dosage forms of THMs, the questionnaire needs to be revised in a future survey.

Third, we investigated the disease categories, not the specific diseases that THMs were prescribed for. In the 2020 national survey, the questionnaire needs to be corrected so that the respondents can reply in regard to specific diseases.

### **5. Conclusions**

*Medicinal Plants - Use in Prevention and Treatment of Diseases*

shown in **Table 8**.

**4. Discussion**

the latter half of 2019 [32].

of boiling herbs reflects this [33].

Results showed that decoction types of THMs frequently used for musculoskeletal diseases were Ojeoksan (36.5%), Gunghatang (15.6%), and Ijintang (7.6%); for respiratory diseases were Ojeoksan (16.1%), Samsoeum (13.8%), and Socheongryongtang (13.8%); for digestive diseases were Pyeongwisan (19.8%), Ojeoksan (19.3%), and Hyangsapyungwisan (10.9%); for neurological diseases was Socheongryongtang (18.8%); for cerebrovascular diseases were Ojeoksan (27.3%) and Yeongyopaedoksan (18.2%); for cardiovascular diseases was Banhabackchulchunmatang (22.2%); for obstetrics and gynecology diseases was Ojeoksan (25.0%); for skin diseases were Gamisoyosan (20.0%), Gunghatang

(20.0%), Ojeoksan (20.0%), Insampaedoksan (20.0%), and Pyeongwisan (20.0%); for mental diseases was Ojeoksan (40.0%); for urogenital diseases were Ojeoksan (66.7%) and Pyeongwisan (33.3%); for endocrine diseases were Gumiganghwaltang (50.0%) and Pyeongwisan (50.0%); for diseases in eyes and ears was Ojeoksan (100.0%); and for cancer (*n* = 1) was Gunghatang (100.0%), as

This study investigated the use of THMs in TKM clinics in South Korea.

with the exception of insurance herbal extracts was 45.2% [27].

may prefer non-decoction types of THMs for economic reason [27].

Results showed that average prescription cases of 590.4 ± 1105.5 decoction types of THMs and 1775.9 ± 2349.1 non-decoction types of THMs had been prescribed by doctors per year in the TKM clinics. According to the Korean national survey [27], the use of decoction types of THMs was 54.8%, and non-decoction types of THMs

The reason for the preference for decoction types of THMs in South Korea is that the traditional way to boil herbs is familiar to the people, and it is possible to prescribe customized prescription according to the symptoms of the patients [31]. Non-decoction types of THMs such as granule, pill, tablet, soft extract, paste, and powder are convenient to store and carry because it is smaller in size than the decoction types of THMs [27]. In the case of the same prescription, the non-decoction types of THMs found to be cheaper than decoction types of THMs, so that patients

According to the 2017 national survey, Koreans responded that decoction types of THMs were too expensive (44.3%) and required health insurance coverage with a top priority (55.2%) [27]. This point will be solved soon since the Korean MHW has a plan to conduct a pilot program for insurance coverage expansion to the THMs in

The Korean MHW has a plan to conduct a pilot program for insurance coverage expansion to the THMs in the latter half of 2019 [32]. This point will make decoction types of THMs more affordable; this is mainly because the decoction type is found to be more potent and used in a wide range than the non-decoction type. As mentioned by Yoo and Son [33], unlike the non-decoction types of THMs, which were mostly used for therapeutic purposes (89.0%), the decoction types of THMs were not only used for the purpose of treatment of diseases (62.5%) but also for health improvement purposes (21.9%). THMs, especially decoction types of THMs, have played an important role in the prevention of diseases and health promotion in people in South Korea [33]. It is related to the viewpoint of TKM, which improves the vitality by correcting the imbalance of the human body, and the traditional way

In respiratory diseases, non-decoction types of THMs (20.5%) were more frequently prescribed than decoction types of THMs (6.3%). It is important to take the medication early during a cold, because of the need to combat the virus. It relieves

**120**

Our study, based on a national survey of TKM doctors, presented the overall status of medical use of THMs in South Korea. However, the 2017 national survey was conducted separately for decoction and non-decoction types of THMs. Therefore, we could not assess the whole status of THM usage and therapeutic effects of each THM formulation. In future survey, we hope to be able to assess the details of medical use of THMs in South Korea.

### **Acknowledgements**

This work was supported by the Policy Support Project for the Development of Traditional Korean Medicine funded by the Ministry of Health and Welfare.

### **Conflict of interest**

The authors declare no conflict of interest.

#### **Abbreviations**



### **Author details**

Ji Yeon Ryu1 , Jung Youn Park<sup>2</sup> , Angela Dongmin Sung1 and Soo Hyun Sung1 \*

1 National Institute of Korean Medicine Development, Seoul, South Korea

2 Yuhan University, Bucheon, South Korea

\*Address all correspondence to: koyote10010@nikom.or.kr

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**123**

*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine…*

2018

2018

2017;**115**:56-65

molecules21050559

10.1155/2014/739895

molecules181214670

10.1136/ewjm.175.2.125

& Alternative Medicine. 2017;**9**:317. DOI: 10.15406/ijcam.2017.09.00317

[9] Research and Markets. Europe Spice and Herb Extracts Market—Segmented by Type, Application, and Geography— Growth, Trends and Forecasts (2018- 2023). Dublin: Research and Markets;

[10] Smith T, Kawa K, Eckl V, Morton C, Stredney R. Herbal supplement sales in US increase 7.7% in 2016. Herbal Gram.

[11] Market Research Future. Herbal Medicine Market Research Report— Forecast to 2023. Maharashtra:

WantStats Research and Media Pvt. Ltd;

[12] Yuan H, Ma Q, Ye L, Piao G. The traditional medicine and modern medicine from natural products. Molecules. 2016;**21**:E559. DOI: 10.3390/

[13] Pan SY, Litscher G, Chan K, Yu ZL,

Chen HQ, Ko KM. Traditional medicines in the world: Where to go next? Evidence-based Complementary and Alternative Medicine. 2014;**2014**:739895. DOI:

[14] Kumar H, Song SY, More SV, Kang SM, Kim BW, Choi DK.

and herbal formulations for cognitive impairment. Molecules. 2013;**18**:14670-14693. DOI: 10.3390/

Traditional Korean East Asian medicine

[15] Vickers A, Zollman C, Lee R. Herbal medicine. The Western Journal of Medicine. 2001;**175**:125-128. DOI:

[16] Na-Bangchang K, Karbwang J. Traditional herbal medicine for the control of tropical diseases. Tropical

*DOI: http://dx.doi.org/10.5772/intechopen.88714*

[1] Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Reports. 2008;**10**:1-23. DOI: 10.1016/j.sigm.2004.07.003

[2] Thomas K, Coleman P. Use of complementary or alternative medicine in a general population in Great Britain. Results from the national omnibus survey. Journal of Public Health.

2004;**26**:152-167. DOI: 10.1093/pubmed/

[3] Eardley S, Bishop FL, Prescott P, Cardini F, Brinkhaus B, Santos-Rey K, et al. A systematic literature review of complementary and alternative medicine prevalence in EU. Forschende Komplementärmedizin. 2012;**19**:18-28.

[4] World Health Organization. Health of Indigenous Peoples. Geneva: World Health Organization; 2007. p. 1132

[5] Gardiner P, Graham R, Legedza ATR, Ahn AC, Eisenberg DM, Phillips RS. Factors associated with herbal therapy use by adults in the United States. Alternative Therapies in Health and

[6] Msomi NZ, Simelane MBC. Herbal Medicine. London: IntechOpen; 2018. pp. 215-227. DOI: 10.5772/

[7] Ekor M. The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety. Frontiers in Pharmacology.

[8] Wegener T. Patterns and trends in the use of herbal products, herbal medicine

International Journal of Complementary

and herbal medicinal products.

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intechopen.72816

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*The Utilization of Traditional Herbal Medicine for Treatment in Traditional Korean Medicine… DOI: http://dx.doi.org/10.5772/intechopen.88714*

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*Medicinal Plants - Use in Prevention and Treatment of Diseases*

TKM Traditional Korean medicine MFDS Ministry of Food and Drug Safety MHW Ministry of Health and Welfare

**122**

**Author details**

, Jung Youn Park<sup>2</sup>

2 Yuhan University, Bucheon, South Korea

provided the original work is properly cited.

\*Address all correspondence to: koyote10010@nikom.or.kr

, Angela Dongmin Sung1

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

1 National Institute of Korean Medicine Development, Seoul, South Korea

and Soo Hyun Sung1

\*

Ji Yeon Ryu1

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**127**

**Chapter 8**

R.M.Sm

**Abstract**

health.

Zingiberaceae

**1. Introduction**

plan future studies.

Pharmacological Activities and

*Etlingera pavieana* (Pierre ex Gagnep) R.M.Sm. (Zingiberaceae family) is commonly found in Southeast Asia. The rhizome of the plant is used as a spice and folk medicine in southeastern Thailand and Cambodia. The extracts, essential oil, and compounds from *E. pavieana* were found to possess a variety of pharmacological activities like anti-inflammatory, antioxidant, antiatherogenic, and antimicrobial effects. Furthermore, phytochemical studies have reported the presence of various chemical constituents, the main being phenylpropanoids such as *trans*-4-methoxycinnamaldehyde (MCD) and 4-methoxycinnamyl *p*-coumarate (MCC). Therefore, *E. pavieana* seems to be a potential source of natural products for treatment of various diseases and promotion of good

**Keywords:** *Etlingera pavieana*, pharmacological activity, phytochemical constituents,

Plant-based nutraceuticals or functional foods have gained attention due to their

health promotion and safety in comparison to synthetic food ingredients [1, 2]. Presently, worldwide researchers have focus on scientific evaluation of medicinal plants to detect their pharmacological activities. Zingiberaceae family is distributed worldwide and comprises approximately 52 genera and 1587 species [3]. It is about 300 species belonging to 26 genera found in Thailand [4]. The plants in this family are the natural sources for traditional medicine, foods, spice, and other ethnobotanical uses [4]. *Etlingera pavieana* (Pierre ex Gagnep) R.M.Sm. is a member of the Zingiberaceae family and a medicinal plant of southeastern Thailand [5]. Several *in vitro* and *in vivo* pharmacological experiments and phytochemistry studies of *E. pavieana* have been reported. This chapter has presented comprehensive information about morphological characteristics, traditional uses, pharmacology activities, and phytochemical constituents of *E. pavieana*, which provide the data to

Phytochemicals of *Etlingera* 

*pavieana* (Pierre ex Gagnep)

*Klaokwan Srisook and Ekaruth Srisook*

### **Chapter 8**
