J Ethnopharmacol. 2016 Nov 30. pii: S0378-8741(16)32158-4. doi: 10.1016/j.jep.2016.11.047. [Epub ahead of print]
- 1Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
- 2Graduate
Institute of Chinese Medicine, College of Chinese Medicine, China
Medical University, Taichung 40402, Taiwan; School of Chinese Medicine,
College of Chinese Medicine, China Medical University, Taichung
40402,Taiwan.
- 3Graduate Institute of Chinese
Medicine, College of Chinese Medicine, China Medical University,
Taichung 40402, Taiwan; School of Chinese Medicine, College of Chinese
Medicine, China Medical University, Taichung 40402,Taiwan; Department of
Chinese Medicine, Tri-Service General Hospital, National Defense
Medical Center, Taipei 11490, Taiwan.
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE:
The regulation policies of substances used in Chinese Herbal Medicine (CHM), have a direct influence on the ability of health providers to practice in the clinic.
AIM OF THE STUDY:
We
set out to assess the truth behind the assumption that practice of CHM
in the west is constrained by the regulations imposed by authorities in
western countries.
MATERIALS AND METHODS:
For
the first part of our study we surveyed and compiled lists of banned
and restricted Chinese Materia Medica (CMM) from six countries: USA, UK,
Germany,
Israel, Canada and Australia. Afterwards, we estimated the relevant
importance of the 300 most-commonly-used CMM to the practice of CHM
according to prescriptions from 2,000,000 randomly selected patients,
from the Taiwanese National Health Insurance Research Database (NHIRD).
We then compared both lists and determined the clinical importance of
the banned and restricted CMM.
RESULTS:
Except
for regulations from Canada, most of the information of banned CMM
proved to be difficult to organize. The USA was found to have the least
amount of banned herbs, with 9 substances. Canada had the highest
amount, with 98. In Germany,
Australia, the UK, and Israel 10, 29, 36, 68 banned CMM were found,
respectively. Apart from aristolochic acid containing substances, ma
huang (, Ephedra sinica) was the only CMM banned in all countries. Most
of the banned CMM were not found to be the most-commonly-prescribed
according to the NHIRD.
CONCLUSION:
Authorities
should make this information more accessible. No clear relation exists
between CHM regulations and any 'Western' common denominator, and the
amount of banned CMM varied greatly among the surveyed countries.
However, even among countries with a larger amount of banned CMM, the
majority of these were in the bottom two-thirds in respect to the
frequency of their use. Thus, regulations in some western countries
surely influence the practice of CHM, however this should be to a
limited extent only.
Copyright © 2016. Published by Elsevier Ireland Ltd.
KEYWORDS:
Chinese herbal
medicine; National Health Insurance Research Database; Taiwan; commonly
used Chinese herbs; global regulation policies; restricted herbs
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