Utilization of traditional herbal medicine formulas for unexplained female infertility in Korea: a retrospective study

Abstract

Background: This study aimed to investigate the prescription of traditional herbal medicines for the treatment of unexplained female infertility in Korea. By analyzing the relationships among the prescriptions and between the prescriptions and treatment outcomes, we aimed to confirm the utilization of standardized prescriptions and the effectiveness of this standardization.

Methods: The data were derived from the "support projects" of the local government for infertile women to receive Korean medical treatments. The presciption data of 453 participants from 2017 to 2018 were analyzed. Data preprocessing, frequency analysis, and network analysis were conducted. For network analysis, the characteristics of the herbal medicine prescriptions were used to calculate the degree centrality, closeness centrality and eigenvector centrality. Modularity clustering was also performed for cluster analysis.

Results: Fifty different prescriptions were used, among which only 22 were used for participants who became pregnant. The recommended standard prescriptions for support projects were used frequently. "BaeranChacksangBang" showed the highest level of in-degree centrality. Among the prescriptions for participants who became pregnant, "JogyeongJongokTang" and "BaeranChacksangBang" were the most influential nodes. "BaeranChacksangBang", "AnjeonYicheonTang", "YukLinZu" and "JogyeongJongokTang" had high closeness centrality among the prescriptions for participants who became pregnant. Clustering analysis of the prescriptions for participants who became pregnant revealed that the prescriptions showed the best modularity when divided into five groups.

Conclusions: These findings depict the utilization of Korean herbal medicine in the real world and the dynamics underlying the herbal medicine prescription patterns for infertile women.

Keywords: Data mining; Herbal medicine; Infertility; Network analysis; Pregnancy; Public Health; Standardization; Subfertility; Traditional East Asian medicine; Unexplained infertility.

Fig. 1

Network of the prescribed herbal medicines and pregnancy results. a JJT and BCB were the largest nodes, and they were the nodes most strongly linked with clinical pregnancy. b JJT and BCB were the largest nodes in the network of herbal medicines prescribed to participants who became pregnant. c BCB was the node most strongly linked with “ongoing pregnancy”. JJT: JogyeongJongokTang, AYT: AnjeonYicheonTang, BCB: BaeranChacksangBang, CDT: ChangbuDodamTang, GBT: GuiBiTang, YLZ: YukLinZu, TBS: TaesanBansucSan, GBH: GyejiBongnyeongHwan, Ongoing pregnancy: pregnancy maintained over 12 weeks, Early pregnancy loss: miscarriage before 12 weeks

Fig. 2

Degree centrality of herbal medicines prescribed for participants who became pregnant. a Degree centrality of herbal medicines prescribed for participants who became pregnant. The bold arrows were directed towards BCB, indicating high in-degree centrality. The arrow from JJT to BCB was especially thick. b Degree centrality of herbal medicine prescribed for participants who became pregnant who maintained pregnancy for over 12 weeks. The bold arrows were coming in towards BCB, and the arrow from JJT to BCB was especially thick. BCB: BaeranChacksangBang, JJT: JogyeongJongokTang

Fig. 3

Closeness centrality of the herbal medicines prescribed for participants who became pregnant. a Closeness centrality of the herbal medicines prescribed for participants who became pregnant. BCB was located at the center of the network. b Closeness centrality of the herbal medicines prescribed for participants who became pregnant who maintained pregnancy for over 12 weeks. BCB was located at the center. BCB: BaeranChacksangBang, JJT: JogyeongJongokTang, GBT: GuiBiTang, ATE: AnTaeEum, OKT: OnKyungTang, AYT: AnjeonYicheonTang

Fig. 4

Clustering analysis results of the herbal medicines prescribed for participants who became pregnant. a Clustering results of the herbal medicines prescribed for participants who became pregnant. The prescriptions were classified into five groups. b Clustering results of the herbal medicines prescribed for participants who became pregnant who maintained pregnancy for over 12 weeks. The prescriptions were classified into six groups. YST: YangkyukSanhwaTang, BCB: BaeranChacksangBang, JJT: JogyeongJongokTang, ATE: AnTaeEum, YLZ: YukLinZu, AYT: AnjeonYicheonTang, OKT: OnKyungTang, GBT: GuiBiTang