Objectives: Chronic rhinosinusitis (CRS) is a disease with a high prevalence and a high socioeconomic burden. This study aimed to conduct a comprehensive systematic review to update the evidence on the use of herbal medicine (HM) for CRS treatment.Methods: A total of 14 electronic databases for randomized controlled trials (RCTs) evaluating the effects of HM on the treatment of CRS were searched for articles published before July 2021. The primary outcome was CRS severity post-treatment, measured with the Visual Analogue Scale (VAS) and Total Effective Rate (TER). The risk of bias of the included studies and the quality of evidence of the main findings were assessed using the Cochrane Collaboration’s risk of bias tool and the Grading of Recommendations, Assessment, Development, and Evaluations tool.Results: A total of 80 RCTs were included. Compared to placebo, HM significantly improved CRS severity as measured by TER and VAS. When HM was compared with conventional treatment (CT) as monotherapy or adjuvant therapy, CRS severity measured by TER and VAS, quality of life, Lund-Kennedy endoscopy score, Lund-Mackay computed tomography score, and nasal mucociliary function were significantly improved in the HM group. No serious adverse events associated with HM were reported. The risk of bias was generally unclear, and the quality of evidence ranged from moderate to low.Conclusion: This review found some limited clinical evidence that HM or HM combined with CT may be more effective and safer than CT alone in treating CRS. However, the methodological quality of the included studies was generally low, and the quality of the evidence needs to be improved.

Background. Chronic rhinosinusitis (CRS) is a highly prevalent disease associated with poor quality of life. In this paper, we appraised the role of acupuncture in the treatment of CRS. Methods. Electronic databases were searched for randomized controlled clinical trials (RCTs) that examined the role of acupuncture in CRS. The primary outcome measures included posttreatment CRS severity, as measured by the Visual Analogue Scale (VAS) and Total Effective Rate (TER). The risk of bias and quality of evidence were evaluated according to the Cochrane Collaborations risk-of-bias tool and GRADE tool, respectively. Results. Evidence from the RCTs (n=10) suggested that acupuncture as a monotherapy or adjunctive therapy to conventional treatment was associated with significant improvements in VAS, TER, and quality of life when compared with conventional treatments for CRS. However, there was a similar incidence of adverse events. The risk of bias was unclear and the quality of evidence for each finding was generally moderate to low. Conclusions. Acupuncture as a stand-alone or adjunctive treatment for CRS was associated with clinical symptom improvement and better quality of life, without any risk for serious adverse events. However, the high clinical heterogeneity of the included RCTs and overall moderate-to-low quality of evidence necessitates rigorous, well-designed trials to confirm these findings. Trial Registrations. This trial is registered with PROSPERO (no. CRD42021292135).

Objectives: Chronic rhinosinusitis (CRS) is often treated with Korean medicine (KM), but comprehensive utilization data is lacking. This study aimed to analyze the patterns of KM use for CRS using National Health Insurance Service data from 2012 to 2022.Methods: We conducted a retrospective analysis of claims data for CRS patients (International Classification of Diseases code: J32) who visited KM institutions. We examined demographic characteristics, visiting patterns, medical costs, treatment modalities, and concurrent use of Western medicine.Results: Of 138,647 patients (52.2% male, mean age 23.8 years), 41.8% were under 10 years old. Annual patient numbers ranged from 14,595-17,242 (2012-2019), decreasing sharply from 2020. Average costs increased 5% annually. Acupuncture was the most common treatment (661,455, 50.5%). The most frequently prescribed insured herbal medicine was Hyeonggaeyeongyo-tang (48,494, 48.5%). Notably, 87.0% (120,610 patients) concurrently received Western medical treatment, indicating a prevalent integrative approach in CRS management. 77.8% received their initial diagnosis at Western institutions.Conclusion: This comprehensive analysis of KM utilization for CRS in Korea reveals significant patterns in patient demographics, treatment preferences, and integration with Western medicine. The high rate of concurrent KM and Western treatment highlights the integrative nature of CRS management in Korea, providing valuable insights for health policy and clinical practice.

Objectives: This study aimed to compare the cost-utility of traditional Korean medicine (TKM) alone versus combined TKM and Western medicine (TKM+WM) as treatment strategies for the prevention of depression in women with menopausal disorders. We utilized nationwide real-world claims data provided by the Health Insurance Review and Assessment Service (HIRA) of South Korea.Methods: A retrospective cohort study was conducted using customized national health insurance claims data from the Health Insurance Review and Assessment Service (HIRA) between 2015 and 2023. Women diagnosed with menopausal disorders (KCD code N95) at Korean medicine institutions were identified and followed for three years from the index date. Based on treatment patterns during the episode period, participants were classified into a traditional Korean medicine (TKM) only group and a TKM plus Western medicine (TKM+WM) group. The incidence of depression was defined using ICD-10 codes F32–F33. Quality-adjusted life years (QALYs) were estimated using utility weights of 0.85 (without depression) and 0.65 (with depression), and incremental cost-effectiveness ratios (ICERs) were calculated. Sensitivity analyses were performed to assess the impact of changes in utility values and discount rates.Results: The TKM+WM group had higher medical costs (160,817 KRW vs. 73,862 KRW) and achieved higher QALYs (2.37 vs. 2.18) compared to the TKM-only group. The resulting incremental cost-effectiveness ratio (ICER) was estimated at 445,657 KRW per QALY gained, which is substantially below the widely accepted willingness-to-pay (WTP) threshold in South Korea (30 million KRW/QALY). Sensitivity analyses confirmed the robustness of these findings across varying assumption.Conclusions: Based on real-world claims data analysis, combined Korean and Western medicine treatment showed favorable cost-effectiveness compared to Korean medicine alone for managing menopausal women at risk of depression in the Korean healthcare context. However, these observational findings should be interpreted with caution regarding causal inference. Further prospective studies are needed to confirm these associations and inform evidence-based policy decisions regarding integrative care and reimbursement strategies.

Facial palsy (FP) is a neurological condition marked by unilateral facial weakness due to facial nerve dysfunction. In November 2020, the Korean government launched a pilot reimbursement program for herbal decoctions, expanding insurance coverage to include treatments traditionally excluded from the national health system. This study aimed to evaluate the real-world utilization, clinical effectiveness, and safety of herbal medicine (HM) for FP within this national reimbursement program. This retrospective study analyzed outpatient claims data from the Health Insurance Review and Assessment Service (HIRA) between November 2020 and April 2024. Patients diagnosed with FP (KCD code G51.0) from January 2018 onward who received treatment at Korean Medicine (KM) clinics participating in the program were included. Patients were excluded if they had fewer than two visits or incomplete treatment records. Descriptive and inferential analyses were conducted to examine patient demographics, treatment patterns, symptom progression, and adverse events (AEs). A total of 3,927 patients were analyzed (2,174 females and 1,753 males; mean age: 54.2 ± 14.7). Peripheral FP was reported in 88.9% of cases. Most patients received treatment in outpatient KM clinics, with 56.2% making two or fewer visits and 36.6% initiating care within two weeks of symptom onset. Ligigeopoong-san (17.0%) and Gamiboik-tang (14.4%) were the most commonly prescribed formulas. Among patients with symptom severity scores at both baseline and follow-up (n = 2,161), 49.2% showed improvement, 45.6% remained unchanged, and 5.2% worsened. The overall AE rate was low (1.76%), with gastrointestinal issues being most frequent. Herbal decoctions prescribed under the Korean pilot reimbursement program for FP showed a low incidence of adverse events and moderate rates of symptom improvement, suggesting a potentially safe and effective treatment option based on large-scale real-world data. These findings support the continued integration of herbal medicine into national health policy. However, limitations include the absence of clinical grading and reliance on administrative data. As the second-phase program expands in scope and duration, further research should explore its long-term clinical and economic outcomes to guide evidence-based healthcare policy development.

To evaluate the feasibility of applying the Observational Medical Outcome Partnership (OMOP) Common Data Model (CDM) to databases of traditional East Asian medicine (TEAM), we composed a TEAM dataset and transformed it to the OMOP CDM. We found that some important TEAM information entities could not be transformed to the OMOP CDM (version 6.0) data fields. We suggest to develop data fields and guideline for transforming TEAM data to the OMOP CDM.