Terminology of herbal medicine used in systematic reviews: standardizing or confusing?

Article type
Authors
Liu J
Abstract
Background: The number of Cochrane reviews on herbs is increasing. Understanding terms commonly used in herbal intervention provides a foundation for people new to herbs and reinforces the basics for those with some experience with herbal medicine. A proper use of terminology regarding herbs is one of the key elements to ensure clarification, completeness of searching, and quality of reporting of herbal interventions in systematic reviews.

Objectives: To understand the terms and words used in herb reviews and try to improve appropriate use of terminology and better reporting of systematic reviews on herbs.

Methods: All Cochrane systematic reviews including protocols on herbs published in The Cochrane Library (Issue 1, 2005) were identified using both MeSH and free text terms. The World Health Organization (WHO) documentation on herbal medicine was also searched.

Results: Sixty-seven Cochrane reviews have been identified on herbs, including 31 reviews and 36 protocols. The intervention varied from herbal therapy (usually of many herbs), single herbs to active ingredients from herbs. There was an inconsistency in describing herbal interventions in the reviews, and many terms have been used to describe 'herbal medicine'. These included 'Chinese herbal medicine', 'Chinese medicinal herbs', 'traditional Chinese medicinal herbs', 'Chinese herbs', 'herbal therapies', 'herbal preparations', 'herbal remedies', 'herbal products', 'medicinal herbs', 'medicinal plant', and 'phytomedicine'. For reviews on single herb, the terms used included commercial (trade) name of the herbal product (e.g., Cernilton, for flower pollen extract), botanical Latin name (e.g., Pygeum africanum), pharmaceutical name (e.g., Radix Ginseng), English name (e.g., green tea for Camellia sinensis), indigenous name such as Chinese spelling (Pinyin) name (e.g., 'Huangqi' for Astragalus membranaceus). In the WHO General guidelines for methodologies on research and evaluation of traditional medicine, herbal medicine was categorized as herbs, herbal materials, herbal preparations and finished herbal products.

Conclusions: There is no consensus on terms used for herbs. As one of the complementary and alternative therapies, 'herbal medicine' is the most commonly used term, and any other alternative terms used for herbs should be clearly defined in the review. For single herb, at least botanical name or pharmaceutical name should be used.