Mean rice statistics (2004–2014) in the main rice producer countries in Asia, Latin America, and the Caribbean (LAC).
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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"65357",title:"Management of Paddy Soil towards Low Greenhouse Gas Emissions and Sustainable Rice Production in the Changing Climatic Conditions",doi:"10.5772/intechopen.83548",slug:"management-of-paddy-soil-towards-low-greenhouse-gas-emissions-and-sustainable-rice-production-in-the",body:'World rice production especially in Southeast Asia and tropical Asia is highly vulnerable to climate change. Rice production systems contribute to global climate change through emissions of carbon dioxide (CO2), methane (CH4), and N2O gases to the atmosphere and simultaneously are affected by the changed climatic variables. Rice is the major cereal crop for more than half of the world’s population and its production needs to be increased 40% by the end of the 2030s to meet the increasing demand for the expanding population [1], which may further accelerate CH4 and N2O emissions to the atmosphere [2]. In 2012, worldwide rice production covered 163 million ha of cropland, where approximately 80 million ha were managed under continuous flood irrigation and contributed to 75% of the world’s rice production [3]. China and India, most densely populated countries in the world, account for 20.0 and 28.5% of the global rice area, respectively [4]. In China, approximately 90% of the rice fields are irrigated [5], while in India, more than 46% of the rice fields are irrigated [6]. Unfortunately, the irrigated rice farming acts as one of the main sources of anthropogenic CH4 emission to the atmosphere [7]. Therefore, IRRI is promoting water-saving alternate wetting and drying techniques for improving water use efficiency, while reducing CH4 production in the rice rhizosphere.
Rice paddy fields act as a source of greenhouse gases such as methane (CH4) and nitrous oxides (N2O) depending on soil organic matter status, land use and cropping intensity, irrigation water and drainage management practices, soil microbial populations and their activities, soil properties, and climatic variables. The management practices such as tillage operations, leveling, plant residue incorporation, irrigation frequency and standing water levels, drainage system, and organic and inorganic soil amendments followed in rice farming influence the amount of CH4 and N2O emitted to the atmosphere. Generally, CH4 gas is produced under flooded or anoxic soil conditions (Figure 1a), while N2O gas is produced through nitrification and denitrification processes depending on soil aerobic (oxygenated) and anaerobic conditions (Figure 1b).
(a) Schematic diagram of methane production, oxidation, and emission from rice paddy field and (b) schematic diagram of N2O, NO, and N2 emissions from rice paddy field.
Typically, N2O emissions are low under flooded fields, while CH4 emissions are high, a trade-off relationship observed which is largely dependent on paddy soil water level, redox status, soil organic matter content, and external sources of organic and inorganic soil amendments. Ali et al. reported that the total GWP of CH4 and N2O gases was decreased by 7–27% and 6–34% with calcium carbide, phospho-gypsum, and silicate fertilizer amendments under continuous and intermittent irrigations, respectively [8]. However, biochar amendments increased the overall GWP of CH4 and N2O gases, which simultaneously increased rice yield [8].
Greenhouse gases (GHGs), mainly carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O), have been contributing to about 80% to the current global radiative forcing [9]. Agricultural activities contribute to approximately 20% of the present concentrations of atmospheric GHGs [10], especially the emissions of CH4 and N2O from paddy fields [9]. Methane (CH4) and nitrous oxide (N2O) are the two most important GHGs from agriculture, with global-warming potentials (GWP) of 25 and 298 CO2-equivalents, respectively, on a 100-year time horizon. Apart from the water vapor, CH4 is a major greenhouse gas contributing 20% toward global warming with almost 25-fold higher global warming potential than carbon dioxide [11]. The concentrations of atmospheric CH4 and N2O have increased from 722 and 270 ppb in the pre-industrial period to 1853 and 328.9 ppb in 2016, respectively [12]. China, the largest rice-producing country, accounts for about 28% of global rice production [4] and the total CH4 and N2O emissions from paddy fields are estimated to be 6.4 Tgyr−1 and 180 Ggyr−1, respectively [13]. Although the global estimates of CH4 emission from rice cultivation vary within 20–150 TgCH4 year−1, the global average CH4 is about 100 TgCH4 year−1 [14] and may increase further due to the expansion of rice cultivation as well as intensification of rice agriculture for the increasing world population [15]. Therefore, it is very important to understand the mechanism of CO2, CH4, and N2O exchange and their main controlling factors for developing appropriate strategies to mitigate GHG emissions.
Paddy soils are mostly alluvial soils and low humic gley soils (or Entisols and Inceptisols). In addition, vertisols, reddish-brown earths or Alfisols, red-yellow podzolic soils or Ultisols, and latosols or Oxisols are utilized for paddy rice cultivation. Paddy soils are found mainly on alluvial lands such as deltas and flood plains of big rivers, coastal plains, fans, and lower terraces. In general, paddy soils are resistant to erosion when they are terraced and there are ridges around the field, as measures to retain surface water. Paddy fields in the lowlands receive new sediments deposited from run-off that carries eroded topsoil down from the uplands, thus sustaining soil fertility and productivity. The paddy soils have medium to high organic matter (1.5–3.97 g/kg), available phosphorus (11.7–19.9 mg/kg), available potassium (61.6–132.9 mg/kg), and cation exchange capacity (15.5–33.1 cmol/kg). The most common practice in paddy rice cultivation is flooding or temporary water logging of the land surface. Soil redox potential (Eh) or electron activity in soil gradually decreases after flooding, which causes significant methane production at around −200 mV [16], and creates high risk of gaseous N losses through denitrification (Figure 2).
Paddy soil redox status, sequential reduction and oxidation of inorganic nitrogen, manganese, and iron in flooded soil, and methane gas formation [16].
In paddy fields, the kinetics of the reduction processes are strongly affected by the composition and texture of soil and its content of inorganic electron acceptors. After flooding, microbial reduction processes sequentially use NO3−, Mn4+, Fe3+, and SO42− as electron acceptors, accompanied by the emission of the trace gases N2O, N2, H2S, and CH4 due to reduction-induced increasing pH-NH3 (Figure 2). Microorganisms drive redox reactions in soil by using organic carbon and electron acceptors for their metabolic activities. Methane is produced at the terminal step under anaerobic decomposition of organic matter and due to the reduction of CO2 into CH4 in wetland soils. Soil Eh values decreased rapidly after flooding within 5–7 weeks then stabilized toward −200 to −240 mV and produced significant amount of methane [17]. High concentrations and fluxes of dissolved organic matter (DOM) in paddy soils from plant debris trigger microbial activity and thus the emission of greenhouse gases. Therefore, the objectives of this thematic topic are to highlight the feasible field management practices for sustainable rice production and recommend appropriate strategies to mitigate GHG emissions from paddy soils in the changing climate.
The static closed chamber technique was used to measure CH4 and N2O emissions during rice growing period [18]. The chambers were made of PVC and consisted of two parts: an upper transparent compartment (100 cm height, 30 cm width, and 30 cm length) was placed on a permanently installed bottom collar (10 cm height, 30 cm width, and 30 cm length). Three replicate chambers were used. Each of these chambers was placed in each plot. Each chamber was installed with a battery-operated fan to homogenize the air inside the chamber headspace, a thermometer to monitor temperature changes during the gas-sampling period, and a gas-sampling port with a neoprene rubber septum at the top of the chamber for collecting gas samples from the headspace. Gas samples were collected twice daily (Figure 3), sampling during 9.00 am to 12.00 and 12.30 pm to 3.30 pm. A 100-mL plastic syringe equipped with a 3-way stopcock was used to collect gas samples from the chamber headspace 0, 15, and 30 min after chamber deployment. Gas samples were collected twice a day. The collected gas samples were immediately transferred to 100-mL air-evacuated aluminum foil bags (Delin Gas Packaging Co., Ltd., Dalian, China) sealed with a butyl rubber septum and transported to the laboratory for analysis of CH4 and N2O concentrations by Gas Chromatograph (Figure 4).
(A) Prototype and (B) gas sampling in rice planted paddy field through the closed chamber technique [18].
Injecting air samples into GC for determination of CH4 and N2O concentrations.
CH4 and N2O concentrations in the headspace air samples were determined by a gas chromatograph (Shimadzu GC-2014, Kyoto, Japan) packed with a Porapak Q column (2 m length, 4 mm OD, 80/100 mesh, stainless steel column) (Figure 4). A flame ionization detector (FID) and an electron capture detector (ECD) were used for the determination of CH4 and N2O concentrations, respectively. Helium (99.9% purity) was used as a carrier gas (30 ml min−1), and a make-up gas (95% argon and 5% CH4) was used for the ECD. Calibration was conducted with 1.01, 7.99, and 50.5 μl CH4 l−1 in He and 0.2, 0.6, and 1.0 μl N2O l−1 in He (CRM/RM Information Center of China) as primary standards.
CH4 and N2O fluxes from the paddy field were expressed as the increase/decrease in CH4 and N2O mass per unit surface area per unit time. CH4 and N2O fluxes were estimated by the following equation [19]: F = MV*dc/dt*H*(273/(273 + T); where F is the CH4 or N2O flux (mg CH4 m−2 h−1 or μgN2O m−2 h−1), M is the molar mass of the respective gas (16 for CH4 and 44 for N2O), V is the molar volume of air at a standard state (22.4 l mol−1), dc/dt is the change in headspace CH4 and N2O concentration with time (μmolmol h−1), H is the height of the chamber above the water surface (m), and T is the air temperature inside the chamber (°C). The total CH4 or N2O emission from paddy fields was the summation of methane and nitrous oxide emissions in all growth stages of rice crop.
To estimate the GWP, CO2 is typically taken as the reference gas, and an increase or reduction in emission of CH4 and N2O is converted into “CO2-equivalents” by means of their GWPs. In this study, we used the IPCC factors to calculate the combined GWPs for 100 years [GWP = (25 × CH4) + (298 × N2O)], kg CO2-equivalents ha−1 from CH4 and N2O under various agricultural practices. In addition, the greenhouse gas intensity (GHGI) was calculated by dividing GWP by grain yield for rice [20, 21].
The mean rice statistics and cumulative methane emissions in the rice producing countries are presented in Table 1.
Country | Harvested area (Mha) | Total production (Mt) | Yield (kg ha−1) | CH4 emission(kg ha−1) |
---|---|---|---|---|
India | 43 | 146 | 43,400 | 110.1 |
China | 29 | 195 | 6500 | 180 |
Indonesia | 12 | 63 | 4900 | 210 |
Bangladesh | 11 | 46 | 4200 | 100 |
Vietnam | 7 | 40 | 5300 | 180 |
Brazil | 2 | 12 | 44,300 | 60 |
Colombia | 0.5 | 2 | 4600 | 210 |
Peru | 0.4 | 3 | 7200 | 240 |
Argentina | 0.2 | 1 | 6600 | 280 |
Uruguay | 0.2 | 1 | 7600 | 280 |
Mean rice statistics (2004–2014) in the main rice producer countries in Asia, Latin America, and the Caribbean (LAC).
Source: M indicates million [22].
It is known that China, India, Indonesia, Bangladesh, and Vietnam have been playing a dominating role in total rice production (Table 1), which may impose a threat to the environment by stimulating CH4 emissions. Phospho-gypsum, a by-product of the phosphate fertilizer manufacturing industry, is a feasible soil amendment to supplement mainly calcium and sulfur for rice cultivation. The high content of sulfate in phospho-gypsum might prevent CH4 formation as well as CH4 emissions due to stronger competitor for substrates (hydrogen or acetate) than methanogens. It was reported that silicate slag and phospho-gypsum in combination with Azolla-cyanobacteria significantly decreased CH4 flux while improved rice rhizospheric redox status (Figure 5) [18, 23]. Ali et al. reported that biochar amendments in paddy soils of Japan and Bangladesh decreased seasonal cumulative N2O emissions by 31.8 and 20.0%, respectively, followed by 26.3 and 25.0% reduction with biochar plus Azolla-cyanobacteria amendments (Table 2) [18]. Seasonal cumulative CH4 emissions and global warming potentials were significantly decreased due to Azolla-cyanobacterial inoculation with phospho-gypsum and silicate slag amendments [18]. Combined effects of blast furnace slag and revolving furnace slag amendments also showed decreasing effects on GWPs (Table 2).
Trends of CH4 flux and soil Eh with different soil amendments during rice cultivation in Bangladesh, Japan, and Korea [18, 23].
Silicate slag and biochar amendments in different soils of Japan also reduced cumulative CH4 flux, while increased rice growth and yield parameters (Table 3) [23].
Rice plant growth, yield components, and cumulative CH4 flux under biochar and silicate amendments in different field sites of Japan. Source: JSPS Report by Ali [23].
Treatments | Flood water paddy field (Showair Union) | Flood water paddy field (Tetulia Union) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Grain yield (kg/ha) | Straw yield (kg/ha) | Gross return (Tk./ha) | Total variable cost (Tk./ha) | Net return (Tk./ha) | BCR | Grain yield (kg/ha) | Straw yield (kg/ha) | Gross return (Tk./ha) | Total variable cost (Tk./ha) | Net return Tk./ha | BCR | |
Control (no top dressing, no ducklings) | 2143 | 4146 | 44,940 | 30,333 | 14,606 | 1.48 | 2106 | 4126 | 44,196 | 30,266 | 13,930 | 1.46 |
NPKS (100%) + ducklings | 2576 | 5106 | 104,086 | 49,450 | 54,636 | 2.12 | 2496 | 4840 | 100,353 | 49,450 | 50,903 | 2.04 |
NPKS (50%) + bioslurry with oyster shell + ducklings | 2446 | 4850 | 101,358 | 49,750 | 51,608 | 2.04 | 2433 | 4883 | 99,108 | 49,750 | 49,558 | 2.0 |
NPKS (50%) + vermicompost + ducklings | 2776 | 5516 | 108,291 | 50,733 | 57,558 | 2.14 | 2693 | 5370 | 104,551 | 47,400 | 57,151 | 2.20 |
NPKS (50%) + azolla-cyanobacterial mixture + duckling | 2650 | 5283 | 105,641 | 48,333 | 57,308 | 2.20 | 2603 | 5183 | 102,658 | 48,334 | 54,325 | 2.14 |
Significance level | ** | ** | ** | * | * | * | * | * | * | * | * | * |
Overall productivity of rice duck farming in wetland paddy ecosystem of Dingaputa Haor, Netrokona district by Ali [28].
Among the amendments, biochar significantly decreased N2O emission rates (Figure 6); however, it increased CH4 emission rates (Figure 1). Silicate slag and phospho-gypsum amendments lowered N2O emission rates compared to control treatment (NPK), although no significant differences were observed (Figure 6) [18].
Trends of N2O flux and DO concentrations under different soil amendments during rice cultivation in Bangladesh, Japan, and Korea [18].
The IPCC 4th Assessment Report (IPPC) states that Southeast Asia is expected to be seriously affected by the adverse impacts of climate change [11]. The frequency of floods, drought, cyclones, tornadoes, thunderstorm, and earthquake increased during the last 5 years, which badly affected the natural vegetation and forest covers, wild animals, wetlands, and land resources, and ultimately, agricultural productivity declined. In Indonesia, the Philippines, Thailand, and Vietnam, the annual mean temperatures are projected to rise by 4.8°C by 2100, and the global mean sea level will increase by 70 cm during the same period [24]. It has been reported that in Southeast Asia, small changes in the annual rainfall are expected to continue up to 2040 [25], and there will be an increase in the occurrence of severe weather including heat waves and precipitation events. Increases in tropical cyclone intensities by 10–20% are anticipated, and temperatures are projected to continue to increase by about 0.7–0.9°C [25]. Furthermore, sea levels have risen by 1–3 mm/year, marginally higher than the global average [24]. Rice production systems of this region have become increasingly threatened by the effects of climate change as a large portion of the rice-growing areas are located in especially vulnerable regions. A decrease of 10% in rice yield has been found to be associated with every 1°C increase in temperature [24], while the yield of dry-season rice crops in the Philippines decreased by as much as 15% for each 1°C increase in the growing season mean temperature. These temperature and aggravating climate change effects may cause a decline in the world rice production, which have already shown negative effects on agricultural production. By 2100, Indonesia, the Philippines, Thailand, and Vietnam are projected to experience a potential fall of about 50% in rice yield due to the occurrence of extreme climatic events [24, 26]. Furthermore, rice yield would be affected severely due to sea level rise and intrusion of saline water in the coastal area, which will hamper rice growth and yield. Rising sea levels in association with heavy monsoon rainfall will create serious waterlogging and prolonged stagnant floods in major rice-growing, low lying mega-deltas in Southeast Asia, which ultimately deteriorate rice production in the deltas since only a few low-yielding rice varieties have evolved to withstand such conditions [27]. The recent natural disasters such as flash floods caused by water of Indian Meghalaya state and excessive rainfall in the low lying ha or areas of Bangladesh [28] badly affected the only cultivated rice crop, the Boro rice (winter rice), at this region; however, due to rice duck mixed farming, the overall productivity and net profit were recovered to some extent (Table 4).
Soil conservation practices such as suitable cover crops, mulches, and minimum tillage (one or two plowing with proper leveling) may be introduced in rice farming not only to control soil erosion and land degradation, while reduce production costs to sustain rice productivity. In addition, conservation tillage will improve environmental quality by lowering GHG emissions (less air pollution) through decreasing the use of diesel fuel and nonburning of rice residues [29]. It has also reported that the no-tillage system in Korean paddy field with silicate fertilization decreased total seasonal CH4 flux by 53 and 36%, while maximizing grain yield by 18 and 13% over the control tillage and control no-tillage systems, respectively [30]. Soil properties were also improved with silicate fertilization under the no-tillage system. It was [31] reported that tillage (after the harvest of late rice) with the incorporation of stubble (3.5 t ha−1) in the winter fallow season significantly decreased both the net GWP and the GHGI while maintained a high grain yield (13.0–13.3 t ha−1 yr−1) in the double-cropping rice system.
Direct seeded rice (DSR) is a process of establishing a rice crop which is done by seeds sown in the field rather than by transplanting seedlings from the nursery. The practice of direct seeding instead of transplanting resulted in a 16–54% reduction in CH4 emission [32]. CH4 emission was more significantly reduced under dry-direct seeding compared to wet-direct seeding. However, grain yield in direct seeded rice (DSR) was found lower than Puddle transplanted rice (PTR), probably due to poor crop stand, high percentage of panicle sterility, and higher weed and root-knot nematode infestation [33]. It was also observed that grain yield of direct-seeded rice (9.0 Mg ha−1) was identical to grain yield of transplanted-flooded rice [34]. Average yield penalty of around 10% was observed for the direct seeded rice (DSR) compared with puddle transplanted rice [34]. It was reported [35] that over the rice-growing season, cumulative CH4 emissions were significantly higher in puddle transplanted rice compared to the direct seeded rice production system.
Water management influences rice yield and CH4 and N2O emissions from rice cultivation systems. Irrigated rice fields are an integral part of the rice production system in Asian countries, which contribute about 75% to global rice production. Single or multiple drainages during a rice growing season (e.g., AWD) are reported to reduce CH4 emissions by 48–93% compared to those observed under continuous flooding systems [36, 37]. Mid-season drainage and intermittent flooding were found effective for increasing productivity and quality of rice as well as reducing methane emissions in Japan [38]. The AWD field showed the same yield as continuous flooded field, but saved 16–24% in water costs and 20–25% in production costs. Most farmers in China, Japan, and South Korea have been practicing this mid-season drainage (5–7 days dry out) to increase rice yield and decrease GHG emissions. Mid-season drainage and intermittent irrigations may reduce methane emissions by about 50%. It was also reported [39] that the AWDI treatment (irrigation applied when water level in the pipe fell 15 cm) showed superiority for the rice yield performance and seasonal CH4 emission reduction, water savings, and maximum water productivity index. However, the AWD irrigation technique increased the N2O emission by 97%, especially in DS [40].
Feasible management approaches based on agroecosystem have to be adopted to sustain agricultural productivity in the changing climatic conditions. For example, the ground cover rice production system (GCRPS), through which paddy soils are covered by thin plastic films to conserve soil moisture nearly at saturated status, is a promising technology to increase yields with less irrigation water. However, increased soil aeration and temperature under GCRPS may cause more CH4 to N2O emissions compared to conventional techniques. Yao et al. [41] reported that the GHG emissions for the ground cover rice production system (GCRPS, i.e., paddy soils being covered by thin plastic film) were found significantly lower (1973 kg CO2 eq ha−1) than that of traditional cultivation (4186 kg CO2 eq ha−1). Total seasonal CH4 emissions under GCRPS were on average 80% lower as compared to the traditional rice cultivation. The yield-scaled GHG emissions from GCRPS were further reduced from 377 to 222 kg CO2 eq Mg−1 as N2O emissions greatly decreased while yields increased. The system of rice intensification (SRI), an agro-ecological methodology, could be a feasible technique to sustain rice productivity by changing the management of plants, soil, water, and nutrients. Successful application of SRI of increased paddy yield by 50–100% while using less inputs, in particular water, (farmers were able to reduce their water requirements by about 25–50%) [42] has already been reported. Suitable rice cropping patterns, rotations, and mixed rice-duck-fish farming hold the potential scope to sustain agricultural productivity and controlling GHG emissions in the changing climatic conditions. For example, in the Philippines, fish or ducks have been raised with rice as well as legumes such as mung bean (Vigna radiata), groundnut (Arachis hypogaea), and soybean (Glycine max) after two rice dropping. Rotation of crops that have their most drought-sensitive phase in different phases of the growing season may prove a valuable adaptation to limited water resources. Haque et al. reported that the nonrice-based cropping patterns had lower GWPs than the rice-rice-based cropping patterns [43]. Ali et al. reported that CH4 emissions from wetland paddy ecosystems were significantly decreased by integrated rice duck farming [28]. It has been reported that azolla application in rice field increased CH4 emission, probably due to the exudation of azolla root and decomposition of dead azolla. In contrast, reverse report on CH4 emission was also found from rice soil ecosystems, probably due to the increase in redox potential in the root region and dissolved oxygen concentration at the soil-water interface. Azolla cover increased N2O emission from rice paddies due to N-fixation by azolla providing a source for N2O production through nitrification and de-nitrification, especially when the azolla died [44]. CH4 emissions have been reported to increase when crop residues are incorporated prior to planting due to higher amounts of readily available carbon stimulating soil microbial activity. Sander et al. reported that incorporation of rice residues immediately after harvest and subsequent aerobic decomposition of the residues before soil flooding for the next crop reduced CH4 emissions by 2.5–5 times and also improved nutrient cycling in paddy field [45]. It was also reported that residue incorporation accelerated CH4 and N2O emissions from irrigated rice field compared to residues (ryegrass and serradella) left on the soil surface. The open burning of crop residues emits CO2, CH4, and N2O. Ali et al. [17] reported that silicate slag and phospho-gypsum amendments with nitrogenous fertilizer in rice cultivation significantly decreased seasonal CH4 flux by 16–20% and increased rice yield by 13–18% in Korean paddy soil, whereas 12–21% reduction in total seasonal CH4 flux and 5–18% increase in rice grain yield were found in the upland rice paddy soils of Bangladesh [46]. Seasonal cumulative CH4 and N2O emissions, GWPs, and yield scaled greenhouse gas emissions were decreased by combined application of Azolla-cyanobacterial mixture with silicate slag, phospho-gypsum, and biochar amendments in rice paddy soils of Japan, Korea, and Bangladesh (Table 2) [18]. Site-specific nutrient management (SSNM) for rice developed by IRRI (2006) in Asia [47] enables rice farmers to tailor nutrient management to the specific conditions of their fields, and provides a framework for nutrient-based management practices for rice. The increase in annual grain yield with use of SSNM in on-farm evaluation trials averaged 0.9 t/ha in southern India, 0.7 t/ha in the Philippines, and 0.7 t/ha in southern Vietnam [48]. Climatic stress tolerant rice cultivars such as drought, salt/saline, and submergence tolerant rice cultivars have to be developed to cope in the real field stress situation. It was reported [49] that indica-type rice cultivars had significantly higher yield-scaled GWP (1101 kg CO2 equiv. Mg−1) compared to Japonica (711 kg CO2 equiv. Mg−1)-type rice cultivar. It was also reported that AWD irrigation practice reduced CH4 emissions by 24–41%, 26–48% compared with continuous flooding, however, an increase in N2O emission was observed in both seasons [50]. It was also reported that biochar application in paddy soil significantly decreased N2O emission, while increased CH4 emission [51].
In the context of global climate change, environment friendly agricultural management practices such as conservation tillage, rice seedling transplanting or direct line seeding, alternate wet and dry irrigation (AWDI), mid-season drainage, soil amendments with biochar, vermicompost, silicate slag and phospho-gypsum, site specific rice based cropping patterns and integrated plant nutrients system (IPNS) should be followed to ensure food security, while mitigating greenhouse gas emissions and global warming potentials. Furthermore, Azolla-cyanobacterial dual cropping with rice, introducing N-fixing legumes and duckling rearing with flood water rice cultivation could be practiced to sustain overall agricultural productivity and minimizing greenhouse gases intensity in the changing climatic conditions.
Traditional herbal medicines (THMs) are the most popular and preferred forms of traditional medicines (TMs) [1, 2, 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].
\nTHMs have gained an increasing popularity in the last two decades in the industrialized countries [6, 7, 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].
\nTMs, 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, 13, 14, 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].
\nTM 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].
\nKoreans 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].
\nIn 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].
\nThe 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].
\nStandards 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].
\nAccording 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.
\nTHMs 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].
\nIn 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 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.
\nTo 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.
\nThe cross-sectional study design has been used to address the research goals.
\nThe population of the study included TKM doctors who worked at the TKM clinics. Inclusion and exclusion criteria are as follows:
\nAll TKM doctors who used to prescribe THMs and provide their consent form have been included.
\nThe 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.
\nThe 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].
\nThere 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.
\n1. How many prescription cases are being used in the practice? (1) Decoction types of THMs: ______________ cases (2) Non-decoction types of THMs: ______________ cases | \n
2. What is the prescription purpose rate when prescribing herbal medicines? (total 100%) (1) Diseases treatment _________% (2) Health improvement _________% (3) Beauty _________% (4) Traffic accident _________% (5) Others _________% | \n
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? 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? 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 | \n
4. Which disease prescribed herbal medicine the most when treating the disease? \n
| \n
Questionnaire on THM prescriptions of TKM doctors.
TKM: Traditional Korean medicine
THM: Traditional herbal medicine
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).
\nA 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.
\nFactors | \nN (%) | \n
---|---|
Gender | \n|
Male | \n1204 (89.5) | \n
Female | \n142 (10.5) | \n
Age (years) | \n|
30–40 | \n191 (14.2) | \n
41–50 | \n550 (40.8) | \n
51–60 | \n440 (32.7) | \n
≥61 | \n165 (12.3) | \n
Place of work | \n|
Capital area | \n779 (57.9) | \n
Chungcheong Province | \n122 (9.1) | \n
Gyeongsang Province | \n287 (21.3) | \n
Jeolla Province | \n158 (11.7) | \n
Clinical experience | \n|
≤20 | \n882 (65.5) | \n
21–38 | \n417 (31.0) | \n
39–56 | \n47 (3.5) | \n
Demographics of participating TKM doctors.
TKM: Traditional Korean medicine
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).
\nPrescription frequency | \nN (%) | \nMean ± SD | \n
---|---|---|
≤200 | \n378 (28.1) | \n590.4 ± 1105.5 | \n
201–400 | \n428 (31.8) | \n|
401–600 | \n256 (19.0) | \n|
≥601 | \n284 (21.1) | \n
Decoction types of THMs prescribed in TKM clinics.
THM: Traditional herbal medicine
TKM: Traditional Korean medicine
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).
\nPrescription frequency | \nN (%) | \nMean ± SD | \n
---|---|---|
≤200 | \n222 (20.7) | \n1775.9 ± 2349.1 | \n
201–400 | \n120 (11.2) | \n|
401–600 | \n92 (8.6) | \n|
≥601 | \n636 (59.4) | \n
Non-decoction types of THMs prescribed in TKM clinics.
THM: Traditional herbal medicine
TKM: Traditional Korean medicine
Decoction types of THMs have been prescribed in the TKM clinics for various reasons: disease treatment (62.5%), health promotion (21.9%), traffic accidents (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.
\nPrescription purpose | \nMean ± SD | \n
---|---|
Disease treatment | \n62.5 ± 24.7 | \n
Health improvement | \n21.9 ± 19.6 | \n
Traffic accidents | \n8.6 ± 12.5 | \n
Beauty | \n5.9 ± 12.5 | \n
Others | \n1.1 ± 4.6 | \n
Purpose of prescribed decoction types of THMs.
THM: Traditional herbal medicine
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.
\nPurpose of prescription | \nMean ± SD | \n
---|---|
Disease treatment | \n89.0 ± 19.3 | \n
Health improvement | \n6.0 ± 13.3 | \n
Beauty | \n2.8 ± 6.5 | \n
Traffic accidents | \n1.4 ± 9.1 | \n
Others | \n0.9 ± 5.1 | \n
Purpose of prescribed non-decoction types of THMs.
THM: Traditional herbal medicine
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%).
\nResults 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.
\nTypes of diseases | \nTop 3 used THMs | \nN (%) | \n
---|---|---|
Musculoskeletal disease (n = 716) | \nOjeoksan (五積散) | \n161 (22.5) | \n
Bojungikgitang (補中益氣湯) | \n74 (10.3) | \n|
Sipjeondaebotang (十全大補湯) | \n54 (7.5) | \n|
Digestive disease (n = 272) | \nBojungikgitang (補中益氣湯) | \n34 (12.5) | \n
Sipjeondaebotang (十全大補湯) Ojeoksan (五積散) | \n24 (8.8) | \n|
Respiratory disease (n = 81) | \nBojungikgitang (補中益氣湯) Socheongryongtang (小靑龍湯) | \n8 (9.9) | \n
Sipjeondaebotang (十全大補湯) Ojeoksan (五積散) | \n7 (8.6) | \n|
Obstetrics and gynecology disease (n = 54) | \nJogyeongjongogtang (調經種玉湯) | \n6 (11.1) | \n
Ojeoksan (五積散) | \n5 (9.3) | \n|
Bojungikgitang (補中益氣湯) | \n4 (7.4) | \n|
Skin disease (n = 38) | \nOjeoksan (五積散) | \n4 (10.5) | \n
Bojungikgitang (補中益氣湯) | \n3 (7.9) | \n|
Dangguisusan (當歸鬚散) Wolbitang (越婢湯) Hwangryunhaedoktang (黃蓮解毒湯) | \n2 (5.3) | \n|
Neurological disease (n = 36) | \nOjeoksan (五積散) | \n6 (16.7) | \n
Galgeuntang (葛根湯) Yukmijihwangtang (六味地黃湯) | \n3 (8.3) | \n|
Cerebrovascular disease (n = 32) | \nOjeoksan (五積散) | \n6 (18.8) | \n
Ganghwangyupungtang (羌活愈風湯) | \n4 (12.5) | \n|
Sipjeondaebotang (十全大補湯) | \n3 (9.4) | \n|
Mental disease (n = 26) | \nGamiondamtang (加味溫膽湯) | \n3 (11.5) | \n
Kwibitang (歸脾湯) Bunsimgieum (分心氣飮) Ojeoksan (五積散) | \n2 (7.7) | \n|
Cardiovascular disease (n = 10) | \nGamiondamtang (加味溫膽湯) | \n3 (30.0) | \n
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) | \n1 (10.0) | \n|
Endocrine disease (n = 8) | \nSipjeondaebotang (十全大補湯) | \n2 (25.0) | \n
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) | \n1 (12.5) | \n|
Urogenital disease (n = 3) | \nSsanghwatang (雙和湯) Ojeoksan (五積散) Yukmijihwangtang (六味地黃湯) | \n1 (33.3) | \n
Disease in eyes and ears (n = 1) | \nOjeoksan (五積散) | \n1 (100.0) | \n
Cancer (n = 1) | \nBanhasasimtang (半夏瀉心湯) | \n1 (100.0) | \n
Disease proportions and pattern of prescribed decoction types of THMs.
THM: Traditional herbal medicine
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%).
\nResults 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.
\nTypes of diseases | \nTop 3 used THMs | \nN (%) | \n
---|---|---|
Musculoskeletal disease (n = 591) | \nOjeoksan (五積散) | \n216 (36.5) | \n
Gunghatang (芎夏湯) | \n92 (15.6) | \n|
Ijintang (二陳湯) | \n45 (7.6) | \n|
Respiratory disease (n = 218) | \nOjeoksan (五積散) | \n35 (16.1) | \n
Samsoeum (蔘蘇飮) | \n30 (13.8) | \n|
Socheongryongtang (小靑龍湯) | \n||
Digestive disease (n = 192) | \nPyeongwisan (平胃散) | \n38 (19.8) | \n
Ojeoksan (五積散) | \n37 (19.3) | \n|
Hyangsapyungwisan (香砂平胃散) | \n21 (10.9) | \n|
Neurological disease (n = 16) | \nSocheongryongtang (小靑龍湯) | \n3 (18.8) | \n
Galgeuntang (葛根湯) | \n2 (12.5) | \n|
Ojeoksan (五積散) | \n||
Gumiganghwaltang (九味羌活湯) | \n||
Samsoeum (蔘蘇飮) | \n||
Pyeongwisan (平胃散) | \n||
Cerebrovascular disease (n = 11) | \nOjeoksan (五積散) | \n3 (27.3) | \n
Yeongyopaedoksan (蓮翹敗毒散) | \n2 (18.2) | \n|
Gunghatang (芎夏湯) | \n1 (9.1) | \n|
Bojungikgi-tang (補中益氣湯) | \n||
Socheongryongtang (小靑龍湯) | \n||
Ijintang (二陳湯) | \n||
Jaeumganghwatang (滋陰降火湯) | \n||
Pyeongwisan (平胃散) | \n||
Cardiovascular disease (n = 9) | \nBanhabackchulchunmatang (半夏白朮天麻湯) | \n2 (22.2) | \n
Gumiganghwaltang (九味羌活湯) | \n1 (11.1) | \n|
Gunghatang (芎夏湯) | \n||
Bojungikgitang (補中益氣湯) | \n||
Sosihotang (小柴胡湯) | \n||
Ijungtang (理中湯) | \n||
Ijintang (二陳湯) | \n||
Pyeongwisan (平胃散) | \n||
Obstetrics and gynecology disease (n = 8) | \nOjeoksan (五積散) | \n2 (25.0) | \n
Gamisoyosan (加味逍遙散) | \n1 (12.5) | \n|
Gunghatang (芎夏湯) | \n||
Bulhwangeumjeonggisan (不換金正氣散) | \n||
Samsoeum (蔘蘇飮) | \n||
Ijintang (二陳湯) | \n||
Pyeongwisan (平胃散) | \n||
Skin disease (n = 5) | \nGamisoyosan (加味逍遙散) | \n1 (20.0) | \n
Gunghatang (芎夏湯) | \n||
Ojeoksan (五積散) | \n||
Insampaedoksan (人蔘敗毒散) | \n||
Pyeongwisan (平胃散) | \n||
Mental disease (n = 5) | \nOjeoksan (五積散) | \n2 (40.0) | \n
Gamisoyosan (加味逍遙散) | \n1 (20.0) | \n|
Gumiganghwaltang (九味羌活湯) | \n||
Daecheongnyongtang (大靑龍湯) | \n||
Urogenital disease (n = 3) | \nOjeoksan (五積散) | \n2 (66.7) | \n
Pyeongwisan (平胃散) | \n1 (33.3) | \n|
Endocrine disease (n = 2) | \nGumiganghwaltang (九味羌活湯) | \n1 (50.0) | \n
Pyeongwisan (平胃散) | \n||
Disease in eyes and ears (n = 1) | \nOjeoksan (五積散) | \n1 (100.0) | \n
Cancer (n = 1) | \nGunghatang (芎夏湯) | \n1 (100.0) | \n
Disease proportions and pattern of prescribed non-decoction types of THMs.
THM: Traditional herbal medicine
This study investigated the use of THMs in TKM clinics in South Korea.
\nResults 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].
\nThe 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].
\nAccording 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].
\nThe 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].
\nIn 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 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.
\nKoreans 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].
\nThere 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.
\nSecond, 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.
\nThird, 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.
\nOur 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.
\nThis work was supported by the Policy Support Project for the Development of Traditional Korean Medicine funded by the Ministry of Health and Welfare.
\nThe authors declare no conflict of interest.
THM | Traditional herbal medicine |
TM | Traditional medicine |
TKM | Traditional Korean medicine |
MFDS | Ministry of Food and Drug Safety |
MHW | Ministry of Health and Welfare |
IntechOpen implements a robust policy to minimize and deal with instances of fraud or misconduct. As part of our general commitment to transparency and openness, and in order to maintain high scientific standards, we have a well-defined editorial policy regarding Retractions and Corrections.
",metaTitle:"Retraction and Correction Policy",metaDescription:"Retraction and Correction Policy",metaKeywords:null,canonicalURL:"/page/retraction-and-correction-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"IntechOpen’s Retraction and Correction Policy has been developed in accordance with the Committee on Publication Ethics (COPE) publication guidelines relating to scientific misconduct and research ethics:
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\\n\\n3.2. CORRIGENDUM
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\\n\\nIn the case of Retraction or removal of the Work, the publisher will be under no obligation to refund the APC.
\\n\\nThe general principles set out above apply to Retractions and Corrections issued in all IntechOpen publications.
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\\n\\nPolicy last updated: 2017-09-11
\\n"}]'},components:[{type:"htmlEditorComponent",content:'IntechOpen’s Retraction and Correction Policy has been developed in accordance with the Committee on Publication Ethics (COPE) publication guidelines relating to scientific misconduct and research ethics:
\n\n1. RETRACTIONS
\n\nA Retraction of a Chapter will be issued by the Academic Editor, either following an Author’s request to do so or when there is a 3rd party report of scientific misconduct. Upon receipt of a report by a 3rd party, the Academic Editor will investigate any allegations of scientific misconduct, working in cooperation with the Author(s) and their institution(s).
\n\nA formal Retraction will be issued when there is clear and conclusive evidence of any of the following:
\n\nPublishing of a Retraction Notice will adhere to the following guidelines:
\n\n1.2. REMOVALS AND CANCELLATIONS
\n\n2. STATEMENTS OF CONCERN
\n\nA Statement of Concern detailing alleged misconduct will be issued by the Academic Editor or publisher following a 3rd party report of scientific misconduct when:
\n\nIntechOpen believes that the number of occasions on which a Statement of Concern is issued will be very few in number. In all cases when such a decision has been taken by the Academic Editor the decision will be reviewed by another editor to whom the author can make representations.
\n\n3. CORRECTIONS
\n\nA Correction will be issued by the Academic Editor when:
\n\n3.1. ERRATUM
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\n\nA published Erratum will adhere to the Retraction Notice publishing guidelines outlined above.
\n\n3.2. CORRIGENDUM
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\n\n4. FINAL REMARKS
\n\nIntechOpen wishes to emphasize that the final decision on whether a Retraction, Statement of Concern, or a Correction will be issued rests with the Academic Editor. The publisher is obliged to act upon any reports of scientific misconduct in its publications and to make a reasonable effort to facilitate any subsequent investigation of such claims.
\n\nIn the case of Retraction or removal of the Work, the publisher will be under no obligation to refund the APC.
\n\nThe general principles set out above apply to Retractions and Corrections issued in all IntechOpen publications.
\n\nAny suggestions or comments on this Policy are welcome and may be sent to permissions@intechopen.com.
\n\nPolicy last updated: 2017-09-11
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