Comparison of herbal product use in US and in China: A literature review

Background: Herbal products continue to play an important role in people's health worldwide. As herbal product use is affected by cultural practice and traditional knowledge, this study aimed to elucidate the difference in such use between the United States and China, two of the largest consumers of herbs. Methods: The online database MEDLINE was searched to identify pertinent peer-reviewed articles in the past decade that evaluated the use of herbal products in US and in China. Results: A total of 53 publications were selected from the preliminary search. Herbal products are used by 4.2-20.5% of the general US population and are more popular among American Indians and whites, female, adults with higher levels of education, and adults with a higher socioeconomic status. In China, Traditional Chinese medicine (TCM) accounts for 40% of healthcare delivered. TCM users are more likely to be female, older, more highly educated, and with a higher socioeconomic status. Concomitant use of herbal and western medicines is prevalent in both countries. However such information is seldom disclosed to physicians. Echinacea, garlic, ginkgo biloba, saw palmetto, and St. John's wort are the most popular herbs in the US. Ginseng, qing bu liang, lycium fruit, and dong quai are the most commonly used herbs in China. TCMs are typically prescribed in traditional formulae composed of 10 – 15 herbs; therefore it becomes a challenge to identify the relationship between adverse drug reactions and the active herb. Conclusion: Despite a high prevalence of herbal product use in both countries, significant differences in user characteristics and popular products are found.