Systematic Review of Randomized Controlled Trials on Herbal Medicine for Treatment of Human Obesity

비만 치료 한약의 무작위 대조임상시험에 대한 체계적 분석

  • Park, Jung-Hyun (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Guk University) ;
  • Nam, Jong-Kyung (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Guk University) ;
  • Kwon, Dong-Hyun (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Guk University) ;
  • Kim, Ho-Jun (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Guk University) ;
  • Lee, Myeong-Jong (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Guk University)
  • 박정현 (동국대학교 한의과대학 한방재활의학과교실) ;
  • 남종경 (동국대학교 한의과대학 한방재활의학과교실) ;
  • 권동현 (동국대학교 한의과대학 한방재활의학과교실) ;
  • 김호준 (동국대학교 한의과대학 한방재활의학과교실) ;
  • 이명종 (동국대학교 한의과대학 한방재활의학과교실)
  • Received : 2009.06.16
  • Accepted : 2009.07.18
  • Published : 2009.07.31


Objectives : The objective of the study was to summarize randomized clinical trials(RCTs) that have assessed the effectiveness of herbal medicine on treatment of obesity and to propose better process of study. Methods : NLM Medline(pubmed), EMBASE, the Cochrane library, Science Direct, EBSCO, 4 Korean medical databases were systematically searched and 4 Korean medical journals were manually searched for clinical trials investigating the efficacy of herbal medicines on treatment of overweight or obese people from 1998 to 2008. The methodological quality was assessed using a Jadad score and validity was assessed using Oxford Pain Validity Scale(OPVS). Results : 14 RCTs met all the inclusion criteria. The methodological and ethical quality of the trials was generally low. The mean score by Jadad was 2.6 and the mean score of validity was 11.2. Complex herbal medicine was used in 8 RCTs and single herbal medicine was used in 6 RCTs. Except 1 RCT, the other RCTs reported positive effects of herbal medicine on treatment of obesity. Herbal medicines didn't seem to affect toxicity. In general adverse events relevant with the therapy were minor, but more than half of RCTs did not report about the safety or adverse events of herbal medicine, questioning their reliability. Conclusions : Although most RCTs concluded the efficacy and safety of herbal medicines on treatment of obesity, the quality of trials was low in general. Further rigorous clinical trials using complex herbal medicine should be performed.


  1. TL Lenz, WR Hamilton. Supplemental products used for weight loss. J Am Pharm Assoc. 2004;44(1):55-67.
  2. C Aschwanden. Herbs for health, but how safe are they? World Health Organization. Bulletin of the World Health Organization. 2001;79(7):691-2.
  3. PG Shekelle, ML Hardy, SC Morton, M Maglione, WA Mojica, MJ Suttorp, SL Rhoeds. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA. 2003;289(12):1537-45.
  4. Evidence-Based Medicine Working Group. Evidence-Based Medicine: a new approach to teaching the practice of medicine. JAMA. 1992;268:2420-5.
  5. 김석원, 최윤선, 안형식, 이희영, 안덕선, 이영미. 국내 학회지에 실린 무작위임상시험논문의 양적 분석 및 질 평가. 가정의학회지. 2004;25:118-25.
  6. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence Based Medicine: what it is and what it isn't. BMJ. 1996;312:71-2.
  7. Jadad AR, ect. Assessing the quality of reports of randomized controlled trial: Is blinding necessary? Controlled clinical trials. 1996;17:1-12.
  8. Egger M, Smith GD, Altman DG. Systematic reviews in heath care: meta-analysis in context. 2nd ed. London:BMJ Pubblishing Groups. 2001 87-108.
  9. Cochrane reviewer's handbook 4.1.5 updated April 2002. The Cochrane Collaboration. Available from URI:
  10. Smith LA, Oldman AD, McQuay HJ, Moore RA. Teasing apart quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain. Pain. 2000;86:119-32.
  11. Ignjatovic V, Ogru E, Heffernan M, Libinaki, R, Lim Y, Ng F. Studies on the use of "Slimax", a Chinese herbal mixture, in the treatment of human obesity. Pharm-biol. 2000;38(1):30-5.;1-B;FT030
  12. Hioki C, Yoshimoto K, Yoshida T. Efficacy of bofu-tsusho-san, an oriental herbal medicine, in obese Japanese women with impaired glucose tolerance. Clin Exp Pharmacol Physiol. 2004 Sep;31(9):614-9.
  13. Shi J, Hu Y, Wang Q. Fufang cangzhu tang for treatment of senile obesity or overweight complicated with impaired glucose tolerance-a clinical observation in 32cases. J Tradit Chin Med. 2006 Mar;26(1):33-5.
  14. Greenway FL, Liu Z, Martin CK, Kai-yuan W, Nofziger J, Rood JC, Yu Y, Amen RJ. Safety and efficacy of NT, an herbal supplement, in treating human obesity. Int J Obes. 2006;30(12):1737-41.
  15. Pan L, Li DL, Lei MR, Zhang LQ, Zhou LX. Preparation-containing node of Lotus Rhizome, green tea and Panax notoginseng for obese adults. Chinese Journal of Clinical Rehabilitation. 2005;9(15):231-3.
  16. Wang C, Yang YM. Cheng ZQ. Improvements of Pinggan Yishen Ditan Yin in blood pressure, body weight and quality of life in patients with obesity hypertension. Chinese Journal of Clinical Rehabilitation. 2006;10(43):24-6.
  17. He CY, Wang WJ, Li B, Xu DS, Chen WH, Ying J, He YM. Clinical research of Yiqi Sanju Formula in treating central obese men at high risk of metabolic syndrome. Journal of Chinese Integrative Medicine. 2007;5(3):263-7.
  18. Ding GA, Yu GH, Liang SC, Fan CH, Tong ZJ, Liu LQ, Huang P, Xiao AX, Tong ZS, Liang FC. Jiawei lingguizhugan tang for obesity induced by psychoactive drugs. Chinese Journal of Clinical Rehabilitation. 2006;10(43):46-8.
  19. Coffey CS, Steiner D, Baker BA, Allison DB. A randomized double-blind placebo-controlled clinical trial of a product containing ephedrine, caffeine, and other ingredients from herbal sources for treatment of overweight and obesity in the absence of lifestyle treatment. Int J. Obesity. 2004;28:1411-9.
  20. Greenway FL, Jonge LD, Blanchard D, Frisard M, Smith SR. Effect of a dietary herbal supplement containing caffeine and ephedra on weight, metabolic rate, and body composition. Obes Res. 2004;12(7):1152-7.
  21. Boozer CN, Nasser JA, Heymsfield SB, Wang V, Chen G, Solonmon JL. An herbal supplement containing Ma Huang-guarana for weight loss: a randomized, double blind trial. Int J Obesity. 2001;25:316-24.
  22. Boozer CN, Daly PA, Home lP, Solomon JL, Balnchard D, Nasser JA, Strauss R, Merendith T. Herbal ephedra/caffeine for weight loss: a 6 month randomized safety and efficacy trial. Int J Obes Relat Metab Disord. 2002;26(5):593-604.
  23. 김수진, 김호준, 고병표, 김형도, 김진아, 박정미, 최승기, 전우현. 저열량 식이요법을 한 폐경 전 비만 여성의 휴식 대사량에 대한 마황과 오수유의 효과. 대한한방비만학회지. 2004;4(1):45-54.
  24. 박정미, 김호준, 김진아, 김수진, 고병표. 오수유와 마황이 저열량 식이요법을 병행한 비만 여성환자의 체구성성분 및 휴식대사량에 미치는 영향. 대한한의학회. 2005;26(3):249-62.
  25. Moore RA, Gavaghan D, Tramer MR, Collins SL, McQuay HJ. Size is everything ${\pm}$ large amounts of information are needed to overcome random effects in estimating direction and magnitude of treatment effects. Pain. 1998;78:209-16.
  26. 김경수. 임상연구 설계와 윤리. 가정의학회지. 2002;23(5):573-82.
  27. Jones B, Jarvis P, Lewis J, Ebbutt A. Trials to assess equivalence: the importance of rigorous methods. BMJ. 1996;313:36-9.
  28. 황미자, 신현대, 송미연. 2000년 이후 비만치료에 사용되는 처방 및 본초에 대한 문헌연구. 대한한방비만학회지. 2008;7(1):39-54.
  29. 김동현. 장내세균에 의한 천연약물성분의 대사와 생리활성변화. International symposium on east-west medicine. 1999;1:76-81.