Recognition of and interventions for Mibyeong (subhealth) in South Korea: a national web-based survey of Korean medicine practitioners

Medically unexplained symptoms (MUSs) are common in primary care. At present, there are no proven, comprehensive treatments available in primary care for patients with MUSs. However, MUS has parallels with “subhealth” or Mibyeong from traditional East-Asian medicine, and thus, Mibyeong interventions could be effective in treating MUS. Unfortunately, studies on Mibyeong and its intervention methods are relatively rare. We administered a web-based survey to 17,279 Korean medicine (KM) practitioners registered with the Association of Korean Medicine. The response rate was 4.9% (n=849). Based on the responses received, we assessed how much they agreed with concepts related to Mibyeong on a 7-point scale from “do not agree” to “strongly agree.” Respondents were also asked to indicate how frequently they encountered various subtypes and patterns of Mibyeong, and how frequently they use listed intervention methods. Data from 818 respondents were analyzed after excluding those with no clinical experience. On average, respondents were male general practitioners aged between 30 years and 49 years, working or living in metropolitan areas such as Seoul, Incheon, and Gyeonggi-do. Responses did not differ by demographics. Respondents generally thought that Mibyeong referred to subjective or borderline findings without certain disease, and that Mibyeong has various subtypes and patterns. Subtypes included fatigue, pain, and digestion problems; patterns were either deficiencies (e.g., qi, blood, and yin deficiency) or stagnations (e.g., liver qi depression and qi stagnation). Decoction was the most frequently used type of intervention for Mibyeong of all items listed, followed by acupuncture and moxibustion. Patient education was also recommended, suggesting healthy eating, promoting healthy environment, and exercise. We were able to provide preliminary results on KM practitioners’ recognition of and interventions for Mibyeong, but further research is needed to develop a detailed definition of Mibyeong and its myriad subtypes and patterns, and evaluations of the efficacy of Mibyeong interventions.