서 론
2000 7
1)
.
,
.
,
.
2007 8 8 2007 8 10
2007 8 30
: , 483
(Tel : 042-868-9464, Fax : 042-868-9471, E-mail : [email protected])
이남헌, 유영법, 하혜경, 이호영, 정다영, 최지윤, 마진열, 신현규
A Study on the Development of Medication Teaching of Herbal Formulas Based on Evidence
Nam-hun Lee, Young-beob Yu, Hye-kyung Ha, Ho-young Lee, Da-young Jung, Ji-yoon Choi, Jin-yeul Ma, Hyeun-kyoo Shin
Dept. of Herbal Pharmaceutical Development, Korea Institute of Oriental Medicine
Background : In western medicine, there has been much interest in medication teaching since the separation of dispensary from medical practice in 2000. On the other hand, few investigations have been carried out about medication teaching for herbal medicine.
Objectives : The purpose of this study wasto investigate the current status of medication teaching of herbal medicine and develop a better guide.
Methods : Pharmaceutical affairs law in Korea was searched and some medication teaching guides were compared and analyzed to develop a better guide suitable for herbal medicine.
Results and Conclusions : The future guide should be based on scientific evidence and include the following: the origin of each herbal formula the constitution of each herbal formula and proportion of each herb included the chief virtue of each herbal formula the efficacy of each herbal formula the safety of each herbal formula combined treatment with herbal formulas and western drugs the way of decocting each herbal formula the way of safekeeping and period of circulation of each herbal formula a summary and evaluation for each herbal formula
references of each herbal formula
Key Words : evidence-based medicine, medication teaching, herbal medicine
, evidence- based medicine(EBM)
1
.
,
,
.
.
,
, EBM
.
연구방법
1.
법 조항 검색
2)
(2007 4 11
), (2007 7 3 )
(2007 5 4
) .
2.
복약지도 관련 서적 조사
, , ,
.
( ),
( ), ( ) ,
( ),
( ), (
), ( ),
( ),
( )
.
결 과
1.
복약지도 관련 법 조항
1)
.
(1) 2 ( )
12. “ ( )”
.
. , · , · ,
, ,
.
2)
.
(1) 23 ( ) :
,
.
(2) 24 ( )
( ) .
1. 한약을 먹을 때 돼지고기를 먹지 마라, 특정 채소를 먹지 마라 등
4
. 3)
.
(1) 8 ( ·
)
23 1 2
.
2.
의약품 복약지도 지침의 사항
2 ( ) 12
3)
. 1)
. 2)
. 3)
(1)
. (2)
. 4)
(1) .
, ,
.
(2) ( , ,
), ( . Nitroglyce- rin)
.
(1)
.
(2) .
( )
- , ,
- , , , , ,
(3)
6) (1)
( ) .
(2)
.
: Theophylline, Aminophylline, Digoxin, Quinidine,
Warfarin, ,
3.
한약처방 및 한약제제 복약지도 지침 문헌 비
교 분석
1)
4), . (Table
1) .
.
.
, ,
.
2)
5), , (Table 2)
.
, , .
, .
. .
.
, .
, .
.
.
, .
.
‘ ’ , ‘ ’ .
, .
. .
. .
.
3)
6)(Table 3) .
,
, .
, .
.
, .
.
, .
. .
, , .
, ,
,
, .
.
.
, , ,
, .
.
.
.
4)
7),
(Table 4) .
, .
, ,
,
.
.
.
, , , , 3 ,
, , 3 .
.
, .
. .
.
.
.
.
, .
, .
.
, .
. .
, , .
.
‘ ’ , 1998
.
5)
8),
(Table 5) .
,
, .
, 1 ,
,
. , ,
.
.
6)
9),
, ,
.
(Table 6) . 6
, ,
, , . .
,
g .
.
1 500ml , ,
3 .
1 .
15 7 2/3, 7 4 1/2, 4 2 1/3,
2 1/4 .
.
.
g .
. .
, 3 ,
, .
7)
10),
. (Table 7)
. “
” ,
,
. ,
,
, .
, .
8)
11)146
,
, , .
. 2
,
. (Table 8)
9)
12)( ) 5017
, 2000
, 1
20 , 1 16
1995
.
( ) ,
, , , ,
, , , , ,
. Summary & First
choice .
. .
.
1 2-3 1
4 .
. .
.
, , .
,
, ,
.
, , ,
. ,
.
(Table 9) .
고 찰
1.
복약지도 관련 문헌 비교 분석 및 문제점
( )
· ,
.
1)
.
,
2
. EBM
,
.
2) International Classification of Disease (ICD- 10)
.
herb-drug interactions ,
.
13),
,
2. 이미 수천 년 동안 셀 수 없는 환자들이 복용한 한약인데, 무엇을 또, 검정하겠다는 것인가?
, .
, 1 , 1
1
,
, ( ) ,
,
( ; - )
( ; - )
,
, ICD-10
. 3)
.
.
. 4)
.
,
.
5) , ,
. ,
,
.
2.
한약처방 복약지도 지침
(안
), EBM
.
1) .
, .
2) (g ) .
( )
.
,
.
.
3) . 10
. ( · ·
· ) .
4) . ICD-10
in vivo
. (Agency for
Health Care Policy and Research, AHCPR)
evidence
14),
a Random meta
b random
a random
b
,
,
.(Table 10)
5) .
, ,
.(Table 11)
6) · .
, .
7) .
, ,
+ KGLP KGLP
,
- ,
.
. .
A Random meta
B random
C random
D ,
E ,
F A F
+ KGLP , KGLP
,
- ,
· , .
. .
.
.
.
8) .
.
9) .
.
10) .
reference
3.
(Table 12) .
결 론
, .
.
,
, ,
, , · ,
, ,
, .
참고문헌