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KMID : 1234920070070020027
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Journal of Korean Oriental Association for Study of Obesity
2007 Volume.7 No. 2 p.27 ~ p.37
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A Clinical Practice Guideline for Ma-huang(Ephedra sinica) Prescription in Obesity
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Han Chang-Ho
Lee Eui-Ju
Song Yun-Kyung
Shin Byung-Chul
Kim Yun-Kyung
Kim Ho-Jun
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Abstract
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Background: Clinical practice guidelines (CPG) are systematically developed statements to assist practitioners and patients on healthcare decisions. They provide recommendations for the average patient, which should take into account individual clinical judgment and the patient’s values and expectations. Ephedra has sympathomimetic effect and has been used for weight loss worldwide. However, its safety is controversial especially in autonomic and cardiovascular systems. Therefore, the need of appropriate CPG for ephedra prescription in obesity was advocated in Korean Traditional Medicine.
Methods: The committee comprised of specialists of obesity, oriental herbology, oriental cardiology, constitutional medicine. The committee collected all relevant references about adverse effect and safety of ephedra in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study and observational study from international and domestic databases and paper journals. 11 English- and 5 Korean-language references were gathered and categorized by PICO (Patient, Intervention, Comparison, Outcome) method. We could not complete strength of recommendation which should be clarified according to the evidence grade estimation.
Result: The first version of CPG for ephedra prescription in obesity was issued by Korean Oriental Association for Study of Obesity. It includes topics of introduction, pharmacokinetics, side effects and adverse events, constitutional aspect and recommendations for dose, indication and contraindication.
Conclusion: There should be periodic upgrade of this CPG from now on. Although there are some drawbacks in this version of CPG, it has significance as the first CPG in Korean Traditional Medicine.
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KEYWORD
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Clinical Practice Guideline, ephedra, Evidence-based Medicine
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