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항응고제 또는 항혈전제와 활혈거어 한약 병용환자에서 침치료 안전성에 대한 후향적 환자-대조군 연구

Safety of Acupuncture Therapy for Patients Undergoing Anticoagulants / antiplatelet-Hwalhyeolgeoeo Herbal Medication: Retrospective Casecontrol Study

  • 이민준 (경희대학교 한의과대학 침구의학교실) ;
  • 임세훈 (경희대학교 한의과대학 침구의학교실) ;
  • 이승민 (경희대학교 한의과대학 침구의학교실) ;
  • 김은석 (경희대학교 한의과대학 침구의학교실) ;
  • 이승훈 (경희대학교 한의과대학 침구의학교실) ;
  • 강중원 (경희대학교 한의과대학 침구의학교실) ;
  • 이재동 (경희대학교 한의과대학 침구의학교실)
  • Lee, Min Jun (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Im, Se Hoon (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Lee, Seung Min (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Eun Seok (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Lee, Seung Hoon (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kang, Jung Won (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Lee, Jae Dong (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University)
  • 투고 : 2014.11.17
  • 심사 : 2014.11.29
  • 발행 : 2014.12.20

초록

Objectives : The aim of this study is to evaluate the safety of acupuncture therapy when applied to patients who are undergoing anticoagulants / antiplatelet medication therapy combined with herbal medicine using a retrospective, case-control study. Methods : 428 charts of patients were reviewed in this study. Odds ratio between case of bleeding-related adverse event and control was calculated as main analysis. Exposures were anticoagulants / antiplatelet medication, Hwalhyeolgeoeo herbal medicine and combination of both drugs. Additionally, odds ratios were calculated according to the severity of bleeding-related adverse events. Results : The results were as following: 1. Analysis of all bleeding-related adverse events showed there was no increased risk of combined therapy compared with other exposures and control group. 2. Analysis of only clinically significant adverse events showed there was no increased risk of combined therapy compared with other exposure and control group. 3. Hwalhyeolgeoeo herbal medicine group showed a tendency of increased risk of bleeding-related adverse events in all analysis but was not statistically significant. Conclusions : The results suggest that Hwalhyeolgeoeo herbal medicine-anticoagulant / antiplatelet medication combined therapy may not increase risk of bleeding-related adverse events in acupuncture therapy. By executing various modules of analysis, it was possible to acquire useful data for possible future studies. Further research is needed to confirm such results.

키워드

참고문헌

  1. NIH Consensus conference. Acupuncture. JAMA. 1998 ; 280(17) : 1518-24. https://doi.org/10.1001/jama.280.17.1518
  2. MacPherson H, Thomas K, Walters S, Fitter M. The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists. BMJ. 2001 ; 323(7311) : 486-7. https://doi.org/10.1136/bmj.323.7311.486
  3. White A, Hayhoe S, Hart A, Ernst E. Adverse events following acupuncture: prospective survey of 32 000 consultations with doctors and physiotherapists. BMJ. 2001 ; 323(7311) : 485-6. https://doi.org/10.1136/bmj.323.7311.485
  4. Melchart D, Weidenhammer W, Streng A et al. Prospective investigation of adverse effects of acupuncture in 97 733 patients. Arch Intern Med. 2004 ; 164(1) : 104-5. https://doi.org/10.1001/archinte.164.1.104
  5. Witt CM, Pach D, Brinkhaus B et al. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch Komplementmed. 2009 ; 16(2) : 91-7. https://doi.org/10.1159/000209315
  6. Kenz S, Webb H, Laggan S. Thigh haematoma following acupuncture treatment in a patient on warfarin. BMJ Case Rep. published online(19 October 2012).
  7. Miller C, Hopperstad B, Johnson P, Dusek J. Acupuncture treatment for hospitalized patients on anticoagulant therapy-a safety study. BMC Complement Altern Med. 2012 ; 12(Suppl 1) : P107. https://doi.org/10.1186/1472-6882-12-S1-P107
  8. Kim YJ, Kim SK, Cho SY et al. Safety of acupuncture treatments for patients taking warfarin or antiplatelet medication: retrospective chart review study. Eur J Integr Med. 2014 ; 6(4) : 492-6. https://doi.org/10.1016/j.eujim.2014.04.004
  9. Lynch SL, Boon AJ, Smith J, Harper CM, Tanaka EM. Complications of needle electromyography: hematoma risk and correlation with anticoagulation and antiplatelet therapy. Muscle Nerve. 2008 ; 38(4) : 1225-30. https://doi.org/10.1002/mus.21111
  10. Gertken JT, Hunt CH, Chinea NIM, Morris JM, Sorenson EJ, Boon AJ. Risk of hematoma following needle electromyography of the paraspinal muscles. Muscle Nerve. 2011 ; 44(3) : 439-40.
  11. Boon AJ, Gertken JT, Watson JC et al. Hematoma risk after needle electromyography. Muscle Nerve. 2012 ; 45(1) : 9-12. https://doi.org/10.1002/mus.22227
  12. Holbrook AM, Pereira JA, Labiris R et al. Systematic overview of warfarin and its drug and food interactions. Arch Intern Med. 2005 ; 165(10) : 1095-106. https://doi.org/10.1001/archinte.165.10.1095
  13. Park SJ, Kwon YK, Shin JG. Current status of herb-drug interaction infromation and information database in Korea. Oriental Physiology & Pathology. 2010 ; 21(1) : 543-52.
  14. Jeonguk Committee of Herbal Pharmacology Department. Herbal Pharmacology. 2nd ed. Seoul : Younglimsa. 2007 : 446-82.
  15. Yamashita H, Tsukayama H, Tanno Y, Nishijo K. Adverse events in acupuncture and moxibustion treatment: a six-year survey at a National Clinic in Japan. J Altern Complement Med. 1999 ; 5(3) : 229-36. https://doi.org/10.1089/acm.1999.5.229
  16. Yamashita H, Tsukayama H, Tanno Y, Nishijo K. Adverse events related to acupuncture. JAMA. 1998 ; 280(18) : 1563-4. https://doi.org/10.1001/jama.280.18.1563
  17. Yamashita H, Tsukayama H, Hori N, Kimura T, Tanno Y. Incidence of adverse reactions associated with acupuncture. J Altern Complement Med. 2000 ; 6(4) : 345-50. https://doi.org/10.1089/10755530050120718
  18. Kim DH, Kim KW, Kim JH et al. Prospective observational study of acupuncture adverse events: 50 patients hospitalized for peripheral facial palsy treatments. The Acupuncture . 2011 ; 28(4) : 65-75.
  19. Park JE, Lee MS, Choi JY, Kim BY, Choi SM. Adverse events associated with acupuncture: A prospective survey. J Altern Complement Med. 2010 ; 16(9) : 959-63. https://doi.org/10.1089/acm.2009.0415
  20. Park JY, Kim SY, Cha YB et al. Systematic review of adverse events related to acupuncture and moxibustion in Korea. J Korean Med. 2010 ; 31(2) : 78-90.
  21. Park JM, Park SW, Jung WS. Short tenn reactions to acupuncture treatment and adverse events following acupuncture in Korea a cross-sectional survey of patient reports. J Korean Med. 2007 ; 28(2) : 66-79.