5 курс / ОЗИЗО Общественное здоровье и здравоохранение / Стратегия_ВОЗ_в_области_народной_медицины_2002_2005_гг_ВОЗ
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;ehyfkt Fvthbrfycrjq vtlbwbycrjq fccjwbfwbb bcgjkmpjdfybt gj rhfqytq vtht jlyjuj bp 16 dbljd fkmnthyfnbdys[ nthfgbq yf ghjnz;tybb ghtlsleotuj ujlf edtkbxbkjcm c 34¢ d 1990 u& lj 42¢ d 1997 u& 13 Rjkbxtcndj gjctotybq nt[^ rnj ghtljcnfdkztn eckeub LFV ctujlyz yfvyjuj ghtdsiftn xbckj gjctotybq dct[ dhfxtq gthdbxyjq vtlbrj-cfybnfhyjq gjvjob d CIF&
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80% |
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70% |
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49% |
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31% |
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hfcntybz Htfkbpfwbz jn |
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33 |
64 |
96 |
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66 |
81 |
24 |
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52 |
126 |
143 |
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76 |
96 |
26 |
Dth,tyf |
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103 |
102 |
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64 |
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85 |
Bcnjxybr% lfyyst bp Scanner Data FDM^ drk.xfz CIF&18
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xbckjv dhfxtq fkkjgfnjd^ ult cjjnyjitybt cjcnfdkztn 1%20 000 bkb xenm vtymit&19^20
Bccktljdfybt^ ghjdtltyyjt d 1991 u& Fvthbrfycrbv futyncndjv gj vt;leyfhjlyjve hfpdbnb.^ ecnfyjdbkj^ xnj d ghbktuf.ob[ r Cf[fht hfqjyf[ Fahbrb nhflbwbjyyst ktrfhb gj xbcke d chfdytybb c fkkjgfnfvb cjcnfdkz.n 100%1&21 Rhjvt njuj^ kbwf^ pfybvf.obtcz fkkjgfnbxtcrjq vtlbwbyjq^ yf[jlzncz ght;lt dctuj d ujhjlf[ bkb d ujhjlcrb[ hfqjyf[& Lkz vyjub[ uhegg yfctktybz yf vtcnf[ YV zdkztncz tlbycndtyysv bcnjxybrjv vtlbrjcfybnfhyjq gjvjob& J,pjhs^ ghjdtltyyst Ghjuhfvvjq DJP gj j,hfotyb. dcgznm vfkzhbb d 1998 u& gjrfpfkb^ xnj d Ufyt^ Vfkb^
Ybuthbb b Pfv,bb ,jktt xtv 60¢ ltntq c dscjrjq ntvgthfnehjq ktxfncz yf ljve hfcnbntkmysvb ktrfhcndtyysvb chtlcndfvb&22^ 23^ 24^ 25 Jlyjq bp jcyjdys[ ghbxby ’njuj zdkztncz ,tcghtgzncndtyysq ljcneg r ktrfhcndtyysv chtlcndfv hfcnbntkmyjuj ghjbc[j;ltybz d ctkmcrb[ hfqjyf[ (cv& nfr;t Hbc& 5)&
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Bcnjxybr% flfgnbhjdfyj bp Ahorlu C et al., 1997 26
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14
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60% |
40% |
22% |
78% |
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Bcnjxybr% Anderson W. et al, 1993; Mason F., 1995; Ostrow MJ et al, 1997 34,35,36&
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Jnyjcbntkmyj ybprfz euhjpf^ rjnjhfz fccjwbbhetncz c bcgjkmpjdfybtv ghjwtlehys[ ajhv nthfgbb YV vj;tn nfr;t cjltqcndjdfnm b[ gjgekzhyjcnb&
Ghb fyfkbpt lfyys[ j ytghfdbkmyjv ktxtybb d 1990-1996 uu& d CIF ;fkj,s yf [bhjghfrnbrjd^ nthfgtdnjd-vfccf;bcnjd b kbw^ ghfrnbre.ob[ fregeyrnehe^ ,skb ujhfplj ht;t b ghbdjlbkb r vtytt cthmtpysv edtxmzv^ xtv nj ,skj d ckexft bcrjd r dhfxfv-vtlbrfv& Rfr gjrfpsdf.n bpscrfybz d kbnthfneht dctuj vbhf yf ghjnz;tybb 15 ktn ,skj pfhtubcnhbhjdfyj kbim 193 ckexfz jckj;ytybq gjckt rehcf fregeyrnehs (drk.xfz chfdybntkmyj ytpyfxbntkmyst afrnjhs^ nfrbt rfr cbyzrb bkb cjcnjzybt njiyjns)&38
1&5 Htfrwbz yf gjgekzhyjcnm
YV#LFV
Ghfdbntkmcndf dj dct ,jkmitq cntgtyb htfubhe.n yf bcgjkmpjdfybt YV#LFV& D hzlt cnhfy d yfcnjzott dhtvz hfphf,fnsdf.ncz pfrjyjgjkj;tybz gj [bhjghfrnbrt^ d nj dhtvz rfr 24 cnhfys e;t bvt.n nfrbt herjdjlcndf (Hbc& 7)& Lheubt cnhfys pfybvf.ncz djghjcfvb htuekbhjdfybz d j,kfcnb hfcnbntkmys[ ktrfhcndtyys[ chtlcnd& Xbckj ujcelfhcndxktyjd DJP^ rjnjhst bvt.n herjdjlcndf^ cdzpfyyst c ktrfhcndtyysvb chtlcndfvb hfcnbntkmyjuj ghjbc[j;ltybz^ djphjckj jn 52-[ d 1994 u& lj 64-[ d 2000 u& (Hbc& 8)& Kbim d 2000 u& htuekbhe.obt gjkj;tybz d jnyjitybb ktrfhcndtyys[ chtlcnd hfcnbntkmyjuj ghjbc[j;ltybz ,skb hfphf,jnfys Fdcnhfkbtq^ Rfyfljq^ Vflfufcrfhjv^ Ybuthbtq b CIF& (DJP jrfpsdfkf cjltqcndbt Vflfufcrfhe b Ybuthbb d hfphf,jnrt ’nb[ gjkj;tybq&) D ytrjnjhs[ cnhfyf[ bvttn vtcnj hfcibhtybt nhflbwbjyys[ cnherneh^ ,.l;tnf b gjlujnjdrb gj YV#LFV (Nf,kbwf 5)&
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15
Hbceyjr 7
{bhjghfrnbrf ctujlyz ibhjrj hfcghjcnhfytyf
Cnhfntubz DJP d j,kfcnb yfhjlyjq vtlbwbys 2002-2005 uu&
Bcnjxybr% flfgnbhjdfyj bp World Federation of Chiropractic and World Chiropractic Alliance in 2000&39^40
Yfhjlyj-Ltvjrhfnbxtcrfz Htcge,kbrf^ Ihb-Kfyrf b Dmtnyfv& (Cv& nfr;t Hbc& 9)&
D nj ;t cfvjt dhtvz hfcntn gjgekzhyjcnm LFV d hfpdbdf.ob[cz cnhfyf[^ rjnjhfz cnfyjdbncz dct ,jktt b ,jktt pfvtnyjq& D 1995 u& Yjhdt;crbq gfhkfvtyn hfccvjnhtk djghjc j njv^ rfrbv j,hfpjv LFV vj;tn ,snm yfbkexibv j,hfpjv drk.xtyf d yjhdt;crbt cke;,s plhfdjj[hfytybz& "nj ghtlecvfnhbdfkj hfccvjnhtybt nfrb[ djghjcjd rfr% eljcnjdthtybt ghjatccbjyfkmyjq gjlujnjdrb b j,extybz gj LFV b ljrevtynfkmyjt gjlndth;ltybt rehcjd ktxtybz^ ghtlkfuftvs[ LFV& D 1997 u& vbybcnthcndj plhfdjj[hfytybz b cjwbfkmyjuj j,tcgtxtybz exhtlbkj rjvbntn lkz hfccvjnhtybz hfpkbxys[ fcgtrnjd LFV& D ljrkflt ’njuj rjvbntnf ghtlkfuftncz fyyekbhjdfnm pfrjyjlfntkmysq frn j ifvfycndt b pyf[fhcndt b cjplfnm cbcntve htubcnhfwbb lkz nt[^ rnj pfybvftncz LFV& D ytv nfr;t ghtlkfuftncz dsltktybt chtlcnd yf ghjnz;tybb gznbktnytuj gthbjlf lkz hfcibhtybz pyfybq j LFV b j,tcgtxtybz cjnhelybxtcndf vt;le ntvb^ rnj ghtljcnfdkztn LFV b yjhdt;crjq cbcntvjq
plhfdjj[hfytybz&42 Dcktl pf ’nbv ,skb jceotcndktys vths yf vt;leyfhjlyjv ehjdyt^ b d 1999 u& ,sk gjlgbcfy
Vtvjhfylev j dpfbvjgjybvfybb b cjnhelybxtcndt d plhfdjj[hfytybb^ rjnjhsq gjlgbcfkb vbybcnhs plhfdjj[hfytybz Rbnfqcrjq Yfhjlyjq Htcge,kbrb b Yjhdtubb& "nj cjukfitybt cjltqcndetn hfpdbnb. plhfdjj[hfytybz d j,tb[ cnhfyf[^ j,hfofz jcj,jt dybvfybt yf djghjcs YV#LFV b hfpdbnbz^ djghjcs htuekbhjdfybz b cjplfybz cnfwbjyfhjd&
Djghjc j ghtljcnfdktybb b bcgjkmpjdfybb LFV ,sk nfr;t jabwbfkmyj hfccvjnhty d Cjtlbytyyjv Rjhjktdcndt c extnjv djphjcituj bynthtcf r djghjcfv ,tpjgfcyjcnb&
D yfcnjzott dhtvz pf bcrk.xtybtv jcntjgfnbb b [bhjghfrnbrb^ rjnjhst pfobotys cjjndtncnde.obv ecnfdjv k.,jq xtkjdtr vj;tn pfybvfnmcz LFV ,tp rfrjqkb,j gjlujnjdrb& D 1999 u& Gfkfnf kjhljd ghtlkj;bkf Rjvbntne gj yfert b nt[yjkjubb ghjdtcnb j,pjh ’njuj dblf vtlbrjcfybnfhyjq gjvjob& Rjvbntn htrjvtyljdfk exhtlbnm wtynhfkmysq vt[fybpv
16
Nf,kbwf 5
Dct ,jkmitt xbckj fahbrfycrb[ cnhfy cjplf.n cnhernehs^ dsltkz.n ,.l;tn b j,tcgtxbdf.n gjlujnjdre gj YV
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Bcnjxybr% Dctvbhyfz jhufybpfwbz plhfdjj[hfytybz^ 2000 u&3
(abyfycbhetvsq ghfdbntkmcndjv b pf cxtn ,kfujndjhbntkmys[ bcnjxybrjd) lkz rjjhlbyfwbb^ rjycekmnfwbq b yflpjhf pf gjlujnjdrjq lkz yfexys[ bccktljdfybq d jnyjitybb LFV& Dj-dnjhs[^ jy ghtlkj;bk^ xnj,s yfwbjyfkmyfz cke;,f plhfdjj[hfytybz^ eghfdktybt gj djghjcfv hfpdbnbz^ f nfr;t Cjdtn gj vtlbwbycrbv yfexysv bccktljdfybzv dsltkbkb ytj,[jlbvst chtlcndf yf yfexyst bccktljdfybz lkz cjplfybz gjrfpfntkmys[ wtynhjd d jnyjitybb bpextybz LFV c bcgjkmpjdfybtv Yfwbjyfkmyjuj wtynhf gj ljgjkybntkmyjq b fkmnthyfnbdyjq vtlbwbyt CIF (cv& cktle.oe. cnhfybwe) d rfxtcndt nfrjq vjltkb&16
Edtkbxtybt gjlujnjdrb b j,extyb. LFV d Cjtlbytyyjv Rjhjktdcndt nfr;t cke;bn
jnhf;tybtv hjcnf bynthtcf r ’njve dble vtlbwbycrjq gjvjob& Nfr^ yfghbvth^ gjlujnjdrf gj fregeyrneht ghtljcnfdkztncz dj dct ,jkmitv b ,jkmitv xbckt frfltvbxtcrb[ exht;ltybq& Rehcs gj LFV nfr;t ghtlkfuf.ncz cneltynfv-vtlbrfv^ [jnz ’nb rehcs j,tcgtxbdf.n kbim frfltvbxtcrjt ddtltybt d ntve b yt j,exf.n rjyrhtnysv rkbybxtcrbv yfdsrfv& Xbckj vtlbwbycrb[ rjkktl;tq d Cjtlbytyyjv Rjhjktdcndt^ ghtlkfuf.ob[ nfrbt rehcs^ edtkbxbkjcm c 10¢ lj 40¢ vt;le 1995 b 1997 ujljv&43 D Cjtlbytyys[ Infnf[ Fvthbrb wtksq hzl vtlbwbycrb[ afrekmntnjd bvt.n nfr;t afrekmnfnbdyst rehcs b ctvbyfhs gj LFV&44
Fyfkjubxyj ’njve ghjbc[jlbn edtkbxtybt abyfycbhjdfybz b cjplfybz yfexyj-
Ukj,fkmysq j,pjh
17
Hbceyjr 8
Dct ,jkmitt xbckj cnhfy eltkztn dybvfybt djghjcfv htuekbhjdfybz ktrfhcndtyys[ chtlcnd hfcnbntkmyjuj ghjbc[j;ltybz
Cnhfntubz DJP d j,kfcnb yfhjlyjq vtlbwbys 2002-2005 uu&
Bcnjxybr% Dctvbhyfz jhufybpfwbz plhfdjj[hfytybz^ 1998 u&41 b lfyyst^ cj,hfyyst Dctvbhyjq jhufybpfwbtq plhfdjj[hfytybz yf ghjnz;tybb 1999-2001 uu&
bccktljdfntkmcrb[ wtynhjd b gjrfpfntkmys[ wtynhjd gj LFV d hfpdbns[ cnhfyf[& D Cjtlbytyyjv Rjhjktdcndt yfwbjyfkmyfz cke;,f plhfdjj[hfytybz ytlfdyj ghjabyfycbhjdfkf ldf bccktljdfybz gj fregeyrneht lkz ktxtybz cjcnjzybq^ cdzpfyys[ c [hjybxtcrjq ,jkm.^ d nj dhtvz rfr d Uthvfybb Wtynh gj LFV d nt[ybxtcrjv eybdthcbntnt d V.y[tyt j,tcgtxbk ghjdtltybt hzlf df;ys[ cbcntvfnbxtcrb[ j,pjhjd&43
D CIF d 1992 u& Rjyuhtcc cjplfk jnltktybt fkmnthyfnbdyjq vtlbwbys d yfwbjyfkmys[ bycnbnenf[ plhfdjj[hfytybz (cv& http:// nccam.nih/gov/)& D 1999 u& vfylfn Jnltkf ,sk hfcibhty^ b jy cnfk Yfwbjyfkmysv wtynhjv gj ljgjkybntkmyjq b fkmnthyfnbdyjq vtlbwbyt (NCCAM)& NCCAM gjkexfk dct ,jkmit ,.l;tnys[ chtlcnd b r 2000 u& tuj ,.l;tn cjcnfdbk 68^4 vky& ljkk& CIF (Hbc& 10)& Jlyjdhtvtyyj c ’nbv <tksq ljv cjplfk cgtwbfkmye. Rjvbccb. gj fkmnthyfnbdyjq vtlbwbyt& Cjplfyyfz ltrhtnjv jn 8 vfhnf 2000 u&^ ’nf Rjvbccbz jndtxftn pf hfphf,jnre pfrjyjlfntkmys[ b flvbybcnhfnbdys[ htrjvtylfwbq lkz
gjkextybz vfrcbvfkmyjq gjkmps jn LFV lkz j,otcndtyyjcnb& D tt cjcnfd d[jlzn ltcznm xktyjd^ drk.xfz ctyfnjhjd b ’rcgthnjd&
Hbceyjr 9
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Bcnjxybr% Dctvbhyfz jhufybpfwbz plhfdjj[hfytybz^ 2000 u&3
18
Hbceyjr 10
Pyfxbntkmyjt edtkbxtybt abyfycbhjdfybt LFV d CIF
70 |
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68.3 |
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60 |
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50 |
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49.9 |
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40 |
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30 |
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20 |
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19.5 |
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10 |
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7.8 |
11.5 |
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2.0 |
4.0 |
5.5 |
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||
2.0 |
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0 |
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92 |
93 |
94 |
95 |
96 |
97 |
98 |
99 |
00 |
Bcnjxybr%Yfwbjyfkmysqwtynhgjljgjkybntkmyjqbfkmnthyfnbdyjqvtlbwbyt^ 2000 u&45
D CIF bvttncz nfr;t ,jkmijt xbckj gjlhfpltktybq^ pfybvf.ob[cz yfexysvb bccktljdfybzvb LFV d yfexyjbccktljdfntkmcrb[ bycnbnenf[^ nfrb[ rfr eybdthcbntn Vthbktylf^ Rjkev,bqcrbq eybdthcbntn d Ym.-Qjhrt^ Ufhdfhlcrbq eybdthcbntn d infnt Vfccfxectnc b Vtvjhbfkmysq wtynh Ckjey- R’nnthbyu gj ,jhm,t ghjnbd hfrf d Ym.-Qjhrt&43
<jktt pfvtnyjq cnfkf b vt;leyfhjlyfz ltzntkmyjcnm d j,kfcnb YV#LFV& Tdhjgtqcrbq cj.p (TC) ytlfdyj pfdthibk hf,jne yfl ghjtrnjv COST (Tdhjgtqcrjt cjnhelybxtcndj d j,kfcnb yfexys[ b
nt[ybxtcrb[ bccktljdfybq)^ rfcf.obqcz ‘ytnhflbwbjyyjq vtlbwbys\^ b d 1999 u& Gfhkfvtyncrfz fccfv,ktz Tdhjgtqcrjuj cj.pf (gjl ’ubljq tdhjgtqcrb[ bccktljdfybq ytnhflbwbjyys[ dbljd ktxtybz) ghbpdfkf ujcelfhcndf-xktys cjltqcndjdfnm jabwbfkmyjve ghbpyfyb. LFV yf vtlbwbycrb[ afrekmntnf[^ cjltqcndjdfnm tt bcgjkmpjdfyb. d cnfwbjyfhf[^ j,hfnbdibcm c ghbpsdjv r dhfxfv-fkkjgfnfv bpexfnm LFV yf eybdthcbntncrjv ehjdyt&46 D Tdhjgt Tdhjgtqcrjt futyncndj gj jwtyrt vtlbwbycrb[ bpltkbq (EMEA) ghjljk;ftn cdj. hf,jne gj djghjcfv rfxtcndf^ ,tpjgfcyjcnb b ’aatrnbdyjcnb ktrfhcndtyys[ chtlcnd hfcnbntkmyjuj ghjbc[j;ltybz& Cgtwbfkmyfz hf,jxfz uheggf gj hfcnbntkmysv ktrfhcndtyysv chtlcndfv ,skf cjplfyf EMEA d 1997 u& (cv& nfr;t Ukfde 4)&
Cjdctv ytlfdyj Ltrkfhfwbz^ ghbyznfz d F,el;t^ gj j,hfotyb. dcgznm vfkzhbb^ rjnjhe. gjlgbcfkb ukfds 53 ukfd ujcelfhcnd b ghfdbntkmcnd Fahbrb d 2000 u&^ erfpfkf yf df;ysq drkfl^ rjnjhsq dyjcbn YV d ,jhm,e c vfkzhbtq& Ltrkfhfwbz cjlth;bn ghtlkj;tybt ghfdbntkmcndfv j,tcgtxbnm ’aatrnbdyjcnm nfrjuj ktxtybz b cltkfnm tuj djpvj;ysv b ljcnegysv lkz ,tlytqituj yfctktybz d j,obyt&
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19