대한한방내과학회지 (The Journal of Internal Korean Medicine)

대한한방내과학회 (The Society of Internal Korean Medicine)
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한의 복진 정량화 연구 - 기능성 소화불량 환자의 복냉 진단을 중심으로 -

Study on the Possibility of Quantitative Measurement of Abdominal Examinations in Korean Medicine - A Focus on Diagnosis of Abdominal Coldness in Functional Dyspepsia Patients -

  • 이재홍 (강동경희대학교 한방병원 한방내과) ;
  • 조수호 (강동경희대학교 한방병원 한방내과) ;
  • 고석재 (강동경희대학교 한방병원 한방내과) ;
  • 김진성 (경희대학교 대학원 임상한의학과) ;
  • 박재우 (강동경희대학교 한방병원 한방내과)
  • Lee, Jae-hong (Dept. of Internal Korean Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Cho, Soo-ho (Dept. of Internal Korean Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Ko, Seok-jae (Dept. of Internal Korean Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Kim, Jin-sung (Dept. of Clinical Korean Medicine, Graduate School of Kyung Hee University) ;
  • Park, Jae-woo (Dept. of Internal Korean Medicine, Kyung Hee University Hospital at Gangdong)
  • 투고 : 2018.08.06
  • 심사 : 2018.09.28
  • 발행 : 2018.09.30
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초록

Objective: This study was designed to investigate the possibility of quantification of the diagnosis of abdominal coldness (AC) in patients with functional dyspepsia (FD). Methods: Forty-four patients with FD were enrolled in this study. Three Korean medicine doctors each randomly examined all abdomens. Diagnosis of AC was made by consensus of at least two of the doctors. Body temperature (oral by digital oral thermometer) and skin temperature (by digital infrared thermal imaging [DITI]) were measured, followed by administration of the Cold and Heat questionnaire (CHQ) and the Instrument of Pattern Identification for Functional Dyspepsia (IPIFD). Results: Of the 44 patients with FD, 22 were assigned to the AC group and 22 to the non-AC group. The concordance rate of diagnosis among the three doctors was 63.6% (28/44), with a ${\kappa}$ of 0.504, indicating means moderate agreement). Neither the oral nor the skin temperatures showed statistically significant differences between the AC and non-AC groups. However, the CHQ scores and 'Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD were higher in AC group and showed statistically significant differences (p=0.010 and 0.009). Conclusions: This is the first study conducting quantitative measurements of abdominal coldness in patients with FD. Although oral and skin temperature showed no statistical significance between AC and non-AC groups, the concordance rate of diagnosis of AC among the three Korean Medicine doctors was moderate. The CHQ scores and 'Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD also suggest that diagnosis of AC is relevant to cold and heat patterns, and these questionnaires could be utilized as supportive data for the diagnosis of AC. Further studies should be conducted for the purpose of quantifying and standardizing abdominal examinations in Korean Medicine.

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참고문헌

  1. Rhie SY, Choi CH, Lee HW, Do MY, Lee SH, Han SP, et al. The Frequency of Functional Dyspepsia Subtypes and its Related Factors for Health Check up Subjects. Journal of Neurogastroenterology and Motility 2007;13(1):31-7.
  2. Aro P, Talley NJ, Ronkainen J, Storskrubb T, Vieth M, Johansson SE, et al. Anxiety is Associated with Uninvestigated and Functional Dyspepsia (Rome III criteria) in a Swedish Population-Based Study". Gastroenterology 2009;137(1):94-100. https://doi.org/10.1053/j.gastro.2009.03.039
  3. Jee SR, Jung HK, Min BH, Choi KD, Rhee PL, Kang YW, et al. Guidelines for the Treatment of Functional Dyspepsia. Korean J Gastroenterol 2011;57(2):67-81. https://doi.org/10.4166/kjg.2011.57.2.67
  4. Zhou W, Su J, Zhang H. Efficacy and Safety of Acupuncture for the Treatment of Functional Dyspepsia: Meta-analysis. The Journal of Alternative and Complementary Medicine 2016;22(5):380-9. https://doi.org/10.1089/acm.2014.0400
  5. Wu H, Jing Z, Tang X, Wang X, Zhang S, Yu Y, et al. To Compare the Efficacy of Two Kinds of Zhizhu Pills in the Treatment of Functional Dyspepsia of Spleen-deficiency and Qi-stagnation Syndrome: A Randomized Group Sequential Comparative Trial. BMC Gastroenterology 2011; 11(1):81-7. https://doi.org/10.1186/1471-230X-11-81
  6. Lv L, Wang FY, Ma XX, Li ZH, Huang SP, Shi ZH, et al. Efficacy and Safety of Xiangsha Liujunzi Granules for Functional Dyspepsia: A Multi-center Randomized Double-blind Placebo -controlled Clinical Study. World Journal of Gastroenterology 2017;23(30):5589-601. https://doi.org/10.3748/wjg.v23.i30.5589
  7. Carbone F, Vandenberghe A, Holvoet L, Vanuytsel T, Van Oudenhove L, Jones M, et al. Validation of the Leuven Postprandial Distress Scale, a Questionnaire for Symptom Assessment in the Functional Dyspepsia/Postprandial Distress Syndrome. Alimentary Pharmacology and Therapeutics 2016; 44(9):989-1001. https://doi.org/10.1111/apt.13753
  8. YJ Kim. A study on Zhong Guo Fu Zhen(中國 腹診). Doctorate Thesis, Department of Korean Medicine, Dong Guk University 2012.
  9. Ko SJ, Lee HJ, Kim SK, Kim MJ, Kim JS, Lee BJ, et al. Development of the Quantitative Indicator of Abdominal Examination for Clinical Application: A Pilot Study. The Journal of Alternative and Complementary Medicine 2015; 21(6):358-63. https://doi.org/10.1089/acm.2014.0185
  10. Ko SJ, Kim HG, Kim SK, Park KM, Lee JC, Lee BJ, et al. Reliability and Validity of Modified Algometer in Abdominal Examination. Evidence-Based Complementary and Alternative Medicine 2016.
  11. Translated by DH Kim. Huangdineijing. Seoul: Euiseoungdang; 2002, p. 692.
  12. Tang SW. Zhengleibencao. Beijing: Huaxia Chubanshe; 1993. quoted in J Heo. translated by SH Yoon and HJ Kim. Daeyeok Donguibogam. Hadong: Donguibogam chulpansa; 2010, p. 82.
  13. Gong TX. Wanbinghuichun. Beijing: Renmin weisheng chubanshe; 1987, quoted in J Heo. Translated by SH Yoon and HJ Kim. Daeyeok Donguibogam. Hadong: Donguibogam chulpansa; 2010, p. 396.
  14. Shuk DY. Effects of Characteristic Cold . Hot Herbs on the Abdominal and Rectal Temperature of Rats. Journal of Oriental Physiology 2000; 15(1):137-47.
  15. Hwang MS, Hwang JH, Kang SY, Kang AN, Roh HS, Park YK. Effects Study of Aconiti Lateralis Radix Preparata Extract on the Regulation of Heat and Cold in PTU-induced Hypothyroidism Rats. The Korean Journal of Herbology 2016;31(6):63-71.
  16. Kang JC. Clinical Study about 62 Cases of Psoriasis Patient Using Pyretotherapy. The Journal of Korean Medical Ophthalmology, Otolaryngology and Dermatology 2012;25(4):35-44. https://doi.org/10.6114/jkood.2012.25.4.035
  17. Niven DJ, Gaudet JE, Laupland KB, Mrklas KJ, Roberts DJ, Stelfox HT. Accuracy of Peripheral Thermometers for Estimating TemperatureA Systematic Review and Meta-analysis Accuracy of Peripheral Thermometers. Annals of Internal Medicine 2015;163(10):768-77. https://doi.org/10.7326/M15-1150
  18. Hooper VD, Andrews JO. Accuracy of Noninvasive Core Temperature Measurement in Acutely Ill Adults: The State of the Science. Biological Research for Nursing 2006;8(1):24-34. https://doi.org/10.1177/1099800406289151
  19. Heo JK, Lee CH, Lee KS. A Study on the D.I.T.I Patterns of Climacteric Patients. The Jounral of Oriental Obsterics and Gynecology 2009;22(3):143-51.
  20. Choi YC, Lim CS, Kwon KR. Standardization Study of Thermal Imaging Using the Acupoints in Human Body. Journal of Pharmacopuncture 2008;11(3):113-22. https://doi.org/10.3831/KPI.2008.11.3.113
  21. Kim EG, Hwang DS, Lee CH, Lee KS. A Clinical Case Study for the Diagnosis and Assessment of Abdominal Cold Hypersensitivity Treatment by DITI. Journal of Oriental Medical Thermology 2009;7(1):55-65.
  22. Ryu HH, Lee HJ, Jang ES, Choi SM, Lee SG, Lee SW. Study on Development of Cold-Heat Pattern Questionnaire. The Korean Journal of Oriental Physiology and Pathology 2008;22(6): 1410-5.
  23. Choi SH, Rhim HM, Oh JG, Rhim JY, Kang HW, Kim YS, et al. Standard Pattern Identifications for Post Stroke Depression by Delphi Method. The Korean Journal of Oriental Physiology and Pathology 2012;26(3):367-75.
  24. Kim JB, Kim JH, Son CG, Kang WC, Cho JH. Development of Instrument of Pattern Identification for Functional Dyspepsia. The Korean Journal of Oriental Physiology and Pathology 2010;24(6):1094-8.
  25. Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, et al. Functional gastroduodenal disorders. Gastroenterology 2006;130(5):1466-79. https://doi.org/10.1053/j.gastro.2005.11.059
  26. Landis JR, GG Koch. The Measurement of Observer Agreement for Categorical Data. Biometrics 1977;33(1):159-74. https://doi.org/10.2307/2529310
  27. Cicchetti DV. Guidelines, Criteria, and Rules of Thumb for Evaluating Normed and Standardized Assessment Instruments in Psychology. Psychological Assessment 1994;6(4):284-90. https://doi.org/10.1037/1040-3590.6.4.284
  28. Park JM, Choi MG, Cho YK, Lee IS, Kim JI, Kim SW. Functional Gastrointestinal Disorders Diagnosed by Rome III Questionnaire in Korea. Journal of Neurogastroenterology and Motility 2011;17(3):279-86. https://doi.org/10.5056/jnm.2011.17.3.279
  29. Jung HK. Diagnostic Approach for Dyspepsia: Exclusive Diagnosis vs. Rome Criteria. The Korean Journal of Medicine 2010;78(2):163-9.
  30. Park JK, Huh KC, Shin CM, Lee H, Yoon YH, Song KH. Current Issues in Functional Dyspepsia. Korean J Gastroenterol 2014;64(3) :133-41. https://doi.org/10.4166/kjg.2014.64.3.133
  31. Lahiri BB, Bagavathiappan S, Jayakumar T, Philip J. Medical Aplications of Infrared Thermography: A Review. Infrared Physics & Technology 2012;55(4):221-35. https://doi.org/10.1016/j.infrared.2012.03.007
  32. Kim MS, Song KJ, Nam CM, Jung IK. A Study on Comparison of Generalized Kappa Statistics in Agreement Analysis. Korean Journal of Applied Statistics 2012;25(5):719-31. https://doi.org/10.5351/KJAS.2012.25.5.719
  33. Randolph JJ. Free-Marginal Multirater Kappa (multirater K [free]): An Alternative to Fleiss' Fixed-Marginal Multirater Kappa. Joensuu University Learning and Instruction Symposium 2005.
  34. Gwet KL. Variance estimation of nominal-scale inter-rater reliability with random selection of raters. Psychometrika 2008;73(3):407-30. https://doi.org/10.1007/s11336-007-9054-8
  35. Goundry B, L Bell, Langtree M, Moorthy A. Diagnosis and Management of Raynaud’s Phenomenon. BMJ 2012;344:e289. https://doi.org/10.1136/bmj.e289