Background : Static blood is a kind of etiological factor including stagnated blood and blood overflowed out of the vessels. It is one of the causes of stroke in oriental medicine. Objectives : The purpose of this study was to evaluate the static blood pattern and its indicators in stroke pattern diagnosis. Methods : For the standardization of pattern diagnosis in stroke, we set 5 patterns (Fire-heat, Dampness-phlegm, Static blood, Qi deficiency, Yin deficiency) and developed 61 indicators. Patients with a first-ever stroke, within 1 month after the onset of stroke. Two physicians checked the indicators independently. They then performed pattern diagnosis and rechecked the indicators which were referred to pattern diagnosis. If pattern identifications were diagnosed the same, it would confirm pattern identification. We examined the frequency of all indicators and referred indicators in static blood pattern patients. Results : In 859 patients, static blood pattern was shared by 24(2.8%). The indicators which affect static blood pattern were mainly rough pulse and bluish purple tongue, other indicators were not major effectors. Conclusion : This result shows that it is inconsistent to set up static blood pattern as a major pattern in stroke. Nevertheless, static blood is still a valuable concept in the clinical field. Other study methods will be required to establish the pattern diagnostic indicators for static blood pattern.
In spite of abundant clinical resources of stroke patients, the objective and logical data analyses or diagnostic systems were not established in oriental medicine. As a part of researches for standardization and objectification of differentiation of syndromes for stroke, in this present study, we tried to develop the statistical diagnostic tool discriminating the 4 subtypes of syndrome differentiation using the essential indices considering the sex. Discriminant analysis was carried out using clinical data collected from 1,448 stroke patients who was identically diagnosed for the syndrome differentiation subtypes diagnosed by two clinical experts with more than 3 year experiences. Empirical discriminant model(V) for different sex was constructed using 61 significant symptoms and sign indices selected by stepwise selection. We comparison. We make comparison a between discriminant model(V) and discriminant model(IV) using 33 significant symptoms and sign indices selected by stepwise selection. Development of statistical diagnostic tool discriminating 4 subtypes by sex : The discriminant model with the 24 significant indices in women and the 19 significant indices in men was developed for discriminating the 4 subtypes of syndrome differentiation including phlegm-dampness, qi-deficiency, yin-deficiency and fire-heat. Diagnostic accuracy and prediction rate of syndrome differentiation by sex : The overall diagnostic accuracy and prediction rate of 4 syndrome differentiation subtypes using 24 symptom and sign indices was 74.63%(403/540) and 68.46%(89/130) in women, 19 symptom and sign indices was 72.05%(446/619) and 70.44%(112/159) in men. These results are almost same as those of that the overall diagnostic accuracy(73.68%) and prediction rate(70.59%) are analyzed by the discriminant model(IV) using 33 symptom and sign indices selected by stepwise selection. Considering sex, the statistical discriminant model(V) with significant 24 symptom and sign indices in women and 19 symptom and sign indices in men, instead of 33 indices would be used in the field of oriental medicine contributing to the objectification of syndrome differentiation with parsimony rule.
Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.
The purpose of this study was to evaluate the diagnostic indicators which are used for the identification of fire-heat pattern in stroke patients. For evaluation of diagnostic indicator, we analyzed the indicators which are composed of symptoms and signs collected from stroke patients based on the clinical records using case report form (CRF). Patients had a first-ever stroke within 1 month after the onset of stroke. Pattern identification was performed and decided by two independent physicians. Two patient groups that consist of fire-heat pattern and the other patterns were compared to isolate important indicators affecting the fire-heat pattern identification of stroke patients. The 8 indicators among 16 fire-heat pattern indicators were significantly more frequent compared with non fire-heat pattern group. Logistic regression analysis revealed that 5 indicators among fire-heat indicators were significantly sensitive indicators being capable of identification of fire-heat pattern. But two of them was from the indicators of dampness-phlegm pattern and yin deficiency pattern. Therefore, further studies are required for the development of Korean standard indicators of Fire-heat pattern identification.
Objectives: The purpose of this study was to investigate distribution of pattern identification by age in stroke patients. Methods: From 1 April, 2007 to 29 September, 2008, 903 patients within a month after onset of stroke were included. Stroke patients were interviewed by oriental medicine doctors who used standard operation procedures for this study. A questionnaire was completed by a question-and-answer form between patients and doctors after explanation of details to patients and patients' agreement given. Results: Distributions of pattern identification in stroke patients differed by age groups. Dampness-Phlegm pattern was more common in the younger group aged under 80 years, while Yin-Deficiency pattern was more common in the older group aged over 80 years. Conclusions: In this study, we found a character of distribution of pattern identification by age in stroke patients within one month after stroke onset. We have concluded that these differences should be considered in the management and treatment of stroke patients.
Objectives: This study was designed to develop a standard tool for pattern identification of gastroesophageal reflux disease (GERD) patients. Methods: Korean and Chinese literature was selected that mentioned pattern identification of GERD. We gathered the pattern identification and their symptoms and a Chinese medical doctor proficient in Korean translated the Chinese characters into Korean. A Korean linguist then confirmed the translation results to develop a draft of the standard tool for pattern identification of gastroesophageal reflux disease (PIGERD). The final PIGERD was developed after assessment by an expert committee composed of professors from the Korean Medicine University, using the following items: inclusion of the pattern identification and its symptoms, importance of items, and validity of translation. Results: Six pattern identifications and 94 symptoms were selected from 45 references and translated into Korean. Four pattern identifications [pattern/syndrome of liver qi invading the stomach (肝胃不和), spleen-stomach weakness (脾胃虛弱), spleen-stomach dampness-heat (脾胃濕熱), and stomach yin deficiency (胃陰不足)] and 49 symptoms were then selected through the Delphi method by the expert committee. The final standard PIGERD tool was completed after the assessment of translation validity and reflection of individual opinions by the expert committee. This tool consists of 40 items including tongue and pulse diagnosis. The weighted value was also computed from assessment of the importance of items. Conclusions: We developed a standard tool for pattern identification of gastroesophageal reflux disease (PIGERD) to clarify the pattern identification of patients with gastroesophageal reflux disease for standardized diagnosis.
To assess the usefulness of tongue inspection for evaluating the Pattern identification in oriental medicine, we observed stroke patient's tongue and tongue coat and compared it with Pattern identification. The test group was composed of 85 acute stroke stage patients(within 72 hours of onset). Subjects were randomly selected from stroke patients admitted in the KyungHee University, Hospital of Oriental Medicine from December 1 1998 to June 30 1999. We took pictures of patient's tongue and tongue coat within 72hours from onset and checked Pattern identification at the same time. Tongues colored pale rose or red greatly outnumbered other colors. Tongue shape tended to be prickly or fissured, and tongue condition tended to be unflexible or deviated. Regarding tongue coat color, there were great amounts of yellow or clark yellow tongue coats, which were moist, thick or greasy in substance. The red tongue was significantly related to Fire-heat and deficiency of Yin syndrome, while faint white tongue to Damp syndrome(P=0.006). In terms of tongue coat, thin coat was related to Wind and Fire-heat syndromes, thick coat to Damp and Blood stasis syndrome, respectively (P=0.002). In conclusion, we thought that tongue inspection could be a useful Oriental medicine diagnosis in stroke.
Background: Pattern identification is a unique diagnostic method of traditional Oriental medicine that has recently been the target of questionnaire-based research. Sasang (four-types) constitutional medicine (SCM) is a practice in traditional Korean medicine that seeks to promote objectivity in diagnostics. This paper attempts to illuminate the relationship between constitutions and the pathogenic factors of pattern identification through questionnaires completed by menopausal women about their symptoms. Methods: From March to October 2012, we examined 291 women from the general population, with ages ranging from 40 to 60 years, applying the Kupperman index, the Menopause-Specific Quality of Life Questionnaire (MENQOL), pattern identification based on the Diagnosis System of Oriental Medicine (DSOM), and SCM. We then analyzed the relationship between constitutional type and pathogenic factors. Results: No significant differences were found in the scores of either the Kupperman index or MENQOL questionnaire in relation to constitutional type. However, in a statistical analysis correlating the DSOM pathogenic factor scores (PFS) with the scores of the Kupperman index and MENQOL vasomotor subscale, heat showed a significant positive correlation with SoYang type (SY) and TaeEum type (TE), but not SoEum type (SE), while insufficiency of yin and insufficiency of yang, as well as blood deficiency, showed a significant positive correlation with the TE and SE types. Conclusion: The pathogenic factors in the menopausal symptoms of middle-aged women, specifically the prominent menopausal symptom of facial flushing, differed significantly according to constitutional type.
The Republican Period of China (1912 to 1949) was when the archetypes of thought (constituting contemporary China) engaged in heated rivalry and were directly influenced by Korea through frequent exchanges. This study analyzes the characteristic of Chinese women's aesthetics towards the human body with a focus on visual materials (such as articles and illustrations concerning hairstyle, makeup, skincare, fashion, and gymnastics) featured in the Chinese women magazines of Fun$\ddot{u}$zazhi (婦女雜誌) and Linglong (玲瓏). This study analyzes these magazines and compares them with Korean counterparts. The movement of the developed and controlled human body was a common characteristic of this period; however, compared to the Chinese, the Japanese colonial period of Korea resulted in an introspective self-examination through excessively objectified eyes. Dress and adornment as the symbol of a new civilization acted as the most remarkable signifier. The overlapping of a western image with a Japanese image led to more resistance in Korea. The criterion for the value of a women's external appearance (that traditionally dualized womanly virtues) collapsed and dress was accepted as an expression of individuality instead of as a social class. The human body was traditionally recognized as a microcosm of the universe that dominated the natural principle of Yin-Yang and the Five Elements. However, the ideal human body was postulated and the aesthetic consciousness of the body changed into an imaginary view of the human body that proceeded to keep the body fit for and gave birth to the concept of supplementing the deficiency of the beauty of the human body with dress and makeup.
In order to enhance the 8 principle pattern diagnosis rate comparing with diagnostic method by self-report questionnaire on cold/heat pattern in the clinical practice, a new diagnostic method using form-color-pulse-symptom (FCPS) system is proposed. FCPS system is composed of outputs of cold/heat pattern through the calculation process of contribution degree to the cold, heat pattern and qi, blood, yin, yang deficiency patterns, based on analysis of 16 mechanisms of disease calculated by diagnostic system of oriental medicine (DSOM) first. And second component is an output of differentiated 8 principle patterns in detail through binding and calculating process with digital informations of pulse, color, form, constitution obtained by computerized measurement system. Putting together above two processes consecutively, cold-heat complex or true/false cold/heat patterns and personalized characters of cold/heat patterns of each patient can be subdivided through a computation method of determining each pattern. In conclusion, 8 principle pattern identification can be performed more accurately using FCPS system than existent self report questionnaire method. These hypothetic proposal is needed to be proven by clinical trial for the future and then the accurate numbers used in each calculational function should be revised properly.
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