• The Journal of Korean Medicine
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• v.32 no.2
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• pp.42-62
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• 2011

Objective: This study was designed to identify and explore the pathological patterns of functional dyspepsia (FD) patients. We also evaluated the usefulness of the Pattern Identification Questionnaire by comparing it with other assessment tools for FD. Methods: We recruited 97 FD patients based on the Rome III criteria for FD diagnosis. The pathological patterns of the subjects were determined by the Pattern Identification Questionnaire. Their dyspepsia-related symptoms were assessed using the Gastrointestinal Symptom Questionnaire (GIS) and the Pyeongwi-san (Pingwei-san) Patternization Questionnaire. Depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and quality of life with the Functional Dyspepsia-Related Quality of Life (FD-QoL) Questionnaire. Tongue coating was measured by the Digital Tongue Diagnosis System (DTDS). Results: The male to female ratio was 1:1.1, and the forties and fifties age groups were largest in number. The spleen deficiency and phlegm-dampness pattern was the most common pattern found among the FD patients. No significant differences in the GIS, BDI, FD-QoL, and DTDS scores were found among the five pattern types. All pattern types showed significant correlation with GIS, Pyeongwi-san Patternization Questionnaire, and FD-QoL scores. Conclusions: Pattern Identification Questionnaire can not only identify the pathological pattern types of FD patients but also evaluate the severity of their symptoms. Compared to conventional assessment tools for FD, it could enable a more dynamic evaluation of FD patients reflecting the severity of dyspeptic symptoms and the quality of life. Further studies on the Pattern Identification of FD patients are anticipated in order to improve the diagnosis and therapy for Korean FD patients.

• The Journal of Internal Korean Medicine
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• v.32 no.4
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• pp.584-598
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• 2011

Objectives : Functional dyspepsia is a type of disease characterized by bothersome postprandial fullness, early satiation, epigastric pain and burning without structural gastrointestinal disease. The aim of this study was to analyze the characteristics of functional dyspepsia patients and evaluate changes in symptoms, quality of life, and electrogastrography parameters before and after oriental medical interventions. Methods : We recruited forty-six functional dyspepsia patients who visited gastroenterology clinic in the oriental medicine hospital of Kyung Hee University between November 2009 and February 2011. Patients were assessed for their frequency of dyspepsia (based on short form-Leeds Dyspepsia Questionnaire: SF-LDQ), quality of life (based on functional dyspepsia-related quality of life questionnaire: FD-QoL), gastric motility (based on electrogastrography: EGG) on the first visit. Then, the effect of oriental medical interventions was evaluated using EGG on the second visit. Results : The majority of patients had symptoms of nausea and indigestion. The largest decrease in EGG parameters was found in the indigestion group. The frequency of regurgitation and postprandial EGG power % bradygastria showed a significant correlation. Also, significant correlations were found between some items of FD-QoL and some EGG parameters. Compared to the EGG parameters before oriental medical interventions, some parameters after treatment had positive results, implying the improvement of gastric motility disorder. We also found improvement of EGG parameters in both digestant medicinal group and digestant combined with qi-tonifying medicinal group. Conclusions : The results of this study suggest that clinical application of EGG can be an objective diagnostic tool in functional dyspepsia patients visiting oriental medical hospital.

• Journal of Acupuncture Research
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• v.40 no.2
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• pp.143-149
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• 2023

Functional dyspepsia (FD) is a chronic and recurrent upper gastrointestinal symptom that has no organic cause. A 49-year-old male patient positive for human immunodeficiency virus (HIV) visited the clinic because of FD and constipation. He received complex Korean medicine treatment, including acupuncture and herbal medicines, from April 14 to July 18, 2022 (27 times) in the outpatient department. Gastrointestinal Symptom Rating Scale (GSRS), Nepean Dyspepsia Index (NDI), FD-related quality of life (FD-QoL), Euro QoL visual analog scale (EQ-VAS), and Numerical Rating Scale (NRS) were used as evaluation tools in this study. Symptoms were relieved after 3 months of treatment, and his QoL improved (GSRS, 15-3; NDI, 110-21; FD-QoL, 52-20 [eating status, 10-3; liveliness status, 12-8; psychological, 1-0; role-functioning status, 18-9]; EQ-VAS, 40-65; NRS, 8-4). The results revealed that complex Korean medicine treatment could alleviate FD and constipation in patients with HIV.

• The Journal of Internal Korean Medicine
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• v.42 no.6
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• pp.1331-1340
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• 2021

A 42-year-old patient with functional dyspepsia had suffered from early satiation and postprandial fullness for 1 year despite Western medicine treatment. We treated her with the Spleen Daoyin method, along with acupuncture, moxibustion, and herbal medicine and scored her symptoms using a 4-point Functional Dyspepsia-related Quality of Life (4p-FD-QoL) questionnaire, the Gastrointestinal Symptom Rating Scale (GSRS), and a visual analogue scale (VAS). A 7-day Spleen Daoyin treatment decreased her 4p-FD-QoL score from 61 to 51, with a marked decrease in the emotional part (18 to 10). Her GSRS score did not change, but her bloating score decreased from 3 to 1. Her VAS score decreased from 6.6 to 4.3 for upper abdomen discomfort, but lower abdomen discomfort was unchanged. The patient showed high compliance and satisfaction with exercise therapy and reported no adverse events. Spleen Dayoin may be a useful therapy for functional dyspepsia, especially when accompanied by psychological problems.

• The Journal of Internal Korean Medicine
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• v.39 no.3
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• pp.405-425
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• 2018

Objective: The purpose of this study was to analyze the correlation between Stomach Qi Deficiency and gastric emptying as measured by abdominal ultrasonography in postprandial distress syndrome (PDS), a subgroup of functional dyspepsia (FD). Methods: Ten patients who met the Rome III diagnostic criteria for PDS and ten healthy controls participated in this study Gastric emptying shown as the half-life of gastric volume ($T_{1/2}$) was measured by abdominal ultrasonography. The degree of Stomach Qi Deficiency was assessed using the scale for Stomach Qi Deficiency pattern (SSQD). In addition, functional dyspepsia-related quality of life (FD-QoL), Nepean dyspepsia index-Korean version (NDI-K), and visual analogue scale (VAS) of distention and fullness were conducted on all subjects. Results: The scores of SSQD, FD-QoL, NDI-K, and VAS of distention and fullness in the patient group were significantly higher than those in the control group (p<0.05). $T_{1/2}$ was also higher in the patient group than in the control group. The SSQD score significantly correlated positively with $T_{1/2}$ in the patient group (r=0.640, p=0.046). However, there was no significant correlation between $T_{1/2}$ and other questionnaire scores in the patient group. Conclusions: Our results suggest that the gastric emptying measured by abdominal ultrasonography could be a quantitative indicator to diagnose Stomach Qi Deficiency in FD patients, especially the PDS subtype.

• The Journal of Internal Korean Medicine
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• v.40 no.3
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• pp.390-408
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• 2019

Objectives: Several pattern diagnosis questionnaires have been developed to objectify the process of pattern diagnosis in Korean medicine. In this context, this study aimed to develop a food retention questionnaire for functional dyspepsia (FRQ-FD) by modifying the previously developed food retention questionnaire (FRQ) and to verify its reliability and validity. Furthermore, this study aimed to identify the optimal cut-off value of the FRQ-FD for standardization and use in clinical situations. Methods: To develop the FRQ-FD, we extracted the major symptoms of food retention pattern for functional dyspepsia from Chinese/Korean medicine textbooks and requested an importance survey from experts using the Delphi method. The first draft of the FRQ-FD was composed of 25 questions comprising 8 questions from the textbooks and the Delphi method and 17 questions from the FRQ already developed in 2013. To analyze its reliability, validity, and optimal cut-off value, 60 subjects were enrolled in this study from June 25 to August 13, 2018. Thirty patients were diagnosed as both functional dyspepsia and food retention pattern, and 30 healthy participants were not. All participants were requested to fill up the FRQ-FD, Stomach Qi Deficiency Questionnaire (SQDQ), Scale for Stomach Qi Deficiency pattern (SSQD), visual analog scale (VAS) for dyspepsia, Nepean Dyspepsia Index-Korean version (NDI-K), and functional dyspepsia-related quality of life (FD-QoL). Results: No statistically significant differences were found in sex distribution, age, and body mass index between the patient group and the control group. As five questions affected the reliability negatively and three questions affected the clinical validity negatively, we decided to exclude the eight questions upon further investigation. The Cronbach's ${\alpha}$ coefficient of the revised FRQ-FD (17 items) was 0.899, and its clinical validity was verified. Construct validity was analyzed by factor analysis and produced five factors. Statistically significant positive correlations were found between the revised FRQ-FD and the other dyspepsia scales, namely, SQDQ, SSQD, VAS, NDI-K, and FD-QoL. VAS and NDI-K especially had strong positive correlations with FRQ-FD. Conclusions: The FRQ-FD developed in this study can provide fundamental reliability and validity for a pattern diagnosis questionnaire. FRQ-FD can help to diagnose food retention pattern in functional dyspepsia patients. Further studies are required to inspect several statistical factors.

• The Journal of Korean Medicine
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• v.37 no.3
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• pp.27-38
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• 2016

Objectives: According to Korean Medicine theory, the skin color of LU10 serves as a diagnostic clue to dyspeptic symptoms. The aims of this study were (1) to find the difference of skin color in LU10 region between functional dyspepsia (FD) and healthy control (HC) and (2) to examine the relationship between LU10 skin color parameters and dyspeptic symptoms. Methods: 39 participants (29 FD and 10 HC) have participated in this study. They were asked to complete gastrointestinal scale (GIS), gastrointestinal symptom rating scale (GSRS), Nepean dyspepsia index (NDI), functional dyspepsia-related quality of life (FD-QoL), visual analogue scale (VAS) for dyspeptic symptoms, food retention questionnaire (FRQ) and cold heat questionnaire (CHQ). $L^*$ (luminance), $a^*$ (red-green balance) and $b^*$ (yellow-blue balance) values of LU10 region were calculated through digital images of the participant's hand. Then we evaluated test-retest reliability of $L^*$, $a^*$ and $b^*$ values of LU10 region. Additionally, we compared $L^*$, $a^*$ and $b^*$ values of LU10 between FD and HC, and examined the relationship between LU10 color parameters and seven questionnaires scores. Results: Only $L^*$ values in LU10 region were significantly higher in FD compared with HC. GIS scores and the subset scores of NDI had a positive correlation with $L^*$ values significantly. Correlation coefficients of test-retest reliability of skin color measurement of LU10 ranged from 0.871 to 0.936 representing very strongly statistically significant (P<0.001). Conclusions: We confirmed the difference of skin color in LU10 region between FD and HC, and relationship between LU10 skin color parameters and dyspeptic symptoms.

• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.406-411
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• 2016

Objective: This case presents the effects of Gyejibanhasaenggang-tang, acupuncture, and moxibustion on functional dyspepsia.Method: A patient was treated with herbal medicine, acupuncture, and moxibustion. Functional dyspepsia-related quality of life (FD-QoL), the gastrointestinal symptom rating scale (GSRS), and the gastrointestinal scale (GIS) were assessed for evaluation.Results: Symptoms of functional dyspepsia improved after the 22 days of Gyejibanhasaenggang-tang treatment.Conclusion: This case suggests that the combination of Gyejibanhasaenggang-tang, acupuncture, and moxibustion could be effective in treating functional dyspepsia.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.570-591
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• 2018

Objective: This study was designed to investigate the correlation between gastric emptying measurement by ultrasonography and the findings of various questionnaires of functional dyspepsia (FD) or in Korean medicine to explore the possibility of quantification of questionnaires. Methods: Eighty-eight patients (44 patients with FD and 44 healthy controls) were recruited from October 2016 to November 2017. Gastric emptying half-time (T1/2) was measured by ultrasonography at fasting, and at 0, 15, 30, 45, 60, 90, and 120 min after meals (apple juice, 500 ml, 224 kcal). The average half-time (average T1/2) was calculated by averaging all measured half-times. A visual analogue scale (VAS), food retention questionnaire (FRQ), damum questionnaire (DQ), cold and heat questionnaire (CHQ), deficiency and excess questionnaire (DEQ), spleen-qi deficiency questionnaire (SQDQ), Nepean dyspepsia index-Korean version (NDI-K), and quality of life of NDI (NDI-QoL) were filled out by all participants. Correlation between the average T1/2 and questionnaires were analyzed for 79 patients (37 patients with FD and 42 healthy controls) after excluding missing and erroneous data. Results: The FRQ, DEQ, SQDQ, NDI-K, and NDI-QoL scores, especially for some gastrointestinal symptoms and general weakness-related symptoms, showed statistically significant correlations with average T1/2. Conclusions: Our results suggest that gastric emptying measurement by ultrasonography may be a quantitative substitute method for some Korean medical questionnaires or for some dyspepsia-related and deficiency-related items among them. However, further studies using various measurements of gastric emptying will be needed.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1105-1121
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• 2022

Objectives: The purpose of this study is to explore the effectiveness and safety of frequently used clinical herbal medicines (Yijung-tang [Lizhong-tang, LJT], Pyeongwi-san [Pingwei-san, PWS], and Shihosogan-tang [Chaihu Shugan-tang, SST]) in patients with functional dyspepsia (FD) when administered according to herbal medicine and Korean medicine pattern identification. The results of this study will be used to standardize the diagnostic instrument used in Korean medicine and to investigate biomarkers of Korean medicine pattern identification. Methods: This study will be a randomized, assessor-blind, 3-arm, parallel, open-label, multi-center clinical trial. A total of 300 FD participants will be recruited from 3 Korean medical hospitals and assigned to the LJT (n=100), PWS (n=100), and SST (n=100) groups according to FD pattern identification. The patients will take the medication for 8 weeks, 3 times a day, before or between meals. The primary outcome will be total dyspepsia symptom (TDS) and the secondary outcomes will be adequate relief (AR) for dyspepsia, overall treatment effect (OTE), visual analogue scale (VAS), functional dyspepsia-related quality of life (FD-QoL), gastrointestinal symptom score (GIS), and pattern identification questionnaires. For the exploratory outcomes, we will analyze blood and fecal metabolome profiles, microbiota from fecal and saliva samples, single nucleotide polymorphism (SNP), and results of Korean medicine diagnosis device measurements (heart rate variability, and tongue, pulse, and abdominal diagnosis). Conclusions: The results of this study will prove objectivity for Korean medicine pattern identifications, and the effectiveness and safety of herbal medicines for the population with FD.