• 대한한방내과학회지
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• 제39권4호
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• pp.495-510
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• 2018

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.

• 대한한방내과학회지
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• 제42권3호
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• pp.259-278
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• 2021

Objectives: This study examines the effect of Sagunja-tang on functional dyspepsia (FD) through a systematic review and meta-analysis of a randomized controlled trial (RCT). Methods: A search for RCTs that tested the effect of Sagunja-tang on functional dyspepsia was conducted in Medline, Embase, PubMed, CENTRAL, CiNii, CNKI, NDSL, RISS, OASIS, and KISS databases on November 8, 2020, with no limit on the year of publication. A meta-analysis was performed by synthesizing the findings, including total efficiency, clinical symptom score, myosin light-chain kinase (MLCK) level (pg/mL, and gastric half-emptying time (min). RevMan 5.4.1 software was used for data analysis. The quality of the literature was evaluated using Cochrane's risk of bias (RoB) tool. Results: A total of 14 RCTs met the selection criteria. As a result of the meta-analysis, the treatment group had higher total efficacy and MLCK levels (gastric antrum, jejunum) than the control group, and the clinical symptom score and gastric half-emptying time were lower. However, due to the low quality of the included RCT and the small sample size, the results may be slightly biased.

• Integrative Medicine Research
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• 제6권3호
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• pp.317-324
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• 2017

Background: Bu-Zhong-Yi-Qi-Tang (BZYQT) has long been used for the treatment of severe weakness caused by general fatigue, loss of appetite, or indigestion. The aim of this feasibility study is to assess the effectiveness and safety of BZYQT for the treatment of functional dyspepsia (FD) with spleen qi deficiency. Methods: This study will be conducted at a single center as a prospective, nonrandomized, nonblinded, single-arm feasibility study. A total of 30 participants diagnosed with FD in accordance with the Rome III criteria will be enrolled. All patients will receive BZYQT for 4 weeks. The primary outcome is the change in the Nepean Dyspepsia Index-Korean version (NDI-K) scores between the baseline and 4-week images. The secondary outcomes include the tongue coating thickness, blood parameters, and BZYQT Questionnaire score. The NDI-K score will be acquired four times, at Weeks 0 (baseline), 2 (during treatment), 4 (after treatment), and 8 (after follow-up). Written informed consent will be obtained from all study participants prior to enrollment. This study has been approved by the Institutional Review Board of Kyung Hee University Korean Medicine Hospital. This study protocol is registered with the national clinical trial registry of the World Health Organization International Clinical Trials Registry Platform. Results will be published in a journal and will be disseminated both electronically and in print. Discussion: The results of this study may serve as a guide for researchers seeking to effectively evaluate the effects of BZYQT.

• Journal of Neurogastroenterology and Motility
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• 제24권4호
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• pp.603-613
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• 2018

Background/Aims Functional dyspepsia (FD) is one of the most common gastrointestinal disorders, and FD imposes social and economic burden worldwide. The aim of this study is to identify the prevalence and risk factors of FD in health check-up population in tertiary centers in Korea. Methods A nationwide multicenter prospective study was performed at 9 tertiary healthcare centers in Korea between September 2016 and June 2017. A total of 2525 subjects were investigated based on endoscopic findings and questionnaires with the Rome III criteria, and Helicobacter pylori serology (IgG). Results A total of 1714 subjects without organic disease were enrolled. The mean (${\pm}SD$) age was 51.5 (${\pm}12.7$) years, and 917 patients (53.5%) were female. The proportion of H. pylori seropositivity was 51.0% (874/1714). The prevalence of FD was 10.3% (176/1714), and the subtypes of postprandial distress syndrome alone, epigastric pain syndrome alone, and postprandial distress syndromeepigastric pain syndrome overlap were 4.8%, 3.0%, and 2.5%, respectively. Multivariate analysis showed that female gender (OR, 1.58; 95% CI, 1.14-2.21) and education below college level (OR, 1.45; 95% CI, 1.01-2.07) were related to FD. Multivariate analysis based on age 60 showed female gender as a significant (OR, 2.90; 95% CI, 1.06-7.94) factor in the group ${\geq}60$ years. Conclusions The prevalence of FD was 10.3% in the health check-up population in Korea. Female sex and education below college level were risk factors for FD. Female sex is a risk factor for FD in old age, underscoring the need for close attention in this age group.

• 대한한방내과학회지
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• 제40권3호
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• pp.369-389
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• 2019

Objectives: This study aimed to analyze the correlation between Ryodoraku diagnosis and three pattern identification questionnaires, namely, Spleen Qi Deficiency, Stomach Qi Deficiency, and Food Retention in functional dyspepsia (FD) patients. Methods: Forty FD patients who met the Rome IV diagnostic criteria for FD participated in this study. The Ryodoraku test was conducted, and three pattern identification questionnaires were filled up by all patients. The average Ryodoraku score was called total average (TA), and the scores on the Ryodoraku points were measured. The degree of Spleen Qi Deficiency, Stomach Qi Deficiency, and Food Retention was assessed by Spleen Qi Deficiency questionnaire (SQDQ), Scale for Stomach Qi Deficiency pattern (SSQD), and Food Retention Questionnaire (FRQ). Results: The TA scores in the SQDQ patient group were lower than those in the SQDQ control group (p=0.091). The TA scores in the SSQD patient group were higher than those in the SSQD control group (p=0.651). The TA scores in the FRQ patient group were lower than those in the FRQ control group (p=0.851). The scores on the LH5, RH5, and RH6 points were significantly lower in the SQDQ patient group than in the SQDQ control group. However, no significant difference was found in the Ryodoraku scores among the other groups. Conclusions: The results suggest that the low TA and low Ryodoraku scores on the LH5, RH5, and RH6 points could be a quantitative indicator to diagnose Spleen Qi Deficiency in FD patients in a simpler manner. Larger studies on the Ryodoraku test in FD patients, the health control group, and other pattern identification groups are required.

• 대한한방내과학회지
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• 제42권6호
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• pp.1199-1210
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• 2021

Objectives: The aim of this study was to analyze the correlation between patterns determined by pattern identification of functional dyspepsia (FD) and tongue features, including tongue coating and tooth marks, in FD patients. Methods: We reviewed the clinical records of 68 FD patients who visited the Department of Digestive Diseases of Kyung Hee University Korean Medicine Hospital from September 1, 2020 to August 31, 2021. The subjects were evaluated with a computerized tongue image acquisition system (CTIS) and by pattern identification of FD. Measurement included the percentage of tongue coating, tooth mark levels, and pattern scores. Results: Statistically significant negative correlations were noted between the scores of the pattern of 'spleen and stomach deficiency and cold' (SSDC) and the percentage of tongue coating in whole, center, and root of the tongue body. However, no other patterns were correlated with any parameter measured by CTIS. No significant difference was noted in the percentage of tongue coating and the tooth mark level between the patterns. Conclusions: This study demonstrated that the pattern of SSDC was significantly associated with the percentage of tongue coating. We suggest that the percentage of tongue coating could be a useful indicator for identifying the degree of patterning of SSDC in patients with FD.

• 대한한방내과학회지
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• 제36권3호
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• pp.348-360
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• 2015

Objectives From observing the tongue of a patient, one can assess the health status; this method has been frequently used in traditional Korean Medicine (KM) clinics. In particular, KM posits that the color of the tongue is highly related to digestive functions. In this study, the color of tongue and heart rate variability (HRV) were compared between chronic dyspepsia (CD) patients and healthy subjects. Methods Healthy subjects and CD patients with functional dyspepsia (FD), gastroesophageal reflux disease (GERD), or chronic gastritis (CG) were enrolled for the study. Profile view images of the tongue were acquired by using a computerized tongue image acquisition system (CTIS). The color of the tongue body was extracted from the non-coated region on the tongue images. Results Color differences in CIE L*a*b* color space between the three sub-types of CD patients and healthy subjects were analyzed by using multiple linear regression analysis with age and sex as the factors. The variable b* was significantly lower in GERD patients than in the controls (p=0.017). Variable a* was significantly lower in CG than in the controls (p=0.03). No significant difference was seen between FD and controls. In GERD, the tongue body seems to be intense red in color; in CG, pale red. Frequency domain analysis showed that HF was significantly lower in GERD patients than in the controls (p=0.041). Conclusions The color of the tongue body and HF of HRV can be used for diagnosing digestive functions in health care.

• 한국동물생명공학회지
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• 제37권1호
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• pp.27-33
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• 2022

Functional dyspepsia (FD) is a gastrointestinal disorder with diverse symptoms but no structural or organic manifestations. Benachio-F^® (herein named 'BF-1') is an over-the-counter liquid digestive formulated with multiple herbal extracts, which has been reported to improve symptoms of FD. A total two experiments were conducted. First, we examined whether BF-1 can modulate the progression of FD through two experimental rat models. A total of three doses (0.3x, 1x, 3x of the human equivalent dose) were used. In the gastric emptying model, both 1x (standard) or 3x (3-fold-concentrated) BF-1 enhanced gastric emptying was compared with that of vehicle-treated animals. In a feeding inhibition model induced by acute restraint stress, treatment with 1x or 3x BF-1 led to a similar degree of restoration in food intake that was comparable to that of acotiamide-treated animals. Among the constituents of BF, fennel is known for its choleretic effect. Thus, we next investigated whether a novel BF-based formula (named 'BF-2') that contains an increased amount of fennel extract (3.5-fold over BF-1), has greater potency in increasing bile flow. BF-2 showed a superior choleretic effect compared to BF-1. Furthermore, the postprandial concentration of serum secretin was higher in animals pretreated with BF-2 than in those pretreated with BF-1, suggesting that the increased choleretic effect of BF-2 is related to secretin production. Our results demonstrate that BF-1 can modulate the pathophysiological mechanisms of FD by exerting prokinetic and stress-relieving effects, and that BF-2 has a better choleretic effect than BF-1.

• 대한한방내과학회지
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• 제43권6호
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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.

• 대한한방내과학회지
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• 제44권4호
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• pp.645-660
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• 2023

Objectives: This study analyzed the clinical characteristics of patients with functional dyspepsia (FD) who received Korean medicine treatment. Methods: A retrospective chart review was conducted to investigate sociodemographic characteristics, clinical characteristics, and prescribed treatments. The clinical records of 192 patients who visited Kyung Hee University Korean Medicine Hospital for FD from May 1, 2022, to May 31, 2023, were analyzed. In addition, the distribution of pattern identification and symptom type according to body mass index (BMI), as well as prescription history, were analyzed. Results: As the degree of obesity increased, the proportion of Spleen-Qi deficiency pattern patients decreased (p=0.012), and the proportion of damp-phlegm pattern patients increased (p=0.000). Additionally, as the degree of obesity increased, the proportion of patients with excess differentiation increased (p=0.002). The PDS (Postprandial distress syndrome) symptom type was significantly more frequent in the underweight and normal groups than in the overweight and obese groups, and the EPS (Epigastric pain syndrome) symptom type was more frequent in the overweight and obese groups. Regardless of the type of pattern identification, the most frequently used prescriptions were Naesowhajung-tang, Hanshin Naeso-san, and Sojeokgunbi-hwan granule. Conclusion: This study analyzed the medical records of patients with FD to elucidate the use of Korean medicine treatments. Our study is meaningful in that we found that the distribution of pattern identification and symptom patterns are linked to the degree of obesity in FD patients and identified the tendency for herbal medicine treatments to be prescribed in clinical practice.