• 사상체질의학회지
• /
• 제33권3호
• /
• pp.95-126
• /
• 2021

Objectives The purpose of this study was to develop diagnostic tools for Sasang Constitutional patterns based on the middle classification of the Sasang Constitutional patterns. Methods Diagnosis and assessment indicators of Soeumin, Soyangin, Taeeumin, and Taeyangin patterns were extracted based on the 『Clinical Practice Guideline for Sasang Constitutional Medicine Symptomatology』 and 『Donguisusebowon』. An online survey was conducted on the 'importance of diagnosis and assessment indicators' by the Sasang Constitutional Medicine expert group. Results Based on the expert consultation results, the importance weight for each diagnosis and assessment indicators symptom was calculated, and the importance was ranked to develop diagnostic tools for Soeumin, Soyangin, Taeeumin, and Taeyangin patterns. Diagnostic tool consisted of 58 questions for Soeumin patterns, 68 questions for Soyangin patterns, 81 questions for Taeeumin patterns, and 42 questions for Taeyangin patterns. The final total score was calculated by reflecting each response score and the weight of each question. Conclusions The developed 'Diagnostic Tools for Sasang Constitutional patterns' can be used to make an effective and objective diagnosis in the clinical site. In the future, if the reliability and validity of these diagnostic tools are tested through clinical study, it will be possible to improve clinical applicability and contribute to standardization of diagnosis.

• 대한한의학회지
• /
• 제38권3호
• /
• pp.185-196
• /
• 2017

Backgrounds: Inpatient Classification System for Korean Medicine (KDRG-KM) was developed and has been applied for monitoring the costs of KM hospitals. Yet severity of patients' condition is not applied in the KDRG-KM. Objectives: This study aimed to develop the severity classification methods for KDRG-KM and assessed the explanation powers of severity adjusted KDRG-KM. Methods: Clinical experts panel was organized based on the recommendations from 12 clinical societies of Korean Medicine. Two expert panel workshops were held to develop the severity classification options, and the Delphi survey was performed to measure CCL(Complexity and Comorbidity Level) scores. Explanation powers were calculated using the inpatient EDI claim data issued by hospitals and clinics in 2012. Results: Two options for severity classification were deduced based on the severity classification principle in the domestic and foreign DRG systems. The option one is to classify severity groups using CCL and PCCL(Patient Clinical Complexity Level) scores, and the option two is to form a severity group with patients who belonged principal diagnosis-secondary diagnosis combinations which prolonged length of stay. All two options enhanced explanation powers less than 1%. For third option, patients who received certain treatments for severe conditions were grouped into severity group. The treatment expense of the severity group was significantly higher than that of other patients groups. Conclusions: Applying the severity classifications using principal diagnosis and secondary diagnoses can advance the KDRG-KM for genuine KM hospitalization. More practically, including patients with procedures for severe conditions in a severity group needs to be considered.

• 농촌의학ㆍ지역보건
• /
• 제44권4호
• /
• pp.165-184
• /
• 2019

이 연구는 도시와 농촌에 거주하는 노인인구의 일반적 특성변수, 건강행태와 만성질병 진단 및 치료경험 등의 차이와 그 관련요인을 비교하고자 하였다. 이 연구는 질병관리본부의 2017년 지역사회건강조사 원시자료를 활용하였다. 연구 대상은 만 65세 이상 노인으로 총 67,835명의 자료를 이용하였다. 카이제곱검정과 단변량 및 다변량로지스틱회귀분석 등을 이용하여 비교분석하였다. 분석결과, 도시 농촌 간의 건강행태, 진단 경험과 치료 경험 등에서 차이가 있는 것으로 확인되었다. 특히, 로지스틱회귀분석 결과, 도시 노인에 비해 농촌 노인에서 당뇨 진단 경험이 1.136배 (1.092-1.183), 이상지질혈증 진단 경험 1.278배(1.278-1.386), 백내장 진단 경험 1.159배(1.116-1.203), 백내장 치료 경험 1.285(1.200-1.375)로 높았고, 관절염 진단 경험은 0.940배 (0.904-0.977) 낮았다. 백내장 치료 경험에서는 농촌 노인이 1.285배(1.200-1.375) 높았으며, 관절염 치료 경험은 0.785배(0.736-0.837) 낮았다. 만성질환 진단 및 치료 경험에는 각 질환별로 다양한 변수들이 기여변수로 도출되었는데 특히, 만성질환 진단 경험에서는 고혈압 진단 경험을 제외한 당뇨병 진단 경험, 관절염 진단 경험, 백내장 진단 경험 및 이상지질혈증 진단 경험에서 도시 농촌 지역변수가 통계적으로 유의의한 차이가 있었다(p<0.01). 치료 경험에서는 관절염과 백내장 치료 경험에서 도시 농촌 지역변수가 통계적으로 유의의한 차이가 있었으나(p<0.01) 기타 고혈압, 당뇨병, 이상지질혈증 등의 치료 경험은 유의한 차이를 보이지 않았다. 따라서 도시 농촌 간의 노인 만성질환의 관련요인을 반영하여 진단과 치료 경험에 차이가 있는 질환에 대한 전략적인 보건관리 사업의 추진이 필요해 보인다. 추후 각 만성질환별로 도시와 농촌의 지역 차이와 이환 및 예방관리 등 차이와 그 관련요인에 대한 추가적인 연구가 필요해 보인다.

• 동의생리병리학회지
• /
• 제22권1호
• /
• pp.262-266
• /
• 2008

We plan to make the standardization of the pattern identifications for stroke and differentiate them by tongue diagnosis. We make a case report form which has questionnaires for tongue diagnosis in stroke patients. And we collected cases from the multi center network which consists of twelve university hospitals and one local hospital. The cases confirmed by diagnosis of medical specialists and residents are 321 cases. They are divided into Qi Defficiency 30.84%, Dampness& Phlegm 25.55%, Fire & Heat 22.43%, Eum Defficiency 18.69% and Blood Stasis 2.49%. We analyzed the markers which classified into the color of tongue body, the color of fur, the quality of fur, the dryness of tongue, the shape of tongue. To make a stroke pattern identification standard, we must try variable ways.

• 동의생리병리학회지
• /
• 제30권3호
• /
• pp.190-200
• /
• 2016

The aim of this study was to suggest the standard process in developing Questionnaire of Pattern Identification (QPI). The process in developing QPI was researched from validated and developed questionnaire and the standard process in developing QPI was suggested through review of the experts in research, statistics and clinics. Check list was also provided. The number of QPI reviewed in this research was 17(4 in disease in Korea Medicine, 5 in Pathological symptoms, 6 in Sasang constitutional Diagnosis, and 2 in etc), The standard process in developing QPI consisted of 11 phage and 33 check lists. 1) Composition of Research Member(3check lists), 2)Set up of the Aim(5), 3) Review for advanced research(3), 4) Finding an Important Index(3), 5) Review of item selection(4), 6) Developing the questions using items(5), 7) Developing Draft of Questionnaire(2), 8) 1^st Survey of Reliability and Validity(2), 9) Revision and Correction of Item(1), 10) 2^st Survey of Reliability and Validity(2), 11) Completion and Application(3). This study suggests the standard process in developing QPI for the first time in Korea. This following step may help A new QPI development.

• 대한한의학원전학회지
• /
• 제24권3호
• /
• pp.15-25
• /
• 2011

The acupuncture procedures in Hwangjenaekyung (黃帝內經) was different to modern ones in many aspects. Especially, the role of pulse diagnosis in acupuncture was totally different and the pulse diagnosis was essential part in acupuncture therapy in Hwangjenaekyung era. We found four noteworthy features on the pulse diagnosis before and after acupuncture in Hwangjenaekyung : (1) Pulse diagnosis was a mandatory process in acupuncture (2) Doctors who used pulse diagnosis in 12 meridians (十二經脈遍診脈法), pulse diagnosis in 9 points of 3 body parts (三部九候脈法), and comparative pulse diagnosis between radial artery and carotid artery (人迎寸口對比脈法) followed the former rule ((1)). (3) The major pulse features to detect before and after acupuncture were conversion between the vacuous pulse (虛脈) and the replete pulse (實脈), and conversion between slippery pulse (滑脈) and rough pulse (澁脈). (4) Deukki (得氣, Deqi) was synonym of Kiji (氣至), and it referred to the changes of arterial pulse, not the sensation followed by acupuncture manipulation.

• 보건의료산업학회지
• /
• 제12권1호
• /
• pp.35-46
• /
• 2018

Objectives : The purpose of this study was to present basic data on organizational changes in a Korean medicine hospital by performing organizational diagnosis and examining the job satisfaction and organizational commitment of the hospital. Methods : The subjects were a total of 218 employees in four Korean medicine hospitals, and data were collected from 1st to 25th September 2015. Using SPSS 21.0, frequency analysis, technical statistical analysis, t-test, ANOVA, Pearson's correlation analysis, and multiple regression analysis were performed. Results : The Korean medicine hospital tended to value relationships, the rewards for and attitudes towards change were low. The number of participants in this study with higher organizational diagnosis scores was high for job satisfaction and organizational commitment, and there was a strong positive correlation. It was seen that rewards, relationship, helpful mechanisms, and leadership among organizational diagnosis areas had an effect on job satisfaction, and helpful mechanisms, purposes, and leadership had an effect on organizational commitment. Conclusions : These findings will be useful because policies, research, and education are needed to facilitate organizational changes in Korean medicine hospitals.

• 대한임상독성학회지
• /
• 제11권1호
• /
• pp.36-40
• /
• 2013

Ethylene glycol poisoning is treated mainly by alcohol dehydrogenase inhibition therapy and hemodialysis. Early recognition and initiation of treatment is important because toxic metabolites increase over time by hepatic metabolism; however, there is no confirmative diagnostic tool in our clinical setting. Therefore, diagnosis is dependent on history, high anion gap acidosis, high osmolal gap, etc.. Diagnosis and treatment are delayed in cases where history taking is not possible, such as a mental changed patient. Authors report on two cases of ethylene glycol poisoning by contrasting clinical outcomes, demonstrating the importance of early diagnosis and treatment for achievement of a good outcome.

• 대한한방부인과학회지
• /
• 제36권2호
• /
• pp.36-54
• /
• 2023

Objectives: This study was aimed to develop a Korean Medicine (KM) clinical practice guideline (CPG) of Nausea and Vomiting of Pregnancy (NVP). Methods: We conducted a questionnaire survey targeting KM doctors belonging to the Association of Korean Medicine by e-mail. We received 1,023 responds, and analyzed the answers. Results: 1. 83.0% of respondents knew the concepts and contents of CPG, and 98.1% had practical use plan. 2. 82.1% of respondents used pattern identification diagnosis for NVP patients, and the most commonly diagnosed pattern was spleen-stomach weakness (脾胃虛弱) with 41.3%. 3. The most frequently used treatment for NVP patients was KM combined treatment (46.7%). Herbal medicine+acupuncture (46.8%) was most used among KM combined treatments, and herbal medicine (37.1%) was most used among KM single treatments. 4. Among the contents of CPG for NVP, the fields of interest were selected in the order of KM treatment, KM-Western medicine cooperative treatment, KM diagnosis, prevention and regimen management. In the 'diagnosis part', the use of the symptom evaluation scale questionnaire was 41.8%, higher than the KM pattern diagnosis (34.4%). In the 'treatment part', herbal medicine accounted for 33.8%, higher than that of acupuncture (including electro-acupuncture) at 23.7%. 5. As for the expected development effects, opinions on evidence-based, safety, clinical use, and standardization were the most common. Conclusions: We figured out KM doctors' recognition of KM clinical practice guideline, clinical diagnosis, treatment on NVP to make the contents of the CPG reflecting the clinical situation.

• 지질동맥경화학회지
• /
• 제7권2호
• /
• pp.122-154
• /
• 2018

Familial hypercholesterolemia (FH) is typically associated with single gene mutation that is inherited by autosomal dominant manner. Due to high cardiovascular risk, aggressive discovery, diagnosis, and treatment of FH are critical. Although FH is being increasingly spotlighted, we do not have sufficient data on Korean patients with FH. Here, we present the content of symposium of the Education Committee, Korean Society of Lipid and Atherosclerosis held in May 2018: 1) epidemiology, clinical diagnosis, Korean FH data, and regulation in Korea; 2) genes associated with FH, sequencing process in suspicious proband, cascade screening, and difficulty in genetic diagnosis in FH; 3) the importance of lipid-lowering therapy in FH, conventional and novel therapeutics for FH; 4) diagnosis of FH in children and adolescence, screening, and treatment of FH in children and adolescence; 5) history of FH studies in Korea, the structure and current status of FH registry of Korean Society of Lipid and Atherosclerosis; and 6) difficulty in diagnosis of heterozygous and homozygous FH, drug intolerance and achievement of treatment target. Discussion between speakers and panels were also added. We hope that this article is helpful for understanding FH and future studies performed in Korea.