• The Journal of Internal Korean Medicine
• /
• v.39 no.3
• /
• pp.405-425
• /
• 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
• /
• v.40 no.3
• /
• pp.390-408
• /
• 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 Internal Korean Medicine
• /
• v.41 no.6
• /
• pp.1030-1051
• /
• 2020

Objective: This study investigated the measurement interval in the ultrasonographic gastric emptying test for patients with functional dyspepsia (FD) and the correlation between gastric emptying and the findings of various questionnaires. Methods: In total, 119 patients (59 patients with FD and 60 healthy controls) were recruited from July 2018 to June 2020. Gastric volume (GV) and gastric emptying half-time (T1/2) were measured by ultrasonography at fasting and again at 0, 5, 10, 15, 30, 45, 60, 90, and 120 min after meals (apple juice, 500 mL, 224 kcal), and the average half-time (average T1/2) was calculated. Questionnaires on food retention (FRQ), phlegm pattern e (PPQ), cold and heat (CHQ), deficiency and excess (DEQ), and spleen-qi deficiency (SQDQ), stomach qi deficiency pattern (SSDQ), visual analogue scale (VAS), and Nepean dyspepsia index-Korean version (NDI-K) were completed by all participants. The differences in GV and T1/2 were analyzed in participants whose maximal GV occurred at 0 min versus after 0 min. The correlation of the average T1/2 with the questionnaire scores was also analyzed after excluding erroneous data. Results: Patients with FD who took a certain amount of time to reach maximal GV after meals had a greater gastric volume up to about 30 minutes after meals, and the PPQ, DEQ, and NDI-K scores, especially for upper gastrointestinal symptoms and general weakness-related symptoms, showed statistically significant correlations with average T1/2. Conclusions: Ultrasonography can be a quantitative evaluation tool for FD. However, further studies on measurement methods based on FD physiopathology are required.

• Integrative Medicine Research
• /
• v.6 no.3
• /
• pp.317-324
• /
• 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.

• The Journal of Internal Korean Medicine
• /
• v.37 no.6
• /
• pp.998-1011
• /
• 2016

Objectives: This study measured the thickness of the abdominal wall at abdominal acupoints using ultrasonography and then investigated the correlations between the thickness of the abdominal wall and other characteristics of patients with functional dyspepsia (FD). Methods: Thirty patients with FD were enrolled in the study from September 2015 to March 2016. The thickness of the abdominal wall was measured at Shangwan (CV12), Zhongwan (CV13), and the left Liangmen (ST21). In addition, height, weight, body mass index (BMI), duration of FD, and the sternocostal angle were investigated. The severities of spleen qi deficiency and the dyspepsia symptoms were assessed by the Spleen Qi Deficiency Questionnaire (SQDQ) and the Nepean Dyspepsia Index-Korean version (NDI-K). Results: The average thickness of the abdominal wall was $24.66{\pm}6.69mm$ at Shangwan, $21.17{\pm}5.83mm$ at Zhongwan, and $21.72{\pm}5.72mm$ at Linagmen, and there were significant differences between the thickness at Shangwan and Zhongwan (p=0.046). Furthermore, there were significant differences between the thickness of the abdominal wall at Zhongwan and the sternocostal angle (r=0.396, p=0.037). Conclusions: These findings indicate the possibility of estimating the thickness of the abdominal wall by looking at the characteristics of patients with FD, including the sternocostal angle.

• The Journal of Internal Korean Medicine
• /
• v.38 no.6
• /
• pp.1085-1095
• /
• 2017

Objectives: The purpose of this study was to investigate the efficacy of Lijin-tang-gamibang on refractory gastroesophageal reflux disease (GERD). Methods: This before-and-after study compared the first medical examination and examination at the end of medical treatment. Twelve refractory GERD patients who visited the Department of Digestive Diseases of Kyung Hee University Korean Medicine Hospital from August 14th, 2017 to October 14th, 2017, were treated with Lijin-tang-gamibang for four consecutive weeks. The clinical characteristics of refractory GERD and the efficacy of herbal medical treatment was assessed by questionnaires, the Nepean Dyspepsia Index-Korean version (NDI-K), the Korean Gastrointestinal Symptom Rating Scale (KGSRS), the Numerical Rating Scale (NRS), the Korean version of the Perceived Stress Scale (KPSS-10), the Qi Stagnation Questionnaire (QSQ), the Spleen Qi Deficiency Questionnaire (SQDQ), and the Patient Global Impression of Change (PGIC). Prolonged effects were reported upon the follow-up telephone survey two weeks after treatment. Results: After treatment with the herbal medicine Lijin-tang-gamibang, the clinical characteristics of 12 refractory GERD patients were improved, especially in terms of the most common symptoms of acid regurgitation and heartburn. Each symptom score of NDI-K, KGSRS, NRS, SQDQ, and PGIC showed significant advances. Prolonged effects were reported in NDI-K, NRS and PGIC questionnaires two weeks after treatment. Conclusions: These results suggest that Lijin-tang-gamibang is an effective treatment for refractory GERD.

• The Journal of Internal Korean Medicine
• /
• v.45 no.3
• /
• pp.519-531
• /
• 2024

Objectives: This case study reports the effectiveness of Korean medical treatment in a patient with cyclic vomiting syndrome. Methods: A 29-year-old female Korean patient with cyclic vomiting syndrome received acupuncture, electroacupuncture, herbal medicine, and moxibustion for 2 weeks in hospital. Changes in symptoms were evaluated using the Gastrointestinal Symptom Rating Scale (GSRS), Visual Analog Scale (VAS), Index for Nausea, Vomiting, and Retching (INVR), Nausea Severity Scale (NSS), Nepean Dyspepsia Index-Korean version (NDI-K), quality of life using the Functional Dyspepsia Related Quality of Life questionnaire (FD-QoL), and gastric motility using electrogastrography (EGG). Results: Post-treatment, the patient showed high satisfaction and improvement in symptoms of nausea and vomiting. The following changes were observed in scores: GSRS: 23 to 19; VAS of nausea: 88 to 95; VAS of dyspepsia: 95 to 12; INVR: 13 to 1; NSS: 17 to 5; NDI-K: 107 to 78; and FD-QoL 84 to 27. We also found positive results in Channel 3 of EGG parameters, implying the improvement of gastric motility disorder. Conclusion: Korean medical treatment can be a therapeutic option for cyclic vomiting syndrome.