• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.696-707
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• 2009

Objective : We designed this study to investigate differences between stroke reattack and stroke first attack group to establish fundamental data and prevent a secondary stroke. Methods : 826 subjects were recruited from the patients admitted to the department of internal medicine at Kyung Hee University Oriental Medical Center, Kyung Hee University East-West Neo Medical Center, Kyungwon University Incheon Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center and Dongguk University Ilsan Oriental Medical Center from 1 April 2007 to 31 August 2009. We compared general characteristics, classification of diagnosis, subtypes of cerebral infarction, risk factors, Sasang constitution, diagnostic classifications between stroke reattck and stroke first attack groups. Results : 1. In general characteristics, age differed significantly between the reattck and first attack groups. 2. Classification of diagnosis differed significantly between reattck and first attack groups. 3. In risk factors, hypertension, diabetes mellitus, alcohol drinking, and stress were significantly different between reattck and first attack groups. 4. Diagnostic classifications were significantly different between reattck and first attack groups. Conclusion : To prevent recurrence of stroke, education on stroke risk factors associated with recurrence is needed. In addition, those who are diagnosed as Dampness-Phlegm need to be well-controlled.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.813-820
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• 2009

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.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.761-771
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• 2009

Objectives : The aim of this study was to assess the relationship between metabolic syndrome and erythrocyte deform ability in acute stroke patients. Methods : Among 88 of the recruited patients, 52 were diagnosed as metabolic syndrome. We assessed their general characteristics, risk factors. We compared the assessed variables between metabolic syndrome and control group. We analyzed the relationship between metabolic syndrome and erythrocyte deform ability. We analyzed relationship between cardiovascular risk factors and erythrocyte deformability. Results : The general characteristics waist and hip circumference, waist/hip ratio were higher in metabolic syndrome group. The metabolic syndrome group was also diagnosed with hypertension, DM, and hyperlipidemia more often than the control group. The blood test metabolic syndrome group showed higher triglycerides, total lipids, fasting blood sugar, and 2 hours postprandial plasma glucose level and lower HDL-cholesterol than the control group. There were more patients diagnosed with Dampness-Phlegm in the metabolic syndrome group. There were more patients showing lower erythrocyte deform ability in the metabolic syndrome group. The plasma homocysteine level was negatively correlated with erythrocyte deform ability. Conclusion : The results reconfirmed that the risk factors are more in metabolic syndrome group. The results indicated that metabolic syndrome lead to a lower erythrocyte deform ability in small vessel disease stroke patients. The Plasma homocysteine level was negatively correlated with erythrocyte deform ability.

• The Journal of Internal Korean Medicine
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• v.31 no.3
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• pp.569-577
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• 2010

Background & Objectives : Yellow fur on the tongue is known to be associated with prognosis of disease in oriental medicine. Higher ratios of low-density lipoprotein cholesterol(LDL) to high-density lipoprotein cholesterol(HDL) & total cholesterol (TC) to high-density lipoprotein cholesterol(HDL) are associated with a greater risk of cardiovascular disease. The aim of this study was to assess the relationship between cardiovascular disease index and yellow fur - oriental medical index - in stroke patients over 60 years old. Methods & Subjects : Among 802 of the recruited patients(434 male, 368 female), 340 were yellow fur group(209 male, 131 female). We assessed their general characteristics and risk factors. We compared the cardiovascular disease index between yellow fur and non-yellow fur groups by sex. Results : On the General Characteristics males have yellow fur more often than females. In cardiovascular disease index, the male yellow fur group showed higher ratios of TC/HDL(atherogenic index), (TC-HDL)/HDL, LDL/HDL and higher LDL and showed lower HDL than the non-yellow fur group. In female patients, there were no differences between the two groups about cardiovascular disease index. There were more patients diagnosed with Fire & Heat in the male yellow fur group, and Dampness & Phlegm in the male non-yellow fur group. The male yellow fur group eat fast food more than the non-yellow fur group. Conclusions : The results indicated that yellow fur may be associated with a high risk of cardiovascular disease. We can thus use yellow fur on the tongue as a cardiovascular disease index in male stroke patients over 60 years old.

• The Journal of Internal Korean Medicine
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• v.21 no.1
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• pp.169-180
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• 2000

Objectives : To satisfy the demand of good treatment of constipation Methods : we investigated the literatures of Oriental Medicine about Constipation. Results: 1. There are three categories of etimological factors of constipation, that is, endogenous, exogenous and non-exo-endogenous factor. The endogenous factor is caused by seven emotions, called depression of Ki and stagnation of Ki. The exogenous factor is six excessive atmospheric influences, for example, wind, cold, dampness, heat and dryness. And the non-exo-endogenous factors are overfatigue, improper diet, stagnated blood and deficiency of Ki and blood that comes from old age, long disease and after delivery. 2. Classification: According to cause of disease it is classified by constipation due to cold, heat, wind, dryness, retention of undigested and phlegm. According to Internal Organs there are constipation due to deficiency syndrome of the stomach, excess syndrome of the stomach, deficiency syndrome of kidney and splenic constipation. And Differentiation of syndromes according to Ki and blood, there are constipation of deficiency type and excess type. There are constipation due to stagnation and deficiency of Ki, deficiency of blood and stagnated blood. 3. Principles and Methods of treatment 1) Herbal Medicine (1) Excess type [1] Constipation due to heat : Seunggitang(承氣湯) and Majainwhan(麻子仁丸) [2] Constipation due to stagnation of Ki : Samatang(四磨湯) and Yukmatang(六磨湯) (2) Deficiency type [1] Constipation due to deficiency of Ki : Whanggitang(黃?湯) [2] Constipation due to deficiency of blood: Yunjangwhan(潤腸丸) [3] Constipation due to cold : Jechunjun(濟川煎) and Banyuwhan(半硫丸) 2) Enema therapy: It is a method to induce defecation by honey or pig's bile juice for weak people. 3) Acupuncture and Moxibustion: Acupoints used to treat constipation are BL25, ST25 and TE6. Moxibustion at CV8, CV6 is good for constipation due to cold. (4) Diet therapy: It is very important that we eat meals regularly and defecate on the same time even if you don't. And we have to eat food like fruits, vegetables and beans. (5) finger pressure: Finger pressing around these points like ST25, SP25, BL25, BL31, BL32, BL33 and BL34 is good for it. (6) Kigong therapy: Abdominal breathing (7) Old man' s constipation: Hip bath or diet therapy is commended. Laxation with lubricant like Supungyunjangwhan(搜風潤腸丸) is used. (8) Women' s constipation: After delivery, we have to administer tonifying prescription Sipjundaebotang(十全大補湯) and enema can be used. Conclusion : We have to examine the cause of disease and bowl movement carefully. After comprehensive analysis of the data gained by the four methods of diagnosis, we diagnose and treat patients on the base of overall of symptoms and signs.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.1
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• pp.138-143
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• 2011

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.

• The Journal of Internal Korean Medicine
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• v.36 no.2
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• pp.93-104
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• 2015

Objectives: This study examined the correlation between the Scandinavian Stroke Scale (SSS) and the Motricity Index (MI) in acute cerebral infarction patients. Methods: We studied 75 inpatients within a month after the onset of cerebral infarction; patients were recruited from July 2012 to November 2013. We analyzed the correlation between changes in SSS and MI by pattern identification. Results: A significant moderate positive linear correlation was noted between SSS and MI in the total patient cohort and in a Fire-heat group, Dampness-phlegm group, Qi deficiency group, and Deficiency syndrome group. A significant strong positive linear correlation existed between SSS and MI in the Excess syndrome group. The Yin deficiency group showed a weak positive linear correlation, but it was not statistically significant. Conclusions: This study provides evidence that the correlation between SSS and MI in acute cerebral infarction patients could differ depending on pattern identification.

• The Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.33-42
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• 2012

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 Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.52-62
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• 2012

Object : The aim of this study was to examine the differences of symptom improvement between different diagnosis classification groups in acute cerebral infarction patients. Methods : We studied inpatients within a month after the onset of cerebral infarction who were admitted at Kyunghee University Oriental Medical Center from May 2011 to October 2012. We compared the improvement of Motricity Index and Scandinavian Stroke Scale score between Fire-heat group(n=20), Yin deficiency group(n=31), Dampness-phlegm group(n=30), and Qi deficiency group(n=13). Results : Yin deficiency group patients with cerebral infarction showed the most improvement in MI and SSS scores, and patients in Fire-heat group showed the poorest improvement in MI and SSS scores. There was a significant difference between the two groups, but there were no significant differences between all four diagnosis classification groups. Conclusions : This study provides evidence that diagnosis classification could be considered as an important factor in predicting the prognosis of acute cerebral infarction.

• The Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.24-32
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• 2012

Object : The purpose of this study is to observe the correlation between change in pattern identification symptoms and scandinavian stroke scale in ischemic stroke patient who had receive traditional Korean medical treatment and conservative treatment. Methods : 43 subjects were recruited from patients with ischemic stroke within 30 days of onset. We chose the subjects who had at least one follow up session and had checked the score between last follow up session and first session in pattern identification and scandinavian stroke scale. We also assessed the correlation between pattern identification and scandinavian stroke scale. Results : There were significant negative correlation between pattern identification and scandinavian stroke scale in Fire-heat pattern and positive correlation in Dampness-phlegm pattern. Conclusions : This study provides evidence that collaborative treatment maybe effective in improving neurologic symptoms in ischemic stroke patients diagnosed as Fire-heat pattern. Further studies with larger scale and longer observation period, more neurologicscales scales, control group would be required.