• Title/Summary/Keyword: deficiency pattern

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Reliability and Validity Analysis of a Standard Instrument of Diagnosis and Assessment for Spleen Qi Deficiency Pattern in Chronic Dyspepsia Patients (비기허증(脾氣虛證) 진단평가도구의 신뢰도 및 타당도 예비 평가: 만성 소화불량 환자 대상 설문지 검증 임상시험)

  • Kim, Jihye;Kim, Juyeon;Kim, Jinsung;Kim, Keun Ho
    • The Journal of Korean Medicine
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    • v.36 no.3
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    • pp.23-34
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    • 2015
  • Objectives: This study is aimed at assessing the reliability of a standard instrument of diagnosis and assessment for Spleen Qi deficiency pattern questionnaire (SQDQ) and examining the validity of the SQDQ by comparing the pattern identification scores of different groups. Methods: We conducted a survey of 72 participants (60 patients with chronic dyspepsia and 12 healthy subjects) using self-reported questionnaire. Participants were given written consent and this study was performed under the permission of institutional review board of Kyung-Hee university Korean medicine hospital. Results: The reliability and the validity of the questionnaire were inspected. Internal consistency of the SQDQ was excellent. Construct validity analyzed by exploratory factor analysis produced 4 factors, which were selected from eigenvalues that are greater than 1.0. The factor 1, 2, 3 and 4 showed 'fatigue', 'meal', 'diagnosis' and 'figure' respectively. For most of SQDQs' items, there were significant differences observed between the Spleen Qi and the non-Spleen Qi groups. However, the 'emaciation', 'tongue diagnosis' and 'pulse diagnosis' showed no significant differences. Conclusions: The SQDQ restructured in this study may provide a fundamental questionnaire and a further study is required for a more advanced, standardized and statistically proven questionnaire.

A study on the theory of there being no excess pattern of the Kidney (신무실증(腎無實證)에 대한 고찰)

  • Yun, Ki-ryoung;Ahn, Jinhe
    • Journal of Korean Medical classics
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    • v.34 no.3
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    • pp.1-20
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    • 2021
  • Objectives : This study aims to examine the background of how the theory of there being no excess pattern of the Kidney has been carried on by looking at contents on Kidney excess patterns pre-Qianyi and at those negating the possibility of Kidney excess post-Qianyi. The history of the Kidney draining method for Kidney excess patterns was studied as well. Methods : Key words such as 腎實(kidney excess), 腎無實(no excess of the kidney), 瀉腎(draning the kidney) were entered into major database such as the Sikuquanshu to excavate contents on both Kidney excess and non-excess from medical classics. Results & Conclusion :In the Neijing, there are few mentions of symptoms due to Kidney excess. The theory of Kidney non-excess marks its beginning with Qianyi, who argued that Kidney manages deficiency in children only. Afterwards, some doctors expanded this theory beyond children and applied it as a general principle of the body. Based on the theory of there being no excess of the Kidney, it could be thought that while there could be excess symptoms of the Kidney, the root mechanism lies in Kidney deficiency. The importance of the Kidney as the basis of heaven-bestowed life, which is responsible for reproduction, growth and development, is what motivated the theories on the Kidney as what needs to be preserved and never drained. It could also be argued that the symptoms of Kidney excess, which were mentioned post-Neijing, got dealt with within the context of other Zhangfu differentiation patterns and deficiency symptoms, and became increasingly less designated to Kidney excess.

A Study on the Relationships between Breathing Disorders and Pathological Patterns Based on the Cold-Heat, Phlegm-, Yin Deficiency-, Lao Juan (勞倦)-Pattern Questionnaires and the Nijmegen Questionnaire (호흡실조와 증형간 연관성 연구: 한열, 담음, 음허, 노권 및 네이메헨 설문을 중심으로)

  • Hong, Hanna;Oh, Hwan-Sup;Park, Young-Bae;Park, Young-Jae
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.215-221
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    • 2016
  • Objectives: The purpose of this study was to examine the relationship between pathological patterns and hyperventilation syndrome, using pathological pattern and Nijmegen questionnaires. Methods: 33 healthy adults were asked to complete the Cold-Heat-, Phlegm-, Yin deficiency, and Lao Juan (勞倦)-pattern questionnaires, the Chalder fatigue scale, and the Nijmegen questionnaire at Kyung Hee University Hospital. We performed Pearson correlation analyses between the pathological pattern questionnaires and the Nijmegen questionnaire. The questionnaires were composed of several factors. Therefore, each factor and Nijmegen questionnaire score were also analyzed. Results: All of the pattern questionnaire scores had a positive correlation with the Nijmegen questionnaire score. The phlegm pattern, in particular, and the LaoJuan (勞倦) questionnaire scores had high correlation coefficients. The coefficient for the phlegm pattern was 0.856 and the coefficient for the LaoJuan (勞倦) pattern questionnaire was 0.855. Conclusions: The results mean that the pathological pattern questionnaires could be one of the reference materials to evaluate hyperventilation syndrome. Furthermore, improvement of pathological patterns may be helpful for treating hyperventilation syndrome, together with conventional therapies including breathing training.

Study II of Diagnosis Criteria for Qi deficiency in Stroke (중풍 기허증 진단 기준에 관한 연구 II)

  • Kang, Byoung Kab;Heo, Tae Young;Yun, Kyung Jin;Park, Tae Yong;Lee, Ju Ah;You, Soo Seong;Park, Geon Hee;Lee, Myeong Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.1
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    • pp.76-81
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    • 2014
  • The aim of this study was to build the diagnosis criteria of Qi deficiency using distribution of sum of 11 items for Qi deficiency in stroke patients. Between September 2006 and December 2010, 2,994 patients from 11 Korean medical hospitals were asked to complete the Korean Standard Pattern Identification for Stroke (K-SPI-Stroke) questionnaire as a part of project 'Fundamental study for the standardization and objectification of pattern identification in traditional Korean medicine for stroke (SOPI-Stroke). Each patient was independently diagnosed by two experts (traditional Korean medicine physicians) from the same site according to one of five patterns. 2,994 patients were divided modeling and testing in 70:30 ratio by stratification of pattern identification. We calculated the sensitivity, specificity, accuracy and odds ratio (OR) using distribution of sum of 11 items (signs and symptoms) for Qi deficiency. More than four from 11 items of Qi deficiency in modeling dataset, sensitivity, specificity, accuracy and OR was 70.07%, 74.94%, 73.92% and 7.00, respectively. In testing dataset, 78.31%, 73.45%, 74.47% and 9.98, respectively. Although this values are not high, after values of sensitivity, specificity, accuracy and OR should be more than current value, and then we should be able to suggest as objective diagnosing criteria.

Study on Tongue Coating Patterns of the Xerostomia in the Elderly Patients (노인 구강건조증 환자들의 설태 양상에 관한 고찰)

  • Han, Gajin;Park, Jae-Woo;Ko, Seok-Jae;Kim, Juyeon;Son, Jiyoung;Jang, Seungwon;Kim, Seul-Ki;Kim, Minji;Kim, Jinsung
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.17 no.3
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    • pp.189-202
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    • 2013
  • Objectives The aim of this study is to analyze the characteristics of the tongue coating pattern in the elderly patients with xerostomia. Methods Ninety-six elderly patients with xerostomia were recruited by advertisement and they visited the oral diseases clinics at Kyung Hee University Korean Medicine Hospital and Kyung Hee University Hospital at Gangdong from November, 2011 to August, 2013. After signifying the assent, the subjects who passed screening were enrolled this study. The subjects were evaluated on their clinical characteristics of xerostomia using visual analogue scale for xerostomia, dry mouth questionnaire, unstimulated salivary flow rate. In addition, Yin-deficiency questionnaire was used to evaluate the Yin-deficiency state and Winkel tongue coating index and Digital Tongue imagin system were used to measure the tongue coating of patients. Results The proportion of women was higher than that of men, and there were few smokers in this study population. This population had chronic and relatively severe xerostomia symptoms. Also, thin coating pattern was showed in this elderly patients with xerostomia and this result was regarded to the influence of Yin-deficiency. The thin coating patten was observed in the group with higher Yin-deficiency score. There was no difference in tongue coating between the hyposalivation and normosalivation group. Conclusion In the elderly patients with xerostomia, Yin-deficiency is might be considered as one of the main cause of xerostomia. Hence, it is thought that this patients showed the thin coating pattern. This results could be used in diagnosis and treatment for the elderly patients with xerostomia in traditional Korean medicine.

Development of a Guideline for the Application of a Diagnostic Tool for Menopausal Syndromes Based on the Use of Systemic Review and Delphi Method (체계적 문헌고찰과 델파이 기법을 활용한 갱년기장애 변증(辨證)진단 도구 개발을 위한 기초 연구)

  • Lee, In-Seon;Kim, Dong-Il;Yoo, Jeong-Eun;Kang, Chang-Wan
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.4
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    • pp.175-202
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    • 2017
  • Objectives: This study was conducted towards developing a screening tool for syndrome differentiation in the diagnosis of menopause in menopausal and perimenopausal women. Methods: We conducted a literature review of studies on menopausal diagnosis based on syndrome differentiation, and examined well-founded differentiated syndromes and their respective clinical symptoms. Based on the findings, we created a questionnaire through consultations with Oriental medicine experts in physiology, pathology, and diagnostics. Finally, the research team conducted an expert Delphi study on differentiated syndromes and the associated clinical symptoms. Results: Seven differentiated syndromes were selected, including Liver Depression (肝鬱), Kidney Yin Deficiency (腎陰虛), Kidney Yang Deficiency (腎陽虛), Liver and Kidney Yin Deficiency (肝腎陰虛), Kidney Yin and Yang Deficiency (腎陰陽兩虛), Heart-Kidney Noninteraction (心腎不交), and Dual Deficiency of Heart and Spleen (心脾兩虛); 4 disease locations, including liver (肝), heart (心), spleen (脾), and kidney (腎); and 3 disease natures, including Yin Deficiency (陰虛), Qi Stagnation (氣滯), and Blood Deficiency (血虛). In addition, we added 3 supplemental disease natures, including Yang Deficiency (陽虛), Qi Deficiency (氣虛), and Heat (火熱), in consideration of syndrome differentiation categories that may possibly be added in a follow-up clinical questionnaire. Conclusions: This resulted in a total of 7 differentiated syndromes, 4 disease locations, and 6 disease natures. We translated the clinical symptoms of these 17 categories into Korean Hangeul. After consulting with 5 Oriental medicine experts and a psychology expert, we produced a questionnaire for use in diagnosing menopause based on syndrome differentiation. The calculation of scores for the syndrome differentiation screening tool will be confirmed through clinical research based on the results of a review of existing literature.

Reliability Study of the Pattern Identification Questionnaire Developed by Korean Institute of Oriental Medicine (한국한의학연구원 개발 변증설문지의 신뢰도 연구)

  • Kim, Bum-Su;Lim, Jung-Hwa;Lee, Min-Hee;Yun, Young-Ju
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.17 no.1
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    • pp.29-44
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    • 2013
  • Objectives This study is aimed at assessing the reliability of the Pattern identification questionnaire (PIQ) developed by Korea Institute of Oriental Medicine and examining the validity of the PIQ by comparing the pattern identification scores of different groups. Methods We conducted a survey of 258 participants (79 teachers and 179 graduate students at one School of Korean Medicine) using self-reported questionnaire and all the samples were retested. The test-retest reliability was assessed by Kappa coefficient(${\kappa}$) and Pearson correlation coefficient. Also we compared the differences in pattern identification scores according to sex, age and occupation. Results 1. One of 116 questions are impossible to calculate; 22 of them (18.97%) scored under 0.4 in ${\kappa}$; 90(77.59%) ranged from 0.4 to 0.8 in ${\kappa}$; and three questions (3.58%) scored 0.8 or over in ${\kappa}$. 2. Pearson correlation coefficients between test score and retest score of all pattern identification items are 0.4 or over. 3. The mean score for pattern identification in women was generally higher than that in men, particularly in patterns of blood-deficiency, blood-stasis, yang-deficiency and kidney disease. 4. The mean score for pattern identification in the graduate student group was generally higher than that in the teacher group. Conclusion In test-retest reliability, the PIQ showed relatively high reliability. The mean pattern identification score showed differences in regards to retaining knowledge about Korean medicine. Therefore, future research involving modification of questionnaire items and confirming the validity of this questionnaire is required.

Preliminary Study to Develop the Instrument on Pattern Identifications Knee Osteoarthritis (퇴행성무릎관절염 변증도구 개발에 관한 기초연구)

  • Jeon, Dong Hwi;Lee, Eun Jung;So, Hyun Woo;Hwang, Man Suk;Yoo, Jeong Eun;Park, Yang Chun;Jung, In Chul;Oh, Min Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.2
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    • pp.77-91
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    • 2017
  • Objectives The aim of this study was to develop a standard tool of pattern identification for Knee Osteoarthritis, which will be applied to clinical research. Methods The advisor committee for this study was organized by 11 panel of experts (Korean Rehabilitation Medicine professors, Acupuncture and Moxibustion professors belonging to Korean Medicine colleges, Principal Researcher of Korea Institute of Oriental Medicine, Doctor of Korean medicine). The pattern identifications and symptoms for this tool were extracted from published Korean and Chinese literature. Through the discussion among internal experts and consultation from advisors, the Instrument on Pattern Identifications for Knee Osteoarthritis was developed. Results 1) Five pattern identifications (The Wind, Chill, and Moisture, The Moist-Heat, Blood Stasis, Yang Deficiency of Spleen and Kidney, Yin Deficiency of Liver and Kidney) were set for the tool. 2) The mean weights which represent the importance of each symptom and scored on a hundred-point scale was obtained. 3) The Instrument on Pattern Identifications for Knee Osteoarthritis was designed in the self-reporting format composed of 46 questions. Conclusions The Instrument on Pattern Identifications for Knee Osteoarthritis was created through this study. Though this study is not proved about validity, reliability, the instrument of pattern identification for Knee Osteoarthritis is meaningful and expected to be applied to the subsequent.

A Study on the Relationship between NIHSS and Distribution of Pattern Identification in Stroke Patients (중풍 환자의 NIHSS에 따른 중풍 변증 분형 분포의 특성 연구)

  • Kim, Mi-kyung;Yang, Na-rae;Choi, Dong-jun;Han, Chang-ho
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.47-53
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    • 2009
  • Objectives : This study was aim to investigate the relationship between NIHSS and distribution of pattern identification in stroke patients. Methods : 1471 participants from the patients hospitalized for stroke within 4 weeks from April 2007 to August 2009 were included. They were grouped according to the NIHSS score; group 1 for the participants whose NIHSS were less than six, group 2 for seven to fifteen, and group 3 for over than sixteen. And the patients were re-divided into two groups according to their post-onset interval. The difference of distribution of five pattern identification for each group were investigated. And five pattern identification were re-analyzed according to the deficiency-excess pattern identification. K-W test was used for statistical synthesis, and the result was regarded as significant one, if its p-value was below 0.05. Results : Dampness-phelegm pattern was the most frequent out of five patterns in total participants as well as all the subgroups. In group 3 with more serious neurological deficit, larger proportion of patients in early acute stage was diagnosed as excess pattern including Fire-Heat pattern. On the other side the proportion of Deficiency of Qi and Yin was larger in late convalescent stage of group 3 than in other groups. But nothing was statistically significant. Conclusions : Further study including patients with more variant classification with follow-up evaluation is needed to reflect the real characteristics of stroke population.

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Association of Korean Medicine Pattern Identifications and Liver Blood Markers with the Severity of Cognitive Impairment in an Elderly Population (경도인지장애와 경도치매 단계에서의 한의 변증 및 간 혈액지표 연관성 탐색 연구)

  • Kahye Kim;Jiyun Cha;Seul Gee Kim;Hyung-Won Kang;Yeoung-Su Lyu;In Chul Jung;Jaeuk U. Ki
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.3
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    • pp.141-150
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    • 2023
  • Objectives: This study aimed to comprehend the characteristics of Korean medicine patterns in relation to varying degrees of cognitive impairment in an elderly population. Methods: The dataset included 127 elderly individuals with cognitive impairment obtained from three Korean medicine hospitals between 2018 and 2021. The participants were categorized into two groups based on Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores: those with questionable impairment (QI) and those with very mild dementia (VMD). A diagnostic framework for Korean medicine patterns encompassing Qi deficiency, Yin deficiency, Phlegm dampness, and Heat-fire was employed. Liver blood markers, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the AST/ALT ratio, were also analyzed. Results: The scores of the cognitive assessment tools (MoCA-K, MMSE-DS, and K-IADL) of the QI group significantly differed from those of the VMD group. CDR-SB exhibited a positive correlation with the scores of each pattern of Qi deficiency, Yin deficiency, Phlegm dampness, and Heat-fire, whereas ALT and AST values displayed negative correlations. Binomial logistic analysis, controlling for potential confounders, such as age, education years, body mass index, the presence of chronic disease, and the presence of medication, verified that the VMD group showed higher pattern scores and lower ALT and AST values than the QI group. Conclusions: Increases in pattern scores along with decreased AST and ALT levels might be indicative of more severe cognitive impairment.