• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.5
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• pp.553-562
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• 2013

This study was performed to develop cold-heat and deficiency-excess pattern identification for dementia, as well as for standard Korean medicine diagnosis and treatment. Five experts comprised of 4 neuropsychiatrists of Korean medicine and 1 statistician to develop cold-heat and deficiency-excess pattern identification for dementia. We searched studies about pattern identification and selected 507 articles using Oasis search terms provided by the KIOM. As a result, 10 pattern identification research study were recruited. Moreover, we analyzed neuropsychological assessments for dementia that evaluate Behavioral and Psychological Symptoms of Dementia (BPSD) and cognitive function using experts conferences and we selected neuropsychological instruments using pattern identification. Six cold patterns, six heat patterns, ten deficiency patterns, and four excess patterns were identified according to the cold-heat and deficiency-excess pattern identification of dementia. We selected the Caregiver-Administered Neuropsychiatric Inventory and the Korean Mini-Mental State Examination as neuropsychological assessments of dementia, which examine behavioral symptoms and cognitive function, suspectively. We formed positive and negative correlation between Korean medicine pattern identification and neuropsychological assessments for dementia. We developed and suggested a forecast module of pattern identification for dementia. But, it is necessary to perform additional clinical trials to verify its validity and accuracy.

• Herbal Formula Science
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• v.27 no.1
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• pp.73-86
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• 2019

Objectives : In spite of the difficulty of getting Agarwood, the number of species of wild Agarwood is rapidly decreasing by insistent demands. Here, we investigate how various formula of Agarwood is used so that we can make use of them more helpful in clinics today. Methods : Determining the range of 'the Sovereign and Minister' component more than 12.96%" or 'equally used', this study distinguished whether Agarwood is used as 'the Sovereign and Minister' component among 409 Agarwood formulas in "Sheng ji zong lu(聖濟總錄)" and 103 Agarwood formulas in "Donguibogam (東醫寶鑑)". Additionally, we analyzed the component ratio of Agarwood, and also the usage in Deficiency-Excess pattern. Results : Among Agarwood formulas in "Sheng ji zong lu" and "Donguibogam", each percentage of Agarwood formulas which Agarwood comprises 'the Sovereign and Minister' component was 26%(106/406) and 13%(13/99). Analyzing these formulas of "Sheng ji zong lu", 53 formulas were used in Deficiency pattern and other 53 formulas were used in Excess pattern. Also in "Donguibogam", 6 formulas were used in each Deficiency pattern and Excess pattern, and only 1 formula in both of Deficiency and Excess pattern. Conclusions : Showing almost equal ratio of usage in Deficiency-Excess pattern, this study showed that those Agarwood formulas of "Sheng ji zong lu" and "Donguibogam" which Agarwood comprises 'the Sovereign and Minister' component can be used in both Deficiency-Excess pattern evenly.

• Journal of Physiology & Pathology in Korean Medicine
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• v.33 no.1
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• pp.1-9
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• 2019

This paper aims to present a model of obesity and leanness based on eum, yang, ki and blood metabolism of Korean medicine. I analyzed the theory of eum, yang, ki and blood metabolism, yang transforming ki and eum forming the body on Korean medicine, and compared them with energy homeostasis by anabolism and catabolism of modern medicine. In the eum and yang theory, the metabolic process of the human body is dominated by synergism and antagonism between eum force and yang force. When the balance of eum and yang collapses, all the pathological actions of the human body appear, and in the eum and yang metabolic process, an imbalance between yang transforming ki and eum forming the body occurs. The function of yang transforming ki is reduced to ki deficiency, and the function of eum forming the body is increased to blood excess. When blood excess and ki deficiency is given, energy intake increases, energy expenditure decreases, overweight and obesity occur. On the contrary, the function of yang transforming ki is increased to ki excess, and the function of eum forming the body is decreased to blood deficiency. When ki excess and blood deficiency is done, energy intake decreases and energy expenditure increases, the body becomes leanness. When the balance of eum, yang, ki and blood metabolism collapses and becomes blood excess and ki deficiency, overweight and obesity occur, and when ki excess and blood deficiency is done, the body becomes leanness. The energy homeostasis of the human body can be explained by eum, yang, ki and blood metabolism of Korean medicine and it contains the concept of anabolism and catabolism of modern medicine.

• The Journal of Korean Medicine
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• v.42 no.1
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• pp.1-11
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• 2021

Objectives: This pilot study aimed to evaluate the agreement between traditional face-to-face Korean medicine (KM) pattern identification and non-face-to-face KM pattern identification using the data from related questionnaires, tongue image, and pulse features in patients with cancer. Methods: From January to June 2020, 16 participants with a cancer diagnosis were recruited at the one Korean medicine hospital. Three experienced Korean medicine doctors independently diagnosed the participants whether they belong to the cold pattern or not, heat pattern or not, deficiency pattern or not, and excess pattern or not. Another researcher collected KM pattern related data using questionnaires including Cold-Heat Pattern Identification (CHPI), tongue image analysis system, and pulse analyzer. Collected KM pattern related data without participants' identifier was provided for the three Korean medicine doctors in random order, and non-face-to-face KM pattern identification was carried out. The kappa value between face-to-face and non-face-to-face pattern identification was calculated. Results: From the face-to-face pattern identification, there were 13/3 cold/non-cold pattern, 4/12 heat/non-heat pattern, 14/2 deficiency/non-deficiency pattern, and 0/16 excess/non-excess pattern participants. In cold/non-cold pattern, kappa value was 0.455 (sensitivity: 0.85, specificity: 0.67, accuracy: 0.81). In heat/non-heat pattern, the kappa value was 0.429 (sensitivity: 0.75, specificity: 0.72, accuracy: 0.75). The kappa value of deficiency/non-deficiency and excess/non-excess pattern was not calculated because of the few participants of non-deficiency, and excess pattern. Conclusions: The agreement between traditional face-to-face pattern identification and non-face-to-face pattern identification seems to be moderate. The non-face-to-face pattern identification using questionnaires, tongue, and pulse features may feasible for the large clinical study.

• 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.

• Journal of Korean Medical classics
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• v.20 no.3
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• pp.49-56
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• 2007

The "Somun Jogyongron(素問 調經論)" describes excess and deficiency syndromes. The study suggests that excess syndrome(實證) is caused by vigorous pathogenic fire(火邪)(the spirit(神)), pathogenic dryness(燥邪)(Gi(氣)), pathogenic wind(風邪)(blood(血)), pathogenic dampness(濕邪)(physique(形)) or pathogenic coldness(寒邪)(will(志)). When pathogenic fire is dominant within the body, Gi and blood becomes excessive and come out of the body, but the body cannot take them back, leading to the symptom in which the patient cannot stop laughing. When pathogenic dryness prevails, the lung(肺) cannot function properly. This means that the convergence(收斂) function of the clearing the lung and descending Gi(肅降) is deteriorated, and the patient shows symptoms of dyspnea and cough. Strong pathogenic wind increases the ascencling Gi in the liver(肝氣) and fuel angry emotion when the patient becomes upset. When pathogenic dampness is dominant, spleen(脾) function drops due to lumping effects, and the patient will experience abdominal distention(腹脹), which will disturb urination and defecation. When pathogenic coldness prevails, abdominal distention occurs due to condensating effects, and Yang Gj(陽氣) in the kidney(腎) is disturbed, leading to digestion disorders and eventually water-grain dysentery. Deficiency syndrome is caused by the lack of essential Gi(精氣) in the five viscera(五藏). Deficiency of sprit means the lack of Gi in the heart(心氣), so the patient becomes vulnerable to sadness. Deficiency of Gi means the lack of Gi in the lung(肺氣), so the patient may have breathing disorders. Deficiency of blood means the lack of Gi in the Liver(肝氣), so the patient can be easily scared. Deficiency of physique means the lack of Gi in the spleen(脾氣), making it difficult to use arms and legs. Deficiency of will means the lack of Gi in the kidney(腎氣), so Gowl syndrome(厥證) can ensue.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.2
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• pp.561-566
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• 2007

After researching on infantile diseases in Hyungsang medicine, the writer got the conclusions as follows. The infants who are excess of the Yang energy need to nourish the Eum- blood. The main causes of the infantile disorders are congenital defect and malfunction of internal organs by nature, as results of these they suffer from mental disorders or being undergrown. And after birth they get ill from internal injury or external affections, mainly epilepsy by retention of undigested food, fever, cough, asthma, nasal obstruction, dermatopathia, and affection by cold, etc. In Hyungsang medicine Dam-body is apt to get ill from deficiency of Eum-blood and bangkwang-body from deficiency of Yang-energy. And infants are hare to be moderate in food, so they become to diseases of the Spleen and stomach, especially infants with Yangmyung type get to epilepsy, cough, skin disorders, and obese for the reasonof overeating. Among main infantile symptoms congenital defects, infantile mental disorders, and convulsive diseases come from congenital defect and malfunciton of internal organs, so it must be treated the symptoms following the reasons. Above all infantile mental disorders are treated not to separate the spirit from the body. And fever, cough and asthma, affection by cold, skin diseases, poor appetite, and obese come from deficiency of Kidney or the deficiency and excess of the Spleen and stomach. In order to prevent from infantile diseases right antenatal training, taking medicine rightly, exercise and eating good habits are needed to give guidance. Seeing through the clinical cases in Hyungsang medicine, we come to know that the infantile mental disorders come out primarily for the reasons of the congenital defect, and the infantile epilepsy come from malfunction of internal organs, and the nasal obstruction and skin diseases come from deficiency of Kidney or the deficiency and excess of the Spleen and stomach.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.18 no.2
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• pp.75-84
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• 2014

Objectives Eyes, one of visual inspection regions, present important clues to pathological patterns including deficiency and excess patterns to the clinicians. The purpose of this study was to develop Eyes Inspection Questionnaire (EIQ) and to examine which items among the EIQ were more predictive of clinicians' determination for the deficiency and excess patterns. Methods Nine questionnaire items for Visual Inspection of Eyes were extracted through the literature review. These items were presented to the 4 Korean medical doctors who are specialized in visual inspection to conduct the Delphi method. The Korean medical doctors were asked to rate the importance of each items for the corresponding Visual Inspection of Eyes, using a Likert 5-point scale(the 3 points of importance as a cut-off point). Then, out of 75 photographs submitted to the Society of HyungSang Medicine in 2009, 30 portrait pictures were selected as samples. The samples were copied to make 60 sample pictures, and then randomly assigned to 4 clinicians. The 4 clinicians evaluated the 60 samples for excess and deficiency of the eyes and were asked to check the 6 questionnaire items. The results were recorded as 5-points-scale, and their average and standard deviations were calculated. Intra- class reliability test and multi regression test were performed using SPSS 13. Results Intra-class correlation coefficient (ICC) was between 0.750 to 0.841 (P<0.05). Indices for visual inspection of the eyes were: endowment of the bone structure around the eyes; brightness of the eyes; upward deviation of the eyes; eye shapes; and definition of iris. 76.92% of deficiency symptom patterns and 86.42% of the excess symptom patterns matched the patterns predicted by the visual inspection of the eyes, according to the frequency analysis. According to the multiple regression analysis, were significantly related to the excessive symptoms, and to the deficiency symptoms. Conclusion This study is the first attempt of development for checklist of excess and deficiency of Visual Inspection of Eyes and quantitative measurement of excess and deficiency using the Visual Inspection of Eyes by the visual inspection experts. Still, additional studies are needed regarding the relationship visual inspection methods have with existing standards of diagnosis.

• The Journal of Internal Korean Medicine
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• v.40 no.4
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• pp.582-596
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• 2019

Objective: The aims of this study were to analyze the deficiency-excess pattern identification (虛實辨證) and compare it to the sputum cytokines of asthma patients. Method: 50 asthma patients who met the inclusion and exclusion criteria were included in this study. They were divided into two groups: deficiency and excess syndrome groups. Sputum examinations were performed including $TNF-{\alpha}$, Interleukin (IL)-4, IL-5, IL-10, and IL-13. The Quality of Life Questionnaire for Adult Korean Asthmatics (QLQAKA), the Visual Analog Scale(VAS), and heart rate variability (HRV) were also measured. We also conducted laboratory tests, including the hematological indexes. Results: Based on the pattern identification, 50 asthma patients can be divided into two categories of groups: the deficiency syndrome group (N=24) and the excess syndrome group (N=26). In the analysis of sputum cytokines, although the $TNF-{\alpha}$, IL-4 and IL-13 were at a higher level in the deficient pattern group than in the excess pattern group, it was insignificantly different. There was a negative correlation in the analysis of QLQAKA and VAS. In the analysis of HRV, although the mean value of VLF, LF, and HF in the deficiency syndrome group was higher than in the excess syndrome group, it was insignificantly different. There was no significant difference in the hematological tests between the deficiency and the excess syndrome group. The mean value of the IgE in the blood tests was five times greater than the reference value. Conclusion: The cytokines of sputum including $TNF-{\alpha}$, IL-4, IL-5, IL-10, and IL-13 were indifferent statistically. Reinforcing the healthy and eliminating the pathogenic factors should be considered.

• Journal of Physiology & Pathology in Korean Medicine
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• v.31 no.4
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• pp.201-212
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• 2017

This study draws pattern differentiations of headache disorders on the ground of modern clinical applications and Korean medical literature. Categorization and symptoms of headache disorders are based on International Classification of Headache Disorders 3rd edition(beta version). And clinical papers are searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). In the aspect of eight principle pattern identification, primary headache occurs due to lots of yang qi and has more inner pattern rather than exterior pattern, heat pattern rather than cold pattern, excess pattern rather than deficiency pattern. And primary headache is related with liver in the aspect of visceral pattern identification and blood stasis, wind and phlegm are relevant mechanisms. Migraine without aura is associated with ascendant hyperactivity of liver yang, phlegm turbidity, sunken spleen qi, wind-heat, blood deficiency or yin deficiency. Migraine with aura is mainly related with wind and it's major mechanisms are ascendant hyperactivity of liver yang, liver fire, yin deficiency of liver and kidney, blood deficiency or liver depression and qi stagnation. High repetition rate of tension-type headache can be identified as heat pattern or excess pattern. And trigeminal autonomic cephalalgias can also be accepted as heat pattern or excess pattern when the occurrence frequency is high and is relevant to combined pattern with excess pattern of external contraction and deficiency pattern of internal damage based on facial symptoms by external contraction and nervous and anxious status by liver deficiency. This study can be expected to be Korean medical basis of clinical practice guidelines on headache by proposing pattern identifications corresponding to the western classifications of headache disorders.