The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
권호 표지
DOI QR코드

DOI QR Code

Correlation Analysis Between Stomach Qi Deficiency Pattern and Gastric Emptying Measured by Abdominal Ultrasonography in Patients with Functional Dyspepsia

기능성소화불량에서 위기허증(胃氣虛證)과 복부초음파로 측정한 위 배출능과의 상관성 분석

  • Nam, Seong-uk (Dept. of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Park, Jae-woo (Dept. of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Kim, Jin-sung (Dept. of Clinical Korean Medicine, Graduate School, Kyung Hee University)
  • 남성욱 (경희대학교 대학원 임상한의학과) ;
  • 박재우 (경희대학교 대학원 임상한의학과) ;
  • 김진성 (경희대학교 대학원 임상한의학과)
  • Received : 2018.05.21
  • Accepted : 2018.06.29
  • Published : 2018.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

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.

Keywords

References

  1. Shin CM, Huh KC. Diagnosis and treatment of functional dyspepsia. Journal of the Korean Medical Association 2016;59(4):311-8. https://doi.org/10.5124/jkma.2016.59.4.311
  2. Ford AC, Marwaha A, Sood R, Moayyedi P. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut 2015;64(7):1049-57. https://doi.org/10.1136/gutjnl-2014-307843
  3. Min BH, Huh KC, Jung HK, Yoon YH, Choi KD, Song KH, et al. Prevalence of uninvestigated dyspepsia and gastroesophageal reflux disease in Korea: a population-based study using the Rome III criteria. Digestive Diseases and Sciences 2014;59(11):2721-9. https://doi.org/10.1007/s10620-014-3243-y
  4. Stanghellini V, Chan FK, Hasler WL, Malagelada JR, Suzuki H, Tack J, et al. Gastroduodenal Disorders. Gastroenterology 2016;150(6):1380-92. https://doi.org/10.1053/j.gastro.2016.02.011
  5. Quartero AO, de Wit NJ, Lodder AC, Numans ME, Smout AJ, Hoes AW. Disturbed solid-phase gastric emptying in functional dyspepsia: a meta-analysis. Digestive Diseases and Sciences 1998;43(9):2028-33. https://doi.org/10.1023/A:1018803129779
  6. Shindo T, Futagami S, Hiratsuka T, Horie A, Hamamoto T, Ueki N, et al. Comparison of gastric emptying and plasma ghrelin levels in patients with functional dyspepsia and non-erosive reflux disease. Digestion 2009;79(2):65-72. https://doi.org/10.1159/000205740
  7. Committee of Digestive Diseases, National Korean Medicine College. Gastroenterology. Seoul: Koonja publisher; 2009, p. 87.
  8. Stempien SJ, Tester RJ, Dagrdi AE. Six hour food and barium retention tests. American Journal of Digestive Diseases 1971;16(5):305-402.
  9. Hunt JN. The viscosity of the test meal; Its influence on gastric secretion and emptying. Lancer(i). 1954;266(6801):17-8.
  10. Muresan C, Surdea Blaga T, Muresan L, Dumitrascu DL. Abdominal Ultrasound for the Evaluation of Gastric Emptying Revisited. Journal of gastrointestinal and liver diseases 2015;24(3):329-38.
  11. Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L. Clinical guideline: management of gastroparesis. American Journal of Gastroenterology 2013;108(1):18-38. https://doi.org/10.1038/ajg.2012.373
  12. Hong SP. Assessment of gastric emptying using three-dimensional ultrasonography. The Korean Journal of Gastroenterology 2004;44(2):103-6.
  13. Irvine EJ, Tougas G, Lappalainen R, Bathurst NC. Reliability and interobserver variability of ultrasonographic measurement of gastric emptying rate. Digestive Diseases and Sciences 1993;38(5):803-10. https://doi.org/10.1007/BF01295904
  14. Lee HW, Park HJ, Lee SI, Park IS, Kang BC, Kim KW. Ultrasonographic Gastric Emptying in Patients with Functional Dyspepsia. Korean Journal of Gastroenterology 1998;31(1):1-8.
  15. Kim DY, Jung HK, Lee YH, Jung SA, Moon IW, Paek JY. The Measurement of Gastric Emptying Time with 3-D Ultrasonography. Korean Journal of Gastroenterology 2004;44(2):71-6.
  16. Baek SH, Kim JS. Correlation Analysis between Gastric Emptying Measured by Ultrasonography and Spleen Qi Deficiency Pattern in Patients with Functional Dyspepsia. The Journal of Korean Oriental Internal Medicine 2015;36(4):527-46.
  17. Department of Physiology, National Korean Medicine College. Oriental Medical Physiology. Seoul: Jipmoondang publisher; 2008, p. 258-62.
  18. Committee of Digestive Diseases, National Korean Medicine College. Gastroenterology. Seoul: Koonja publisher; 2009, p. 67-9.
  19. Brun R, Kuo B. Functional dyspepsia. Therapeutic Advances in Gastroenterology 2010;3(3):145-64. https://doi.org/10.1177/1756283X10362639
  20. Van de Putte P, Perlas A. Ultrasound assessment of gastric content and volume. British Journal of Anaesthesia 2014;113(1):12-22. https://doi.org/10.1093/bja/aeu151
  21. Bolondi L, Bortolotti M, Santi V, Calletti T, Gaiani S, Labo G. Measurement of gastric emptying time by real-time ultrasonography. Gastroenterology 1985;89(4):752-9. https://doi.org/10.1016/0016-5085(85)90569-4
  22. Perlas A, Mitsakakis N, Liu L, Cino M, Haldipur N, Davis L, et al. Validation of a Mathematical Model for Ultrasound Assessment of Gastric Volume by Gastroscopic Examination. Anesthesia and Analgesia 2013;116(2):357-63. https://doi.org/10.1213/ANE.0b013e318274fc19
  23. Lee JH, Park JW, Ko SJ, Kim JS. Development and validation of a new pattern identification scale for Stomach Qi Deficiency. European Journal of Integrative Medicine 2018;17:56-63. https://doi.org/10.1016/j.eujim.2017.11.009
  24. Lee EH, Hahm KB, Lee JH, Park JJ, Lee DH, Kim SK, et al. Development and validation of a functional dyspepsia-related quality of life (FD-QOL) scale in South Korea. Journal of Gastroenterology and Hepatology 2006;21(1):268-74. https://doi.org/10.1111/j.1440-1746.2006.04196.x
  25. Talley NJ, Haque M, Wyeth JW, Stace NH, Tytgat GN, Stanghellini V, et al. Development of a new dyspepsia impact scale: the Nepean Dyspepsia Index. Alimentary Pharmacology and Therapeutics 1999;13(2):225-35. https://doi.org/10.1046/j.1365-2036.1999.00445.x
  26. Cho YK, Choi MG, Kim SH, Lee IS, Kim SW, Chung IS, et al. The effect of mosapride on quality of life in functional dyspepsia. The Korean journal of gastroenterology 2004;43(3):160-7.
  27. Tack J, Bisschops R, Sarnelli G. Pathophysiology and treatment of functional dyspepsia. Gastroenterology 2004;127(4):1239-55. https://doi.org/10.1053/j.gastro.2004.05.030
  28. Mahadeva S, Ford AC. Clinical and epidemiological differences in functional dyspepsia between the East and the West. Journal of Neurogastroenterology and Motility 2016;28(2):167-74. https://doi.org/10.1111/nmo.12657
  29. Aro P, Talley NJ, Ronkainen J, Storskrubb T, Vieth M, Johansson SE, et al. Anxiety is associated with uninvestigated and functional dyspepsia (Rome III criteria) in a Swedish population-based study. Gastroenterology. 2009;137(1):94-100. https://doi.org/10.1053/j.gastro.2009.03.039
  30. Kugler T. The Usefulness of Water-drinking Ultrasonography Combined Test for Evaluating Patients with Functional Dyspepsia. The Korean Journal of Gastroenterology 2015;66(2):92-7. https://doi.org/10.4166/kjg.2015.66.2.92
  31. Meyer JH: Invasive (intubation) and non invasive (radionuclide imaging) techniques for studying gastric emptying; in Dubois A, Castell DO(eds): Esophageal and Gastric Emptying. Baca Raton, CRC Press 1985:73-81.
  32. Gilja OH. Ultrasound of the stomach - the EUROSON lecture 2006. Ultraschall Med 2007;28(1):32-9. https://doi.org/10.1055/s-2007-962866
  33. Hillyard S, Cowman S, Ramasundaram R, Seed PT, O'Sullivan G. Does adding milk to tea delay gastric emptying? British Journal of Anaesthesia 2014;112(1):66-71. https://doi.org/10.1093/bja/aet261
  34. Szarka LA, Camilleri M. Gastric emptying. Clinical Gastroenterology and Hepatology 2009;7(8):823-7. https://doi.org/10.1016/j.cgh.2009.04.011
  35. Park KS, Lee JY. Probing the Utility of Ultrasonography for Assessing Degree of Functional Dyspepsia. The Korean Journal of Gastroenterology 2015;66(2):67-9. https://doi.org/10.4166/kjg.2015.66.2.67

Cited by

  1. 초음파 위배출 측정과 한의설문 간의 상관성 분석 vol.39, pp.4, 2018, https://doi.org/10.22246/jikm.2018.39.4.570
  2. 기능성소화불량 환자의 한의 변증 설문과 양도락 결과의 상관성 연구 vol.40, pp.3, 2019, https://doi.org/10.22246/jikm.2019.40.3.369
  3. 기능성소화불량의 식적설문지 개발과 신뢰도 및 타당도 검정 vol.40, pp.3, 2019, https://doi.org/10.22246/jikm.2019.40.3.390
  4. A Review of the Clinical Use of Ultrasound in Korean Traditional Medicine vol.36, pp.4, 2018, https://doi.org/10.13045/jar.2019.00297
  5. 기능성 소화불량에서 초음파 위배출능 측정간격에 대한 임상연구 vol.41, pp.6, 2018, https://doi.org/10.22246/jikm.2020.41.6.1030
  6. 전립선비대증 변증도구의 신뢰도 평가 및 IPSS, 요속과의 상관관계에 대한 탐색적 연구 vol.41, pp.6, 2018, https://doi.org/10.22246/jikm.2020.41.6.1052