Objectives This study was aimed to propose the guideline of the diarrhea in Sasang Constitutional Medicine. Methods 1) Literature search It was investigated that the prescriptions stated the diarrhea as a main and accessory symptoms to be treated in "Donguisasangshinpyun", "Donguisusebowon Sasang Chobongwon", "Donguisusebowon Gabobon", "Donguisusebowon Sinchukbon", "Dongmuyugo" 2) Clinial paper search (1) The foreign papers were searched by using the search word with 'Sasang AND Diarrhea' in pubmed (http://www.ncbi.nlm.nih.gov/pubmed/) and The Cochrane Library(http://www.thecochranelibrary.com) (2) The domestic papers were searched by using the search word with 'Soeumin AND Diarrhea', 'Soyangin AND Diarrhea', 'Taeeumin AND Diarrhea', 'Taeyangin AND Diarrhea', 'Sasang AND Diarrhea' in NDSL (http://www.ndsl.kr), KISS(http://kiss.kstudy.com), Oasis(http://oasis.kiom.re.kr), RISS(http://www.riss.kr) (3) The extracted factors were the evaluations on the mainly complained symptom, adopted four constitutional therapy and efficacy. Results & Conclusions The guidelines for treating the diarrhea in the Four Constitutional Medicine are as follows. 1) It is to categorize the constitution. 2) The diarrhea of taeeumin is prescribed with 'A Series of Taeeumjowi-tang, Galgeunhaegi-tang, Cheongsimyeonja-tang, Sahyang-san, etc'. by classifying into cold, fever, consumption and addiction. 3) The diarrhea of soyangin is regarded as an internal disease and it is prescribed with 'Baekhaobuja-tang, Baekhaobujaijung-tang, etc'. by classifying taeeum symptom and so-yin symptom. 4) The diarrhea of soeumin is Mangeum-disease and 'Jeoryeongchajeonja-tang, Hyeongbangsabaek-san, Hwalseokgosam-tang, Hyeongbanggihwang-tang, etc'. is prescribed depending on the complication.

Objectives This study was aimed to validate Sasang Constitution Questionnaire for Japanese (SSCQ-J). Methods Sasang Constitution Questionnaire for Patients (SSCQ-P) was developed by joint researches between the Society of Sasang Constitutional Medicine and Korea Institute of Oriental Medicine. We translated SSCQ-P into Japanese and modified some items of that for Japanese. By getting approval from the Institutional Review Board（IRB）of School of Medicine, Keio University, we conducted a questionnaire survey of patients who visited Oriental Medicine Center from early January until mid-February 2011. The total of 364 patients filled out that Questionnaire and gave an interview with a Sasang constitution specialist. Using this Questionnaire data, we made Sasang constitutional classification functions and calculated diagnostic accuracy rate of SSCQ-J using discrimination analysis. Results 1. Male group's diagnostic accuracy rate of SSCQ-J was 77.01% and female was 78.10%. 2. Diagnostic accuracy of SSCQ-J was a little higher than SSCQ-P Conclusions 1. SSCQ-J can be considered to have good discriminant power compared with SSCQ-P 2. Further research with SSCQ-J will be helpful in the comparison study on the usual symptoms between Korean and Japanese as well as development of good discriminant function.

Objectives In this study, the Sasang Constitutional diagnosis were carried out to Vietnamese subject living in Vietnam, and the external applicability of Sasang Constitutional Medicine was evaluated by analyzing the physiological symptoms and the pathological symptoms according to their constitutions. Methods Total 170 Vietnamese subjects who live in Hanoi were invited from Sep. 2012 to Jun. 2013 for the research, and subjects were diagnosed by 2 Sasang Constitution Medicine specialists. The collected data were analyzed in terms of the physiological symptoms and the pathological symptoms according to the Sasang Constitutions. Results There were significantly different in the physiological symptoms according to Sasang Constitutions, which were 'digest', 'perspiration', 'excrement', 'hot and cold', 'water' and in the pathological symptoms, which were 'sting pain in head' in Soyangin, 'back pain' in Soeumin, 'chest discomfort' in Taeeumin, 'skin discomfort' in Taeeumin, 'fatigue in the afternoon' in Soyangin, 'digestion' in Soeumin. Conclusions The Sasang Constitution Medicine which is a Korean traditional medicine is also applicable to foreign countries, and it can contribute to the health promotion.

Objectives The purpose of this study was to find correlations between gastrointestinal disorders, pain, sleep disorder, fatigue, and to figure out characteristics of fatigue in Sasang Constitution using medical devices data. Methods Sixty three subjects were divided into fatigue group and non-fatigue group, both groups had to undergo blood tests, questionnaire, Sasang constitutional analysis tool (SCAT), pulse wave analyzer examination, heart rate variability examination, nail fold capillary microscopic examination. Results 1) The results of questionnaire about fatigue, gastrointestinal disorder, pain, sleep disorder, quality of life had significant differences between fatigue and non-fatigue groups. 2) Soeumin had more serious gastrointestinal problem and Soyangin had more serious sleep disorder in fatigue groups than non-fatigue groups. 3) According to blood test results, there was no difference between fatigue and non-fatigue groups. 4) Elastic parameter of pulse wave analyzer and nail fold capillary microscopic examination showed significant differences between fatigue and non-fatigue groups in Soyangin. Conclusions We reach the conclusion that fatigue is usually accompanied by gastrointestinal disorder, pain, sleep disorder, deterioration in the quality of life. In Soeumin, treating gastrointestinal disorders can be helpful for treatment of fatigue. In Soyangin, improving sleep disorder may be more effective way to treat fatigue.

Objectives We carried out this study to know that there is any differences on the health condition of the middle aged women between Sasang coustitution. We used Diagnosis System of Oriental Medicine(DSOM) for diagnosis and determining pattern identification. Methods This research was approved by the Dongeui University Oriental Hospital Institutional Review Board (certificate no. 2011-06). From March 2012 to October 2012, we examined Kupperman's index, the MENQOL, DSOM, and Sasang Constitution of 291 women from the general population, with ages ranging from 40 to 60 years. And we compared the results statistically by the chi-square test and F-test. Results and Conclusions We excluded 4 Taeyangin to analyze because they were few, and analyzed 287 subjects which were 53 Soyangin, 131 Taeeumin, and 103 Soeumin. 1. The pathogenic factors that showed significant differences were deficiency of qi, insufficiency of Yin, heat on the frequency of the output and deficiency of qi, heat, phlegm on the mean of pathogenic factor score. Deficiency of qi was higher in Soeumin, insufficiency of Yin and heat were higher in Taeeumin, and phlegm was higher in Taeeumin and Soeumin. Overall, Soyangin tended to be lower than others on both the frequency of the output and the mean of pathogenic factor score. 2. The middle aged women with ages ranging from 40 to 60 years tended to be dryness, kidney, damp and became to be blood-deficiency, stagnation of qi, heart easily. Soyangin was more health than others, Taeeumin tended to be heat, phlegm, insufficiency of Yang, and Soeumin tended to be deficiency of qi.

Objectives This study was to examine the differences on alexithymia, rumination, depression and somatic symptoms by each Sasang constitution, and aimed at combining the psychological construct with Korean medical treatment. Methods One hundred eighty men and women aged from 20 to 69 who reside in Geoje-si were selected, and data from 173 people consisting of the three constitutions-Soyangin(39), Taeeumin(83), and Soeumin(51), excepted the minority sample of Taeyangin(7 people)-were analyzed. Collected data were analyzed and tested by IBM SPSS Statistics 20: frequency analysis for demographic data; t-test for gender differences; one-way ANOVA for differences among three constitutions; and Pearson correlation analysis for the correlation between variables. Results The result of t-test taken for the gender differences between variables was not significant. According to the result of one-way ANOVA conducted by different Sasang constitutions, no variables showed a significant result except that of alexithymia. The correlation analysis showed that the alexithymia had positive correlation with rumination, depression, and somatic symptoms. Rumination was in positive correlation with depression and somatic symptoms. Especially, depression had high positive correlation with somatization symptoms. Among the variables analyzed by each constitution, only the survey result of the alexithymia was significant. Conclusions Given that each constitution showed different levels of the alexithymia, it can be concluded that therapeutic intervention in the treatment for the Taeeumin who shows a high level of alexithymia is needed to improve their emotional recognition and expression. In this context, application of program which focus on the emotional ability such as emotion coaching to the Korean medical treatment is expected to improve alexithymia, depression, and somatic symptoms.

Objectives This study aimed to observe the effect of Hyangsayangwi-tang on the cisplatin-induced gastrointestinal dysfunctions in rats. Methods Four groups(each of 8 rats per group) were used in this study. Saline and distilled water treated control rats are Intact vehicle control group. Delayed gatrointestinal mortility was induced by intraperitoneal treatment of cisplatin 2mg/kg, once a week for 5 weeks(Cisplatin control group). Hyangsayangwi-tang aqueous extracts(HY) were orally administered in a volume of 5ml/kg, once a day for 14 days from 4th ciplatin treatmernt(HY group). Ondansetron 1mg/kg was subcutaneously treated, in a volume of 1ml/kg, as same as HY(ondansetron group). We measured the body weights, intestinal charcoal transit ratio, fecal parameters, fundus MDA, GSH contents and SOD, CAT activities, TPH and MAO activities, pyloric gastrin and serotonin contents with their immunoraective cells, colonic serotonin-immunoreactive cells, the histopathology of pylorus, fundus mucosa and colon. Results and Conclusions (1) The body weight gains, the small intestinal charcoal transfer rates, the fecal parameters(numbers, weights and water contents) were increased in HY, ondansetron group. (2) The inhibit of fundus antioxidant defense systems by cisplatin were decreased in HY, ondansetron group. (3) The pyloric TPH activities were increased and the pyloric MAO activities were decreased in HY group. (4) The pyloric gastric contents and the gastrin-immunoreactive cells were increased in HY group. And the pyloric serotonin contents and the pyloric and colonic serotonin-immunoreactive cells were decreased in HY group. (5) The pyloru atrophic changes and the gastric surface erosive damage regions by cisplatin were favorably inhibited by treatment of HY. HY, a representative Soeumin prescription improve GI dysfunctions and constipation retarded by cisplatin through modulations of GI enterochromaffin cells, serotonin and gastrin-producing cells and antioxidative systems. Especially HY showed the highest favorable effects more than those of ondansetron.

Objectives The object of this study was to observe the effects of Hyeongbangjihwhang-tang (HB; Soyangin prescription) on the 5/6 NTX induced CRF rats. Methods Each of Hyeongbangjihwhang-tang aqueous extracts 200mg/kg were orally administered once a day for 35 days from 4 weeks after 5/6 NTX surgery. Four groups, each of 8 rats per group were used in this study, were sham group, CRF group, ${\alpha}$-Tocoperol group and HB group. Changes on the left remnant kidney weights, serum BUN, creatinine levels, caspase-3, PARP immunoreactivities were observed to nephroprotective effects, and relative immunomodulatory effects were monitored based on the changes of lymphatic organ weights and splenic cytokine contents. In addition, the changes on the kidney MDA, GSH contents and SOD, CAT activities were also calculated for antioxidant effects, and the effects on the CRF related cachexia were demonstrated based on the changes of body and epididymal fat pad weights, serum TG, TC, LDL and HDL levels. Results and Conclusions 1) HB was significantly decreased the left remnant kidney weights, serum BUN, creatinine levels and caspase-3, PARP immunoreactivities. 2) HB was significantly increased lymphatic organ weights and splenic cytokine contents. 3) HB was significantly increased body and epididymal fat pad weights, and was significantly decreased serum TG, TC, LDL and HDL levels. 4) HB was significantly decreased MDA contents, and was significantly increased GSH contents and SOD, CAT activities. The results obtained in this study suggest that HB significantly retarded immunosuppressions and cachexia related to the 5/6 NTX induced CRF through modulations of oxidative defense systems. Especially HB showed the highest favorable effects more than those of ${\alpha}$-tocoperol.

Objectives The purpose of this clinical trial was evaluate the safety and efficacy of Mahwangjeongcheon-tang (MJT). Methods Twenty six volunteers were recruited as subjects. They were divided into two groups, which were MJT test group and placebo group. The investigated items related to the safety were the weight, the results of renal function and liver function. The investigated items related to the efficacy are the results of the spirometer, the clinical asthma measurement scale in oriental medicine-V (CAMSOM-V) and the quality of life questionnaire for adult Korean asthmatics (QLQAKA). Results There are no difference in the weight, the results of the renal functions and the liver functions between MJT test group and placebo group. There are the some differences in the result of the questionnaires related to the efficacy between MJT test group and placebo group. The significant difference were observed in the CAMSOM-V at the 4th visit. Conclusion MJT is the safe and effective herbal prescription that is useful to the asthma patients.

Objectives We report a series of 3 chronic tension-type headache cases who were constitutionally typed as the Soeum type, Taeeum type and treated with Dangguibaekhaoguanjung-tang, Chungshimyeonja-tang or Chunghyulganggui-tang. Methods In treating 1 patient who was constitutionally typed as the Soeum type, Case 1 fell into the category of the Taeeum symptomatology, 2 patients who were constitutionally typed as the Taeeum type, Case 2 and Case 3 fell into the category of Dry-Heat symptomatology. Each patient was given Sasang medication according to protocol: Dangguibaekhaoguanjung-tang to Case 1, Chungshimyeonja-tang to Case 2, Chunghyulganggui-tang to Case 3. On admission day and approximately 2 weeks later, patients evaluated their pain and quality of life using SF-36 and HIT-6. The patients symptoms were observed daily and NRS scores were recorded daily. Results and Conclusions 2 Patients(Case1, Case2) showed improvement in their NRS scores, SF-36 scores and HIT-6 scores. 1 patient(Case3) showed improvement in NRS scores, but worse SF-36 scores and no improvement in HIT-6 scores. Treating chronic tension-type headache based on Sasang Constitutional therapy was found to be effective for managing pain. The treatment protocol suggested in this investigation should be explored and verified in future studies.

Objectives The purpose of this study was to evaluate the effects of Soeumin's Bojungikgi-tang, which is based on the Sasang constitutional medicine, for the patient who has suffered from Urinary Disturbance. Methods A 29 year-old woman who suffered from Urinary Disturbance but had no significant organic lesion, was enrolled in this study. The patient had the symptoms including urinary incontinence, pollakiuria, painful urination, discomfort after urinating, general body weakness, chilling sign, and abdominal pain. We diagnosed her as Soeumin Yang Depletion pattern and treated with Soeumin's Bojungikgi-tang. Results After 12 days of admission treatment with Soeumin's Bojungikgi-tang, remarkable improvement was seen on her total number of urination and the Qualiveen Questionnaire score. Conclusions This clinical case indicates that Soeumin's Bojungikgi-tang is effective in treatment of a Soeumin Mang-yang Syndrome, including Urinary Disturbance.

Objectives The purpose of this case study was to report improvement of palpitation, epistaxis, nausea, and anorexia after treatment with Dojeokgangki-tang gamibang in a middle-aged woman who has been taking Panax Ginseng continually. Methods Upon beginning her Dojeokgangki-tang gamibang regimen the patient was asked to self-evaluate the degree of discomfort in her symptoms using a using a number scale from 0 (no symptoms) to 10 (most severe). Evaluation of palpitation and chest discomfort was made a high priority. Results The palpitation the patient experienced, and self-evaluated as an "8" on the number scale at the time of her admission to the hospital, had disappeared (become "0") by the fourth day of hospitalization. The numerous symptoms which accompanied her palpitations (chest discomfort, nausea, anorexia, general weakness, weight loss, and depression) also improved accordingly. Conclusions Health functional food can pose serious health risks such as sudden bleeding and palpitations in individuals with pre-existing health problems. One must exercise extreme caution in deciding to take such supplements. As seen in the case of the middle-aged woman, the quality of life of patients who had experienced adverse reactions to such supplements can be treated through the administration of Dojeokgangki-tang gamibang.

Objectives The purpose of this case study was to report the main effect of Yangdokbaekho-tang to a Soyangin atopic dermatitis patient. Methods This patient was treated by Yangdokbaekho-tang, topical herbal extract, moxa and acupuncture according to the result of Sasang constitutional diagnosis. Results and Conclusions The patient's subjective symptoms of atopic dermatitis and general condition were improved after using Yangdokbaekho-tang in spite of patient's loose stool. The SCORAD index (Scoring Atopic Dermatitis Severity Index) which was used to evaluate the therapeutic effect of Sasang constitutional treatment on atopic dermatitis was also decreased from 86.3 to 42.8 without using anti-histamine or steroid medications.

Objectives The purpose of this case study was to evaluate the effects of Sasang Constitutional diagnosis and treatment of recurrent gastric cancer patient. Methods Nausea and vomiting of recurrent gastric cancer patient was diagnosed Soyangin Emheooyol Pattern based on their Nature & Emotion, physical characteristics, symptoms. He was medicated dokhwaljihwang-tanggami. Results and Conclusions Nausea and vomiting of recurrent gastric cancer patient who was treated with Dokhwaljihwang-tanggami showed improvement in nausea vomiting appetite loss and general condition. This case study describe the effectiveness on Nausea and vomiting of Recurrent Gastric Cancer Patient by using Dokhwaljihwang-tanggami.

Objectives Despite the treatment with antibiotics, patients with sepsis has a high mortality (80%) in the underlying disease group. The aim of this study was to report the improvement of septic condition of the cholangiocarcinoma patient after the treatment with Handayeolso-tang, Fel Tauri, and antibiotics. Methods We retrospectively reviewed the medical records. The patient's subjective symptoms such as chilling and abdominal pain were evaluated by NRS and the performance status was evaluated by ECOG. This case was literally compared with relevant published studies on prognosis of sepsis. Results Despite poor prognostic factor(MEDS score 18), the patient's symptoms such as fever, chilling, abdominal pain, and diarrhea and ECOG(Eastern Cooperative Oncology Group) improved. The patient was hemodynamically stabilized on 3rd day from the treatment, and her laboratory test results were normalized on 7th day. Conclusions A female patient of metastatic cholangiocarcinoma came to the hospital for cholangitis, later causing septic shock. Both her symptoms and laboratory tests showed significant improvement after the treatment of antibiotics, Handayeolso-tang and Fel Tauri. To our knowledge, this is the first case reporting the synergistic combination of Korean oriental medicine and Western medicine approaching to sepsis.

Objectives This case study was about a Taeeumin patient with advanced Parkinson's disease diagnosed as Dry-heat symptomatic pattern. In this study, we reported significant improvement of motor and non-motor symptoms of this patient after Sasang constitutional medicine treatment. Methods The patient was diagnosed with Taeeumin Dry-heat symptomatic pattern and treated with Taeeumin's constitutional medications and acupuncture. The primary outcome measure for this study is Unified Parkinson Disease Rating Scale(UPDRS) to assess the overall function of patient. Secondary outcome assessments include Global Assessment Scale(GAS), change of patient's sleep, stool and urine. Results and Conclusions The patient treated with Taeeumin's constitutional medications and acupuncture had reduction in UPDRS (specifically Part II, Part III and Part IV) and GAS of motor symptoms. Furthermore, patient's sleep, stool and urine were reported to be normal after treatment. In conclusion, this study shows that Sasang constitutional medicine can be effective treatment for Taeeumin patient with Advanced Parkinson's disease diagnosed as Dry-heat symptomatic pattern.