• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.2
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• pp.29-49
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• 2019

Objectives: This study was a methodological study to verify the reliability and validity and to make a diagnosis of a diagnostic tool for climacteric and postmenopausal syndrome pattern identification (CaPSPI). Methods: This study was conducted from June 1, 2018 to October 18, 2018 with ${{\bigcirc}{\bigcirc}}$ University Korean Medicine Hospital IRB's approval (2018-3). To make a diagnosis using CaPSPI, we decided the cut-points for the tool. Three professors of ${{\bigcirc}{\bigcirc}}$Korean Medical University conducted pattern identification diagnosis. The result is marked from 0 to 3, 0 is 'No', 1 is 'Slightly Yes', 2 is 'Yes' and 3 is 'Very Yes'. And if two or more professors' diagnoses are the same, we took the diagnoses as a diagnostic criteria. The decision of pattern by three experts converted to 0-1 scores in two ways. In "method 1", if the diagnosis was zero points, the score was 0 (have no such identification), and the rest was 1 (have such identification). In "method 2", if the diagnosis was zero or 1 point, the score was 0, and the rest was 1. After that, intraclass correlation was calculated for experts agreement. And logistic regression was conducted. A response variable was the results of the experts' diagnosis and an explanatory variable was the results of the pattern identification diagnostic tool. Results: The diagnosis of the three experts showed excellent concordance of more than 0.794 and showed a significant correlation with the diagnostic tool. Both 'Method 1' and 'Method 2' showed statistically significant effects with the diagnosis of 3 experts and the results of the diagnostic tool. The frequency of cumulative pattern identification diagnosis in 'Method 1' and 'Method 2' were found to be 578 occasions and 203 occasions, respectively. The average number of pattern held by participants in 'Method 1' and 'Method 2' were found to be 5.26 and 1.85, respectively. In both "Method 1" and "Method 2," the yield frequency of liver qi depression was the highest, and the frequency of kidney yin deficiency and liver-kidney yin deficiency was relatively high. Conclusions: Based on the above results, it is thought that, in diagnosis using CaPSPI of menopausal women, 'method 1' could be used for the health diagnosis and prevention, 'method 2' could be used for the pattern diagnosis. On the conclusion, CaPSPI is thought to be available for pattern diagnosis of menopause women.

• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.1
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• pp.1-14
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• 2021

Objectives: We studied for the adjustment of the patterns of 'The Diagnostic Tool for Climacteric and Postmenopausal Syndrome Pattern Identification (hereinafter CaPSPI)' (studyI) and the correlation between CaPSPI and Korean medicine doctors' diagnosis which was carried out without knowing the results of CaPSPI (studyII). Methods: The studyI followed the previous study method in 2018 (2018-3). The studyII was conducted from June 1, 2019 to July 10, 2020 with ◯◯ University Korean Medicine Hospital IRB's approval (2019-4). Doctors' diagnosis was conducted face-to-face with the subjects. Doctors' diagnosis was carried out based on the Kupperman's questionnaire, 'Diagnosis System of Oriental Medicine (hereinafter DSOM)' and four examinations (四診) records. The diagnosis was marked with 0 for 'no', 1 for 'somewhat', 2 for 'yes' and 3 for 'very yes'. The correlation between CaPSPI and the mean of doctors diagnostic scores were investigated statistically. Results: The studyI showed that heart-heat (心火) pattern was added. The Factor loading coefficient for heart-heat was 0.551 to 0.789, and the Cronbach's coefficient was 0.896. The studyII showed that the diagnosis (Kappa statistic) of two doctors showed statistically significant concordance (all eight patterns), with correlation of them were 0.3 or higher. And the correlation between the CaPSPI score and the mean of doctors' diagnostic score showed a statistically significant correlation, with liver qi depression (肝鬱) being the highest at 0.552 and dual deficiency of the heart-spleen (心脾兩虛) being the lowest at 0.301. Conclusions: Since the diagnosis results of CaPSPI showed a significant correlation with the diagnosis of Korean traditional medicine experts, it was believed that the CaPSPI results can be trusted and used for clinical purposes.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.3
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• pp.215-230
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• 2006

Purpose : To evaluate the clinical use of the menopause-specific quality of life questionnaire(MENQOL) for scoring menopausal symptoms by comparison with the conventional Kupperman's index. Methods : A population sample of 66 women was randomly selected from the female patients(aged 45-55) who had visited two oriental medical clinic in Seoul or Woo-Shin-Hwang oriental hospital from 1st April to 15th May in 2006. They completed both the MENQOL and the Kupperman's index and were asked a few additional questions. Results : 1. A degree of the Climacteric symptoms were not significantly related to either an education level or an income level. 2. A comparison of the MENQOL with the Kupperman's index produced a high positive correlation. 3. 41 of subjects (62.1%) answered that the MENQOL was more efficient for explaining their symptoms than the Kupperman's index. 49 (74.2%) of subject thought that both questionnaires are equally not difficult to fill out and 44(66.7%) of subject found no difficult questions to answer in any of questionnaires. Conclusion : The MENQOL is a valuable modern tool for the assessment of climacteric symptoms in place of the Kupperman's index. The MENQOL was excellent in applicability. The MENQOL could serve as an adequate diagnostic instrument for climacteric symptoms.

• The Journal of Korean Obstetrics and Gynecology
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• v.28 no.4
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• pp.57-64
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• 2015

Objectives : To study correlation between Digital Infrared Thermal Imaging, Kupperman’s Index (KI) and Menopause Rating Scale (MRS) of Postmenopausal Women Methods : We analyzed 114 patients visiting Pohang Oriental Hospital from 1 ^st January 2014 to 30 ^th September 2015. The evaluating indexed of this trial were Age, DITI, KI, MRS. Temperature and different of temperature, such as In-dang (HN3), dan-Jung (CV17), gwan-won (CV4), hyup-back (LU4), no-gung (PC8), bock-to (ST31), and tae-chung (LR3). Results : Age was no correlation with DITI, KI, and MRS. There were positive correlation with KI and MRS significantly. DITI was not correlated with Age, KI and MRS, while ⊿T1 (LU4-PC8) was correlated with ⊿T2 (ST31-LR3) and ⊿T3 (CV17-CV4). Conclusions : There were non-significant correlation between DITI and Menopausal scale, but significant correlation in DITI themselves, Menopausal themselves. The More studies ar needed for the more accurate oriental medical diagnosis

• Proceedings of the Ginseng society Conference
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• 2002.10a
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• pp.176-184
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• 2002

Objective; Antistress effect of Korean red ginseng (RG) on postmenopausal women with severe climacteric syndrome (CS) were evaluated from the viewpoint of traditional KAMPO-medicine and Western medicine. Methods; All patients with CS were treated with daily oral administration of 6g RG for 30 days. Nine patients with CS were evaluated with the use of diagnostic scores for KI-deficiency (deficiency of vital energy) and OKETSU (blood stagnation) syndrome from the viewpoint of KAMPa-medicine. In the same patients with CS, peripheral blood levels of $\beta$-endorphin and total plasminogen activator inhibitor-1 (t-PAI-1) were measured before and after treatment with RG. In another group, 12 patients with CS, psychological test using CMI, STAI and SDS were performed from the viewpoint of Western medicine. Stress related hormones, such as ACTH, cortisol and DHEA-S in those 12 patients with CS were also measured before and after treatment with RG. Results; KI-deficiency score and OKETSU score in patients with CS were significantly (p<0.001) higher than those in patients without CS. After treatment with RG, both scores were markedly (p<0.001) decreased compared to before treatment with RG. ${\beta}-endorphin$ levels in patients with CS were significantly (p<0.05) higher than those in patients without CS. Total PAI-I levels in patients with CS were increased before treatment with RG. No significant difference, however, were observed between patients with and without CS. After treatment with RG, both levels of ${\beta}-endorphin$ and total PAI-l in patients with CS were significantly (p<0.01 and p<0.05, respectively) decreased compared to before treatment with RG. CMI and STAI scores in patients with CS were significantly (p<0.05) higher than those in patients without CS. SDS scores in patients with CS were also markedly (p<0.001) higher than in those without CS. After treatment with RG, all scores decreased within normal range. DHEA-S levels in patients with CS were about a half of those without CS. Consequently, cortisol/DHEA-S (C/D) ratio was significantly (p<0.001) higher in patients with CS than in those without CS. Although the decreased DHEA-S levels were not restored to the levels in patients without CS, the C/D ratio decreased significantly (p<0.05) after treatment with RG. Conclusion; Reinforcement of vital energy and improvement of stagnant blood circulations by oral administration of RG were elucidated from the viewpoint of traditional KAMPO-medicine. From the viewpoint of Western medicine, effect of RG on postmenopausal women with CS seemed to be brought about in part by not only an improvement of psychoneuroendocrine dysfunctions but also an amelioration of blood coagulation systems.

• Journal of Ginseng Research
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• v.27 no.3
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• pp.110-114
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• 2003

Objective; Antistress effect of Korean red ginseng (RG) on postmenopausal women with severe climacteric syndrome (CS) were evaluated from the viewpoint of traditional KAMPO-medicine and Western medicine. Methods; All patients with CS were treated with daily oral administration of 6g RG for 30 days. Nine patients with CS were evaluated with the use of diagnostic scores for KI-deficiency (deficiency of vital energy) and OKETSU (blood stagnation) syndrome from the viewpoint of KAMPO-medicine. In the same patients with CS, peripheral blood levels of ${\beta}$-endorphin and total plasminogen activator inhibitor-1 (t-PAI-1) were measured before and after treatment with RG. In another group, 12 patients with CS, psychological test using CMI, STAI and SDS were performed from the viewpoint of Western medicine. Stress related hormones, such as ACTH, cortisol and DHEA-S in those 12 patients with CS were also measured before and after treatment with RG. Results; KI-deficiency score and OKETSU score in patients with CS were significantly (p<0.001) higher than those in patients without CS. After treatment with RG, both scores were markedly (p<0.001) decreased compared to before treatment with RG. ${\beta}$-endorphin levels in patients with CS were significantly (p<0.05) higher than those in patients without CS. Total PAI-levels in patients with CS were increased before treatment with RG. No significant difference, however, were observed between patients with and without CS. After treatment with RG, both levels of ${\beta}$-endorphin and total PAI-1 in patients with CS were significantly (p<0.001 and p<0.05, respectively) decreased compared to before treatment with RG. CMI and STAI scores in patients with CS were significantly (p<0.05) higher than those in patients without CS. SDS scores in patients with CS were also markedly (p<0.00l) higher than in those without CS. After treatment with RG, all scores decreased within normal range. DHEA-S levels in patients with CS were about a half of those without CS. Consequently, cortisol/DHEA-S (C/D) ratio was significantly(p<0.001) higher in patients with CS than in those without CS. Although the decreased DHEA-S levels were not restored to the levels in patients without CS, the C/D ratio decreased significantly (p<0.05) after treatment with RG. Conclusion; Reinforcement of vital energy and improvement of stagnant blood circulations by oral administration of RG were elucidated from the viewpoint of traditional KAMPO-medicine. From the viewpoint of Western medicine, effect of RG on postmenopsusal women with CS seemed to be brought about in part by not only an improvement of psychoneuroendocrine dysfunctions but also an amelioration of blood coagulation systems.

• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.2
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• pp.70-86
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• 2022

Objectives: This study attempted to provide prescriptions that can be used according to the classification of menopausal disorders in order to increase the clinical utilization of CaPSPI (Diagnostic System for Climacteric and Postmenopausal Syndrome Pattern Identification). Methods: Delphi method survey was conducted for expert consensus on the Pattern Identification that could be used for each prescription by selecting frequent prescriptions based on the literature researched on the prescription of Korean medicine used for women with menopausal disorders. 11 experts participated in the questionnaire for posterity and 7 experts for sasang constitution. The survey was divided into the main prescription that can be mainly used for the patterns and the minor prescription that can be used although the suitability is somewhat low. Expert consensus was obtained through the second survey, and the pattern classification of prescriptions that were not confirmed here was confirmed through a face-to-face meeting. Results: There were 56 prescriptions mainly used for treatment for menopause, 45 for posterity and 11 for Sasang constitution. There were 69 identifications of 45 posterity prescriptions and 17 classifications of 11 Sasang constitutional prescriptions including major and minor patterns. By pattern identifications, the number of major/minor prescriptions was as follows. 肝鬱 14/5, 腎陰虛 8/2, 腎陽虛 4/1, 肝腎陰虛 2/7, 腎陰陽兩虛 3/1, 心腎不交 6/3, 心脾兩虛 15/2, 心火 7/6. Conclusions: In the future, by accumulating and analyzing the data on the diagnosis and treatment using CaPSPI, the clinical status of Korean medicine for menopausal disorders can be reviewed, and it can be used as the basis for the clinical practice guidelines for menopausal disorders. In addition, it is thought that analyzing the results of the diagnosis of pattern identifications and the prescription of Sasang constitution can be helpful in research on the posterity and Sasang constitution.

• Journal of Acupuncture Research
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• v.22 no.1
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• pp.117-130
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• 2005

Objective : Generation after generation, by Oriental medicine literatures, Soyo-san has been used as a clinical prescription that is important to climacteric syndrome, and also has been used extensively to psyco-neurotic problems, melancholia and stress symptoms. The experimental study of Soyo-san's effect has been reported, but the effect of herbal acupuncture solution by Soyo-san is not reported yet. Thus the purpose of this experiment is to test whether Herbal acupuncture of Soyo-san have anti-stress or antidepressant effects in the menopause or not. Methods : Female Sprague-Dawley(240-260g) rats were used. Temperature controlled within $20-25^{\circ}C$. Water and food not limited, and Manipulated the day and night 12 hours each. In the experiment, enforced Morris water maze after immobilization stress for 5 minutes, and operating Herbal acupuncture of Soyo-san 30 minutes before stress every day during 7 days. Flowed through by 4% paraformaldehyde and fixed brain tissue after test of 7 days. Results : 1) As a result of the acquisition test, Soyo-san group was recognized by significant difference compared to Ovx group and the retention test Soyo-san group increased significantly compared to Sham and Ovx group. 2) Soyo-san group showed that the degree of revealation of Tyrosine hydroxylase decreased comparing to Ovx group in ventral tegmental area and that of Choline acetyltransferase increased comparing to Ovx group in CAI region of Hippocampus. Conclusion : As a result of this experiment to grasp those effects on postmenopausal depression or learing disability and memory disorder, the possibility of Herbal acupunture by Soyo-san is warranted as a suitable treatment to relieve women's monopausal depression and those of stress reaction, improving tearing disability and memory disorder.