• 제목/요약/키워드: Phlegm-fire.

검색결과 132건 처리시간 0.025초

다기관 임상연구를 통해 도출된 중풍변증표준안의 진단프로그램개발에 관한 연구- I (Study for Diagnosing Program of Korean Standard Differentiation of the Symptoms and Signs for the Stroke by Multi Center Trials- I)

  • 박세욱;강병갑;장인수;홍석;한창호;권정남;선승호;전찬용;조기호;박세진;이인;설인찬;최선미
    • 대한한의학회지
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    • 제28권3호통권71호
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    • pp.126-137
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    • 2007
  • Objectives : Standardization of pattern identification for stroke and development of a diagnostic tool for Korean medicine. Methods : We organized a committee for stroke diagnosis standardization of Korean traditional medicine and submitted the Korean standard differentiation of the symptoms and signs for stroke (KSDSS). We collected cases through a multi-center network consisting of twelve university hospitals and one local hospital. We analyzed the data with discriminant function and logistic regression. Results : 321 cases were confirmed by diagnosis of medical specialists and residents. They were divided into qi deficiency 30.84%, dampness & phlegm 25.55%, fire & heat 22.43%, eum deficiency 18.69% and blood stasis 2.49%. The accordance rate between discriminant function and doctor's diagnosis was calculated. Conclusions : To make a stroke diagnostic program, we must raise the accordance rate between doctor's diagnosis and the program.

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한의 중풍 변증 표준화 연구에서 어혈증에 관한 고찰 (A Review of Static Blood Pattern in Stroke Pattern Diagnosis)

  • 이정섭;김소연;강병갑;고미미;김정철;오달석;김윤식;이인;조기호;전찬용;한창호;방옥선
    • 대한한방내과학회지
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    • 제30권4호
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    • pp.813-820
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    • 2009
  • Background : Static blood is a kind of etiological factor including stagnated blood and blood overflowed out of the vessels. It is one of the causes of stroke in oriental medicine. Objectives : The purpose of this study was to evaluate the static blood pattern and its indicators in stroke pattern diagnosis. Methods : For the standardization of pattern diagnosis in stroke, we set 5 patterns (Fire-heat, Dampness-phlegm, Static blood, Qi deficiency, Yin deficiency) and developed 61 indicators. Patients with a first-ever stroke, within 1 month after the onset of stroke. Two physicians checked the indicators independently. They then performed pattern diagnosis and rechecked the indicators which were referred to pattern diagnosis. If pattern identifications were diagnosed the same, it would confirm pattern identification. We examined the frequency of all indicators and referred indicators in static blood pattern patients. Results : In 859 patients, static blood pattern was shared by 24(2.8%). The indicators which affect static blood pattern were mainly rough pulse and bluish purple tongue, other indicators were not major effectors. Conclusion : This result shows that it is inconsistent to set up static blood pattern as a major pattern in stroke. Nevertheless, static blood is still a valuable concept in the clinical field. Other study methods will be required to establish the pattern diagnostic indicators for static blood pattern.

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60세 이상 뇌경색환자에서 황태는 심혈관질환의 유용한 지표가 될 수 있는가? - 다기관임상연구 (Can Yellow Fur on the Tongue be Useful as an Index of Cardiovascular Disease in Stroke Patients over 60 Years Old? - Multi Center Trial)

  • 임정태;박수경;우수경;곽승혁;정우상;문상관;조기호;박성욱;고창남
    • 대한한방내과학회지
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    • 제31권3호
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    • pp.569-577
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    • 2010
  • Background & Objectives : Yellow fur on the tongue is known to be associated with prognosis of disease in oriental medicine. Higher ratios of low-density lipoprotein cholesterol(LDL) to high-density lipoprotein cholesterol(HDL) & total cholesterol (TC) to high-density lipoprotein cholesterol(HDL) are associated with a greater risk of cardiovascular disease. The aim of this study was to assess the relationship between cardiovascular disease index and yellow fur - oriental medical index - in stroke patients over 60 years old. Methods & Subjects : Among 802 of the recruited patients(434 male, 368 female), 340 were yellow fur group(209 male, 131 female). We assessed their general characteristics and risk factors. We compared the cardiovascular disease index between yellow fur and non-yellow fur groups by sex. Results : On the General Characteristics males have yellow fur more often than females. In cardiovascular disease index, the male yellow fur group showed higher ratios of TC/HDL(atherogenic index), (TC-HDL)/HDL, LDL/HDL and higher LDL and showed lower HDL than the non-yellow fur group. In female patients, there were no differences between the two groups about cardiovascular disease index. There were more patients diagnosed with Fire & Heat in the male yellow fur group, and Dampness & Phlegm in the male non-yellow fur group. The male yellow fur group eat fast food more than the non-yellow fur group. Conclusions : The results indicated that yellow fur may be associated with a high risk of cardiovascular disease. We can thus use yellow fur on the tongue as a cardiovascular disease index in male stroke patients over 60 years old.

성별을 고려한 중풍 변증진단 판별모형개발(V) (Discriminant Model V for Syndrome Differentiation Diagnosis based on Sex in Stroke Patients)

  • 강병갑;이정섭;고미미;권세혁;방옥선
    • 동의생리병리학회지
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    • 제25권1호
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    • pp.138-143
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    • 2011
  • In spite of abundant clinical resources of stroke patients, the objective and logical data analyses or diagnostic systems were not established in oriental medicine. As a part of researches for standardization and objectification of differentiation of syndromes for stroke, in this present study, we tried to develop the statistical diagnostic tool discriminating the 4 subtypes of syndrome differentiation using the essential indices considering the sex. Discriminant analysis was carried out using clinical data collected from 1,448 stroke patients who was identically diagnosed for the syndrome differentiation subtypes diagnosed by two clinical experts with more than 3 year experiences. Empirical discriminant model(V) for different sex was constructed using 61 significant symptoms and sign indices selected by stepwise selection. We comparison. We make comparison a between discriminant model(V) and discriminant model(IV) using 33 significant symptoms and sign indices selected by stepwise selection. Development of statistical diagnostic tool discriminating 4 subtypes by sex : The discriminant model with the 24 significant indices in women and the 19 significant indices in men was developed for discriminating the 4 subtypes of syndrome differentiation including phlegm-dampness, qi-deficiency, yin-deficiency and fire-heat. Diagnostic accuracy and prediction rate of syndrome differentiation by sex : The overall diagnostic accuracy and prediction rate of 4 syndrome differentiation subtypes using 24 symptom and sign indices was 74.63%(403/540) and 68.46%(89/130) in women, 19 symptom and sign indices was 72.05%(446/619) and 70.44%(112/159) in men. These results are almost same as those of that the overall diagnostic accuracy(73.68%) and prediction rate(70.59%) are analyzed by the discriminant model(IV) using 33 symptom and sign indices selected by stepwise selection. Considering sex, the statistical discriminant model(V) with significant 24 symptom and sign indices in women and 19 symptom and sign indices in men, instead of 33 indices would be used in the field of oriental medicine contributing to the objectification of syndrome differentiation with parsimony rule.

급성기 뇌경색 환자에서 Scandinavian Stroke Scale과 Motricity Index 간의 상관관계에 대한 연구 (The Correlation between the Scandinavian Stroke Scale and the Motricity Index in Acute Cerebral Infarction Patient)

  • 이영은;;노현석;이동혁;양승보;이현중;조승연;박성욱;정우상;문상관;박정미;조기호;고창남
    • 대한한방내과학회지
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    • 제36권2호
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    • pp.93-104
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    • 2015
  • Objectives: This study examined the correlation between the Scandinavian Stroke Scale (SSS) and the Motricity Index (MI) in acute cerebral infarction patients. Methods: We studied 75 inpatients within a month after the onset of cerebral infarction; patients were recruited from July 2012 to November 2013. We analyzed the correlation between changes in SSS and MI by pattern identification. Results: A significant moderate positive linear correlation was noted between SSS and MI in the total patient cohort and in a Fire-heat group, Dampness-phlegm group, Qi deficiency group, and Deficiency syndrome group. A significant strong positive linear correlation existed between SSS and MI in the Excess syndrome group. The Yin deficiency group showed a weak positive linear correlation, but it was not statistically significant. Conclusions: This study provides evidence that the correlation between SSS and MI in acute cerebral infarction patients could differ depending on pattern identification.

불면증(不眠症)의 병인병리(病因病理)에 관한 문헌고찰 (Literatual Study on Pathology of Insomnia)

  • 최재홍;이동원
    • 동의신경정신과학회지
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    • 제12궈1호
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    • pp.81-95
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    • 2001
  • Though, these days there are increasing many patient of insomnia, there was not considered literatual study on insomnia. So, the result of consideration about cause and process of insomnia from thirty kinds of literatures, are as follows. 1. Early literature like Huangjaenankyung(黃帝內經), Sanghanron(傷寒論) reffered to insomnia as accompanying symptom. on the other hand, Myung(明), Chung(淸)'s literatures reffered to that as chief symptom or distinguished chief symptom from accompanying symptom. 2. There were tendency of deductive expanding of various masters and tendency of induction of simple theory that was based on Huangjaenankyung(黃帝內經). 3. Huangjaenankyung(黃帝內經) showed basic process of the sleep disorder that 'exhausting of Yin and excess of Yang (陰盡陽盛)', protecting energy does not invade Yin portion(陽氣不入於陰). And Huangjaenankyung(黃帝內經) showed cause of insomnia that deficiency of vital energy and blood, imbalanced of spleen and stomach, a fever as a invasion in the outside, lung system's disease. This became a basic cause and process of the sleep disorder in ancient period. 4. Sanghanron(傷寒論) occurred to insomnia as accompanying symptom in progress, remedy of a fever invaded outside, Kumkyeyoriak showed as origination in weakness, fatique, various diseases. Out of that, there is a significance in description of insomnia from some disease like histery or neurosis. 5. Jaebyungwonhuron(諸病源候論), Chunkumbang(千金方), Kukbangseo(局方書.) occured to a fire of heart(心慤) and a deficiency of heart and gall bladder(心膽虛) in defails. Insomnia is caused by agony of seven emotion, delivering of a child, are similar to insomnia is caused by psychologic disorders. Injaesanghanyusu(仁劑傷寒類書) occured to exhausting of Yin and excess of Yang (陰盡陽盛), imbalanced of stomach(胃不和) invasion of coldness(傷寒) are brought a conclusion of assumption of sap(津液耗損) brought about unreturn of yin energy. 6. Manbyunghuechum(萬病回春) in Myung period (明代) made much of portion of phlegm's influence about spiritual function. Kyungakjunsu(景岳全書) valued much of treatment divided according to excess and deficiency. Junginmaekchi(證因脈治) occurred to concept of pyorihesil(表裏虛實), Dongyibokam(東醫寶鑑) synthesised various theories. 7. Hyuljungron(血證論), Byunjungkimun(辨證奇聞), Suksilbirok(石室秘錄) made much of surprisemeni(驚恐) Consideration(思慮), liver's dryness(肝燥) is caused by liver's weakness(肝虛), imbalance of haert -kidney(心腎不交), seven emotion(七情). Especially, ftyujungchijae(類證治載) said that heart, liver, gall-bladder, kidney, surprisment, consideration baought to a conclusion of inbalance of Yang and Yin (陽不交陰). There is a tendency in literature mostly that literature showed separation of insomnia as a chief symptom. 8. These days there are increasing many patient of insomnia. So, it is needed to study about insomnia as a psychologic disease. Saying in conclusion, it is needed that we have to recognize in modern style based on ancient style of cause and process of insomnia. It is regarded to study about insomnia definitely and experimently.

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치통(齒痛)의 병인병기(病因病機) 및 침구치료(鍼灸治療)에 대(對)한 문헌적(文獻的) 고찰(考察) (The Literature Study on Classification of Cause and the Effect of Acupuncture and Moxibustion Treatment for Dentalgia)

  • 이성노;이현;이병렬
    • 혜화의학회지
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    • 제10권1호
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    • pp.269-286
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    • 2001
  • Objectives : This Investigation was aimed to find out the Classification of Cause and the Effect of Acupuncture and Moxibustion Treatment for Dentalgia Methods : We surveyed the oriental medical books from $\ll$HungTiNeiChing$\gg$ to recent published books concerning the Acupuncture therapy for Dentalgia Results : 1. Since the time of $\ll$HungTiNeiChing$\gg$ there was called "yateng", "yatong", "chiyaqutong", "kouchitong", "nichi", "chichong", "fengchi", "chongshitong", "chongshiyachi", "chifengzhongtong", "chiyinzhong", "yachuangzhongtong" 2. The Oriental Medical cause of Dentalgia are fire, wind, cold, blood stasis, stomach-heat, phlegm, difficiency of kidney, late snack, insect and wound, and then the Western Medical cause are cacodontia, periodontal disease, trigeminal nerve pain, stress 3. The meridians used for the treatment are large intestine, stomach, triple warmer, gallbladder and small intestine 4. The most frequently used acupuncture point for the treatment are Hapkok(LI3), Naejong(S44), Hyopko(S6), Igan(LI2), Sohae(H3), Yanggok(SI5), Hagan(S7), Taeyong(S5), Samgan(LI3), Kokehi(LI11) 5. The most frequently used moxibustion for the treatment are Sungjang(CV24), Yolgyol(L7), Kyonu(LI15), Taeyon(L9), Hapkok(LI3) 6. In the superior dental pain there commonly used the acupuncture point of stomach meridian, triple warmer meridian, gallbladder meridian in the inferior dental pain there commonly used the acupuncture point of large intestine meridian. 7. The most frequently used acupuncture point for the superior dental pain are Naejong(ST44), Yanggok(SI5), Chongnyong(G17), Kakson(TE20), In the inferior detal pain there are Taeyong(S5), Hapkok(LI3), Igan(LI2), Sangyang(LI1), Samgan(LI3) 8. In the treatment of dental pain The Acupuncture therapy utilized the division of region are the Erzhen therapy(耳針療法), the Touzhen therapy(頭鍼療法), the Shouzhen therapy(手鍼療法), the Zuzhen therapy(足鍼療法), the Bizhen therapy(鼻針療法), the Wanhuaizhen therapy 9. In dental pain the other therapy are the Taozhen therapy(陶鍼療法), the Pifuzhen therapy(皮膚針療法), the Dianzhen therapy(電鍼療法), the Yaozhen therapy(藥針療法).

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주의력결핍 과잉행동장애(ADHD) 한의 변증 설문지 개발 연구 (Development of Pattern Identification Questionnaire for Attention-Deficit/Hyperactivity Disorder (ADHD) in Korean Medicine)

  • 안윤영;정민정;김미연;김락형
    • 동의신경정신과학회지
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    • 제30권1호
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    • pp.1-11
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    • 2019
  • Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity impulsivity that interferes with function or development in children. In traditional Korean medicine (TKM) and traditional Chinese medicine (TCM), ADHD is classified by several patterns based on symptoms and signs. However, currently, there is no objective diagnostic tool for ADHD in traditional medicine. The objective of this study was to develop the Pattern Identification Questionnaire for ADHD (parents-survey style) to be used in Korean medicine, through a literature review and consultation with groups of experts. Methods: The types of pattern identifications of ADHD mentioned in 13 pieces of Korean and Chinese literatures and their symptoms and signs were analyzed. The advisory committee (15 Neuropsychiatrist and 11 Pediatrist in Korean Medicine) assessed the appropriateness of the literature selection and the types of pattern identification selection and their symptoms and signs, and weighed the significance of the symptoms and signs. The Pattern Identification Questionnaire for ADHD was developed using the calculated weights by evaluated significance. The translation of symptoms and signs to the Korean language was achieved through consultation with expert translators. Results: 1. Four pattern identification types and their symptoms and signs were selected according to frequency of appearance in the Korean and Chinese literatures, and were reviewed by the advisory committee: Kidney yin deficiency and liver yang ascendant hyperactivity (腎虛肝亢), Dual deficiencies in the heart and spleen (心脾兩虛), Phlegm-fire harassing the heart (痰火擾心), and Spleen weakness and liver energy preponderance (脾虛肝旺). 2. The weights of all the symptoms and signs in the four patterns were calculated using the means and standard deviations of the symptoms and signs' importance that were obtained from specialists' significance weighting. 3. The Pattern Identification Questionnaire for ADHD (parents-survey style) in Korean medicine composed of 38 questions was suggested. Conclusions: Using a review of the literature and expert advice, Pattern Identification Questionnaire for ADHD (parents-survey style) in Korean medicine was developed. Further clinical study is required to develop a final version of the questionnaire through the evaluation of reliability and validity.

급성기 뇌경색 환자에 있어 변증형별 유의한 임상지표의 분석 (Analysis of Clinical Indicators related to Pattern-Identification in Acute Cerebral Infarction Patient)

  • 이은찬;현상호;곽승혁;우수경;박주영;정우상;문상관;조기호;박성욱;고창남
    • 대한중풍순환신경학회지
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    • 제13권1호
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    • pp.33-42
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    • 2012
  • Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.

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불면증 변증도구 신뢰도와 타당도 평가 및 심리검사와의 상관성에 대한 초기연구 (A Pilot Study of Evaluating the Reliability and Validity of Pattern Identification Tool for Insomnia and Analyzing Correlation with Psychological Tests)

  • 정진형;이지윤;김주연;김시연;강위창;임정화;김보경;정인철
    • 동의신경정신과학회지
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    • 제31권1호
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    • pp.1-12
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    • 2020
  • Objectives: The purpose of this study was to evaluate the reliability and validity of the instrument on pattern identification for insomnia (PIT-Insomnia) and verify the correlation between PIT-Insomnia and psychological tests. Methods: Two evaluators examined the pattern identification of the participants who met insomnia disorder diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) and took the Insomnia Severity Index (ISI) score over 15 once manually and twice using the PIT-Insomnia to measure the inter-rater and test-retest reliability. We also conducted the following surveys: the Pittsburgh Sleep Quality Index (PSQI), the Korean version of Beck's depression inventory (K-BDI), the Korean version of the State-Trait Anxiety Inventory (STAI-K), the Korean Symptom checklist-95 (KSCL-95), and the EuroQol-5 dimension (EQ-5D), to measure concurrent validity and correlation between the PTI-Insomnia and psychological tests. Results: 1. The test-retest reliability analysis of the pattern identification results showed moderate agreement, and test-retest reliability analysis of each pattern identification score showed agreements from poor to moderate. 2. The inter-rater reliability analysis of the pattern identification results via manual showed slight agreement, when analysis was performed with calibration, the inter-rater reliability analysis of the pattern identification results via manual showed fair agreement. 3. The concordance analysis between results via manual and the PIT-Insomnia showed poor agreement, when the analysis was performed with calibration, concordance analysis showed fair agreement. 4. The concordance analysis between the PIT-Insomnia and the PSQI showed positive linear correlation. 5. The concordance analysis between the PIT-Insomnia and the PSQI, K-BDI, STAI-K, KSCL-95, and EQ-5D showed that non-interaction between the heart and kidney have positive linear correlation with the K-BDI, anxiety item of KSCL-95, dual deficiency of the heart-spleen have positive linear correlation with somatization item of KSCL-95, paranoia item of KSCL-95, heart deficiency with timidity have positive linear correlation with stress vulnerability item of KSCL-95, parania item of KSCL-95, phlegm-fire harassing the heart have positive linear correlation with K-BDI, paranoia item of KSCL-95, depressed liver qi transforming into fire have positive linear correlation with the anxiety item of KSCL-95, parania item of KSCL-95, all pattern identification have negative linear correlation with EQ-5D. Conclusions: The PIT-Insomnia has moderate agreement of reliability and reflects the severity of insomnia since it has some concurrent validity with the PSQI. There are some correlations between the PTI-Insomnia with specific psychological tests, so we could suggest it can be used appropriately in the clinical situation.