• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.5
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• pp.964-968
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• 2009

The purpose of this study is to select the major pulse indicators and evaluate their significance in discriminating the subtypes of Pattern Identifications (PI) from stroke patients. Decision tree analysis was carried out using clinical data collected from 835 stroke patients with the same subtypes diagnosed identically by two experts with more than 3 year clinical experiences. Among the 10 pulse indicators, 6 major pulse indicators (slow, rapid, strong, weak, slippery, and fine pulse) were selected by decision tree analysis. The accumulated distributions of six pulse indicators in each PI showed that strong was major pulse indicator in Fire-Heat pattern, slippery in Dampness Phlegm pattern, weak in Qi Deficiency pattern. But there were two major combinations in Yin deficiency pattern, weak or fine with rapid pulse and weak or fine without rapid pulse. Therefore, it is suggested that 6 pulse indicators can be used for discrimination of PI in stroke patients, though the combination studies between these pulse indicators and the other PI indicators are left for further study.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.4
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• pp.903-907
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• 2009

The purpose of this study is to investigate the pattern of metabolic syndrome(Mets) in stroke patients who were hospitalized in Daejeon oriental hospital. The present study was done over 445 hospitalized patient with stroke in the Daejeon University Oriental Medical Hospital in the period of November 2006 to December 2008. Stroke patients had been interviewed by residents and specialists who studied standard operation procedures in Fundamental study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. We analyzed all registered data and evaluated the prevalence of Mets and specific components of Mets. The distribution of Mets in stroke patients according to American Heart Association/National Heart Lung and Blood Institute(AHA/NHLBI) criteria is 65.63%. The distribution of Mets in stroke patients according to International Diabetes Federation(IDF) criteria is 48.05%. The distribution of female patients is higher than that of male patients. The distribution of central obesity, low HDL cholesterol and hypertension is higher in female patients. There is no significant relationship between Mets and stroke type in AHA/NHLBI criteria.. But, there is significant relationship between Mets and stroke type in IDF criteria.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.1
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• pp.76-81
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• 2014

The aim of this study was to build the diagnosis criteria of Qi deficiency using distribution of sum of 11 items for Qi deficiency in stroke patients. Between September 2006 and December 2010, 2,994 patients from 11 Korean medical hospitals were asked to complete the Korean Standard Pattern Identification for Stroke (K-SPI-Stroke) questionnaire as a part of project 'Fundamental study for the standardization and objectification of pattern identification in traditional Korean medicine for stroke (SOPI-Stroke). Each patient was independently diagnosed by two experts (traditional Korean medicine physicians) from the same site according to one of five patterns. 2,994 patients were divided modeling and testing in 70:30 ratio by stratification of pattern identification. We calculated the sensitivity, specificity, accuracy and odds ratio (OR) using distribution of sum of 11 items (signs and symptoms) for Qi deficiency. More than four from 11 items of Qi deficiency in modeling dataset, sensitivity, specificity, accuracy and OR was 70.07%, 74.94%, 73.92% and 7.00, respectively. In testing dataset, 78.31%, 73.45%, 74.47% and 9.98, respectively. Although this values are not high, after values of sensitivity, specificity, accuracy and OR should be more than current value, and then we should be able to suggest as objective diagnosing criteria.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.3
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• pp.318-326
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• 2013

This study was performed to investigate relationship between each pattern identification and heart rate variability(HRV) indices. We analyzed 201 subjects who participated in stroke check up. We classified the subjects into four groups of pattern identifications; Fire-Heat pattern(FH), Yin Deficiency pattern(YD), Qi Deficiency pattern(QD) and Dampness-Phlegm pattern(DP) that based on Korean Standard Pattern Identifications for Stroke-III. We investigated significance of HRV indices between each pattern identification and heart rate variability indices. The total number of the subject group was 201, whereas the groups were divided into four groups; Fire-Heat pattern group(n=47), Yin Deficiency pattern(n=65), Qi Deficiency pattern(n=33), and Dampness-Phlegm pattern(n=56). SDNN, TP, Ln(TP), VLF, Ln(VLF), LF, Ln(LF) and HF were significantly higher in the Fire-Heat pattern(FH) group than other groups of pattern identifications, but there was no differences among the Yin Deficiency group, the Qi Deficiency group and the Dampness-Phlegm group. Ln(HF), LF(NORM), HF(NORM) and LF/HF ratio were significantly higher in the Fire-Heat group than in the Qi Deficiency group. However, there was no significant differences among the Dampness-Phlegm group, the Yin Deficiency group, Fire-Heat group and the Qi Deficiency group. Through this study, we found out some significant relationships between each pattern identification group and HRV indices. The result of this study demonstrates that sympathetic nerve was more active in the Fire-Heat group than other groups.

• Journal of Oriental Neuropsychiatry
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• v.24 no.1
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• pp.13-26
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• 2013

Objectives : The purpose of this study is to investigate the correlation between pattern identification of traditional Chinese medicine (TCM) and western medicine, examined by a systematic research of Chinese medicine papers. Methods : We searched for the papers regarding pattern identification of TCM published from 1994 to 2012 in CNKI (China National Knowledge Infrastructure http://www.cnki.net) at April, 2012. Results : A total of 30 studies were finally included; 18 studies of them were related to stroke (cerebral infarction) and there were 12 studies regarding other diseases, such as hypertension, chronic colonitis, vascular dementia, mild cognitive impairment and etc. All 30 studies were analyzed and classified by diseases, differentiation of syndromes, numbers of subjects, the instrument of pattern identification, items of western medicine examination and statistical results. Conclusions : According to our study, there are some correlations between pattern identification of TCM and various items of western medicine examination. The result suggests a possibility of using the western medicine examination data for pattern identification of TCM.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.6
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• pp.1460-1464
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• 2009

In spite of many studies on statistical model for pattern identifications (PIs), little attention has been paid to the complexity of pattern diagnosis processed by oriental physicians. The aim of this study is to develop a statistical diagnostic model which discriminates four PIs using multiple indicators in stroke. Clinical data were collected from 981 stroke patients and 516 data of which PIs were agreed by two independent physicians were included. Discriminant analysis was carried out using clinical indicators such as symptoms and signs which referred to pattern diagnosis, and applied to validation samples which contained all symptoms and signs manifested. Four Fischer's linear discriminant models were derived and their accuracy and prediction rates were 93.2% and 80.43%, respectively. It is important to consider the pattern diagnosis processed by oriental physicians in developing statistical model for PIs. The discriminant model developed in this study using multiple indicators is valid, and can be used in the clinical fields.

• Korean Journal of Oriental Medicine
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• v.13 no.2 s.20
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• pp.53-58
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• 2007

Background and Purpose : The purpose of this study was to investigate that which symptoms are adequate indicator of the Dampness-Phlegm pattern in the stroke patients. Methods : In the time period Jul. 2005 to Sep. 2006, 136 patients with a first-ever stroke admitted in the department of Internal Medicine of Daejeon University Oriental Medical Hospital in Daejeon city, Wonkwang Oriental Medical Hospital in Iksan, JeonJu city were included. Patients were hospitalized within 3 months after the onset of stroke. Stroke patients had been interviewed by resident who studied standard operation procedures in Fundamental Study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. Gi-deficiency patients was confirmed by medical specialist diagnosis, resident diagnosis, case report form analysis without a dissenting voice. Results : Dampness-Phlegm group included 37 case, Non Dampness-Phlegm group 45 case out of 136 patients. white tongue coating, slippery purse, yellowish complexion, enlarged tongue, swollen tongue were higher among Dampness-Phlegm group. Dampness-Phlegm and Non Dampness-Phlegm patients do not significantly differ in heavy sensation in the head, voice with sputum, teeth printed tongue, borborygmus, dizziness with nausea. Conclusions : This study was insufficiency because sample size is very small. More data from prospective cohort studies will help to Korean Standard Differentiation of the Symptoms and Signs for the Stroke.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.6
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• pp.1486-1490
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• 2009

To develop the diagnostic tool for Fire-heat pattern, we analyzed sensitivity and specificity of symptom signs to diagnose the Fire-heat pattern in stroke patients. Korean medicine doctor surveyed Fire-Heat of the symptoms for the Stroke(KSDS) case report form in stroke patients within 1 month of onset. The sensitivity of "more 1/5 in major sings and 2/11 in helpful sings", "more 2/5 in major sings and 2/11 in helpful sings", "more 3/5 in major sings and 2/11 in helpful sings", "more 1/5 in major sings and 3/11 in helpful sings" "more 2/5 in major sings and 3/11 in helpful sings" "more 3/5 in major sings and 3/11 in helpful sings" are respectively 93%, 59%, 33%, 80%, 53%, 32%. The specificity are respectively 93%, 59%, 33%, 80%, 53%, 32%. The sensitivity(59%) and specificity(80%) of "more 2/5 in major sings and 2/11 in helpful sings" that to be implanted.

• The Journal of Internal Korean Medicine
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• v.30 no.3
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• pp.550-557
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• 2009

Objectives : The purpose of this study was to investigate the possibility of Bi-Su as a pattern identification (PI) index in stroke patients. Methods : The subjects were 424 hospitalized stroke patients within 1 month from onset and diagnosed with the same PI subtypes (dampness & phlegm, qi deficiency, fire & heat, eum deficiency, and blood stasis) by agreement of two clinical experts. Bi-Su type is a kind of body shape (Bi : fat, Su : lean). Bi-Su type and degree (Bi-Su score) were decided by clinical expert. Body mass index (BMI) and waist-hip ratio (WHR) were used as an obesity index. Correlation analysis between Bi-Su score and obesity index (Spearman) and variance analysis for Bi-Su score, BMI, and WHR among PI subtypes (ANOVA) and sex were carried out. Results : While there was partial correlation between Bi-Su type and BMI($r^2$=0.634, p<0.001), the distribution of the BMI group based on the Bi-Su group showed the broadest range. The Bi-Su score in the dampness & phlegm group was higher than in the other groups (p<0.001). BMI in the dampness & phlegm groups was also higher but the BMI differences among PI subtypes was low (p=0.002). The Bi-Su score in the dampness & phlegm group was similar in both sexes, although the hand score in the eum deficiency group was the lowest, especially in males. Conclusions : Although BMI is not an objective enough tool for evaluating Bi-Su type, Bi-Su type is more appropriate than BMI as PI index. Therefore Bi-Su type could be used as one of the PI indices for dampness & phlegm or eum deficiency group in stroke patients.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.772-779
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• 2009

Object : In the present study, we investigated the obesity and blood parameters between Qi-deficiency and Fire/Heat pattern identification/syndrome differentiation (PI/SD) in acute stroke patients. Materials and Methods : A total of 391 stroke patients within 7 days after onset were consecutively recruited from 12 hospitals across South Korea from Nov. 1st, 2006 to Jun. 31st, 2009. They were diagnosed as Fire/Heat or Qi-deficiency among five PI/SD subtypes by two independent stroke experts. We investigated the differences of obesity and blood characteristics between Fire/Heat and Qi-deficiency by statistical analyses. Results : In male subjects, obesity was significantly associated with Fire/Heat PI/SD. The averaged mean BMI ($24.13kg/m^2$) and waist circumference(89.34cm) of the Fire/Heat group were higher than those of the Qi-deficiency group ($22.60kg/m^2$ and 83.43 cm, respectively). The number of obese patients was larger in the Fire/Heat group than in the Qi-deficiency group (p = 0.001). Hyperlipidemia was also related with Fire/Heat. However, obesity was not associated with PI/SD in female subjects where the number of hyperlipidemic patients was higher in the Qi-deficiency group. Among blood parameters, the levels of triglycerides and fasting blood sugar were higher in the Fire/Heat group compared with the Qi-deficiency group in male subjects. However, total cholesterol of the Qi-deficiency group was higher than in the Fire/Heat group among female subjects. Conclusion : This study shows that obesity and hyperlipidemia are significantly difference between Qi-deficiency and Fire/Heat. We suggests that PI/SD may be associated with clinical characteristics and large population study between PI/SD and clinical characteristics including blood parameters are needed.