• 제목/요약/키워드: clinical pattern

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슬통의 침구임상 진료지침 프로토콜 개발을 위한 전자우편 설문조사 (E-mail Survey for Developing Clinical Trial Protocol on Acupuncture Treatment for Knee Pain)

  • 윤은혜;김은정;정찬영;장민기;이승덕;남동우;김현욱;이은용;조현석;이건목;이재동;김선웅;김갑성
    • Journal of Acupuncture Research
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    • 제26권3호
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    • pp.59-65
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    • 2009
  • Objectives : This survey was done in order to find out how Korean medical doctors derive pattern identification for acupuncture prescriptions in treating knee pain in real clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society from March 26th to April 14th in 2009. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results : 1.54 Korean medical doctors selected meridian pattern identification based on the course of the meridians(52.5%), visceral pattern identification(27.1%), pattern identification based on cause of disease(8.5%) as the most commonly used pattern identification methods for acupuncture prescription when treating knee pain patients in real clinical practice. 2. In meridian pattern identification based on the course of the meridians, liver meridian of the medial knee region(13.2%), bladder meridian of the posterior knee region(12.0%), spleen meridian of the lateral knee region(11.7%), stomach meridian of the anterior knee region(9.8%) and kidney meridian of the medial knee region(8.6%) were selected. 3. In visceral pattern identification, blood stasis of sinews due to liver and kidney deficiency(5.3%), damp joint with yang deficiency of liver and kidney(4.9%), kidney qi deficiency with congealing cold(4.5%), yin deficiency of liver and kidney(4.1%) were selected. Conclusions : In our e-mail survey, Korean medical doctors answered that Meridian Pattern Identification based on the course of the meridians is the most often used diagnosis method. Visceral pattern identification, pattern identification based on cause of disease, pattern identification based on symptom and pattern identification based on qi-blood-yin-yang theory in order of frequency used, were selected for knee pain diagnosis in real clinical practice.

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기능성소화불량에 대한 담음 변증설문지 개발과 신뢰도 및 타당도 검정 (Development of a Phlegm Pattern Questionnaire for Functional Dyspepsia and Analysis of Its Reliability and Validity)

  • 백소영;하나연;고석재;박재우;김진성
    • 대한한방내과학회지
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    • 제41권4호
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    • pp.563-582
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    • 2020
  • Objectives: The aim of this study was to develop a Phlegm Pattern Questionnaire for Functional Dyspepsia (PPQ-FD) by modifying a previously developed Phlegm Pattern Questionnaire (PPQ) and to verify its reliability and validity. Further objectives were to obtain the optimal cut-off value for the PPQ-FD for standardization and for clinical use. Methods: The PPQ-FD was developed by extracting the major symptoms of the phlegm pattern in functional dyspepsia and by using the Delphi method to administer a requested importance survey to experts. The reliability, validity, and optimal cut-off value of the PPQ-FD were analyzed by enrolling a total of 60 subjects in this study. Thirty patients were diagnosed with both functional dyspepsia and phlegm pattern and thirty patients were diagnosed with only functional dyspepsia. All participants were requested to fill out the PPQ-FD. Results: No statistically significant differences were detected in the two groups for sex distribution, age, or body mass index. Five of the survey questions negatively affected its reliability; therefore, we decided to exclude those five questions on further inspection. The Cronbach's α coefficient of the revised PPQ-FD was 0.853, and clinical validity was verified. Construct validity was analyzed by factor analysis and identified four factors. Statistically significant positive correlations were found between the revised PPQ-FD and other dyspepsia scales, such as the SQDQ, SSQD, VAS, NDI-K, and FD-QoL scales. The VAS had particularly strong positive correlations with the PPQ-FD. Conclusions: The PPQ-FD developed in this study has fundamental reliability and validity for use as a pattern-diagnosis questionnaire. The PPQ-FD can help to diagnose the phlegm pattern in patients with functional dyspepsia.

소양인체질병증 임상진료지침: 음허오열병 (Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology)

  • 유준상;이의주
    • 사상체질의학회지
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    • 제26권3호
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    • pp.272-280
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    • 2014
  • Objectives This research was carried out to establish the clinical practice guideline(CPG) for Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology of Soyangin disease. Methods Dongeuisusebowon(sinchuk edition) and several kinds of literatures including journal articles concerning this symptomatology of Soyangin disease were collected and classified. Sasang constitutional specialists' conference was held to make an agreement on the conflicting issues as well. Consensus was drawn as a result of the conference. Results & Conclusions 3 papers were selected as an inclusion and exclusion criteria for the relevant articles to Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology of Soyangin disease. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology consists of two aspects : Yin-Deficit Diurnal-Heat (Eumheo-oyeol) severe pattern and Yin-Deficit Diurnal-Heat (Eumheo-oyeol) critical pattern. In Yin-Deficit Diurnal-Heat (Eumheo-oyeol) severe pattern contains 1 disease, namely, Clear Yang Depletion of Large Intestine (Daejang-cheongyang Moson) pattern (Lower wasting-thirst (Haso) pattern). In Yin-Deficit Diurnal-Heat (Eumheo-oyeol) critical pattern contains 2 diseases, Yin-Deficit Diurnal-Heat (Eumheo-oyeol) pattern and Yin-Deficit Diurnal-Heat (Eumheo-oyeol) advanced pattern. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) symptomatology has several kinds of symptoms like dry mouth, disliking to drink much water, diurnal body fever, coldness on the back and nausea as well as body fever, chest discomfort, constipation or dry stool as a common symptoms of Interior Heat disease. Clear Yang Depletion of Large Intestine (Daejang-cheongyang Moson) pattern (Lower wasting-thirst (Haso) pattern) has above mentioned symptoms and much urine/turbid urine, thin thigh and knee joints and twinge of joint pain over the body. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) pattern has symptoms like indigestion and epigastric discomfort, abdominal pain and vomiting in addition. Yin-Deficit Diurnal-Heat (Eumheo-oyeol) advanced pattern has symptoms like hematemesis as well.

소음인체질병증 임상진료지침: 진단 및 알고리즘 (Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm)

  • 이준희;이의주
    • 사상체질의학회지
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    • 제26권1호
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    • pp.11-26
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Diagnosis and Algorithm. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods We searched the literature and articles related to Soeumin Symptomatology diagnosis and algorithm. For developin diagnosis and algorithm, we searched the classification, ordinary symptom, present symptom of the Soeumin Symptomatology Results & Conclusions We classified the Soeumin Symptomatology by 4 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern, initial-intermediate-advanced pattern. And at the unfavorable pattern, ordinary symptom is very important. So Doctors focuss on the symptom of unfavorable's ordinary symptom such as temperament inclined symptom, excessive sweating, diarrhea, and vexation.

소양인체질병증 임상진료지침: 진단 및 알고리즘 (Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm)

  • 이준희;이의주
    • 사상체질의학회지
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    • 제26권3호
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    • pp.224-240
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soyangin Disease of Sasang Constitutional Medicine(SCM): Diagnosis and Algorithm. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods We searched the literature and articles related to Soyangin Symptomatology diagnosis and algorithm. For developing diagnosis and algorithm, we searched the classification, ordinary symptom, present symptom of the Soyangin Symptomatology. Results & Conclusions We classify the Soyangin Symptomatology by 4 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern (initial-advanced pattern). And at the unfavorable pattern, ordinary symptom is very important. So doctors need to focus on the symptom of unfavorable's ordinary symptom such as temperament inclined symptom, diarrhea, and diurnal body fever.

폐쇄성수면무호흡증후군의 무호홉-저호흡 지수에 따른 수면양상의 비교 (Comparison of Sleep Pattern According to Apnea-Hypopnea Index with Obstructive Sleep Apnea Syndrome)

  • 진복희
    • 대한임상검사과학회지
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    • 제39권3호
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    • pp.264-270
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    • 2007
  • Obstructive sleep apnea syndrome (OSAS) is defined by sleep apnea with decreased oxygen saturation, excessive snoring with daytime sleepiness, and frequent awakening during the night time sleep. The present study was performed to investigate how apnea-hypopnea, that possibly causes breathing disturbance during sleep, can affect sleep pattern in patients with OSAS. We included 115 patients (92 men, 23 women) who underwent a polysomnography from January 2006 to May 2007. As the frequency of sleep apnea-hypopnea increases, the proportion of non-rapid eye movement (REM) sleep (p<0.001), and stage I sleep (p<0.001) increased, while that of stage II sleep (p<0.001), stage III and IV sleep (p<0.01), and REM sleep (p<0.05) decreased. Furthermore, sleep apnea-hypopnea was closely correlated with REM sleep (r=0.314, p<0.001), stage I sleep (r=0.719, p<0.001), stage II sleep (p=-0.342, p<0.05), stage III and IV sleep (r=-0.414, p<0.001), and REM sleep (r=-0.342, p<0.05). Stage I sleep could account for the 51% of the variance of apnea-hyponea. Our study shows sleep apnea-hypopnea affects sleep pattern in pattern with OSAS significantly, and the change of stage I sleep is the most important factor in estimating the disturbance of sleep pattern.

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태음인·태양인체질병증 임상진료지침: 진단 및 알고리즘 (Clinical Practice Guideline for Taeeumin and Taeyangin Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm)

  • 이준희;이의주
    • 사상체질의학회지
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    • 제27권1호
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    • pp.13-41
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    • 2015
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Taeeumin and Taeyangin Disease of Sasang Constitutional Medicine(SCM): Diagnosis and Algorithm. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods We searched the literature and articles related to Taeeumin and Taeyangin Symptomatology diagnosis and algorithm. For developing diagnosis and algorithm, we searched the classification, ordinary symptom, present symptom of the Taeeumin and Taeyangin Symptomatology Results and Conclusions We classified the Taeeumin Symptomatology by 4 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern, initial-intermediate-advanced pattern. And we classified the Taeyangin Symptomatology by 3 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern. At the unfavorable pattern, ordinary symptom is very important. So doctors are considered to need to focus on the symptom of unfavorable's ordinary symptoms.

한국형(韓國型) 출혈열(出血熱)에서의 Renogram에 대(對)한 연구(硏究) (A Study of Renogram in Korean Hemorrhagic Fever)

  • 최태규;이정상;고창순;이문호
    • 대한핵의학회지
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    • 제8권1_2호
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    • pp.13-24
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    • 1974
  • The patterns of renogram in patients with Korean hemorrhagic fever were evaluated with clinical course and renal hemodynamic changes in various clinical stages. The renal plasma flow was measured by hippuran blood clearance using $^{131}I$-ortho-iodohippurate and hippuran renogram was analysed by means of quantitative and qualitative methods in 26 patients of Korean hemorr hagic fever. The results obtained with this study were as follows; 1. During the oliguric phase of Korean hemorrhagic fever, the renogram showed non-functioning (flat) or obstructive pattern. The group of patients with non-functioning pattern of renogram had more severe impairement of renal function and grave prognosis than the group with obstructive pattern of renogram. 2. During the diuretic phase, the renogram showed obstructive or dysfunction or normal pattern, which was related with the recovery of renal function. Obstruction pattern of renogram was observed till the 2nd week of diuretic phase. Normal pattern of renogram began to appear by the 2nd week of diuretic phase. 3. During the convalescent phase of Korean hemorrhagic fever, 40% of patients showed dysfunnction pattern of renogram, and the recovery of abnormal renogram in Korean hemorrhagic fever was more delayed than the recovery of clinical features and laboratory findings. 4. The renogram showed normal pattern 6 months after onset of Korean hemorrhagic fever in all cases. 5. There was significant correlationship between the pattern of renogram and the decreace of renal plasma flow in the patients with Korean hemorrhagic fever. The decreace of renal plasma flow was maked in the patients with non-functioning pattern of renogram and was least in the patients with dysfunction pattern of renogram. All above results suggested that the renogram reflects the effective renal plasma flow and degree of renal impairement, and the renogram may be one of the important indexes which could give us a more precise prognosis in Korean hemorrhagic fever.

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Pattern Analysis of Left Ventricular Remodeling Using Cardiac Computed Tomography in Children with Congenital Heart Disease: Preliminary Results

  • Hyun Woo Goo;Sang-Hyub Park
    • Korean Journal of Radiology
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    • 제21권6호
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    • pp.717-725
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    • 2020
  • Objective: To assess left ventricular remodeling patterns using cardiac computed tomography (CT) in children with congenital heart disease and correlate these patterns with their clinical course. Materials and Methods: Left ventricular volume and myocardial mass were quantified in 17 children with congenital heart disease who underwent initial and follow-up end-systolic cardiac CT studies with a mean follow-up duration of 8.4 ± 9.7 months. Based on changes in the indexed left ventricular myocardial mass (LVMi) and left ventricular mass-volume ratio (LVMVR), left ventricular remodeling between the two serial cardiac CT examinations was categorized into one of four patterns: pattern 1, increased LVMi and increased LVMVR; pattern 2, decreased LVMi and decreased LVMVR; pattern 3, increased LVMi and decreased LVMVR; and pattern 4, decreased LVMi and increased LVMVR. Left ventricular remodeling patterns were correlated with unfavorable clinical courses. Results: Baseline LVMi and LVMVR were 65.1 ± 37.9 g/m2 and 4.0 ± 3.2 g/mL, respectively. LVMi increased in 10 patients and decreased in seven patients. LVMVR increased in seven patients and decreased in 10 patients. Pattern 1 was observed in seven patients, pattern 2 in seven, and pattern 3 in three patients. Unfavorable events were observed in 29% (2/7) of patients with pattern 1 and 67% (2/3) of patients with pattern 3, but no such events occurred in pattern 2 during the follow-up period (4.4 ± 2.7 years). Conclusion: Left ventricular remodeling patterns can be characterized using cardiac CT in children with congenital heart disease and may be used to predict their clinical course.

만성기침 변증도구 개발을 위한 기초연구 (Preliminary Study for Development of Pattern Identification Tool of Chronic Cough)

  • 김관일;신승원;이나라;이범준;정희재;정승기;이준희
    • 대한한방내과학회지
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    • 제36권1호
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    • pp.22-39
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    • 2015
  • Objectives : The aim of this study was to develop a standard tool of pattern identification for chronic cough, which will be applied to clinical research. Methods : The items and structures of the instrument were based on reviews of textbooks and published literature. The advisor committee on this study consisted of 11 Korean respiratory internal medicine professors, one clinical fellow, and five clinicians with 10 years of experience. The questionnaire, which includes the signs and symptoms of chronic cough, was studied by the delphi method. Delphi examination was carried out via email, through evaluating the importance of symptoms included in each pattern. Results : We divided the pattern identification of chronic cough into five patterns: Wind-Cold, Phlegm-Turbidity, Liver-Fire, Lung Deficiency, and Kidney Yang Deficiency. By the Delphi method and a score evaluation, 38 items were chosen for pattern identification of chronic cough. Conclusions : Through this study, we created a Korean instrument for the pattern identification tool for chronic cough. We expect to apply this tool to subsequent research as its validity and reliability are further confirmed.