Objectives: Several pattern diagnosis questionnaires have been developed to objectify the process of pattern diagnosis in Korean medicine. In this context, this study aimed to develop a food retention questionnaire for functional dyspepsia (FRQ-FD) by modifying the previously developed food retention questionnaire (FRQ) and to verify its reliability and validity. Furthermore, this study aimed to identify the optimal cut-off value of the FRQ-FD for standardization and use in clinical situations. Methods: To develop the FRQ-FD, we extracted the major symptoms of food retention pattern for functional dyspepsia from Chinese/Korean medicine textbooks and requested an importance survey from experts using the Delphi method. The first draft of the FRQ-FD was composed of 25 questions comprising 8 questions from the textbooks and the Delphi method and 17 questions from the FRQ already developed in 2013. To analyze its reliability, validity, and optimal cut-off value, 60 subjects were enrolled in this study from June 25 to August 13, 2018. Thirty patients were diagnosed as both functional dyspepsia and food retention pattern, and 30 healthy participants were not. All participants were requested to fill up the FRQ-FD, Stomach Qi Deficiency Questionnaire (SQDQ), Scale for Stomach Qi Deficiency pattern (SSQD), visual analog scale (VAS) for dyspepsia, Nepean Dyspepsia Index-Korean version (NDI-K), and functional dyspepsia-related quality of life (FD-QoL). Results: No statistically significant differences were found in sex distribution, age, and body mass index between the patient group and the control group. As five questions affected the reliability negatively and three questions affected the clinical validity negatively, we decided to exclude the eight questions upon further investigation. The Cronbach's ${\alpha}$ coefficient of the revised FRQ-FD (17 items) was 0.899, and its clinical validity was verified. Construct validity was analyzed by factor analysis and produced five factors. Statistically significant positive correlations were found between the revised FRQ-FD and the other dyspepsia scales, namely, SQDQ, SSQD, VAS, NDI-K, and FD-QoL. VAS and NDI-K especially had strong positive correlations with FRQ-FD. Conclusions: The FRQ-FD developed in this study can provide fundamental reliability and validity for a pattern diagnosis questionnaire. FRQ-FD can help to diagnose food retention pattern in functional dyspepsia patients. Further studies are required to inspect several statistical factors.
Objectives: This study measured the thickness of the abdominal wall at abdominal acupoints using ultrasonography and then investigated the correlations between the thickness of the abdominal wall and other characteristics of patients with functional dyspepsia (FD). Methods: Thirty patients with FD were enrolled in the study from September 2015 to March 2016. The thickness of the abdominal wall was measured at Shangwan (CV12), Zhongwan (CV13), and the left Liangmen (ST21). In addition, height, weight, body mass index (BMI), duration of FD, and the sternocostal angle were investigated. The severities of spleen qi deficiency and the dyspepsia symptoms were assessed by the Spleen Qi Deficiency Questionnaire (SQDQ) and the Nepean Dyspepsia Index-Korean version (NDI-K). Results: The average thickness of the abdominal wall was $24.66{\pm}6.69mm$ at Shangwan, $21.17{\pm}5.83mm$ at Zhongwan, and $21.72{\pm}5.72mm$ at Linagmen, and there were significant differences between the thickness at Shangwan and Zhongwan (p=0.046). Furthermore, there were significant differences between the thickness of the abdominal wall at Zhongwan and the sternocostal angle (r=0.396, p=0.037). Conclusions: These findings indicate the possibility of estimating the thickness of the abdominal wall by looking at the characteristics of patients with FD, including the sternocostal angle.
Kim, Keum-ji;Cho, Soo-ho;Park, Ji-seon;Ko, Seok-jae;Park, Jae-woo
The Journal of Internal Korean Medicine
/
v.40
no.6
/
pp.1268-1277
/
2019
Objective: The purpose of this study was to report the effectiveness of Korean medicine in the treatment of functional dyspepsia in a fibromyalgia patient with a history of long-term NSAIDs use. Methods: The patient was diagnosed as a Soeumin, one of the four constitution types in Korean medicine, and treated with herbal medicines such as Seungyangikgibuja-tang and Pyeongjinsunjeom-san. Acupuncture and moxibustion treatment were also performed. The severity of symptoms was assessed using the Numerical Rating Scale (NRS) of epigastric pain, daily oral intake changes, the Korean Gastrointestinal Symptom Rating Scale (KGSRS), the Gastrointestinal Symptom Score (GIS), and the Functional Dyspepsia-Quality of Life (FD-QOL) score. Results: After treatment for 48 days, the severity of epigastric pain decreased from NRS 8 to NRS 0, and daily oral intake was increased. The KGSRS score decreased from 55 to 43, the GIS score was reduced from 18 to 10, and the FD-QOL score also decreased from 69 to 55. Conclusions: This study suggests that Korean medical treatment could be an effective option for treating functional dyspepsia in fibromyalgia patients with a history of long-term NSAIDs use.
Objectives The purpose of this study was to investigate the correlation between gastric emptying measured by ultrasonography and Korean medical instruments of diagnosis and assessment in functional dyspepsia (FD) patients. Among the subgroups of FD, postprandial distress syndrome (PDS) is related to gastric motility disorder.Methods Ten patients with FD and particularly with PDS as well as 10 healthy controls were enrolled in the study from September to November 2015. The gastric emptying shown as the half-life of gastric volume (T1/2) was measured by ultrasonography. The severities of spleen qi deficiency and dyspepsia symptoms were assessed by a spleen qi deficiency questionnaire (SQDQ) and the Nepean Dyspepsia Index-Korean version (NDI-K), respectively. In addition, a food retention questionnaire (FRQ), a damum questionnaire (DQ), a cold and heat questionnaire (CHQ), a deficiency and excess questionnaire (DEQ), and a visual analogue scale (VAS) of distention and fullness were completed by every participant.Results In comparison with the control group, the FD group showed significantly higher scores for the SQDQ, NDI-K, FRQ, DQ, DEQ, and VAS of distention and fullness. T1/2 was also significantly higher in the FD group than in the control group. There were significant correlations between T1/2 and the SQDQ score. However, there were no significant correlations between T1/2 and other questionnaire scores except for one item of the NDI-K.Conclusions According to these findings, it was determined that measuring gastric emptying using ultrasonography could be a quantitative indicator to diagnose spleen qi deficiency in FD patients.
Objectives: Cold hypersensitivity has been regarded to be associated with digestive function. This study is aims to evaluate the correlation between digestive function and coldness of hands. Methods: We made a research of 80 women who is in ${\bigcirc}{\bigcirc}$ University. The patients were subjected to thermometer, and those with thermal difference between upper arm and palm were diagnosed with cold hypersensitivity. The patients were divided into two group by cold hypersensitivity group (n=20), and non-cold hypersensitivity group (n=19), and 39 women are mesured by Nepean dyspepsia index-Korean version (NDI-K) to evaluate the severity of functional dyspepsia. Results: There was no difference between two groups on age, height, weight. In functional dyspepsia symptom score, 6 symptoms (Pain in upper abdomen, Burning in upper abdomen, Cramps in upper abdomen, Pressure in upper abdomen, Vomiting, Bad breath) out of 15 were significantly increased in cold hypersensitivity group compared with non-cold hypersensitivity group. And in quality of life score, 3 domains (Tension/sleep, Interference with daily activities, Knowledge/control) out of 5, and total quality of life score were significantly decreased in cold hypersensitivity group compared with non-cold hypersensitivity group. Conclusions: This study shows the correlation between cold hypersensitivity and digestive function.
In patients with functional gastrointestinal disorders, dietary factors have an important effect on the development or worsening of gastrointestinal symptoms. Therefore, nutritional advice is often needed for the treatment of these patients. Although no firm conclusions can be drawn from current studies, the use of low-fat diets can be recommended in patients with functional dyspepsia. Constipation can be treated with a high-fiber diet. There are few studies in irritable bowel syndrome patients with diarrhea. The diet recommendations must be applied to each patient depending on symptoms.
Objectives: Clinically, patients with dyspepsia often complain of several gastrointestinal (GI) and extra-GI symptoms. However, there have been few studies investigating the relationship between GI symptoms and extra-GI symptoms. The aim of this study was to characterize the clinical features of the 991 outpatients with GI and extra-GI symptom and the relationships between GI and extra-GI symptoms. Methods: 991 patients newly visiting Weedahm Oriental Hospital for GI symptoms were included. Those who had disorders caused by the hepatobiliary-pancreatic system were excluded. The 991 outpatients were interviewed with a standardized questionnaire inquiring about demography, past medical history, past institutional care, GI symptoms and extra-GI symptoms. Results: Among 991 patients, 780 (78.7%) had more than three GI symptoms and 451 (45.5%) had more than five. Among 991 patients, 545 (55.0%) had more than three extra-GI symptoms and 285 (28.8%) had more than five. There was a statistically significant correlation between GI symptoms and extra-GI symptoms such as headache, fatigue, forgetfulness, eyeball pain, unrest, dizziness, muscle pain, chest pain, and dyspnea. Conclusions: We found that there was statistically significant correlation between GI symptoms and extra-GI symptoms, which suggests the possibility of main common pathophysiology between GI symptoms and extra-GI symptoms. Further studies will be required to elucidate the main common pathophysiology between GI symptoms and extra-GI symptoms.
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.
Background & Object : The aim of this study was to investigate the usefulness of electrogastrography on differential diagnosis of deficiency or excess Condition in patients with functional dyspepsia Methods : Selected symptoms for diagnosis of deficiency and excess in functional dyspepsia have been reviewed in some literatures, notably within Oriental medicine, Donguibogam and Gogeumdoseojipseong-uibujeolrok. This is what was investigated in this study. 93 patients (male 32, female 61) were divided into three groups; Non-pain group, Pre-treatment pain group (chief complain was abdominal pain at the first medical examination), and Mid-treatment pain group(they had no pain at the time of first medical examination, but showed abdominal pain within two weeks). 10 healthy people participated as normal controls. Gastric motility were recorded and analyzed using electrogastrography during fasting and postprandial period. In assessment, effectiveness was divided into validity, sensitivity and specificity. Results : Epigastric pain reflected the tendency for excess condition in comprehensive diagnosis, which was linked with postprandial arrhythmia in electrogastrography(p=0.001). Postprandial arrhythmia detected abdominal pain with a validity of 78.6%, a sensitivity of 79.2%, and a specificity of 78%(p<0.001). Conclusions : Results 1Tom Postprandial arrhythmia in electrogastrography support that the index of excess condition in the comprehensive diagnosis of symptoms is useful for patients with functional dyspepsia.
Objective: The aim of this case report is to report the effect of Korean medicine treatment, including Shihogayonggolmoryo-tang, on anxiety and abdominal pulsation in a patient diagnosed with functional dyspepsia. Method: The patient was treated with Shihogayonggolmoryo-tang, including acupuncture, moxibustion, and cupping therapy. Changes in symptoms were evaluated using a self-reported numerical rating scale (NRS) score every morning. The gastrointestinal symptom score (GIS) was checked on admission and discharge day. Results: After 6 days, the NRS scores for anxiety, abdominal pulsation, abdomen discomfort, and GIS all decreased. Conclusion: The results suggest that Shihogayonggolmoryo-tang with Korean medicine could be effective for treating anxiety, abdominal pulsation, and accompanying abdomen symptoms. However, further evaluation is needed to clarify the relationship between the treatment's effect and Shihogayonggolmoryo-tang.
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