• 대한한방내과학회지
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• 제39권3호
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• pp.405-425
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• 2018

Objective: The purpose of this study was to analyze the correlation between Stomach Qi Deficiency and gastric emptying as measured by abdominal ultrasonography in postprandial distress syndrome (PDS), a subgroup of functional dyspepsia (FD). Methods: Ten patients who met the Rome III diagnostic criteria for PDS and ten healthy controls participated in this study Gastric emptying shown as the half-life of gastric volume ($T_{1/2}$) was measured by abdominal ultrasonography. The degree of Stomach Qi Deficiency was assessed using the scale for Stomach Qi Deficiency pattern (SSQD). In addition, functional dyspepsia-related quality of life (FD-QoL), Nepean dyspepsia index-Korean version (NDI-K), and visual analogue scale (VAS) of distention and fullness were conducted on all subjects. Results: The scores of SSQD, FD-QoL, NDI-K, and VAS of distention and fullness in the patient group were significantly higher than those in the control group (p<0.05). $T_{1/2}$ was also higher in the patient group than in the control group. The SSQD score significantly correlated positively with $T_{1/2}$ in the patient group (r=0.640, p=0.046). However, there was no significant correlation between $T_{1/2}$ and other questionnaire scores in the patient group. Conclusions: Our results suggest that the gastric emptying measured by abdominal ultrasonography could be a quantitative indicator to diagnose Stomach Qi Deficiency in FD patients, especially the PDS subtype.

• 대한한방내과학회지
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• 제40권3호
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• pp.369-389
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• 2019

Objectives: This study aimed to analyze the correlation between Ryodoraku diagnosis and three pattern identification questionnaires, namely, Spleen Qi Deficiency, Stomach Qi Deficiency, and Food Retention in functional dyspepsia (FD) patients. Methods: Forty FD patients who met the Rome IV diagnostic criteria for FD participated in this study. The Ryodoraku test was conducted, and three pattern identification questionnaires were filled up by all patients. The average Ryodoraku score was called total average (TA), and the scores on the Ryodoraku points were measured. The degree of Spleen Qi Deficiency, Stomach Qi Deficiency, and Food Retention was assessed by Spleen Qi Deficiency questionnaire (SQDQ), Scale for Stomach Qi Deficiency pattern (SSQD), and Food Retention Questionnaire (FRQ). Results: The TA scores in the SQDQ patient group were lower than those in the SQDQ control group (p=0.091). The TA scores in the SSQD patient group were higher than those in the SSQD control group (p=0.651). The TA scores in the FRQ patient group were lower than those in the FRQ control group (p=0.851). The scores on the LH5, RH5, and RH6 points were significantly lower in the SQDQ patient group than in the SQDQ control group. However, no significant difference was found in the Ryodoraku scores among the other groups. Conclusions: The results suggest that the low TA and low Ryodoraku scores on the LH5, RH5, and RH6 points could be a quantitative indicator to diagnose Spleen Qi Deficiency in FD patients in a simpler manner. Larger studies on the Ryodoraku test in FD patients, the health control group, and other pattern identification groups are required.

• 대한한방내과학회지
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• 제41권3호
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• pp.467-477
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• 2020

Objectives: This study investigated the cutaneous electrogastrogram (EGG) and other clinical characteristics of dyspeptic patients who have been diagnosed with Stomach Qi Deficiency (SQD) using the Scale for Stomach Qi Deficiency (SSQD). Methods: This study reviewed the clinical records of 38 patients with dyspepsia who were evaluated with SSQD and EGG at the Department of Digestive Diseases of Kyung Hee University Korean Medicine Hospital in Seoul, Korea from November 1, 2019 to February 29, 2020. We evaluated the EGG and other clinical characteristics of the SQD patients to determine if there was an association between the SSQD scores and the EGG. Results: In terms of the EGG, the SQD patients showed no significant increase in the percentage of normal slow wave after a meal and a slightly decreased power ratio at Channel 1 and Channel 2. We also found an association between the SSQD scores and the EGG parameters at Channel 1 and Channel 3. The average Ryodoraku score of the patients was 33.00±14.90 (μA). In the Heart Rate Variability (HRV) test, the average Total Power (TP) and Low Frequency/High Frequency (LF/HF)) ratio was 1356.60±13 6.41(ms²) and 1.68±2.25, respectively. Conclusions: The results of this study suggest that clinicians can use Electrogastrography to enhance accuracy when diagnosing the SQD pattern.

• 대한한방내과학회지
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• 제41권6호
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• pp.1030-1051
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• 2020

Objective: This study investigated the measurement interval in the ultrasonographic gastric emptying test for patients with functional dyspepsia (FD) and the correlation between gastric emptying and the findings of various questionnaires. Methods: In total, 119 patients (59 patients with FD and 60 healthy controls) were recruited from July 2018 to June 2020. Gastric volume (GV) and gastric emptying half-time (T1/2) were measured by ultrasonography at fasting and again at 0, 5, 10, 15, 30, 45, 60, 90, and 120 min after meals (apple juice, 500 mL, 224 kcal), and the average half-time (average T1/2) was calculated. Questionnaires on food retention (FRQ), phlegm pattern e (PPQ), cold and heat (CHQ), deficiency and excess (DEQ), and spleen-qi deficiency (SQDQ), stomach qi deficiency pattern (SSDQ), visual analogue scale (VAS), and Nepean dyspepsia index-Korean version (NDI-K) were completed by all participants. The differences in GV and T1/2 were analyzed in participants whose maximal GV occurred at 0 min versus after 0 min. The correlation of the average T1/2 with the questionnaire scores was also analyzed after excluding erroneous data. Results: Patients with FD who took a certain amount of time to reach maximal GV after meals had a greater gastric volume up to about 30 minutes after meals, and the PPQ, DEQ, and NDI-K scores, especially for upper gastrointestinal symptoms and general weakness-related symptoms, showed statistically significant correlations with average T1/2. Conclusions: Ultrasonography can be a quantitative evaluation tool for FD. However, further studies on measurement methods based on FD physiopathology are required.

• 대한한방내과학회지
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• 제40권3호
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• pp.390-408
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• 2019

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.