• 제목/요약/키워드: syndrome differentiation (辨證)

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중풍 변증 모델에 의한 진단 정확률과 예측률 비교 (Comparison of Diagnostic Accuracy and Prediction Rate for between two Syndrome Differentiation Diagnosis Models)

  • 강병갑;차민호;이정섭;김노수;최선미;오달석;김소연;고미미;김정철;방옥선
    • 동의생리병리학회지
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    • 제23권5호
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    • pp.938-941
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    • 2009
  • In spite of abundant clinical resources of stroke patients, the objective and logical data analyses or diagnostic systems were not established in oriental medicine. In the present study we tried to develop the statistical diagnostic tool discriminating the subtypes of oriental medicine diagnostic system, syndrome differentiation (SD). Discriminant analysis was carried out using clinical data collected from 1,478 stroke patients with the same subtypes diagnosed identically by two clinical experts with more than 3 year experiences. Numerical discriminant models were constructed using important 61 symptom and syndrome indices. Diagnostic accuracy and prediction rate of 5 SD subtypes: The overall diagnostic accuracy of 5 SD subtypes using 61 indices was 74.22%. According to subtypes, the diagnostic accuracy of "phlegm-dampness" was highest (82.84%), and followed by "qi-deficiency", "fire/heat", "static blood", and "yin-deficiency". On the other hand, the overall prediction rate was 67.12% and that of qi-deficiency was highest (73.75%). Diagnostic accuracy and prediction rate of 4 SD subtypes: The overall diagnostic accuracy and prediction rate of 4 SD subtypes except "static blood" were 75.06% and 71.63%, respectively. According to subtypes, the diagnostic accuracy and prediction rate was highest in the "phlegm-dampness" (82.84%) and qi-deficiency (81.69%), respectively. The statistical discriminant model of constructed using 4 SD subtypes, and 61 indices can be used in the field of oriental medicine contributing to the objectification of SD.

허실 변증 설문지 개발 가능성에 대한 고찰 (Study on Deficiency-Excess Pattern Questionnaire Development Possibility)

  • 유현희;이혜정;장은수;이시우;이기상;김종열
    • 동의생리병리학회지
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    • 제23권3호
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    • pp.534-539
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    • 2009
  • Deficiency and excess pattern differentiation is unique characteristic of traditional oriental medicine on diagnosis and treatment. This differentiation is accomplished through pulse, tongue diagnosis and question examination, but most of these processes need to be objectified for efficacious treatment and traditional medicine development. In this study, we developed the deficiency and excess pattern questionnaire for objectification of question examination. The deficiency and excess pattern questionnaire was made out through The Traditional Oriental Medical Literature with Delphi Technique. Patients who visited oriental medical hospital filled out the questionnaire by themselves. Diagnosis of deficiency and excess pattern are conducted separately by oriental medical doctors with more than 5 years' clinical experience. Various physical condition factors were derived for the deficiency and excess pattern questionnaire. (Ordinary health degree, pain pattern, fatigue, weight change, sweating, uncomfortable awareness on chest and abdomen) Deficiency symptoms group acquired internal consistency, but excess symptoms group did not. (Cronbach's ${\alpha}$ > 0.6) There were significant associations between doctor's diagnosis and deficiency and excess symptoms in 'ordinary heath degree', 'voice weakening', and 'chest distress' (p-value < 0.1) There were significant differences between deficiency and excess syndrome patients groups in deficiency questionnaire score but there were no significant differences between deficiency and excess syndrome patients groups in excess questionnaire score. We acquired the internal consistency and significant result of deficiency pattern questionnaire, but we can find out some difficulties in development of the excess pattern questionnaire. These difficulties are associated with insufficiency description of traditional literature and small number of patients diagnosed as excess pattern.

요통과 견비통 환자에서 사상체질별 특성 연구 (A Study on the Characteristics of Low Back Pain and Shoulder-Arm Pain Patients by Sasang Constitution)

  • 신우용;고호연;정수현;신미란
    • 사상체질의학회지
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    • 제29권4호
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    • pp.336-346
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    • 2017
  • Objectives The purpose of this study is to investigate the characteristics of low back pain and shoulder arm pain patients according to the Sasang Constitution. Method We classified Seventy-nine participants by their Sasang Constitution. We investigated various aspects of the participant's pain such as the location of pain, diseases and Syndrome Differentiation etc. then intended to confirm relationship the Sasang Constitution and these research items through the statistics analysis. Results The numbers of lower back pain patients was statistically higher in Soyangin group than any other groups and the number of shoulder arm pain patients was statistically higher in Taeeumin group or Eumin group (Taeeumin group and Soeumin group) than Soyangin group. The number of diabetes patients and obesity patients was statistically higher in Taeeumin lower back pain patients, and that of obesity patients was statistically higher in Taeeumin shoulder arm pain patients than any other groups. The numbers of shoulder arm pain patients due to blood stasis and lower back pain patients due to kidney deficiency were statistically higher in Soyangin group than any other groups. The numbers of shoulder arm pain patients due to phlegm fluid retention and lower back pain patients due to phlegm fluid retention were statistically higher in Taeeumin group than any other groups. Conculsions The characteristics of lower back pain and shoulder arm pain could be different according to Sasang constitution.

다양한 유행성 감염병의 진단 일원화를 위한 통합변증방법 연구 (Contrivance of Integrated Pattern Differentiation Method for Diagnostic Unification of Exogenous Contagious Diseases)

  • 지규용
    • 동의생리병리학회지
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    • 제30권1호
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    • pp.1-6
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    • 2016
  • In recent years, there were frequent exogenous contagious diseases in Eastasia like SARS(severe acute respiratory syndrome), Avian influenza, Swine influenza, MERS etc. But there are various interpretations about their pathological differentiations and lead to controversy to diagnosis and medicinal use. So there needs universal and consistent understanding methods. Several conclusions are obtained from the research on differentiation theories of various epidemic diseases. Essential elements of differential diagnostic system are pathogen, characters and matters of disease and loci, especially three yin and three yang has close affinity with constitutional features or body shape. Binding these 3 categories, an integrated differentiation 3 dimensional coordinates are made. Out of these, each elements of 3 pathogen-axial lines are related with names of exogenous disease, and those of 3 feature-axial lines are related with 8 principal patterns. And those of 3 locus-axial lines implicating therapeutic method are related with steps and location of exterior and interior, 3 yin 3 yang, Defense, Qi, Nutrient and Blood, five viscera and six bowels and tissues. Additionally, 3 lines of each axis consist of factors which have their own affinity each other, so classification of pathogen, feature, locus of disease has layered interconnectedness. This classification system is included in constitutional features of individual patient. Afterwards, these cognitive structure can be used as a general theory guiding method of therapy, prevention and aftercure healthcare.

소아 식욕부진의 병인, 변증, 치료에 대한 고찰 -중의학 논문을 중심으로- (A Review of Etiology, Pattern Identification, Treatment of Traditional Chinese Medicine for Childhood Anorexia)

  • 서혜선;김혜연;박슬기;이선행;이진용;장규태
    • 대한한방소아과학회지
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    • 제36권1호
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    • pp.1-37
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    • 2022
  • Objectives This study aimed to provide a basis for applying Korean medical treatment for childhood anorexia in clinical practice by examining Korean medical etiology, pattern differentiation, and treatment, and focusing on research articles on Chinese medicine. Methods Articles on Chinese medicine related to childhood anorexia published before November 4, 2021, in the China National Knowledge Infrastructure (CNKI), were analyzed. The etiology, pattern differentiation, and Chinese medical treatment were summarized. Results Of a total of 73 studies, 13 were randomized controlled trials (RCT), 32 were case studies, and 28 were review papers. The most common Chinese medical etiology of childhood anorexia was emotional instability, and the western medical etiology was problems with diet and lifestyle. The most frequently reported pattern differentiations were spleen-stomach-qi deficiency (脾胃氣虛), stomach-yin deficiency (胃陰不足), and spleen failing in transportation syndrome (脾失健運). The most frequent prescriptions were modified Yangwijeungaektang (养胃增液湯加減), Samryongbakchulsan (蔘苓白术散加减), and Ekongsan (異功散加減). As frequntly used tuina acupoints, Naepalgwae (内八卦), Joksamli (足三里), and Bigyeong (脾經) were mentioned. Conclusions This study analyzed the etiology, pattern differentiation, and Korean medical treatment of anorexia in children. Based on this study, standardization and well-designed clinical studies on Korean medical treatments for childhood anorexia can be expected in the future.

급성기 중풍환자에서 비만 및 혈액지표의 기허 및 화열 변증의 차이에 대한 고찰 (Study on the Obesity and Blood parameters Differences between Fire/Heat and Qi-deficiency Pattern Identification/Syndrome Differentiation among Acute Stroke Patients)

  • 차민호;김소연;임지혜;강병갑;고미미;김노수;이정섭;방옥선
    • 대한한방내과학회지
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    • 제30권4호
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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.

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중풍환자의 기허변증지표에 관한 연구 (Study of The Indicators of Gi Deficiency Pattern Identification In Stroke Patients)

  • 고호연;강경원;강병갑;고미미;김보영;문진석;차민호;설인찬;이인;조현경;최선미
    • 한국한의학연구원논문집
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    • 제12권3호통권18호
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    • pp.69-77
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    • 2006
  • Background and Purpose The purpose of this study was to confirm that what symptoms are adequated indicator in the Gi-Deficiency patients. Methods In the time period July. 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 Gi deficiency group included 23 case, Non Gi deficiency group 47 case out of 136 patients. Fatigue, weakness purse, somnolence, low voice, difficulty of uprise, pale face, pale tongue were higher among Gi deficiency group. Gi deficiency and Non Gi deficiency patients do not significantly differ in white coating tongue, light-red tongue, poor appetite, frequent sweating, teeth printed tongue. Conclusions This study was insufficiency because sample size very small. More data from prospective cohort studies will help to Korean Standard Differentiation of the Symptoms and Signs for the stroke.

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중풍환자의 음허변증 진단지표에 관한 연구 (Study of The Diagnostic Indicators of Deficiency of Eum Pattern Identification In Stroke Patients)

  • 강경원;고호연;강병갑;김정철;고미미;김보영;설인찬;이인;조현경;최선미
    • 동의생리병리학회지
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    • 제21권6호
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    • pp.1655-1659
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    • 2007
  • The purpose of this study was to investigate that which symptoms are adequate indicator of the deficiency of Eum pattern in the stroke patients. In the time period Dec. 2006 to Aug. 2007, 479 patients with a first-ever stroke admitted in the department of Internal Medicine of 12 Oriental Medical Hospitals were included. Patients were hospitalized within 1 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. Eum-deficiency patients was confirmed by medical specialist diagnosis, resident diagnosis, case report form analysis without a dissenting voice. Deficiency of Eum group included 65 case, Non Eum group 414 case out of 479 patients. dryness of mouth, short and rapid purse, white face and reddish zygoma, mirror-like tongue were higher among Eum group. Eum and Non Eum patients do not significantly differ in reddened tongue, dryness in tongue, night sweat, palpitation, afternoon tidal heat, palmar heat, sores of the mouth or tongue. 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.

"동의보감(東醫寶鑑)" 내경편(內景編)에 나타난 질병(疾病)의 병기론적(病機論的) 변증(辨證)화 연구 - 정신기혈(精神氣血)을 중심으로 - (Study on Mechanistic Pattern Identification of Disease for NaeGyungPyen of DongEuiBoGam)

  • 김영목
    • 동의생리병리학회지
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    • 제24권2호
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    • pp.177-186
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    • 2010
  • This study is about researching DongEuiBoGam by analysing with pattern identification of modern Traditional Korean medical patholgy as more logical, systematic and standardized theory. Disease pattern mechanisms of essence, spirit, qi and blood in NaeGyungPyeb of DongEuiBoGam are these. In Essence, this explain mechanism of disease patterns those are seminal emission, dream emission, spermatorrhea, white ooze. These disease pattern's mechanisms are kidney yang deficiency, kidney yin deficiency, heart yang deficiency, heart yin deficiency, heart qi deficiency, spleen qi deficiency and so on. On viewpoints of viscera and bowels they are related with heart, kidney, spleen. And most of them are deficiency from deficiency-excess Pattern Identification. Classifying disease pattern of qi is about upward, downward movement and more concentrated deficiency than excess pattern. Fright palpitations can be classified heart deficiency with timidity, heart blood and qi deficiency, heart qi deficiency, heart blood deficiency, heart qi movement stagnation, water qi intimidating the heart, phlegm-fire harassing the heart, phlegm clouding the pericardium, and so on. Palpitations can be classified heart blood deficiency, heart yin deficiency, heart deficiency with timidity, heart spleen blood deficiency, spleen qi deficiency, phlegm-fire harassing the heart, intense heart fire, and so on. Forgetfulness can be classified heart spleen blood deficiency, heart spleen qi deficiency, kidney essence deficiency, heart qi deficiency, non-interaction between the heart and kidney, etc. for deficiency pattern, phlegm clouding the pericardium for excess pattern. In Blood just say inside bleeding pattern's category, there are nose bleeding, flopping syncope, qi counterflow, blood vomiting, hemoptysis, spitting of blood, bloody stool, hematuria, and so on. Like these, this study identify pattern of disease in DongEuiBoGam by mechanism of disease theory.

"상한론(傷寒論)" 육경지면설(六經地面說)에 관한 연구(硏究) (A study on the Six-surface theory in Shang-Han-Lun - Focussed on the Ke-qin's Shang-Han-Lun-Yi -)

  • 이상협
    • 대한한의학원전학회지
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    • 제26권3호
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    • pp.33-52
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    • 2013
  • Objective : Zhang Zhong-jing's Shang-Han-Lun is based on Six-channels system(六經) to classified a disease, but the notion of this seems to be a very various angles. Among them, Ke-qin(柯琴)'s Six-surface theory(六經地面說) is very clearly explained the notion of Six-channels system(六經) and it provide crucial clue to understanding a Shang-Han-Lun Method : I will try to describe the Six-surface theory(六經地面說) through the Ke-qin's Shang-Han-Lun-Yi(傷寒論翼). At the core of this paper, The diaphragm is the most important criterion to understand a Six-channels system(六經), and it is based on the human body to divided into Yin-Yang(陰陽). Result : Ke-qin's Six-surface theory(六經地面說) is connected with Meridian system(經絡), Viscera and Bowels(臟腑), and their functions. It is the concept of comprehensive to including those related were grouped into the surface. Conclusion : Six-surface(六經地面) is far beyond the simple concept of Meridian, and it include organization of pathology concepts carrying up to what happens on the human body caused by disease. We can see that Zhong-jing's(仲景) medical treatment from syndrome differentiation(辨證) is associated with a holism(整體觀).