Perception of pattern identification in traditional medicine:a survey of Korean medical practitioners

OBJECTIVE: To survey assesses the perception of pattern identification(PI) diagnosis of Traditional Medicine(TM)by Korean medical doctors(KMDs).METHODS: A total of 14 485 KMDs affiliated with the Association of Korean Medicine were sent surveys via email, and 1646(11.1%) responded to the questionnaire on their perception of PI diagnosis.RESULTS: Of the 1646 respondents, more than ninety percent(1562, 94.9%) reported that they treated patients using PI.The most critical problem with PI diagnosis was the lack of objective diagnostic indicators(561, 34.1%). Ninety percent had issues diagnosing patients because of different diagnoses between KMDs(1491, 90.5%). The majority of respondents thought herbal medicine was most related to PI(1528, 92.8%). Half of the respondents answered that PI of Ba Gang was the most commonly used PI system. Participants reported that it was most important to study standardisation of PI diagnosis and to develop standardised PI diagnoses using the classification system of the Korean Standard Classification of Diseases. The foremost PI type that physicians thought should be included in standardisation and objectification of PI of TKM was the PIof Ba Gang.CONCLUSION: Our data suggest that we should focus on the standardisation of PI diagnosis and PI of Ba Gang in future research on PI diagnosis inTM.However, we cannot completely discount the possibility that a biased selection of subjects and a low response rate limit the generalisability of the findings.

Cancer incidence varies significantly depending on Sasang constitution of Traditional Korean Medicine

OBJECTIVE: Sasang constitutional medicine is a component of Traditional Korean Medicine that stresses the hereditary makeup of disease incidences or therapeutic responses. This study investigated the relationship between the incidence of cancer and Sasang constitution classification. METHODS: Five hundred and one cancer patients were classified as having one of the four types of Sasang constitutions (Taeumin, Soumin, Soyangin, Taeyangin) using Questionnaire for Sasang Constitution Classification II, then compared with data from 1423 healthy subjects. RESULTS: The Sasang constitutional distribution for the cancer patients was significantly differentfrom that for healthy subjects: 22.8% vs 46.9% for Taeumin, 35.5% vs 24.0% for Soumin, and 41.7% vs 29.1% for Soyangin. Our results assumed that the lowest cancer incidence would be in Taeumin (around 2-fold in both sex) while the highest cancer incidence in Soumin males (2.8-fold) and Soyangin females (2.1-fold). CONCLUSION: This study identified a trend involving the frequency of cancer and the Sasang constitutional classification. We hope that this finding will provide new ideas for the study of cancer incidence and its preventive management.

Inter-observer Reliability of Indicators and Decision of Pattern Identification Using Diagnostic Flowchart with Traditional Korean Medicine

Objective： To evaluate the consistency of patterns and pattern identification（PI）, and the improvement in the diagnosis of blood stasis after the standard operating procedures（SOPs） were enhanced by using a diagnostic flowchart. Methods： A total of 358 subjects who were admitted by the Jaseng Hospital of Korean Medicine between June 2013 and December 2014 were included in the study. Each patient was independently diagnosed by two experts from the same department. In 2014, the SOPs included the use of a diagnostic flowchart for each indicator. Inter-observer consistency was assessed by simple percent agreement and by the kappa and AC1 statistics. Results： The improvements in inter-observer agreement for the indicators（for al patients） and PI were greater in 2014 than in 2013. In 2013, the j-value measure of agreement between the two experts ranged from ＂poor＂（κ=–0.051） to ＂good＂（κ=0.968）. The AC1 measure of agreement between the experts was generally high for the indicators and ranged from –0.010 to 0.978. In most cases, agreement was considerably lower when it was assessed by the j-values compared with the AC1 values. In 2014, the j-value measure of agreement on the indicators（for the subjects） general y ranged from poor to good, with the values ranging from –0.007 to 0.994. Moreover, the AC1 measure of agreement between the experts was general y high for al of the indicators and ranged from ＂moderate＂（AC1=0.408） to ＂excel ent＂（AC1=0.996）. Conclusions： In four examinations, there was moderate agreement between the clinicians on the PI indicators of blood stasis. To improve clinician consistency（e.g., in the diagnostic criteria used）, it is necessary to analyse the reasons for inconsistency and to improve clinician training.（Trial registration No. KCT0000916）

Analysis of Herbal Medicine Prescriptions for Patients in An Academic Korean Medical Hospital:A Cross Sectional Study of Electronic Medical Records(2010–2013)

Objective： To obtain fundamental information for the standardization of herbal medicine in Korea. Methods： We analyzed the herbal medicine prescription data of patients at the Pusan National University Korean Medicine Hospital from March 2010 to February 2013. We used the Dongui-Bogam （Dong Yi Bao Jian） to classify prescribed herbal medicines. Results： The study revealed that the most frequently prescribed herbal medicine was ‘Liuwei Dihuang Pill （LWDHP, 六味地黄丸）＇ which was used for invigorating ‘Shen （Kidndy）-yin＇. ‘LWDHP＇ was most frequently prescribed to male patients aged 50-59, 60-69, 70-79 and 80-89 years, and ‘Xionggui Tiaoxue Decoction （XGTXD, 芎归调血饮）＇ was most frequently prescribed to female patients aged 30-39 and 40-49 years. According to the International Classification of Diseases （ICD） codes,‘Diseases of the musculoskeletal system and connective tissue＇ showed the highest prevalence. ‘LWDHP＇ and ＇XGTXD＇ was the most frequently prescribed in categories 5 and 3, respectively. Based on the percentage of prescriptions for each sex, ‘Ziyin Jianghuo Decoction （滋阴降火汤）＇ was prescribed to mainly male patients, and ‘XGTXD＇ with ‘Guima Geban Decoction （桂麻各半汤）＇ were prescribed to mainly female patients. Conclusion： This study analysis successfully determined the frequency of a variety of herbal medicines, and many restorative herbal medicines were identified and frequently administered.

Anti-anger Effects of Herbal Medicine:A Mini-Review of Rat Studies

Objective:To analyze the available data on the anti-anger effects of herbal medicines(HMs)as well as their underlying mechanisms in rat models.Methods:From 6 electronic databases[PubMed,EMBASE,China National Knowledge Infrastructure(CNKI),Wanfang,Oriental Medicine Advanced Searching Integrated System(OASIS),and Research Information Sharing Service(RISS)],relevant animal experiments were searched by using"anger,""rats,"and"animal"as search keywords.The last search was conducted on November 22,2019,and all experiments involving rat models of anger and treatment using HMs published until the date of the search were considered.Results:A total of 24 studies with 16 kinds of HMs were included.Most studies have used the tail irritating method and"social isolation and resident intruder"method to establish anger models.According to the included studies,the therapeutic mechanisms of HMs for anger regulation and important herbs by their frequency and/or preclinical evidence mainly incladed regulation of hemorheology(Bupleuri Radix,Paeoniae Radix Alba,and Glycyrrhizae Radix),regulation of sex hormones(Bupleuri Radix,Cyperi Rhizoma,and Paeoniae Radix Alba),regulation of neurotransmitters(Cyperi Rhizoma),regulation of anger-related genes(Bupleuri Radix,Glycyrrhizae Radix,and Paeoniae Radix Alba),and other effects.Overall,Liver(Gan)qi-smoothing herbs including Bupleuri Radix and Cyperi Rhizoma were the most frequently used.Conclusions:This review found the frequent methods to establish an anger model,and major mechanisms of anti-anger effects of HMs.Interestingly,some Liver qi-smoothing herbs have been frequently used to investigate the anti-anger effects of HM.These findings provide insight into the role and relevance of HMs in the field of anger management.

Effect of modified fasting therapy on body weight, fat and muscle mass, and blood chemistry in patients with obesity

OBJECTIVE: The aim of this study was to investigate the effects and safety of modified fasting therapy using fermented medicinal herbs and exercise on body weight, fat and muscle mass, and blood chemistry in obese subjects.METHODS: Twenty-six patients participated in a14-day fast, during which they ingested a supplement made from fermented medicinal herbs and carbohydrates(intake: 400-600 kcal/d). The schedule included 7 prefasting relief days and 14 days of stepwise reintroduction of food. The patients also took part in an exercise program that incorporated Qigong, weight training, and walking exercises. The efficacy of treatments was observed by assessing body fat mass and muscle mass, and alanine aminotransferase(ALT), aspartate aminotransferase(AST),cholesterol, and triglycerides in each study period.Specific symptoms or side effects were reported.RESULTS: Body weight and body fat mass both decreased significantly by(5.16 ± 0.95) and(3.89 ±0.79) kg(both P < 0.05), while muscle mass decreased by an average of(0.26 ± 0.22) kg, without statistical significance. ALT levels were significantly decreased(P < 0.05), while AST levels decreased without statistical significance(P = 0.052). The levels of total cholesterol and triglycerides were also significantly decreased(both P < 0.05). There were few adverse events except for mild dizziness, which did not affect everyday living.CONCLUSION: These results suggest that modified fasting therapy using fermented medicinal herbs and exercise could be effective and safe on obese patients.

Current Research and Future Directions in Pattern Identification： Results of an International Symposium

A symposium on pattern identification（PI）was held at the Korea Institute of Oriental Medicine（KIOM）on October 2,2013,in Daejeon,South Korea.This symposium was convened to provide information on the current research in PI as well as suggest future research directions.The participants discussed the nature of PI,possible research questions,strategies and future international collaborations in pattern research.With eight presentations and an extensive panel discussion,the symposium allowed participants to discuss research methods in traditional medicine for PI.One speaker presented the topic,＇Clinical pattern differentiation and contemporary research in PI.＇Two speakers presented current trends in research on blood stasis while the remaining five other delegates discussed the research methods and future directions of PI research.The participants engaged in in-depth discussions regarding the nature of PI,potential research questions,strategies and future international collaborations in pattern research.

Distributions of Sasang constitutions and six syndromes in patients with functional dyspepsia and healthy subjects

OBJECTIVE:To investigated the characteristics of patients with functional dyspepsia(FD)in terms of Sasang constitutional medicine.METHODS:A total of 116 patients with FD were recruited based on diagnosis by gastroscopy and symptomatic measurements.The distributions of Sasang constitutions and six syndromes in terms of TKM theory in the patients was compared with those from 1423 healthy subjects.RESULTS:The distribution of Sasang constitutions for the patients with FD significantly differed from that for healthy subjects,especially among women;36.7%vs 45.6%for Taeumin,28.9%vs 33.9%for Soumin,and 34.4%vs 20.4%for Soyangin.Our results assumed a high prevalence in Soyangin women(around 1.7 folds),and Soumin(45.2%),inparticular,had a high prevalence of"deficiency and coldness of spleen and stomach"compared with Taeumin(14.9%)and Soyangin types(15.7%).CONCLUSION:This study identified a trend for the frequency of FD and the Sasang constitutions.The findings may provide new ideas for the study of prevention and management of FD.