Qi Deficiency Pattern Research Articles

Characteristics of functional constipation and the need for treatment with traditional medicine of students in University of Medicine and Pharmacy, Hue University

Background: Functional constipation (FC) is considered as a common functional bowel disorder that have substantial impact on patient quality of life. Objectives: To study characteristics of FC and the need for treatment with traditional medicine of students in University of Medicine and Pharmacy, Hue University. Materials and method: A cross-sectional descriptive study was conducted in 451 students from 9 academic majors at University of Medicine and Pharmacy, Hue University. Using the Bristol Stool Form (BSF) Scale to characterize human stool and ROME III Diagnostic Questionnaire to assess constipation symptoms, using anxiety, depression, stress rating scale - DASS-21. Results: The prevalence of FC among students was 8.9% (40/451) according to ROME III criteria, female are higher than male (85.0% vs 15.0%). According to traditional medicine, Deficiency accounts for 65.0%, Excess 60.0%, Cold 42.5% and Heat 57.5%. Qi stagnation pattern accounts for 42.5%, Qi deficiency pattern 25.0%, large intestinal heat bind pattern 20.0%, blood deficiency pattern 10.0% and yang deficiency pattern 2.5%. The proportion of students who need for treatment with traditional medicine is 52.5%, acupress massage and traditional medicines are the two methods with the highest demand for treatment. Conclusion: FC among students in University of Medicine and Pharmacy, Hue University are with relatively high prevalence. Most of them have manifestations of Excess and Deficiency, Qi stagnation pattern and Qi deficiency pattern are higher than the other. Demand for treatment of FC with traditional medicine is quite high, most of them need treatment with acupress massage and traditional medicines. Key words: functional constipation, students, the need for treatment, ROME III criteria.

TCM Syndrome Recognition Model of Type 2 Diabetes Mellitus in Shanghai Based on TCM Inquiry Information.

Background Type 2 diabetes mellitus (T2DM) has become one of the serious public health problems in China, and it affects the quality of survival of patients significantly. The long-term monitoring and early warning of T2DM and its complications should be paid attention to. Artificial diagnosis of T2DM in traditional Chinese medicine (TCM) is subjective and unrepeatable at the present stage. It is important to develop standardized collection and objective analysis methods of TCM inquiry. Therefore, we are interested in establishing syndrome recognition models. Objective The establishment of the TCM syndrome recognition model of T2DM is helpful to the syndrome diagnosis of the disease, and the clear diagnosis of the syndrome is the prerequisite for the effective treatment of the disease by TCM. At present, there are few studies on syndrome recognition models of T2DM. Therefore, based on the inquiry information of TCM, we establish a latent structure model (LSM) of T2DM syndrome in Shanghai, hoping to provide services for the health management of TCM for diabetes in the future. Methods A total of 587 effective samples of T2DM patients in Shanghai were collected. The gender, course of disease, and chronic complications were analyzed by one-way ANOVA and frequency analysis. Inquiry symptoms that could be included in the model were screened. In the study, 30 symptoms were used as observable variables to analyze the symptom information of TCM inquiry, and then, the TCM syndrome recognition model was established. Results The clinical syndromes of patients with T2DM in Shanghai were mixed with deficiency and excess. The LSM divided the pattern of the disease into qi-yin deficiency pattern, yin deficiency pattern, qi deficiency pattern, and qi stagnation pattern. These patterns were mainly located in the spleen and stomach, liver, and kidney. Conclusion The results of the syndrome classification of T2DM by LSM are basically consistent with the TCM clinical characteristics of the disease, which could reflect its main etiology and pathogenesis. The LSM of TCM inquiry syndrome diagnosis of T2DM confirmed the objectivity of TCM syndrome differentiation to some extent, and it will lay a foundation for the development of a mobile APP for TCM health management of T2DM.

Protocol for evaluating the effects of Danggui Shaoyao Powder in the treatment of DPN with qi deficiency and blood stasis pattern based on routine therapy: a randomized controlled trial

Protocol for evaluating the effects of Danggui Shaoyao Powder in the treatment of DPN with qi deficiency and blood stasis pattern based on routine therapy: a randomized controlled trial

A Data Mining-Based Analysis of Core Herbs on Different Patterns (Zheng) of Non-Small Cell Lung Cancer.

Objective To explore the role of Chinese prescriptions in non-small cell lung cancer (NSCLC) and provide references for the application of herbs and prescriptions. Methods Randomized and quasirandomized controlled clinical trials on Chinese herbal medicine in the treatment of NSCLC were collected from seven databases to establish a database of prescriptions on NSCLC. Data-mining analyses were performed by RStudio (v4.0.3) software. Results A total of 970 prescriptions were obtained from 945 included studies, involving 7 syndromes and 428 herbs. The main patterns of NSCLC included qi deficiency pattern, yin deficiency pattern, blood deficiency pattern, kidney deficiency pattern, heat toxin pattern, phlegm-dampness pattern, and blood stasis pattern. High-frequency herbs on NSCLC were Astragali Radix (Huangqi), Atractylodis Macrocephalae Rhizome (Baizhu), Glycyrrhizae Radix Rhizome (Gancao), Poria (Fuling), Ophiopogonis Radix (Maidong), Hedyotidis Diffusae Herba (Baihuasheshecao), Codonopsis Radix (Dangshen), and Glehniae Radix (Beishashen). The properties of the herbs were mainly cold, warm, and mild. The flavors of the herbs were mainly sweet, bitter, and pungent. The main meridian tropisms were Lung Meridian of Hand-Taiyin, Spleen Meridian of Foot-Taiyin, and Stomach Meridian of Foot-Yangming. Conclusion Applying clearing and tonifying method by targeting the lung and spleen was the most frequently used therapy in the treatment of NSCLC. This study offered a glimpse of unique views of traditional Chinese medicine on NSCLC and may benefit the treatment of NSCLC.

Clinical Study on Measurement Intervals in the Ultrasonographic Gastric Emptying Test for Functional Dyspepsia

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. Keywords: abdominal examination, gastric emptying, ultrasonography, functional dyspepsia, questionnaire

Development of a Food Retention Questionnaire for Functional Dyspepsia and the Analysis of Its Reliability and Validity

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 α 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. Keywords: food retention, functional dyspepsia, pattern identification, questionnaire, reliability, validity

Identifying the functions and biomarkers of Codonopsis pilosula and Astragalus membranaceus aqueous extracts in hepatic cells

BackgroundHomeostasis is a crucial concept used to describe the condition of patients and the roles of herbs in traditional Chinese medicine. Qi-deficiency pattern is one of the conditions when loss of homeostasis and is usually characterized by symptoms including lassitude, spontaneous sweating, and a weak pulse, which are not easy to quantitate. Codonopsis pilosula and Astragalus membranaceus were usually prescribed for carriers with hepatitis and patients with metastatic colon cancer, because these patients tended to experience fatigue. However, crude drugs were prescribed based on the exterior symptoms of patients without controlling clinical setting, such as gender, age, and dietary habits. Limited molecular evidence of using gene expression as the guide for description is available. Therefore, the purpose of this study was to identify potential and objective biomarkers of these two qi-related drugs in a simplified cellular system.MethodsAqueous extracts of crude qi-tonifying herbs, C. pilosula and A. membranaceus, and that of a qi-consuming drug, Citrus reticulata, were prepared. Human liver cancer HepG2 cells were treated with the extracts of qi-tonifying herbs for 24 h. Differentially expressed genes were identified using microarrays and quantitative RT-PCR (qRT-PCR) and validated in two other hepatocellular cell lines, Huh7 and L-02.ResultsA total of 67 differentially expressed probes that responded to both herbs were identified. A pathway analysis revealed that these genes were involved in the development, growth, movement, and viability of the liver cells.ConclusionsAfter qRT-PCR validation and examination of clinical data from public domains, our results showed that two genes, GDF15 and HMOX1, could serve as biomarkers in liver cells for identifying responses after treatment with C. pilosula and A. membranaceus.

An innovative method to evaluate the severe level of general Qi deficiency

OBJECTIVEThe study aim was to use existing relevant indexes to establish an index series for the quantitative measurement of Qi deficiency pattern (QDP) in Traditional Chinese Medicine (TCM). METHODSSeventeen indexes of arterial oxygen saturation (SaO2), TCM pulse diagnosis, heart rate, and blood pressure were integrated into an index series, and 94 selected subjects were divided into a healthy control group, a mild QDP group, and a typical QDP group. All three groups were then synchronously given a breath-holding (BH) test and index detections using TCM apparatus for auxiliary diagnosis and treatment and a photoplethysmograph. The detections were carried out repeatedly until there was no monotonic change in the value of the minimal SaO2 during a BH measurement (SaO2MIN) or in the duration of BH during a BH measurement (TBH). RESULTSBH measurement and index detection data from 380 eligible cases were analyzed and a significant intergroup difference was found for 12 indexes. CONCLUSIONAn index series for quantitative QDP measurement could comprise the 12 effective indexes: RSaO2d (rate of decline of SaO2 during a BH measurement), RSaO2r (recovery rate of SaO2 after a BH measurement), SaO2min, BFV (blood flow velocity), TSaO2d (the time at which SaO2 started declining during a BH measurement), TBH, TSaO2min (the time of occurrence of the minimal SaO2 during a BH measurement), TSaO2max (the time of occurrence of the maximal SaO2 after a BH measurement), PTP (pulse-touching pressure), SBP (systolic blood pressure), PWV (pulse wave velocity), and DBP (diastolic blood pressure). Of the indexes, RSaO2d could play a key role in quantitative QDP measurement; RSaO2r and SaO2min could be used to differentiate the QDP symptom of shortness of breath and as early-warning indexes for chronic obstructive pulmonary disease. BFV, TSaO2d, and TBH could be used to quantitatively assess the QDP symptoms of spontaneous perspiration and shortness of breath.

Correlation Analysis Between Stomach Qi Deficiency Pattern and Gastric Emptying Measured by Abdominal Ultrasonography in Patients with Functional Dyspepsia

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 RomeIII diagnostic criteria for PDS and ten healthy controls participated in this study Gastric emptying shown as the half-life of gastric volume (T1/2) 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). T1/2 was also higher in the patient group than in the control group. The SSQD score significantly correlated positively with T1/2 in the patient group (r=0.640, p=0.046). However, there was no significant correlation between T1/2 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. Keywords: functional dyspepsia, postprandial distress syndrome, stomach Qi deficiency, gastric emptying, abdominal ultrasonography

Correlation between Dysgeusia and Spleen qi Deficiency Patterns in Patients with Burning Mouth Syndrome

Objectives This study evaluated the correlation between taste function and spleen qi deficiency in patients with burning mouth syndrome (BMS) and compared subgroups of BMS (i.e., dysgeusia and non-dysgeusia subgroups). Methods This study included 60 participants categorized into two groups: a BMS group and healthy control (HC) group. Taste threshold was measured within six levels using solutions of four basic taste qualities. Subjects’ Oral Health Impact Profiles (OHIPs-14) and Spleen qi Deficiency Questionnaire (SQDQ) scores were analyzed. Results Taste thresholds for sweet (sucrose) and salty (NaCl) tastes were significantly lower in the BMS group than in the HC group, but sour (citric acid) and bitter (quinine HCl) tastes showed no significant differences between groups. In the dysgeusia and non-dysgeusia subgroups, no significant differences in the four basic taste thresholds were found. SQDQ scores were significantly higher in the BMS group compared to the HC and in the dysgeusia group compared to the non-dysgeusia group. OHIPs-14 and SQDQ scores for the BMS group were significantly and positively correlated. Conclusions Spleen qi deficiency is related to taste function and can be used to treat BMS patients with taste dysfunction. Keywords: burning mouth syndrome, dysgeusia, taste disorder, taste threshold, spleen qi deficiency

Metabolomics Analysis for Defining Serum Biochemical Markers in Colorectal Cancer Patients with Qi Deficiency Syndrome or Yin Deficiency Syndrome.

Colorectal cancer is one of the leading causes of tumor-associated death, and traditional Chinese medicine (TCM) classifies colorectal cancer into various subtypes mainly according to the symptomatic pattern identification (ZHENG). Here, we investigated the difference in metabolic profiles of serum by comparing colorectal cancer subjects with Nondeficiency (ND), Qi deficiency (QD), and Yin deficiency (YD). The ratio of subjects with carcinoembryonic antigen (CEA) was higher in YD pattern, and the ratio of subjects with carbohydrate antigen 19-9 (CA19-9) was higher both in YD and in QD, compared with ND. As a result of metabolomics analysis, twenty-five metabolites displayed differences between QD and ND, while twenty-eight metabolites displayed differences between YD and ND. The downregulated metabolites in QD/ND and YD/ND mainly include carbohydrates and the upregulated metabolites mainly include amino acids and fatty acids, suggesting conversion obstruction of carbohydrates, fatty acids, and amino acids occurs in patients with QD and YD compared with ND. Our results demonstrate that colorectal cancer patients with QD or YD were associated with metabolic disorders and the variations of serum metabolic profiles may serve as potential biochemical markers for diagnosis and prognosis of colorectal cancer patients displayed QD or YD patterns.

Validation of the qi blood yin yang deficiency questionnaire on chronic fatigue.

BackgroundChronic fatigue (CF) reflects an imbalance of inter-organ functions or of the four essential physiological components qi, blood (xue), yin, and yang. CF can be subdivided into different patterns. However, there are no diagnostic methods for CF. This study aimed to clinically validate a pattern identification method by identifying correlations between CF and responses to the qi blood yin yang deficiency questionnaire (QBYY-Q).MethodsParticipants were recruited between May and June 2014 through the Kyung Hee University Korean Medicine hospital website and via posters and comprised 129 CF patients diagnosed with the United States Centers for Disease Control and Prevention (1994) criteria. Participants who had organic diseases that explained the CF were excluded. A total of 159 participants were asked to complete the QBYY-Q, the fatigue severity scale, and the Chalder fatigue scale. The latter two questionnaires were used to assess convergent validity with the QBYY-Q. Among the 129 CF participants, 70 and 59 had chronic fatigue syndrome and idiopathic chronic fatigue, respectively. Two Korean medical doctors independently assessed participants’ qi, blood, yin, and yang deficiency patterns using QBYY deficiency pattern identification guidelines. Based on the results of a preliminary study of the QBYY-Q, we selected 32 reliable items for symptoms corresponding to each deficiency pattern. The items were used to estimate internal consistency and construct validity. Multinomial logistic regression analysis was performed for scores on each deficiency pattern.ResultsThe data were means and standard deviations or numbers of participants and proportions for continuous and categorical variables, respectively. A statistical significance level of P < 0.05 was assumed. The QBYY-Q showed satisfactory internal consistency. Explanatory factor analysis extracted two factors for each deficiency pattern. The percentages of explained variance for qi, blood, yin, and yang deficiency were 45.1, 58.0, 52.2, and 63.4 %, respectively. Each QBYY-Q deficiency score was positively associated with each corresponding deficiency pattern. Qi deficiency was used as a reference category. Odds ratios of blood, yin, and yang deficiency were 10.97, 10.69, and 14.64, respectively.ConclusionThe QBYY-Q was suitable for estimating the influences of qi, blood, yin, and yang deficiencies in CF.Trial registration This trial was registered with the Korean Clinical Trial Register (KCT0001199)Electronic supplementary materialThe online version of this article (doi:10.1186/s13020-016-0092-y) contains supplementary material, which is available to authorized users.

Protocol for the evaluation and validation of Qi Blood Yin Yang deficiency pattern questionnaire: prospective observational study

BackgroundThe aim of this study is to validate the pattern identification standard of qi, blood, yin, and yang deficiency patterns diagnosis. The current study will investigate the usefulness of the Qi Blood Yin Yang deficiency pattern questionnaire as a diagnostic tool for qi, blood, yin, and yang deficiencies by assessing the agreement between the scores and a gold standard established by assessors. MethodsThis protocol is for a single center, prospective, observational study. A total of 248 eligible patients with unexplained chronic fatigue will be assigned to four groups in a 1:1:1:1 ratio as the qi deficiency group, blood deficiency group, yin deficiency group, and yang deficiency group. The primary outcome will be measured using the score of the Qi Blood Yin Yang deficiency pattern questionnaire and the secondary outcomes will be measured using the fatigue severity scale, Korean-translated chalder fatigue scale, computerized tongue image analysis system, and three types of pattern identification questionnaires (cold-heat, food accumulation, and seven emotions patterns). The safety of the clinical study will be assessed after measurements at every visit. All statistical analysis will be performed using the R Statistics program. Statistics experts will analyze the relationship between clinical data using the Pearson's Chi-squared test and independent t-test. DiscussionThis study will provide reference data and good evidence that are applicable to future studies. Furthermore, the results of the present study are useful to improve the care of patients with unexplained chronic fatigue and unexplained chronic fatigue-related disorders.

Efficacy of integrative medicine in deficiency of both qi and yin in the rat model of type 2 diabetes

ObjectiveTo establish a rat model of type 2 diabetes (T2DM) manifesting the Chinese medicine syndrome pattern of both qi and yin deficiency for evaluating the efficacy of a Chinese herbal formula (CHF), integrative medicine (IM), and pioglitazone (PIO) on T2DM indicators in the animal model. MethodsThe rat model was induced by a high-fat diet (HFD) and streptozotocin (STZ, 30 mg/kg). CHF (3.4 g/kg), PIO (2.7 mg/kg), and IM (3.4 g CHF + 2.7 mg PIO) were administered to rats once daily for 14 days. Related laboratory parameters were observed. ResultsDiabetic rats showed unsmooth fur, alopecia, reduced activity, huddling, somnolence, depression, pale or reddened tongue, damp/dark red tail, and high levels of water and food intake, urine volume, and stool weight, but weakened grip strength. Low levels of serum SOD, Na+-K+-ATPase, cAMP/cGMP, and a high level of iNOS were observed. Hyperglycemia, hyperinsulinemia, insulin resistance, high levels of serum glucagon/IDE and pancreatic amylin, and low serum and pancreatic SS levels were evident as well. ConclusionsA rat model of T2DM with both qi and yin deficiency was successfully replicated. CHF appeared to be more efficacious than IM and PIO in the rat model of qi and yin deficiency pattern of T2DM, though IM and PIO were each found to have their merits and drawbacks in attenuating T2DM indicators in the rat model.

Reliability and Validity Analysis of a Standard Instrument of Diagnosis and Assessment for Spleen Qi Deficiency Pattern in Chronic Dyspepsia Patients

Objectives: This study is aimed at assessing the reliability of a standard instrument of diagnosis and assessment for Spleen Qi deficiency pattern questionnaire (SQDQ) and examining the validity of the SQDQ by comparing the pattern identification scores of different groups. Methods: We conducted a survey of 72 participants (60 patients with chronic dyspepsia and 12 healthy subjects) using self-reported questionnaire. Participants were given written consent and this study was performed under the permission of institutional review board of Kyung-Hee university Korean medicine hospital. Results: The reliability and the validity of the questionnaire were inspected. Internal consistency of the SQDQ was excellent. Construct validity analyzed by exploratory factor analysis produced 4 factors, which were selected from eigenvalues that are greater than 1.0. The factor 1, 2, 3 and 4 showed ‘fatigue’, ‘meal’, ‘diagnosis’ and ‘figure’ respectively. For most of SQDQs’ items, there were significant differences observed between the Spleen Qi and the non-Spleen Qi groups. However, the ‘emaciation’, ‘tongue diagnosis’ and ‘pulse diagnosis’ showed no significant differences. Conclusions: The SQDQ restructured in this study may provide a fundamental questionnaire and a further study is required for a more advanced, standardized and statistically proven questionnaire.

Clinical Study on Relationship between Pattern Identifications for Stroke and the Second Derivative of Photoplethysmogram Waveform from Stroke Preventive Examination

This study was performed to find a relationship between each pattern identification and vascular status using the second derivative of photoplethysmogram waveform(SDPTG) indices. We analyzed 200 subjects who participated in stroke preventive examination. We classified the subjects into four groups of pattern identifications; Fire-Heat pattern (火熱證; FH), Yin Deficiency pattern(陰虛證; YD), Qi Deficiency pattern(氣虛證; QD) and Dampness-Phlegm pattern(濕痰證; DP) that based on Korean Standard Pattern Identifications for Stroke-Ⅲ. We studied a relationship between each pattern identification and the SDPTG. The total number of the subject group was 200, whereas the groups were divided into four groups; Fire-Heat pattern group(n=49), Yin Deficiency pattern(n=57), Qi Deficiency pattern(n=45), and Dampness-Phlegm pattern(n=49). b/a ratio was related with age and systolic blood pressure, c/a ratio was associated with age, systolic blood pressure, fasting blood sugar and Total cholesterol, d/a ratio was affected with age, diastolic blood pressure, and hypertension, e/a ratio was related with age and sex and SDPTG AI was associated with age. c/a ratio and d/a ratio were significantly higher in the Fire-Heat group than in the Qi Deficiency group. SDPTG AI was significantly higher in the Qi Deficiency group than in the Fire-Heat group. The Qi Deficiency group was significantly older than the Fire-Heat group and the number of hypertension patients was significantly more in the Fire-Heat group than in the Qi Deficiency group. Through this study, we found out some significant relationships between each pattern identification group and the SDPTG indices.

Fundamental study for the Standardization and Objectification of Pattern Identification in traditional Korean medicine for Stroke (SOPI-Stroke): An overview of the second and third stages

IntroductionAim of this paper is to provide an overview of the second and final stages of the Fundamental Study for the Standardization and Objectification of Pattern Identification in Traditional Korean Medicine (TKM) for stroke (SOPI-Stroke). MethodsThe total duration of this project was nearly 9 years (April 2005 to December 2013), and was divided into 3 stages. The objective of the second and third stages of this project was the validation and confirmation of pattern identification in the SOPI-Stroke using the clinical data from cross-sectional and prospective clinical studies and finding candidate biomarkers for Pattern Identification (PI) diagnosis. Approximately 117 researchers from 3 national institutes, 11 universities and 27 hospitals participated in the second stage. The clinical evaluation of PI for stroke was performed during the third stage using observational design and follow-up. ResultsWe finally confirmed 4 patterns ((Fire-heat pattern, damp-phlegm pattern (dampness-phlegm pattern), Qi-deficiency pattern, and Yin-deficiency pattern)) with 44 pattern indicators for diagnosing Korean patients with stroke. The Korean standard PI for stroke (K-SPI-Stroke) tool was developed, and a clinical and biomedical database (totaling 6400 cases) was constructed at the end of the second stage. At the end of the third stage, the “Handbook of Terminology and Formulae for Pattern Identification of Stroke in Korean Medicine” and the white paper titled ‘White Paper of Pattern Identification Research in Korean Medicine’, describing the full process of the SOPI-Stroke project, were completed. ConclusionsThis study will help to design future research and advance the scientific knowledge of physicians by enhancing the accuracy of PI in TKM.

NEURO-ENDOCRINE-IMMUNE BIOLOGICAL NETWORK CONSTRUCTION OF QI DEFICIENCY PATTERN AND QI STAGNATION PATTERN IN TRADITIONAL CHINESE MEDICINE

Nowadays, it is quite challenging to clarify Chinese medicine's results and its internal biological foundation in the traditional Chinese medicine (TCM) field. The key to break through this problem is to make the right methodological choices. From our study, a pattern consisting of many kinds of characterizations has been found, and every characterization corresponds with its internal biological indicators. If the relationship of every characterization and its biological indicators can be structured, and of each pattern and its biological indicators, it will help us to understand TCM better. Therefore, it is a better method to construct and analyze the "pattern-characterization-biological indicator" network. The aim of this paper is to distinguish two common Chinese medicine patterns, qi deficiency pattern and qi stagnation pattern, and their characterizations in terms of internal biology by using literature-mining methods. Furthermore, the results will be validated by clinical data to examine the methodological reliability. A neuro-endocrine-immune (NEI)-related gene data dictionary and a human phenotype ontology (HPO) characterizations terminology database have been established for these two patterns. Relevant literatures about the characterizations of these two patterns can be found on PubMed. Two different literature-mining software PubMiner and GenCliP, were used on the principle of "pattern-characterization-biological indicator" co-occurrence to find the characteristic NEI gene and the chemical messenger (CM) of Qi deficiency and qi stagnation patterns and to explore the difference in the bioactive substances between the two patterns, such as Hormones, Receptors, Cytokine, Neurotransmitters, etc. Biological networks of the two patterns and their various characterizations were separately constructed by using two literature-mining methods. After integrating and analyzing all kinds of networks, we found that qi deficiency pattern genes based on the NEI network include CD4, CHAT, EPO, GCG, INS, PTH, PRL, REN, SHBG and MAOA; and the key chemical transmitters include IgA, IgM, IgG, IL6, INFα, C3, C4, IL2, T, TSH, T3, T4, NO, EPO, E2, Serotonin, Histamine, ACTH, Hydrocortisone, Insulin, Cytokine, Calcitriol, Aldosterone, Adenosine, Somatostatin, Progesterone Acetylcholine, NE and Dopamine. Qi stagnation pattern genes based on the NEI network include EGF, EGFR, INS, PRL, SHBG, SNAP25, BDNF, COMT, DRD4, CD4 and IL6; and the key chemical transmitters include T3, E2, Prolactin, Serotonin, Steroids, T, ACTH, TSH, NE, ACTH and IL6. By comparing the literature data with clinical data, we found that abnormalities of the endocrine system, especially the thyroid, adrenal gland and gonadal gland, are closely related to the occurrence of coronary heart disease (CHD). The abnormalities in the endocrine system affect the immune system and nervous system, which eventually leads to CHD. The CHD of qi deficiency pattern emphasizes the imbalance of the immune system, while that of qi stagnation patients focuses on the imbalance of the nervous system. To some extent, it is feasible to use literature-mining methods to construct and analyze the "pattern-characterization-biological indicator" network as a new method of finding syndromes for the biological indicators. It provides an advanced, effective and concise method for the objectivity and internalization of traditional medicine. However, the universality and reliability of this method will need to be further validated by other syndrome studies.

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases of Paediatrics (Part 3)

Aim of this paper is to provide an overview of the second and final stages of the Fundamental Study for the Standardization and Objectification of Pattern Identification in Traditional Korean Medicine (TKM) for stroke (SOPI-Stroke).The total duration of this project was nearly 9 years (April 2005 to December 2013), and was divided into 3 stages. The objective of the second and third stages of this project was the validation and confirmation of pattern identification in the SOPI-Stroke using the clinical data from cross-sectional and prospective clinical studies and finding candidate biomarkers for Pattern Identification (PI) diagnosis. Approximately 117 researchers from 3 national institutes, 11 universities and 27 hospitals participated in the second stage. The clinical evaluation of PI for stroke was performed during the third stage using observational design and follow-up.We finally confirmed 4 patterns ((Fire-heat pattern, damp-phlegm pattern (dampness-phlegm pattern), Qi-deficiency pattern, and Yin-deficiency pattern)) with 44 pattern indicators for diagnosing Korean patients with stroke. The Korean standard PI for stroke (K-SPI-Stroke) tool was developed, and a clinical and biomedical database (totaling 6400 cases) was constructed at the end of the second stage. At the end of the third stage, the “Handbook of Terminology and Formulae for Pattern Identification of Stroke in Korean Medicine” and the white paper titled ‘White Paper of Pattern Identification Research in Korean Medicine’, describing the full process of the SOPI-Stroke project, were completed.This study will help to design future research and advance the scientific knowledge of physicians by enhancing the accuracy of PI in TKM.

Exploring the etiology relationships between YangMing internal heat and Wind-warm Lung-heat disease by prospective cohort study methodology

Purpose: Unexplained chronic fatigue (CF) is common symptom in worldwide. According to the theory of Korean Medicine (KM), CF is considered to be the imbalance of interorgan functions or the four essential components of the human body, including qi, blood, yin and yang. Thus CF appears to have individual differences, it can be subdivided into different pattern identification (PI) for a personalized diagnosis in KM. However, there are no diagnostic tools, such as questionnaires or medical devices. The purpose of this studywas to develop PI questionnaires and to complete a clinical trial to determine the correlation between CF and Qi Blood Yin Yang Deficiency Questionnaires (QBYYDQs). Methods: A total of 151 participants, including 121 CF patients and 30 healthy subjects, were asked to complete the QBYYQs. Two Korean medical doctors independently assessed participants’ qi, blood, yin and yang deficiency patterns (DPs) by the PI guidelines. We selected reliable questionnaire items for symptoms corresponding to each DP based on the results of a preliminary study. These itemswere used to estimate internal consistency and construct validity. A multinomial logistic regression analysis (MLRA) was performed by each DP score. Results: The qi (9 items), blood (8 items), yin (9 items) and yang (6 items) DQs showed sufficient internal consistency (0.816, 0.826, 0.807 and 0.717, respectively). Two subscales from each DQ were extracted by an explanatory factor analysis. The variances for each qi, blood, yin, and yang DQ were 52.8%, 58.0%, 52.2%, and 63.5%, respectively. Odds ratios from the MLRA demonstrated that each deficiency score was positively associated with each corresponding DP (adjusted odds ratio: qi score=0.041, blood score=5.877, yin score=12.57, yang score=13.56, reference category: qi deficiency). Conclusion:These results suggest that the QBYY-Q is a reliable and valid instrument for estimating the influence of qi, blood, yin and yang deficiencies on CF. Contact: Jihye Kim, wisdom00311@kiom.re.kr