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한의 복진 정량화 연구 - 기능성 소화불량 환자의 복냉 진단을 중심으로 -

Study on the Possibility of Quantitative Measurement of Abdominal Examinations in Korean Medicine - A Focus on Diagnosis of Abdominal Coldness in Functional Dyspepsia Patients -

고석재|김진성|박재우|조수호|이재홍
대한한방내과학회 (The Society Of Korean Oriental Internal Medicine)|2018.09|대한한방내과학회지 (The Journal of Korean Oriental Internal Medicine)|제39권 제4호|pp. 495-510

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참고문헌

키워드

abdominal examinationfunctional dyspepsiaabdominal coldnessoral temperaturedigital infrared thermal imaging
주제분류한의학

초록

Objective: This study was designed to investigate the possibility of quantification of the diagnosis of abdominal coldness (AC) in patients with functional dyspepsia (FD). Methods: Forty-four patients with FD were enrolled in this study. Three Korean medicine doctors each randomly examined all abdomens. Diagnosis of AC was made by consensus of at least two of the doctors. Body temperature (oral by digital oral thermometer) and skin temperature (by digital infrared thermal imaging [DITI]) were measured, followed by administration of the Cold and Heat questionnaire (CHQ) and the Instrument of Pattern Identification for Functional Dyspepsia (IPIFD). Results: Of the 44 patients with FD, 22 were assigned to the AC group and 22 to the non-AC group. The concordance rate of diagnosis among the three doctors was 63.6% (28/44), with a κ of 0.504, indicating means moderate agreement). Neither the oral nor the skin temperatures showed statistically significant differences between the AC and non-AC groups. However, the CHQ scores and 'Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD were higher in AC group and showed statistically significant differences (p=0.010 and 0.009). Conclusions: This is the first study conducting quantitative measurements of abdominal coldness in patients with FD. Although oral and skin temperature showed no statistical significance between AC and non-AC groups, the concordance rate of diagnosis of AC among the three Korean Medicine doctors was moderate. The CHQ scores and ‘Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD also suggest that diagnosis of AC is relevant to cold and heat patterns, and these questionnaires could be utilized as supportive data for the diagnosis of AC. Further studies should be conducted for the purpose of quantifying and standardizing abdominal examinations in Korean Medicine.

Abstract

Objective: This study was designed to investigate the possibility of quantification of the diagnosis of abdominal coldness (AC) in patients with functional dyspepsia (FD). Methods: Forty-four patients with FD were enrolled in this study. Three Korean medicine doctors each randomly examined all abdomens. Diagnosis of AC was made by consensus of at least two of the doctors. Body temperature (oral by digital oral thermometer) and skin temperature (by digital infrared thermal imaging [DITI]) were measured, followed by administration of the Cold and Heat questionnaire (CHQ) and the Instrument of Pattern Identification for Functional Dyspepsia (IPIFD). Results: Of the 44 patients with FD, 22 were assigned to the AC group and 22 to the non-AC group. The concordance rate of diagnosis among the three doctors was 63.6% (28/44), with a κ of 0.504, indicating means moderate agreement). Neither the oral nor the skin temperatures showed statistically significant differences between the AC and non-AC groups. However, the CHQ scores and 'Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD were higher in AC group and showed statistically significant differences (p=0.010 and 0.009). Conclusions: This is the first study conducting quantitative measurements of abdominal coldness in patients with FD. Although oral and skin temperature showed no statistical significance between AC and non-AC groups, the concordance rate of diagnosis of AC among the three Korean Medicine doctors was moderate. The CHQ scores and ‘Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD also suggest that diagnosis of AC is relevant to cold and heat patterns, and these questionnaires could be utilized as supportive data for the diagnosis of AC. Further studies should be conducted for the purpose of quantifying and standardizing abdominal examinations in Korean Medicine.

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