Cases of Idiopathic Sensorineural Hearing Loss Exhibiting Medium Pattern and Excess Pattern / 日本東洋医学雑誌

We have reported cases of idiopathic sensorineural hearing loss treated with Japanese Kampo medicine in the past, but they all exhibited deficiency pattern. This time, we experienced cases of idiopathic sensorineural hearing loss, which exhibited medium pattern and excess pattern. Case 1 is a 57-year-old man. He had a chief complaint of ringing and hearing loss in his right ear from 3 days ago and was diagnosed with right idiopathic sensorineural hearing loss Grade3b. He exhibited medium pattern with liver qi depression and blood stasis, and was administered shosaikoto and keishibukuryogan. He was cured after 2 weeks. Case 2 is a 48-year-old man. He had a chief complaint of hearing loss in his right ear and dizziness from 2 days ago and was diagnosed with right idiopathic sensorineural hearing loss Grade4a. He exhibited excess pattern with liver qi depression and blood stasis, and was administered daisaikoto and tokakujokito for 1 week. After that, we switched tokakujokito to keishibukuryogan and continued treatment, but there remained a slight difference in hearing around the treble part, and it stopped at a remarkable recovery.

Prediction Model for Deficiency-Excess Patterns, Including Medium Pattern / 日本東洋医学雑誌

We have previously reported on a predictive model for deficiency-excess pattern diagnosis that was unable to predict the medium pattern. In this study, we aimed to develop predictive models for deficiency, medium,and excess pattern diagnosis, and to confirm whether cutoff values for diagnosis differed between the clinics. We collected data from patients' first visit to one of six Kampo clinics in Japan from January 2012 to February 2015. Exclusion criteria included unwillingness to participate in the study, missing data, duplicate data, under 20 years old, 20 or less subjective symptoms, and irrelevant patterns. In total, 1,068 participants were included. Participants were surveyed using a 153-item questionnaire. We constructed a predictive model for deficiency, medium, and excess pattern diagnosis using a random forest algorithm from training data, and extracted the most important items. We calculated predictive values for each participant by applying their data to the predictive model, and created receiver operating characteristic (ROC) curves with excess-medium and medium-deficiency patterns. Furthermore, we calculated the cutoff value for these patterns in each clinic using ROC curves, and compared them. Body mass index and blood pressure were the most important items. In all clinics, the cutoff values for diagnosis of excess-medium and medium-deficiency patterns was > 0.5 and < 0.5, respectively. We created a predictive model for deficiency, medium, and excess pattern diagnosis from the data of six Kampo clinics in Japan. The cutoff values for these patterns fell within a narrow range in the six clinics.