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Comprehension of the medical diagnoses of doctors and treatment of diseases is important to understand the underlying principle in selecting appropriate acupoints. The pattern recognition process that pertains to symptoms and diseases and informs acupuncture treatment in a clinical setting was explored. A total of 232 clinical records were collected using a Charting Language program. The relationship between symptom information and selected acupoints was trained using an artificial neural network (ANN). A total of 11 hidden nodes with the highest average precision score were selected through a tenfold cross-validation. Our ANN model could predict the selected acupoints based on symptom and disease information with an average precision score of 0.865 (precision, 0.911; recall, 0.811). This model is a useful tool for diagnostic classification or pattern recognition and for the prediction and modeling of acupuncture treatment based on clinical data obtained in a real-world setting. The relationship between symptoms and selected acupoints could be systematically characterized through knowledge discovery processes, such as pattern identification.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Neural Networks, Computer , Republic of Korea , SyndromeABSTRACT
[Objective] For six consecutive years, we investigated 83 cases of the effect of acupuncture therapy on children with night terrors.[Subjects and Methods] The number of subjects was 83 (38 boys and 45 girls, mean age: 2.2 ± 2.8 years old). Acupuncture therapy for infants was defined as pattern identification/syndrome differentiation and treatment. The acupuncture therapy used spoon needles and moxibustion; skin stimulation was applied to the acupuncture point. Infant needles in the Daishi style and moxibustion of the incense stick were used as a method to approach the hole. Therapeutic effect was judged by a self-written evaluation form certified by the Japan Society of Pediatric Acupuncture. One major item, "sleep disorder (broad sense of night terrors)," three minor items ('night terror' in a narrower sense), 'difficulty in falling asleep,' 'nocturnal awakening,' number of nocturnal awakenings at night, and satisfaction with acupuncture therapy in infants were investigated. Evaluations were made at the time of the first treatment and before the fifth treatment. In the statistical analysis, the change in the score of the evaluation slip and the number of partial awakenings were tested by the Wilcoxon signed-rank-sum test. The level of significance was set at 5%.[Results] Significant improvement was observed in the score for the major item, minor items, and number of partial awakenings. The degree of satisfaction was 90.4%.[Conclusion] It was suggested that acupuncture therapy in infants is effective for ameliorating symptoms of "sleep disorder."
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<p><b>OBJECTIVE</b>To investigate the important diagnostic indicators for blood stasis syndrome (BSS) in patients of childbearing age with gynaecological diseases.</p><p><b>METHODS</b>A partial least squared-discriminant analysis (PLS-DA) were applied to BSS symptoms data of patients with gynaecological diseases, and the diagnostic indicators used by doctors of Korean medicine (DKMs) among BSS patients with gynaecological diseases were also investigated.</p><p><b>RESULTS</b>A total of 103 patients of childbearing age with gynaecological diseases and 40 healthy controls were enrolled. Among the 103 patients, 63 (61.7%) and 40 (38.8%) were diagnosed with BSS and non-BSS, respectively, and BSS patients exhibited a more severe extent of disease. A score plot of PLS-DA showed clearly different patterns among the 3 groups. Based on the variable importance on projection of PLS-DA model, menstrual pains, dark lumps in the menstrual blood, ileocoecal tenderness and resistance, sharp pains, and sublingual varicosities were selected as the top five most important indicators. Moreover, more than 75% of DKMs chose dark lumps in menstrual blood, menstrual pain, and dark menstrual blood as the diagnostic indicators of BSS in patients with gynaecological diseases, and more than 49% of them also considered sharp pains, dark red tongue, sublingual varicosities, and tendency to bruise easily as diagnostic indicators of BSS.</p><p><b>CONCLUSION</b>DKMs focused on menstrual symptoms and certain gynaecological symptoms to diagnose BSS patients of childbearing age with female diseases.</p>
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<p><b>OBJECTIVE</b>To investigate the diagnostic indicators and herbal treatments for blood stasis syndrome (BSS) patients with traumatic injuries and to identify the association between BSS and traumatic injury in Korea.</p><p><b>METHODS</b>Two-hundred and four patients with traumatic injury were recruited from the Gangnam and Daejeon branches of Jaseng Hospital of Oriental Medicine between June 2014 and December 2014. Two independent doctors of Korean medicine (DKMs) determined the diagnosis of BSS or non-BSS based on the subjects signs and symptoms. The scores assigned to BSS symptoms and DKMs' reasons for diagnosing BSS in patients with traumatic injury were investigated. Both medication and herbal prescription records from a 3-month period were collected for all patients diagnosed with BSS by both DKMs.</p><p><b>RESULTS</b>A total of 169 of 204 (82.8%) patients received consistent diagnosis related to BSS by two DKMs. Among them, 54.4% (92 cases) were diagnosed with BSS, and 45.6% (77 cases) were not diagnosed with BSS. DKMs most frequently cited symptoms of recent traumatic injury as justifications for BSS diagnoses, and also selected pain-related indicators such as abdominal pain, sharp pain and nocturnal pain as important reasons in diagnosing BSS. In addition, an inconsistency in the pattern identification theory with respect to traumatic injury was observed. Although only 92 cases (54.4%) of patients were diagnosed with BSS, 77.6% of them were prescribed decoctions for BSS.</p><p><b>CONCLUSIONS</b>DKMs considered traumatic injury could cause BSS, and utilized decoction for BSS in patients with traumatic injury without confirming a diagnosis of BSS because they assumed the main symptoms or pathologies of traumatic injury to be closely related to BSS.</p>
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Female , Humans , Male , Middle Aged , Cross-Sectional Studies , Medicine, Korean Traditional , Syndrome , Wounds and Injuries , Diagnosis , Drug TherapyABSTRACT
Conventional Western medicine (CWM) and traditional Chinese medicine (TCM) have different approaches and lead to different practices in experimental design, research methodology, regulation, and standards. TCM emphasizes on the optimal or holistic health. In contrast, CWM is an allopathic medicine primarily based on anatomy, biology, biochemistry, molecular biology and modern technology, and rejects the concept of invisible substances and quantum entanglement. Consequently, CWM emphasizes on abnormal lab tests or obvious diseases. In the early 1970s, TCM and acupuncture quickly emerged as an alternative to CWM as Westerners explored new TCM concepts while questioning the side effects of CWM. Many countries accept traditional acupuncture as a legal alternative medical practice. Some CWM physicians nowadays are more enthusiastic and are receptive to learning and practicing acupuncture. The common goal of CWM and TCM is to enhance human health, but problems arise over differences in approach. As a response to some Western journal papers that failed to validate the real acupuncture effect because of their incorrect methodologies and their ignorance of the holistic acupuncture approaches, the authors hereby present a group of case studies to demonstrate the real and unique effects of genuine acupuncture. The objective was to explore the clinical effects of acupuncture for knee pain. Thirty-six patients with knee pain were divided into five groups based on age. Holistic TCM diagnosis was performed at the beginning of each case and then made a personalized acupuncture treatment prescription according to the root of illness found by the diagnosis. The symptoms and signs were recorded before and after every treatment, and the treatment effects were assessed based upon the self-reported feeling and the observed changes of the patient following the numeric rating scale (NRS). The results were summarized after the completion of the minimal 5 acupuncture treatments or the standard 10 acupuncture treatments. Among the 36 patients who participated in the cases studies, 17 patients reported a complete healing for knee pain (47.2%). About 60 kinds of illness other than knee pain were improved (98.9%) and the complete healing rate was about 44.2%. This leads to the conclusion that TCM acupuncture is remarkably effective in treating knee pain. TCM and CWM share a common goal in promoting the health of human being. The efficacy of TCM acupuncture in treating knee pain shouldn't be denied or distorted.
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Objective:To observe the clinical efficacy of electroacupuncture (EA) combined with tuina for chronic tension-type headache (CTTH). Methods:A total of 97 CTTH cases were randomly allocated into an observation group (n=52) and a control group (n=45). Patients in the observation group were treated with EA plus tuina based on pattern identification, whereas patients in the control group were treated with oral amitriptyline and oryzanol. Patients in both groups were treated for 8 weeks. A follow-up was conducted 3 months after the treatment. The intensity, duration, and frequency of the headache were recorded and compared before and after the treatment. Additionally, the patients' psychological state and quality of life (QOL) were compared between the two groups. Results:There were intra-group statistically significant differences in headache intensity score, headache duration, and headache frequency after the treatment and during the follow-up compared with those before the treatment (allP0.05). The World Health Organization quality of life-BREF (WHOQOL-BREF) scores were significantly reduced in both groups after the treatment or during the follow-up (allP<0.05); and the scores in the observation group were significantly lower than those in the control group (allP<0.05) during the same time frame. The total effective rate was 88.0% in the observation group, versus 71.4% in the control group, showing a significant difference (P<0.05). Conclusion:EA combined with tuina can significantly decrease the frequency of chronic tension-type headache, alleviate headache intensity, shorten headache duration, and improve the patients' wellness. It is better than amitriptyline plus oryzanol.
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<p><b>OBJECTIVE</b>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 flflowchart. 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 flflowchart for each indicator. Inter-observer consistency was assessed by simple percent agreement and by the kappa and AC1 statistics.</p><p><b>RESULTS</b>The improvements in inter-observer agreement for the indicators (for all 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) generally 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 generally high for all of the indicators and ranged from "moderate" (AC1=0.408) to "excellent" (AC1=0.996).</p><p><b>CONCLUSIONS</b>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).</p>
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<p><b>OBJECTIVE</b>To observe the influence of treatment based on Chinese medicine pattern identification on cellular immunophenotype of the myelodysplastic syndrome (MDS).</p><p><b>METHODS</b>Sixty patients with MDS were randomly and equally assigned to the treatment group and the control group using a randomized digital table. Thirty patients in each group included 3 risk levels (low, moderate and high risks) with each level 10 patients according to the international prognostic scoring system. The control group was given conventional therapy which was also used in the treatment group. While the treatment group was given Zuogui Pill () and Yougui Pill () for low risk patients; Qingwen Baidu Decoction () and Bazhen Decoction () for moderate risk patients; Gexia Zhuyu Decoction () and Qinghao Biejia Decoction () combined with Shiquan Dabu Decoction () for high risk patients. After the treatment, the differences of overall response rate and immunophenotype (CD13, CD14, CD15, CD33 and CD34) of each group were analyzed.</p><p><b>RESULTS</b>The overall response rate of the treatment group was significantly higher than the control group in low risk and moderate risk patients (P=0.029), there was no statistical differences of overall response rate between the treatment group and the control group in high risk patients (P=0.089). The expressions of CD13, CD14, CD33 and CD34 in all three risk levels of the treatment group were obviously decreased after the treatment, while CD15 in all three risk levels of the treatment group was obviously increased after the treatment (P<0.05 or P<0.01). Meanwhile, the difference values of CD13 and CD33 in low risk level of the treatment group, CD33 and CD34 in moderate risk level of the treatment group as well as CD34 and CD15 in high risk level of the treatment group, were all greater than the control groups and they were statistically significant (P<0.05 or P<0.01).</p><p><b>CONCLUSIONS</b>It shows a better therapeutic effect if the MDS patients treated with Chinese medicine pattern identification in addition to conventional therapy. Since the treatment may inhibit the malignant clones and improve the dysmaturity of granulocyte differentiation, it is a feasible option in clinical practice.</p>
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Objective] To summarize the clinical key points of acupoint sticking therapy in the application of treating disease before its onset. [Method] From the treatment timing, treatment principle, acupoint selection to expound the academic perspective and clinical experience of our department in the application of acupoint sticking therapy by consulting the ancient literature and summarizing clinical practice. [Result] Through the correct selection of treatment timing for acupoint sticking therapy, which is mainly used in summer, secondly used in winter, and focusing on tonifying Yang-qi, and point selection by pattern identification, paying attention to the accumulation of curative effect, this therapy has good curative effect in the treating disease before its onset.[Conclusion] Nowadays, there are more and more sub-health people. Since acupoint sticking therapy has advantages of“easy, convenient, cheap, uesful”and safe, it is a good therapy to apply for treating disease before its onset.
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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.
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Humans , Internationality , Medicine, Chinese Traditional , Research , SyndromeABSTRACT
<p><b>OBJECTIVE</b>To explore the correlation between single acupoints used and the recurrence rate of cystitis among cystitis-prone women receiving acupuncture as a prophylactic treatment.</p><p><b>METHODS</b>In all, 58 cystitis-prone women were included in the analysis. Customised acupuncture treatments were given twice a week, over 4 weeks. The main effect parameter was the number of cystitis episodes during the 6-month observation time. Residual urine was measured at baseline, 2, 4 and 6 months using portable ultrasound equipment. Sympathetic and vagotone nerve activities were measured by using skin conductance and respiratory sinus arrhythmia, respectively.</p><p><b>RESULTS</b>The main acupoints used for patients with Kidney (Shen) qi/yang deficiency were Shenshu (BL23), Taixi (KI3), Zhongji (CV3), Sanyinjiao (SP6) and Pangguangshu (BL28), compared with Taichong (LR3), CV3, BL28, Yinlingquan (SP9) and SP6 for Liver (Gan) qi stagnation, and SP6, CV3, BL28, Zusanli (ST36) and SP9 for Spleen (Pi) qi/yang deficiency patients. The combination BL23 and KI3 were used in 16 women, 13 of which were Kidney pattern related patients. When used, the number of symptomatic episodes were reduced to a third compared with what occurred in the 42 women where this combination was not used (3/16 vs. 28/42, P<0.05). BL23 application correlated to a significant reduction in residual urine measured a few days after treatment. Patients with the pattern of Spleen qi/yang deficiency had an initial increase in residual urine after treatments.</p><p><b>CONCLUSION</b>Treating Kidney pattern related patients with the combination of BL23 and KI3 resulted in far better outcome than other points/combination of points for other Chinese medicine diagnoses. The acupoint SP6 may be less indicated than previously assumed when treating cystitis-prone women prophylactically.</p>
Subject(s)
Female , Humans , Acupuncture Points , Acupuncture Therapy , Cystitis , Therapeutics , Urine , Recurrence , Syndrome , Urinary Tract Infections , Therapeutics , Urine , Vagus NerveABSTRACT
An international brainstorming session on standardizing pattern identification (PI) was held at the Korea Institute of Oriental Medicine on October 1, 2013 in Daejeon, South Korea. This brainstorming session was convened to gather insights from international traditional East Asian medicine specialists regarding PI standardization. With eight presentations and discussion sessions, the meeting allowed participants to discuss research methods and diagnostic systems used in traditional medicine for PI. One speaker presented a talk titled "The diagnostic criteria for blood stasis syndrome: implications for standardization of PI". Four speakers presented on future strategies and objective measurement tools that could be used in PI research. Later, participants shared information and methodology for accurate diagnosis and PI. They also discussed the necessity for standardizing PI and methods for international collaborations in pattern research.
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Internationality , Medicine, Chinese Traditional , Reference Standards , Reference Standards , ResearchABSTRACT
On 20 January, 2015, U.S. President Obama announced an ambitious plan called "Precision Medicine (PM) Initiative", aiming to deliver genetics-based medical treatments. PM has shown a promising prospect by tailoring disease treatments and preventions to individuals. However, a predominantly genetics-based method restricts its benefit and applicability in most chronic and complex diseases. Pattern identification (PI) is one of the representative characteristics of Chinese medicine implying the concept of holism and individualized treatment. It is another classification method taking environmental, psychosocial and other individual factors into account. Integrating PI with disease diagnosis of Western medicine will provide a strong complement to genetics-based PM, thus establish an integrative model for individualized medicine. PI provides new perspectives for PM, not only in clinical practice, but also in new drug development and clinical trial design. It is for sure that the integrative approach will ultimately lead to a safer, more convenient and effective patient-centered healthcare and most patients will benefit in the era of PM.
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Medicine, Chinese Traditional , Precision MedicineABSTRACT
Xinjiang is the area with a high incidence of AIDS, and a high incidence of pulmonary tuberculosis. Cases of AIDS combined with pulmonary tuberculosis have continued to increase in recent years. According to the characteristics of AIDS, traditional Chinese medicine (TCM) reveals that AIDS belongs to epidemic febrile disease, and in accordance with the category of warm disease caused by incubating pathogens.
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The article reviews the viewpoints and thinking toward eczema with pattern identification in Traditional Chinese Medicine in recent five years,including professional standard given by the government and program of pattern identification which is summarized by experts of TCM from their clinical practice.The pattern identification emphasis on different stages,Zang-organs,Fu-organs,lesions and different meridians,with the principals for treatment as cleaning heat,resolving dampness,dispelling wind and arresting itching,promoting blood circulation and resolving blood stasis,it thinks highly of factors of mind in its treatment,so that to approach better thinking to normalize the treatment of eczema in TCM.