The Autonomic Nervous Function and the Yin-Yang Constitutional Characteristics of the Patients with Functional Gastrointestinal Disorders / 신경정신의학

ABSTRACT

OBJECTIVES: It was revealed that autonomic dysfunction, especially decreased parasympathetic functions, seems to be one of the major etiological factors in functional gastrointestinal disorders(FGID) The physiological characteristics of sympathetic and parasympathetic functions are externally similar to the features of Yin and Yang based on oriental medicine theory. And it was also revealed that gastrointestinal symptoms are prevalent in Lesser Yin constitutional type riginated from four types of constitution shown in Sasang constitutional theory. If we obtain the findings on the similarities or compatibilities between autonomic nervous functions and physical constitutional features in functional gastrointestinal disorders, we could apply various oriental treatment modalities to the patients with functional disorders, especially according to Yin-Yang constitutional concept. METHODS: We investigated the correlations between characteristics of physical constitution(Yin and Yang)and imbalance of the autonomic functions in patients with FGID. Subjects consisted with three groups: 27 patients with FGID (including irritable bowel syndrome, functional dyspepsia, functional abdominal pain syndrome according to the Rome criteria) 28 patients with somatoform disorders who had symptoms other than abdominal symptoms (other somatoform disorders) and 26 normal healthy controls. Characteristics of constitutions were evaluated and divided into two major groups, i.e., Lesser Yin constitution and other constitutions (Greater Yin & Yang and Lesser Yang included)according to the Je-Ma Lee's Classification Questionnaire for Four Constitutional Types (Song et al. 1993) For evaluating the autonomic functions, three parasympathetic functions and two sympathetic functions were measured. Levels of anxiety and depression were also evaluated to be used as a covariant controlling the autonomic functions. RESULTS: 1)FGID group showed significantly lower parasympathetic functions compared to healthy controls, however, there was no differences between FGID and other somatoform disorder groups. 2)Lesser Yin constitutional type was not so prevalent in FGID group. 3)When FGID and other somatoform disorder groups were combined and compared with normal healthy controls, the former group showed significantly lower parasympathetic functions than the latter group. CONCLUSIONS: According to these results, Lesser Yin constitutional type do not seem to be closely related with FGID. However, it was suggested that decreased parasympathetic functions were partly associated with this group. We could not find any correlations or compatibilities between two constitutional characteristics and autonomic dysfunction in FGID. This means that functional symptoms of FGID when those were deducted as Yin and Yang characteristics based on oriental medicine could not be understood as two oppositional and co-operative functions such as autonomic functions. Further research with more restricted symptoms selected in the functional disorders and with other physiological cues applied would be needed.