Developing an optimized cold/heat questionnaire

윤영흠,김호석,이영섭,유종향,이시우 한국한의학연구원 2015 Integrative Medicine Research Vol.4 No.4

Background The cold/heat questionnaire is one of the most actively developed patient diagnostic tools in traditional Korean medicine (hereafter abbreviated as TKM) because of its objectivity. Unfortunately, the existing questionnaires contain too many items to hold the respondent's attention. In the current study, we aimed to develop an optimized cold/heat questionnaire to be used as a complement to the existing questionnaires. Methods We developed a new cold/heat questionnaire based on a domain analysis of the existing questionnaires. The questionnaire's reliability was examined via two test–retest reliability analyses involving 1890 individuals in November 2013 and February 2014. Its validity was examined using a professional cold/heat diagnosis kappa value. Results The new cold/heat questionnaire consisted of a total of seven items, which were created based on an analysis of the existing questionnaires. A reliability analysis performed using the study participants revealed a correlation coefficient of 0.609, 74.5% agreement with professional cold/heat diagnoses by TKM practitioners, and a kappa value of 0.487. Conclusion In the current study, we developed an optimized cold/heat questionnaire. The level of agreement between the questionnaire and professional cold/heat diagnoses by TKM practitioners was significant, which indicates great potential for its widespread use as a diagnostic tool in TKM.

론문(論文) : 주단계(朱丹溪)의 상화론(相火論)이 나오기 이전까지의 화(火)에 대한 고찰

윤영흠 ( Young Heum Yoon ),윤창열 ( Chang Yeol Yun ) 대한한의학원전학회(구 대한원전의사학회) 2014 대한한의학원전학회지 Vol.27 No.1

Objective: The writer has come to see that a study of the Theory of Ministerial Fire of JuDanGae presupposes a study of earlier theories of fire. Therefore, I have analyzed and studied the theories of fire presented by medical doctors since 『Nae Gyeong(黃帝內經)』 Method: To begin with, I have studied the concepts of grand fire(壯火) and small fire(少火), imperial fire(君火) and ministerial fire(相火) in 『Nae Gyeong』, and have construed the meaning of human fire(人火) and dragon fire(龍火) by Wang Bing(王氷), and fatty fire(膏火) by Sohn Sa-mak(孫思邈). Next, I have studied true fire(眞火) by Huh Sook-mi(許叔微) and true yang(眞陽) and pit fire(坎火) by Eom Yong-hwa(嚴用和), Theory on Right Kidney as the Gate of Life and Ministeiral Fire(右腎命門相火說) by Yu Wan-so(劉完素), and the reason why Jang Wan-so(張元素) asserted Theory of Three Burners as Ministerial Fire(三焦相火說). Result: I have understood the influence that the concepts of grand fire and small fire, imperial fire and ministerial fire in 『Nae Gyeong』have exercised on the later medical doctors, and have also understood the physiological and pathological Fire that influences the human body. Moreover, I have seen that Fire, as discussed by scholars from Huh Sook-mi and Eom Yong-hwa to Yu Wan-so and Jang Wan-so, made great contribution to the later development of Theory of the Gate of Life, getting its entire picture in Eum Hwa. Conclusion: Seeing that the theories of Fire presented by medical doctors since 『Nae Gyeong』 and prior to JuDan-Gae had great influence on the later development of Theory of the Gate of Life, I have come to understand that along with Eum Hwa by Lee Dong-wan, they must precede a study of the Theory of Ministerial Fire of JuDan-Gae.

논문(論文) : 『격치여론(格致餘論)』에 나타난 양생사상(養生思想)에 관한 연구

윤영흠 ( Young Heum Yoon ),윤창열 ( Yun Chang Yeol ) 대한한의학원전학회(구 대한원전의사학회) 2014 대한한의학원전학회지 Vol.27 No.4

Objectives : This paper was motivated by the discovery that there is a regimen which is more realistic and can be used in practical life with deep consideration of Dangye`s thought through Judangye`s book Gyeokchiyeoron. Methods : First, after looking into the movement of the heart through the contents of natural science underlying Dangye`s regimen thought, this paper intends to examine regimens by dividing them into a regimen of food, regimen of sexual desire, and regimen for infancy and the elderly according to age on the basis of the contents included in Gyeokchiyeoron. Results : As for food, Dangye argued that it`s necessary that people should avoid overeating and savory taste and observe the proper time for eating, and as for sexual desire, Dangye argued that people should control themselves from bodily and mental aspects. In addition, this paper could learn that as for infants, what matter are eating, clothes to wear, their mother`s role, and education while as for the elderly, what matter are taking good care of the spleen and stomach, and children`s filial piety, and the elderly should awaken themselves to sound mentality. Conclusions : Through the research on Gyeokchiyeoron, this paper was able to learn that Dangye-argued regimen includes a regimen of food, sexual desire, and a regimen for infants and the elderly; in addition, this paper could learn that there are some parts of Dangye-argued regimen contents, which anyone can easily apply in reality.

朱丹溪의 四傷(氣血痰鬱)學說에 관한 硏究 -『格致餘論』과 『金軌鉤玄』을 중심으로-

윤영흠 ( Young Heum Yoon ),윤창열 ( Chang Yeol Yun ) 대한한의학원전학회(구 대한원전의사학회) 2014 대한한의학원전학회지 Vol.27 No.3

Objectives : As there was no sufficient research done on Sasang (four harms: 氣[qi], 血[blood], 痰[phlegm], and 鬱[congestion]), which serves as a precept in treatment of miscellaneous diseases, in contrast with ‘Yang is always teeming whereas Yin is always scarce’ and ‘Sanghwa-ron’, which are Judangye’s major theories, I have come to work on it. I expect that with this, we can understand Judangye’s medical theory and therapy for a variety of diseases. Methods : To begin with, I take a look at the definition of Sasang. And then, I make selections of theories and therapy related to Sasang from Gyeokchiyeoron(格致餘論) and Geumgweguhyeon(金軌鉤玄), which are Judangye’s writings. My study follows the order of energy, blood, phlegm, and congestion. Results : Through Gyeokchiyeoron, I have learned more about Judangye’s theory on how energy, blood, phlegm, and congestion cause diseases. And as for therapy, I have tapped into Geumgweguhyeon to use sagunja-tang(四君子湯) for drained energy, samul-tang(四物湯) for drained blood, ijin-tang(二陳湯) for phlegm, and wolguk-hwan(越鞠丸) for congestion, thus verifying the originality of Judangye’s theory. Conclusions : “Judangye for miscellaneous diseases” was confirmed through his treatments for energy, blood, phlegm, and congestion. And his idea of Yang-eum(養陰 ‘nurturing yin’) is now reflected in therapy for miscellaneous diseases, now serving as a study that provides a comprehensive understanding of Judangye’s medical theories.

건강 증진을 위한 평소 증상 기반의 한열변증 설문지 개발 - 일치도를 중심으로

배광호,윤영흠,여민경,김호석,이영섭,이시우,Bae, Kwang-Ho,Yoon, Youngheum,Yeo, Minkyung,Kim, Ho-Seok,Lee, Youngseop,Lee, Siwoo 대한예방한의학회 2016 대한예방한의학회지 Vol.20 No.2

Objectives : We presented the results of reliability study in advance, and analyzed agreement between Korean medicine doctors(KMDs)' diagnosis and cold-heat pattern identification questionnaire(CHPI)'s diagnosis. Methods : This survey was conducted from May 16 to 17, 2015. The subjects were 93 adults living in rural society. Diagnosis of CHPI was performed by 2 KMDs who have clinical experience more than 5 years. The KMDs' diagnosis was set as a reference index, and then we compare 23 items(cold pattern 11 items and heat pattern 12 items) of CHPI questionnaire and 15 items(cold pattern 8 items and heat pattern 7 items) that were brief form of it. We had cut-off value by standard of KMDs' diagnosis using receiver operating characteristic-curve(ROC-curve), with which we calculated agreement including kappa value. Correlation analysis between CHPI evaluation score by KMDs and by the questionnaire was fulfilled as well. Results : Agreement about 11 and 8 cold pattern items showed 87.1% together, and the value of kappa each recorded 0.742 and 0.741. Agreement about 12 and 7 heat pattern items suggested 81.7% and 78.5%, and the value of kappa showed 0.634 and 0.570. Correlation coefficients were 0.803 of 11 items and 0.761 of 8 items about cold pattern. In addition, correlation coefficients were 0.789 of 12 items and 0.767 of 7 items about heat pattern. The significant probability (p-value) was under 0.001. Conclusions : We have developed CHPI questionnaire involving reliability and agreement based on usual symptoms, and hope additional complements so that Korean medicine diagnostics and Korean preventive medicine would be improved.

Perception of cold and heat pattern identification in diseases: a survey of Korean medicine doctors

배광호,이영섭,박기현,윤영흠,문수정,이시우 한국한의학연구원 2017 Integrative Medicine Research Vol.6 No.1

Background: This study aimed to investigate the extent to which Korean Medicine doctors consider cold and heat pattern identification when prescribing herbal treatment for a disease. Methods: A survey was sent by e-mail to 15,841 members of the Association of Korean Medicine for whom member information was registered. Of these, 699 (4.4%) members participated in the survey. The survey included questions regarding the frequency of use of cold and heat pattern identification in deciding a herbal treatment prescription, the diseases for which cold and heat pattern identification-related herbal treatment was most efficacious, the type of herbal treatment prescribed, and the duration of the treatment. Results: Of the 699 respondents, 591 (84.5%) reported that they considered cold and heat when prescribing herbal treatment. The diseases for which consideration of cold and heat patterns was effective were, in order, menopausal disorder (124, 18.3%), chronic rhinitis (98, 14.5%), dyspepsia (94, 13.9%), hwa-byung (92, 13.6%), diarrhea (83, 12.3%), dysmenorrhea (61, 9.0%), headache (59, 8.7%), inflammation in the digestive tract (58, 8.6%), coldness in hands and feet (58, 8.6%), and atopic dermatitis (55, 8.1%). The typical treatment duration differed widely for different diseases: atopic dermatitis was most frequently treated for >2 months (38, 34.5%), whereas diarrhea was most frequently treated for ≤ 10 days (73, 43.6%). Conclusion: These findings indicate that cold and heat pattern identification is a useful tool employed by Korean Medicine doctors. This study may provide a basis for clinical research investigating the effect of pattern identification-based treatment of diseases.

Goligher 분류상 1기-3기에 해당하는 항문질환 환자의 한의치료 증례군보고

김찬영,성강욱,안해인,윤영흠,김남권 대한한방내과학회 2020 大韓韓方內科學會誌 Vol.41 No.6

Background: Hemorrhoid surgery is a frequently performed surgery in Korea, second only to cataract surgery. However, it has serious complications, including bleeding, infection, anal stenosis, and urinary retention, so active conservative therapies are in need at an early stage. Case summary: Thirteen patients with anal disease complained of main symptoms of pain, bleeding, and prolapse, with additional complaints of itching and mucus discharge. An herbal medicine mixture of Eulja-tang and Hwangryeonhaedok-tang was administered twice daily, and dry cupping therapy, acupuncture, and hot pack placements were administered on pelvic and sacral regions once weekly for four weeks. The symptoms were evaluated before and each week after the treatments. The treatments had statistically significant therapeutic effects. Conclusion: Korean medicine treatment—effectively alleviating the symptoms of anal disease, such as pain, bleeding, and prolapse—may represent an alternative therapy for conservative treatments in the early stages of anal disease.

경추간판 장애 및 척수병증을 동반한 후종인대골화증 환자에 대한 한의 복합 치료 1례 증례보고 : 추나 요법을 중심으로

홍민우(Min-Woo Hong),김재균(Jae-Kyoun Kim),박민정(Min-Jung Park),윤영흠(Young-Heum Yoon),김수용(Su-Yong Kim),김남권(Nam-Kwen Kim) 척추신경추나의학회 2020 척추신경추나의학회지 Vol.15 No.1

Objectives : This study reports the clinical case of a patient diagnosed with ossification of the posterior longitudinal ligament treated with Korean Medicine focusing on Chuna therapy. Methods : The patient was treated by a doctor from July 18th, 2019 to November 28th, 2019. The patient was diagnosed with ossification of the posterior longitudinal ligament based on magnetic resonance imaging results and was recommended to undergo surgery at another hospital. The primary complaint of the patient was left neck pain, left arm sensation, right leg sensation, and right leg loss of strength. The doctor treated the patient with Chuna therapy, acupuncture, cupping, herbal medicine, and pharmacopuncture. The effect of treatment was evaluated using visual analogue scale, neck disability index, pain rating score and Japanese Orthopedic Association score. Spurling, compression, and distraction tests were utilized. Results : Visual analogue scale decreased from 10 at the arm and 10 at the leg to 1 and 2, respectively. Neck disability index decreased from 25 to 11, pain rating score decreased from 66 to 1, and Japanese Orthopedic Association score recovered from 12 to 17 points. In addition, positive spurling test, compression test, and distraction test all improved to negative. Conclusions : Korean medicine treatment can be effective for ossification of the posterior longitudinal ligament patients, even when surgery is recommended. Further clinical studies, such as case series and case-control studies, are required to verify these findings.

한방 치료로 고안드로겐혈증을 개선한 다낭성 난소 증후군 연속증례연구

신혜규 ( Haegue Shin ),배지용 ( Ji-yong Bae ),지영근 ( Young-geun Ji ),안해인 ( Hae In Ahn ),윤영흠 ( Youngheum Yoon ),김남권 ( Namkwen Kim ) 대한한방부인과학회 2021 大韓韓方婦人科學會誌 Vol.34 No.3

Objectives: This study aims to analyze the medical record of eight cases of polycystic ovary syndrome (PCOS) in a local Korean medicine clinic, in order to provide evidence on Korean medicine treatment of PCOS and to suggest the direction of future studies. Methods: The medical records of eight cases diagnosed with PCOS based on 2003 Rotterdam Criteria and whose total testosterone level was 0.53 ng/ml and over were retrospectively analyzed. The primary outcome was total testosterone level, and the secondary outcomes included luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, LH/FSH ratio, weight, last mentrual period (LMP), numerical rating scale (NRS) score of dysmenorrhea, and other associated symptoms pre- and post-treatment. Korean medicine treatment consists of the complex herbal prescription consisting of Yukmijihwang-tang, Baekho-tang, Daesiho-tang, and Gyejibokryeong-hwan, modified according to symptoms; acupuncture and electroacupuncture on 中脘(CV12), 下脘(CV10), 關元(CV4), 石門(CV5), 合谷(LI4), 太衝(LR3), 三陰交(SP6), and 懸鍾(GB39); and indirect moxibustion on 神闕(CV8). Results: The average total testosterone level lowered statistically significantly after the treatment. The average FSH and LH levels lowered with insignificance, while the average LH/FSH ratio and weight lowered statistically significantly. During the treatment period of three to six months, every patient had the menstrual cycle shortened except for one case; and two cases with infertility problem succeeded in being pregnant. There was no adverse event. Conclusions: The Korean medicine treatment was found effective in treating PCOS, especially regarding hyperandrogenism, amenorrhea or oligomenorrhea, and infertility.

A study on the status and applicability of Korean medicine EMR for establishment of Korean medicine standard EMR certification criteria: Through surveys of Korean medical institutions and Korean medicine EMR companies

You Jin Heo,이참결,Soo Min Ryu,Jung Won Byun,Jeong Du Roh,Na Young Jo,서병관,박연철,백용현,Jung Hyun Kim,최선미,윤영흠,이은용 대한한의학회 2023 대한한의학회지 Vol.44 No.4

Objectives: The aim of this study is to explore and investigate the status of EMR currently used in Korean medical institutions and the suitability of the existing certification criteria for Korean medicine EMR certification. Methods: The survey was conducted using a related questionnaire from September to October 2022. The survey for current status and the suitability of the existing certification criteria was conducted separately between Korean medical institutions and Korean medicine EMR companies. Results: In a survey of Korean medical institutions on the current status of EMR, more than 80% answered that the imaging system and Korean medicine EMR could be linked. Most medical institutions did not exchange clinical information between institutions. When asked about the intention to develop standard EMR of Korean medicine in the future, 57% of institutions answered ‘yes’. In future, if Korean medicine EMR certification criteria are developed, all EMR companies are willing to develop the EMR that satisfy them. Looking at the satisfaction survey of the existing EMR certification criteria of the Korean medicine EMR system, it was found that high/low satisfaction was shown in various areas, and in particular, the overall clinical information exchange function was insufficient. Conclusion: In order to introduce the Korean medicine EMR certification criteria, it must be considered of the current status of EMR and applicability of Korean medicine EMR for establishment of Korean medicine standard EMR certification criteria. By developing Korean medicine EMR certification criteria, high-quality medical services can be provided to medical consumers who want Korean medical treatment.