Developing indicators of pattern identification in patients with stroke using traditional Korean medicine

Abstract

BackgroundThe traditional Korean medical diagnoses employ pattern identification (PI), a diagnostic system that entails the comprehensive analysis of symptoms and signs. The PI needs to be standardized due to its ambiguity. Therefore, this study was performed to establish standard indicators of the PI for stroke through the traditional Korean medical literature, expert consensus and a clinical field test.MethodsWe sorted out stroke patterns with an expert committee organized by the Korean Institute of Oriental Medicine. The expert committee composed a document for a standardized pattern of identification for stroke based on the traditional Korean medical literature, and we evaluated the clinical significance of the document through a field test.ResultsWe established five stroke patterns from the traditional Korean medical literature and extracted 117 indicators required for diagnosis. The indicators were evaluated by a field test and verified by the expert committee.ConclusionsThis study sought to develop indicators of PI based on the traditional Korean medical literature. This process contributed to the standardization of traditional Korean medical diagnoses.

A Study of Tongue and Pulse Diagnosis in Traditional Korean Medicine for Stroke Patients Based on Quantification Theory Type II

“…As a part of the SOPI-STROKE project, the KIOM recently created the Korean standard PI for stroke (K-SPI) for use in Korea [4–6]. This system consists of 4 types of PI (FH, DP, YD, and QD) and 44 types of indicators [5].…”

“…The QD pattern is characterized by Qi deficiency with diminished internal organ function, which is marked by shortness of breath, lassitude, listlessness, spontaneous sweating, a pale tongue, and a weak pulse. The YD pattern is characterized by Yin deficiency with diminished moistening and the inability to restrain yang, which is usually manifested as fever [4–6]. …”

“…As part of the research on the standardization of oriental medicine stroke PI, the Korea Institute of Oriental Medicine (KIOM) collected stroke data for stroke PI from June 2006 to March 2009 [4–6]. The data were obtained from 12 TKM hospitals and oriental medical universities throughout the nation (Figure 1).…”

“…The Kolmogorov-Smirnov method was used to test the normality of the continuous variables, which were analyzed using one-way ANOVA (as a parametric method) and the Kruskal-Wallis test (as a nonparametric method). The examination parameters were extracted from CRFs for the standardization of stroke diagnosis developed by an expert committee organized by the KIOM [4–6]. Each patient received an examination of the status of the tongue and pulse, tongue color (pale, pale-red, red, or bluish purple), fur color (white fur or yellow fur), fur quality (thick fur or dry fur), special tongue appearance (teeth marked, enlarged, mirror, or spotted), pulse location (floating or sunken), pulse rate (slow or rapid), pulse force (strong or weak), and pulse shape (fine, slippery, rough, or surging).…”

“…Previous reports have described the PI process for differentiating stroke victims with four TKM types: the fire-heat pattern, dampness-phlegm pattern, Yin-deficiency pattern, and Qi-deficiency pattern [4–6]. However, the meaning of a pattern is often ambiguous in clinical practice, and it is difficult to objectively arrange or accumulate the clinical data regarding these patterns or perform a systematic analysis of the results.…”