Constitutional Medicine & Diagnosis Research Group, Medical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 305-811, Republic of Korea.
BMC Complement Altern Med. 2012 Jul 4;12:85. doi: 10.1186/1472-6882-12-85.
Sasang constitutional medicine (SCM) is a unique form of traditional Korean medicine that divides human beings into four constitutional types (Tae-Yang: TY, Tae-Eum: TE, So-Yang: SY, and So-Eum: SE), which differ in inherited characteristics, such as external appearance, personality traits, susceptibility to particular diseases, drug responses, and equilibrium among internal organ functions. According to SCM, herbs that belong to a certain constitution cannot be used in patients with other constitutions; otherwise, this practice may result in no effect or in an adverse effect. Thus, the diagnosis of SC type is the most crucial step in SCM practice. The diagnosis, however, tends to be subjective due to a lack of quantitative standards for SC diagnosis.
We have attempted to make the diagnosis method as objective as possible by basing it on an analysis of quantitative data from various Oriental medical clinics. Four individual diagnostic models were developed with multinomial logistic regression based on face, body shape, voice, and questionnaire responses. Inspired by SCM practitioners' holistic diagnostic processes, an integrated diagnostic model was then proposed by combining the four individual models.
The diagnostic accuracies in the test set, after the four individual models had been integrated into a single model, improved to 64.0% and 55.2% in the male and female patient groups, respectively. Using a cut-off value for the integrated SC score, such as 1.6, the accuracies increased by 14.7% in male patients and by 4.6% in female patients, which showed that a higher integrated SC score corresponded to a higher diagnostic accuracy.
This study represents the first trial of integrating the objectification of SC diagnosis based on quantitative data and SCM practitioners' holistic diagnostic processes. Although the diagnostic accuracy was not great, it is noted that the proposed diagnostic model represents common rules among practitioners who have various points of view. Our results are expected to contribute as a desirable research guide for objective diagnosis in traditional medicine, as well as to contribute to the precise diagnosis of SC types in an objective manner in clinical practice.
沙参康体医学（SCM）是一种独特的韩国传统医学形式，它将人类分为四种体质类型（太阳：TY、太阴：TE、少阳：SY 和少阴：SE），这些类型在遗传特征上有所不同，例如外表、性格特征、对特定疾病的易感性、药物反应以及内部器官功能的平衡。根据 SCM，属于特定体质的草药不能用于其他体质的患者；否则，这种做法可能会导致无效或产生不良反应。因此，SC 类型的诊断是 SCM 实践中最关键的步骤。然而，由于缺乏 SC 诊断的定量标准，诊断往往具有主观性。
我们试图通过基于各种东方医学诊所的定量数据分析，使诊断方法尽可能客观。基于面部、体型、声音和问卷调查的回答，我们使用多项逻辑回归开发了四个个体诊断模型。受 SCM 从业者整体诊断过程的启发，然后通过结合四个个体模型提出了一个综合诊断模型。
在测试集中，将四个个体模型整合到一个单一模型中后，男性和女性患者组的诊断准确率分别提高到 64.0%和 55.2%。使用综合 SC 评分的截止值（例如 1.6），男性患者的准确率提高了 14.7%，女性患者的准确率提高了 4.6%，这表明综合 SC 评分越高，诊断准确率越高。
本研究首次尝试基于定量数据和 SCM 从业者整体诊断过程来整合 SC 诊断的客观化。尽管诊断准确率不高，但值得注意的是，所提出的诊断模型代表了具有各种观点的从业者的共同规律。我们的研究结果有望为传统医学的客观诊断提供理想的研究指导，并有助于在临床实践中以客观的方式对 SC 类型进行精确诊断。
