Park Tae-Yong, Lee Ju Ah, Kang Byoung-Kab, Moon Tae-Woong, Ko Mi Mi, Lee Myeong Soo
Department of Oriental Medicine, Catholilc Kwandong University International St. Mary's Hospital Incheon, Republic of Korea.
Medical Research Division, Korea Institute of Oriental Medicine Daejeon, South Korea.
Int J Clin Exp Med. 2014 Dec 15;7(12):5146-57. eCollection 2014.
Differences in the value that individual clinicians place on each clinical indicator, when performing pattern identification, can be a significant obstacle in achieving accurate and consistent pattern identification. In this study, we aimed to identify and rank the importance of clinical indicators that correspond to each pattern. During the fundamental study to standardize and objectify the identification of patterns in traditional Korean medicine (TKM) treatment for stroke (the SOPI-Stroke project), we developed the Third Standardization for Pattern Identification (K-SPI-Stroke-III), which includes 44 clinical indicators that belong to one of the four patterns (Dampness-Phlegm, Fire-Heat, Qi deficiency, and Yin deficiency). Between September 2006 and December 2010, a total of 105 TKM doctors from 11 hospitals performed four examinations on 4,012 subjects based on the clinical indicators in the K-SPI-Stroke-III, and they were asked to leave a special mark on the indicators they thought were important, regardless of the number of the indicators. A total of 1,018 patients were included in the study. Among the 44 clinical indicators of the K-SPI-Stroke-III, four indicators were highly significant in differentiating between patterns and the frequency within a pattern. In contrast, another seven indicators were almost useless. Meanwhile, six confounding indicators had outlying values for differentiating between patterns and the frequency within a pattern. In conclusion, the four significant indicators should be actively considered when identifying patterns for strokes in clinical practice. Regarding the six confounding indicators, a further study should be conducted to modify some parts of the current K-SPI-Stroke-III.
在进行证型识别时，各个临床医生对每个临床指标的重视程度存在差异，这可能成为实现准确且一致的证型识别的重大障碍。在本研究中，我们旨在识别与每种证型相对应的临床指标并对其重要性进行排序。在韩国传统医学（TKM）治疗中风的证型识别标准化和客观化的基础研究（SOPI - 中风项目）中，我们制定了第三版证型识别标准（K - SPI - 中风 - III），其中包括44个临床指标，这些指标分属于四种证型（痰湿、火热、气虚和阴虚）之一。在2006年9月至2010年12月期间，来自11家医院的105名韩医根据K - SPI - 中风 - III中的临床指标对4012名受试者进行了四项检查，并要求他们在认为重要的指标上做特殊标记，而不考虑指标数量。共有1018名患者纳入研究。在K - SPI - 中风 - III的44个临床指标中，有四个指标在区分证型和证型内频率方面具有高度显著性。相比之下，另外七个指标几乎无用。同时，有六个混淆指标在区分证型和证型内频率方面具有异常值。总之，在临床实践中识别中风证型时应积极考虑这四个显著指标。对于这六个混淆指标，应进一步研究以修改当前K - SPI - 中风 - III的某些部分。
