Zedler Paul, Büntzel Judith, Kuchta Kenny, Yamaoka Denichiro, Sato Nanoha, Watanabe Kenji, Cameron Silke
Clinic for Gastroenterology and Gastrointestinal Oncology, University Medical Center Göttingen (UMG), Göttingen, Germany.
Department of Gastroenterology and General Internal Medicine, Clinic Hann. Münden, Hann. Münden, Germany.
Front Pharmacol. 2024 Sep 27;15:1426491. doi: 10.3389/fphar.2024.1426491. eCollection 2024.
In traditional Japanese Kampo medicine, a profound anamnesis is completed by clinical examination. The resulting clinical image forms the basis of the patient's diagnosis pattern, including the recent mental, physical, and social contexts. Kampo questionnaires support pattern diagnosis and bridge traditional and Western medicine diagnoses.
Traditional Kampo therapy is tailored to a specific body constitution, while Western medicine treatment is tailored to a specific disease. The aims of this study were to analyze whether traditional Kampo diagnosis is applicable to German patients and whether specific symptom patterns are characteristic for defined diseases.
This study validates for the first time a Kampo questionnaire adapted for German patients. The analysis focuses on patients with gastrointestinal diseases, the main field for Kampo medicines.
In total, we prospectively included 251 participants; of those, 58 were cancer patients (23.1%), 35 had Crohn's disease (13.9%), 18 had ulcerative colitis (7.2%), 17 had irritable bowel syndrome (6.8%), and 103 had other abdominal diseases (41%), as well as 20 German controls (8%). The patient population consisted of 144 female (57.4%) and 107 male (42.6%) participants. The median age was 65 years. The disease duration (average: 211 months) varied from 1 month (cancer patient) to 540 months (patient with Crohn's disease). The scores for questions on the state of mind were significantly higher in patients with inflammatory bowel disease (IBD) as well as irritable bowel syndrome (IBS)-in comparison to the tumor and control groups. This was reflected in questions about abdominal discomfort, appetite, fecal habits, and cold sensation. Accordingly, symptoms of (i.e., ) deficiency were mostly observed in patients with chronic diseases such as Crohn's disease and ulcerative colitis. Defined symptom combinations did not reflect conventional Western diagnosis.
Our study results show that symptom patterns are independent of the underlying disease. They rather depict the individual patient within an individual time frame. Traditional Kampo questionnaires were found to be valid for the analysis of a patients' body constitution () and serve as a guide for Kampo treatment. We propose that individual pattern diagnosis should be taken into account to help treatment individualization.
在传统的日本汉方医学中，详细的问诊是通过临床检查来完成的。由此得出的临床图像构成了患者诊断模式的基础，包括近期的心理、身体和社会背景。汉方问卷有助于模式诊断，并在传统医学和西医诊断之间架起桥梁。
传统汉方疗法是根据特定的体质量身定制的，而西医治疗是根据特定的疾病量身定制的。本研究的目的是分析传统汉方诊断是否适用于德国患者，以及特定的症状模式是否是特定疾病的特征。
本研究首次验证了一份适用于德国患者的汉方问卷。分析重点是患有胃肠道疾病的患者，这是汉方药物的主要应用领域。
我们总共前瞻性纳入了251名参与者；其中，58名是癌症患者（23.1%），35名患有克罗恩病（13.9%），18名患有溃疡性结肠炎（7.2%），17名患有肠易激综合征（6.8%），103名患有其他腹部疾病（41%），还有20名德国对照者（8%）。患者群体包括144名女性（57.4%）和107名男性（42.6%）参与者。中位年龄为65岁。病程（平均：211个月）从1个月（癌症患者）到540个月（克罗恩病患者）不等。与肿瘤组和对照组相比，炎症性肠病（IBD）以及肠易激综合征（IBS）患者在心理状态问题上的得分明显更高。这在关于腹部不适、食欲、排便习惯和寒冷感的问题中得到了体现。因此，诸如（即）虚证的症状大多在患有克罗恩病和溃疡性结肠炎等慢性病的患者中观察到。特定的症状组合并未反映传统的西医诊断。
我们的研究结果表明，症状模式与潜在疾病无关。它们更像是在个体时间框架内描绘个体患者。发现传统汉方问卷对于分析患者的体质（）是有效的，并可作为汉方治疗的指南。我们建议应考虑个体模式诊断以帮助实现治疗个体化。
