91 DOI : 10.3831/KPI.2010.13.4.091 Received : 10. 11. 15 Accepted : 10. 11. 23 A Clinical Study on Syndrome Differentiation of Male with Teeth-Mark Tongue Key Words: Teeth-mark tongue, Qi-Deficiency, Dampness and Phlegm, HRV, APG, Body Composition, Syndrome Differentiation. Soo-Jung Lee*, Sang-In Baek*, Byung-Gwon Lee*, Ah-Ram Lee*, Koang-Lok Kim*, Hyun-Min Yoon**, Won-Il Kim* *Dept. of Internal Medicine, College of Oriental Medicine, Dong-Eui University **Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Dong-Eui University ABSTRACT Objectives : The purpose of this study was to analyze the propensity and find out the Syndrome Differentiation of teeth-mark tongue by taking survey and body examinations with 178 male patients. 164 patients out of 178 were checked up on Heart Rate Variability (HRV), Accelerated Photoplethysmograpy (APG), Body Composition. This study was also planned to find out the distinctive characteristics of teeth-mark tongue diagnosis and compare differences between Qi-Deficiency and Accumulation of Dampness and Phlegm patients group. Methods : The questionnaire was carried out targeting 178 male with teeth-mark tongue respondents among who had Oriental Health Examination and patients from the 3rd oriental-internal medicine department in Dongeui Hospital from 1 st, March 2005 to 30 th, April 2010. Only 164 patients were checked on HRV, APG and Body composition examinations. Results : It showed that 86 patients had Qi-Deficiency and 78 had Dampness and Phlegm but 14 couldn t be categorized. The major symptoms of Qi-Deficiency compared to Dampness and Phlegm were Frequent running nose, Soft stool, Chronic fatigue, and Eyestrain. On the contrary, Dampness and Phlegm s dominant symptoms were Chest discomfort, Feeling bloated, Back pain, Feeling sluggish, and Itchy skin. However, all symptoms were not matched with the Syndrome Differentiation of Qi-Deficiency or Dampness and Phlegm. It also showed that teeth-mark tongue patients frequent symptoms were Stuffy nose, Feeling bloated, Oliguria, Shoulder pain, Chronic fatigue, Eyestrain and these symptoms were matched with the Syndrome Differentiation of Qi-Deficiency and Dampness and Phlegm. In the results from this study, there were no significant differences between Qi-Deficiency and Dampness and Phlegm. Conclusions : It is hard to conclude that teeth-mark tongue could be only one to diagnose Qi- Deficiency or Dampness and Phlegm with 3 examinations. Tel:051-850-8630 Fax:051-867-5162 E-mail:omdstar@deu.ac.kr
92 Journal of Pharmacopuncture 13 4 2010 12 I (Diagnose system of oriental medicine, DSOM) 3 178 14 164 II 1 2005 3 1 2010 4 30 3 3 178 164 2 1) (Appendix 1) (Appendix 2) 2) (Heart Rate Variability HRV) SA-3000P (Medicare
93 co. Korea) 5 Report 3) (Accelerated Photoplethysmograpy; APG) SA-3000P 5 (Differential Pluse Wave Index DPI) (Stress Power SP) (Blood Vessel Tension BVT) (Remained Blood Volume RBV) (Ventricular Contraction Time VCT) (Heart Rate; HR) 4) X-scan (JAWO N MEDICAL Co. Korea) 3 SAS 9.1 T-TEST p-value< 0.05 III 1 1) 178 20 21 (11.8%) 30 85 (47.8%) 40 52 (29.2%) 50 13 (7.3%) 60 5 (2.8% 70 2 (1.1%) 39.26 (Table 1) 2 178 1) 38 (21.35 %) 24 (13.48%) 23 (12.92%) 19 (10.67%) 17 (9.55 % ) 16 (8.99%) 14 (7.87%) 10 (5.62%) 7 (3.93%) 4 (2.25%) 3 (1.69%) (Table 2) 2) 35 (19.66 %) 25 (14.04%) 21 (11.8%) 19 (10.67%) 18 (10.11%) 14 (7.87%) 13 (7.30%) 11 (6.18%) 9 (5.86%) 6 (3.37%) 1 (0.56%) (Table 3) 3) 28 (15.73 %) 7 (3.93%) 2
94 Journal of Pharmacopuncture 13 4 2010 12 (1.12%) 1 (0.56%) (Table 4) 4) 72 (40.45%) 64 (35.96%) 44 (24.72%) 22 (12.36%) 21 (11.8%) 20 (11.24%) 14 (7.87%) 8 (4.49%) 5 (2.81%) 3 (1.69%) 2 (1.12%) 1 (0.56%) (Table 5) 5) 61 (34.27%) 29 (16.29%) 23 (12.92%) 14 (7.87%) 12 (6.74%) 11 (6.18%) 10 (5.62%) 5 (2.81%) 3 (1.69%) (Table 6) 6) 70 (39.33%) 37 (20.79%) 33 (18.54%) 32 (17.98%) 21 (11. 80%) 20 (11.24%) 18 (10.11%) 16 (8.99%) 14 (7.87%) 8 (4.49%) 7 (3.93%) 6 (3.37%) 5 (3.93%) 4 (2.25%) (Table 7). 3 74 14 15 5 13 12 15 26 31 178 86 (48.31%) 78 (43.82%) 14 (7.87%) 4 178 86 1) 17 (19.77%) 15 (17.44%) 14 (16.28%) 11 (12.79%), 9 (10.47%) 7 (8.14%), 6 (6.98%) 4 (4.65%) 2 (2.33%) (Table 2) 2) 18 20.93%), 12 (13.85%), 11 (12.79%) 9 (10.47%) 7 (8.14%) 6 (6.98%) 5 (5.81%) 4 (4.65%), 3 (3.49%) 1 (1.16%) (Table 3)
95 3) 16 (18.6%) 4 (4.65%) 2 (2.33%) 1 (1.16%) (Table 4) 4) 34 (39.53%) 29 (33.72%) 17 (19.77%) 11 (12.79%) 8 7 (8.14%) 5 (5.81%) 4 (4.65%) 2 (2.33%) 1 (1.16%) (Table 5) 5) 47 (54.6 5%) 17 (19.77%) 11 (12.79%) 9 (10.47%) 8 (9.3%) 7 (8.14%) 6 (6.98%) 5 (5.81%) 4 (4.65%) 3 (3.49%) 1 (1.16%) (Table 6) 6) 48 (55.81%) 26 (30.23%) 21 (24.42%) 20 (23.26 %) 17 (19.77%) 9 (10.47%) 8 (9.3%) 7 (8.14%) 6 (6.98%) 5 (5.81%) 4 (4. 65%) 3 (3.49%) 2 (2.33%) (Table 7) 178 78 1) 17 (21.7 9%) 16 (20.51%) 15 (19.23 %) 11 (14.1%) 10 (12.82%) 8 (10.26%) 7 (8.97%) 2 (2.56%) 1 (1.28%) (Table 2) 2) 23 (29.49 %) 13 (16.67%) 9 (11.54%) 8 (10.26%) 7 (8.97%) 6 (7.69%) 4 (5.13%) 3 (3.85%) 2 (2.56%) (Table 3) 3) 10 (12.8 2%), 3 (3.85%), 1 (1.28%) (Table 4) 4) 33 (42.31 %) 29 (37.18%) 25 (32.05%) 13 (16.67 %) 11 (14.1%) 8 (10.26%) 4 (5.13%) 3 (3.85%) 2 (2.56%) 1 (1.28%) (Table 5) 5 5)
96 Journal of Pharmacopuncture 13 4 2010 12 17 (21.79%) 11 (14.1%) 10 (12.82%) 9 (11.54%) 7 (8.97%) 5 (6.41%) 3 (3.85%) 2 (2.56%) 1 (1.28%) (Table 6) 6) 17 (21.79%) 14 (17.95%) 11 (14.1%) 10 (12.82%) 9 (11.54%) 8 (10.26%) 7 (8.97 %) 5 (6.41%) 4 (5.13%) 3 (3.85%) 2 (2.56%) 1 (1.28%) (Table 7) 6 (Table 4) 4) (Table 5) 5) (Table 6) 6) (Table 7) 1) (Table 2) 2) (Table 3) 3) 7 178 14 164 38.15 76 74 14 1) 50 70
97 70~90 90~110 110~130 130~150 150~100 100~50 50~0 50~70 70~90 90~110 110~130 130~150 150~130 130~110 110~90 90~70 70~50 150~130 130~110 110~90 90~70 70~50 50~60 60~65 65~81 81~100 100~110 50~70 70~90 90~110 110~130 130~150 164 87.40 47.32 89.09 104.24 110.26 77.18 93.38 1 15 87.33 48.24 88.80 104.08 110.84 76.46 91.91 1 10 88.15 48.45 90.51 103.23 108.96 77.62 95.05 1 5 2) 164 DPI -69.25, SP -82.86, BVT -14.35, RBV - 18.82, VCT 288.11, HR 76.22 28 (17.07%) 1 129 (78.66%) 2 3 (1.83%) 3 3 (1.83%) 4 1 (0.61%) 56.76 111 (67.68%) 23 (14.02%) 24 (14.63%) 6 (3.66%) DPI -70.11, SP -83.45, BVT -14.24, RBV - 18.25, VCT 287.53, HR 75.28 16 (21.05%) 1 55 (72.37%) 2 3 (3.95%) 3 1 (1.32%) 4 1 (1.32%) 56.93 52 (68.42%) 10 (13.16%) 11 (14.47%), 3 (3.95%) DPI -68.19, SP -82.02, BVT -14.76, RBV - 19.23, VCT 287.47, HR 76.74 9 (12.16%) 1 63 (85.14%) 2 0 (0%), 3 2 (2.70%) 4 0 (0%) 56.57 50 (67.57%) 10 (13.51%) 12 (16.22%), 2 (2.70%) 3) 100% 164 171.01cm 70.62 53.87 (76.23%) 49.77 (54.88%) 38.78 (54.88%) 11.00 (15.57%) 4.09 (5.77%) 17.08 (23.65%) 0.35 24.26 / 23.65% 0.90 171.87 71.31 54.41 (76.09%) 50.28 (70.33%), 39.17 (54.78%) 11.10 (15.54%) 4.13 (5.77%) 17.38 (23.65%) 0.35 24.29 / 23.65% 0.90 170.42cm 70.46 53.77 (76.32%)
98 Journal of Pharmacopuncture 13 4 2010 12 49.69 (70.45%) 38.72 (54.95%) 10.99 (15.58%) 4.07 (5.77%) 16.90 (23.67%) 0.35 24.35 / 23.67% 0.89 IV (DSOM) 178 39.26 (Table 1) 178 86 (48.31%) 78 (43.82%) 14 (7.87%) (Table 2-7)
99
100 Journal of Pharmacopuncture 13 4 2010 12 APG 0.35 (0.30~ 0.36) 24.26 / 23.65% 0.90 V 178 164 1. 178 86 (48.31%) 78 (43.82%) 14 (7.87%) 2. 3. 4.
101 VI 1. pp 41-42, 1986 2. pp 74, 288, 418, 1978 3. pp 104-146, 1980 4. pp 41-43, 50-61, 1981 5. pp 247, 2007 6. 45 pp 84, 1997. 7. 22(1):266, 2008. 8. 2002. 9. DSOM (r) S.1.1 2006. 10. 17(4):845-851, 2003. 11. 1 pp 84-89, 101-125, 162-177, 1995. 12. 2 pp 17-198, 1996 13. pp 364, 2002. 14. pp 362-79, 2004. 15. pp 80, 218, 254-63, 287-90, 308-11, 321-3, 340-2, 395-6, 409-10, 467-89, 2002. 16. 2(1):183-189, 195-196, 199-200, 1998. 17. pp 54, 2009. 18. 2 pp 74-76, 2003. 19. pp 4, 49, 2007. 20. 34 12(1):28-32, 1998. 21. 11(1):127-138, 2005. 22. pp 2-3, 40-43, 2007 23. 16(1):100-111, 2004 24. 8(1):176-349, 1996
102 Journal of Pharmacopuncture 13 4 2010 12 Table 1. Distribution of age Age 20 29 30 39 40 49 50 59 60 69 70 79 Total Mean age no. (%) 21 (11.8) 85 (47.8) 52 (29.2) 13 (7.3) 5 (2.8) 2 (1.1) 178 (100) 39.26 Table 2. Respiratory symptoms Symptoms Group Qi-Deficiency (%) Dampness and Phlegm (%) All (%) Stuff nose 17 (19.77) 17 (21.79) 38 (21.35) Frequent running nose* 15 (17.44) 8 (10.26) 24 (13.48) Chest discomfort* 6 (6.98) 16 (20.51) 24 (13.48) Frequent sneezing 11 (12.79) 10 (12.82) 23 (12.92) Frequent coughing* 6 (6.98) 11 (14.1) 19 (10.67) Hard sputum* 4 (4.65) 15 (19.23) 19 (10.67) Sputum in throat* 4 (4.65) 15 (19.23) 19 (10.67) Frequent sighing* 9 (10.47) 8 (10.26) 17 (9.55) Canker sores in nose* 14 (16.28) 2 (2.56) 16 (8.99) Chest pain 6 (6.98) 7 (8.97) 14 (7.87) Rhinorrhagia* 7 (8.14) 2 (2.56) 10 (5.62) Gasp for breath* 6 (6.98) 1 (1.28) 7 (3.93) Coughing at night* 2 (2.33) 1 (1.28) 4 (2.25) Dyspnea* 2 (2.33) 0 (0) 3 (1.69) *: p-value 0.05, Respondent number comparisons by meaningful symptoms from Qi-Deficiency group and Dampness and Phlegm group
103 Table 3. Digestive symptoms Symptoms Group Qi-Deficiency (%) Dampness and Phlegm (%) All (%) Feeling bloated* 11 (12.79) 23 (29.49) 35 (19.66) Soft stool* 18 (20.93) 6 (7.69) 25 (14.04) Frequent burp 12 (13.85) 8 (10.26) 21 (11.8) Dyspepsia 9 (10.47) 8 (10.26) 19 (10.67) Diarrhea* 4 (4.65) 13 (16.67) 18 (10.11) Heartburn 7 (8.14) 7 (8.97) 14 (7.87) Tenesmus* 6 (6.98) 8 (10.26) 14 (7.87) Constipation* 3 (3.49) 9 (11.54) 13 (7.30) Anorexia* 5 (5.81) 4 (5.13) 11 (6.18) Frequent diarrhea 4 (4.65) 6 (7.69) 11 (6.18) Dry vomiting* 3 (3.49) 4 (5.13) 9 (5.86) Often having acid reflux 5 (5.81) 3 (3.85) 9 (5.86) Stomach 4 (4.65) 2 (2.56) 6 (3.37) Frequent vomiting 1 (1.16) 0 (0) 1 (0.56) Dysphagia 0 (0) 0 (0) 0 (0) *: p-value 0.05, Respondent number comparisons by meaningful symptoms from Qi-Deficiency group and Dampness and Phlegm group. Table 4. Urinary symptoms Symptoms Group Qi-Deficiency (%) Dampness and Phlegm (%) All (%) Oliguria 16 (18.6) 10 (12.82) 28 (15.73) Residual urine 4 (4.65) 3 (3.85) 7 (3.93) Dysuria 1 (1.16) 1 (1.28) 2 (1.12) Urodynia* 2 (2.33) 0 (0) 2 (1.12) Urinary incontinence 1 (1.16) 0 (0) 1 (0.56) *: p-value 0.05, Respondent number comparisons by meaningful symptoms from Qi-Deficiency group and Dampness and Phlegm group.
104 Journal of Pharmacopuncture 13 4 2010 12 Table 5. Muscle and bone symptoms Symptoms Group Qi-Deficiency (%) Dampness and Phlegm (%) All (%) Shoulder pain 34 (39.53) 33 (42.31) 72 (40.45) Pain in nape 29 (33.72) 29 (37.18) 64 (35.96) Back pain* 17 (19.77) 25 (32.05) 44 (24.72) Knee pain* 8 (9.30) 13 (16.67) 22 (12.36) Wrist pain* 7 (8.14) 11 (14.1) 21 (11.8) Twinge in knee 11 (12.79) 8 (10.26) 20 (11.24) Finger pain 5 (5.81) 8 (10.26) 14 (7.87) Ankle pain 4 (4.65) 4 (5.13) 8 (4.49) Frequent sprain ankle 2 (2.33) 3 (3.85) 5 (2.81) Elbow pain 1 (1.16) 2 (2.56) 3 (1.69) Twinge in back to turn over 1 (1.16) 2 (2.56) 3 (1.69) Frozen shoulder 1 (1.16) 1 (1.28) 2 (1.12) Toe pain 0 (0) 1 (1.28) 1 (0.56) *: p-value 0.05, Respondent number comparisons by meaningful symptoms from Qi-Deficiency group and Dampness and Phlegm group. Table 6. Neuropsychiatric symptoms Symptoms Group Qi-Deficiency (%) Dampness and Phlegm (%) All (%) Chronic fatigue* 47 (54.65) 11 (14.1) 61 (34.27) Headache* 17 (19.77) 9 (11.54) 29 (16.29) Dizziness 11 (12.79) 10 (12.82) 23 (12.92) Feeling sluggish* 5 (5.81) 17 (21.79) 23 (12.92) Heart palpitation 7 (8.14) 7 (8.97) 14 (7.87) Insomnia* 7 (8.14) 3 (3.85) 12 (6.74) Easily stunned* 9 (10.47) 2 (2.56) 12 (6.74) Frequently awaken 8 (9.3) 3 (3.85) 12 (6.74) Feeling weak in whole body 6 (6.98) 5 (6.41) 11 (6.18) Frequently dreaming* 3 (3.49) 7 (8.97) 10 (5.62) Anxiety 4 (4.65) 1 (1.28) 5 (2.81) Depression 1 (1.16) 2 (2.56) 3 (1.69) *: p-value 0.05, Respondent number comparisons by meaningful symptoms from Qi-Deficiency group and Dampness and Phlegm group.
105 Table 7. Other symptoms Symptoms Group Qi-Deficiency (%) Dampness and Phlegm (%) All (%) Eyestrain 48 (55.81) 17 (21.79) 70 (39.33) Blear eye* 21 (24.42) 14 (17.95) 37 (20.79) Hydropedesis* 26 (30.23) 7 (8.97) 33 (18.54) Frequent blood-shot eyes* 20 (23.26) 10 (12.82) 32 (17.98) Tinnitus* 17 (19.77) 4 (5.13) 21 (11.80) Itchy skin* 7 (8.14) 11 (14.1) 21 (11.80) Eye gunk 8 (9.3) 11 (14.1) 20 (11.24) Much coating on tongue* 9 (10.47) 9 (11.54) 18 (10.11) Hair loss 8 (9.3) 7 (8.97) 16 (8.99) Dipsia* 6 (6.98) 8 (10.26) 14 (7.87) Swollen face* 3 (3.49) 5 (6.41) 8 (4..49) Bradyacusia* 5 (5.81) 1 (1.28) 7 (3.93) Throat pain 4 (4.65) 2 (2.56) 6 (3.37) Tasting bitter 2 (2.33) 3 (3.85) 5 (3.93) Ear pain 2 (2.33) 2 (2.56) 4 (2.25) *: p-value 0.05, Respondent number comparisons by meaningful symptoms from Qi-Deficiency group and Dampness and Phlegm group.
106 Journal of Pharmacopuncture 13 4 2010 12 Appendix 1.
107 Appendix 2.