Data-driven meal events detection using blood glucose response patterns

BACKGROUND

In the Diabetes domain, events such as meals and exercises play an important role in the disease management. For that, many studies focus on automatic meal detection, specially as part of the so-called artificial [Formula: see text]-cell systems. Meals are associated to blood glucose (BG) variations, however such variations are not peculiar to meals, it mostly comes as a combination of external factors. Thus, general approaches such as the ones focused on glucose signal rate of change are not enough to detect personalized influence of such factors. By using a data-driven individualized approach for meal detection, our method is able to fit real data, detecting personalized meal responses even when such external factors are implicitly present.

METHODS

The method is split into model training and selection. In the training phase, we start observing meal responses for each individual, and identifying personalized patterns. Occurrences of such patterns are searched over the BG signal, evaluating the similarity of each pattern to each possible signal subsequence. The most similar occurrences are then selected as possible meal event candidates. For that, we include steps for excluding less relevant neighbors per pattern, and grouping close occurrences in time globally. Each candidate is represented by a set of time and response signal related qualitative variables. These variables are used as input features for different binary classifiers in order to learn to classify a candidate as MEAL or NON-MEAL. In the model selection phase, we compare all trained classifiers to select the one that performs better with the data of each individual.

RESULTS

The results show that the method is able to detect daily meals, providing a result with a balanced proportion between detected meals and false alarms. The analysis on multiple patients indicate that the approach achieves good outcomes when there is enough reliable training data, as this is reflected on the testing results.

CONCLUSIONS

The approach aims at personalizing the meal detection task by relying solely on data. The premise is that a model trained with data that contains the implicit influence of external factors is able to recognize the nuances of the individual that generated the data. Besides, the approach can also be used to improve data quality by detecting meals, opening opportunities to possible applications such as detecting and reminding users of missing or wrongly informed meal events.

Chinese herbal medicines in the treatment of ulcerative colitis: a review

Objective

To investigate how the ulcerative colitis (UC) be treated with Chinese herbal medicines (CHM), using Chinese medicine (CM) pattern (zheng) identification, in the current clinical practice.

Methods

A total of 7 electronic databases were systematically searched for UC clinical studies with CHM interventions (including single herbs and CHM formulas) published in English and Chinese from the date of their inception to November 25, 2020. Descriptive statistics were adopted to demonstrate the characteristics of study design, and to collate the commonly CM patterns of UC and frequently used CHM herbs and formulas. Further, IBM SPSS Modeler 18.0 and Cytoscape 3.7.1 software were used to analyze and visualize the associations between different categories of CHM and their zheng indications.

Results

A total of 2311 articles were included in this study, of which most (> 90%) were RCTs with CHM formulas. The most common zheng of UC was Large intestine dampness-heat, while the basic type of CM patten was Spleen deficiency. The most frequently used classical formula was Bai-Tou-Weng-Tang, followed by Shen-Ling-Bai-Zhu-San, and the commonly used proprietary CHM was Xi-Lei-San (enema). Sulfasalazine and Mesalazine are commonly used as concomitant western medicines. The most frequently used single medicinals were Huang Lian and Bai Zhu, which also identified as the core herbs for different CM patterns.

Conclusion

This study examined the application of CHM interventions for UC and summarized their characteristics in clinical practice. These data indicated there were limited information about the safety assessment of CHM formulas and further RCTs including CM pattern(s) with strict design are necessary.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13020-022-00591-x.

A structured methodology to understand municipal waste generation at local level with minimized effort: development and case study

Understanding municipal solid waste (MSW) generation is a key requirement for designing and optimizing MSW collection services. The present contribution proposes a statistical methodology to identify MSW generation patterns from MSW collection records. The methodology aims at finding statistically distinct household waste generation patterns within the days of the week and within months (seasonal variation). It is based on standard statistical methods (ANOVA complemented by non-parametric tests and cluster analysis). The methodology was applied to a Portuguese neighbourhood to assist in the definition of a waste sampling campaign to support the implementation of a pilot PAYT. The results showed the existence of groups with statistically distinct MSW generation patterns both at the weekly and monthly time scales. Three clusters of days of the week, with high, medium and low generation, and two clusters of months, with high and low generation, were identified. These results allowed to design and implement a customized field waste sampling campaign to estimate the MSW generated at the study site with minimal field work. Instead of implementing a homogeneous sampling campaign (equal number of samples for every day of the week and for every month), the samples were collected from the days and months that showed statistically distinct MSW generation pattern. The systematic procedure can be easily adapted to any given location, thus being a useful tool that combines statistical analysis with field collected data.

Jiao-tai-wan for insomnia symptoms caused by the disharmony of the heart and kidney: a study protocol for a randomized, double-blind, placebo-controlled trial

BACKGROUND

Insomnia seriously affects people's normal lives and work. However, effective treatment strategies are scarce. The purpose of this study is to explore the efficacy and safety of Jiao-tai-wan (JTW) for ameliorating insomnia symptoms caused by disharmony of the heart and kidney.

DESIGN

This is a randomized, double-blind, placebo-controlled pilot clinical trial. A total of 124 participants suffering from insomnia symptoms will be randomly assigned to the JTW or placebo group in an equal ratio. The participants will be asked to take JTW or placebo granules twice a day for 1 week. All data will be gathered at baseline and at the end of the drug intervention. The primary outcome measures will be the mean change in the Pittsburgh Sleep Quality Index (PSQI) from baseline to the end of the drug intervention. Secondary outcome measures will include the altered sleep parameters in polysomnography, ¹H-magnetic resonance spectroscopy (¹H-MRS) evaluation, the Disharmony of Heart and Kidney Scoring System score, and blood tests, including the levels of serum adenosine and melatonin. A laboratory test will be taken before and after treatment to assess the safety of JTW.

DISCUSSION

The outcomes of this study will confirm the efficacy of JTW for the treatment of insomnia symptoms and will also be used to monitor the safety of JTW.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR1800019239. Registered on 1st November 2018.

Analysis of diagnostic decision in acupuncture from the actual functional dyspepsia patient's clinical information

Background

Clinical research in acupuncture has been criticized for not reflecting real-world practice in terms of diagnosis and intervention. This study aimed to collect data on the principles of diagnosis and selection of acupoints from Korean medicine doctors (KMDs) and analyze the patterns and priorities in decision-making.

Methods

The study design was based on the data of an actual patient with functional dyspepsia (FD) (according to Rome III criteria) to create simulated patients, and a KMD specialized in gastrointestinal disorders was allocated to collect the clinical information as objectively as possible. Sixty-nine KMDs were recruited to diagnose a simulated patient based on the actual patient's clinical information, in a manner similar to that performed in their clinics.

Results

After the diagnostic procedures were completed, the pattern identification, selected acupoints, reasons for choosing them, and importance of symptoms for deciding their diagnoses were documented. The information needed was clearly distinguishable from those routinely asked in western medicine, and information regarding fecal status, abdominal examination, appetite status, pulse diagnosis, and tongue diagnosis were listed as vital. The doctors identified the patient's pattern as "spleen-stomach weakness", "liver qi depression", or "food accumulation or phlegm-fluid retention". The most frequently selected acupoints were CV12, LI4, LR3, ST36, and PC6.

Conclusion

There are common acupoints across different patterns, but pattern-specific acupoints were also recommended. These results can provide useful information to design clinical research and education for better clinical performance in acupuncture that reflects real-world practice.

Herbal medicine and pattern identification for treating COVID-19: a rapid review of guidelines

Background:

Coronavirus disease 2019 (COVID-19) is pandemic and has caused illness to many people worldwide. This review aimed to summarize and analyze the herbal formulae provided by the guidelines for their pattern identifications (PIs) and compositions of herbs to treat patients with COVID-19.

Methods:

We searched 7 data sources for eligible traditional medicine guidelines up to March 6, 2020 and found a total of 28 traditional medicine guidelines that provide treatment measures for COVID-19.

Results:

Of the 28 guidelines, there were 26 government-issued Chinese guidelines and 2 Korean guidelines. After standardizing the terminology of the PIs and herbal formulae, there were 8 PIs and 23 herbal formulae for the mild stage, 11 PIs and 31 herbal formulae for the moderate stage, 8 PIs and 21 herbal formulae for the severe stage, and 6 PIs and 23 herbal formulae for the recovery stage in the Chinese guidelines. In the Korean guidelines, there were 4 PIs and 15 herbal formulae for the mild stage, 3 PIs and 3 herbal formulae for the severe stage, and 2 PIs and 2 herbal formulae for the recovery stage. In the frequency analysis of herbs, Glycyrrhizae Radix et Rhizoma was found to be the herb with the highest frequency of usage in the Chinese guidelines.

Conclusion:

This review can be used as guidance for the traditional medicine treatment of COVID-19. Clinical evidence is needed in the future to evaluate the efficacy of traditional medicine.

Herbal prescription for managing menopausal disorders: A practice survey in Korean medicine doctors

BACKGROUND

The aim of this study was to investigate the clinical practice of Korean medicine doctors (KMDs) for managing menopausal disorders.

METHODS

We conducted a web-based questionnaire for KMDs to respond to recommendations across the three main KM domains: major symptoms of menopausal disorders, herbal prescriptions, and pattern identification.

RESULTS

We received responses from 227 doctors who have treated menopausal disorders. The major pattern identifications recommended by the doctors for the pre-, peri-, and postmenopausal phases, respectively, were depression of liver energy (59.5%), kidney yin deficiency (49.8%), and kidney yin deficiency (50.7%). The most frequent herbal remedies prescribed for the pre-, peri-, and postmenopausal phases were Jiawei shaoyao-san (58.1%), Jiawei shaoyao-san (48.5%), and Jiawei guipi-decoction (37.9%), respectively.

CONCLUSION

The results of our clinical practice survey provide information on KMDs' clinical experiences of using herbal medicines and their use of pattern identification to manage menopausal disorders.

Exploratory analysis of cold, heat, deficiency, or excess pattern distribution in women with dysmenorrhea

OBJECTIVE

To understand the impact and implications of cold, heat, deficiency, or excess pattern identification in relation to dysmenorrhea, comparing the prevalence of these patterns between women with and without dysmenorrhea is needed.

METHODS

We gathered data from the Korea Constitutional Multicenter Bank. A total of 508 patients were recruited and provided with cold, heat, deficiency, or excess pattern and dysmenorrhea questionnaires. On the basis of their responses, they were divided into the dysmenorrhea group (moderate or severe dysmenorrheic pain; n = 90) and non-dysmenorrhea group (no dysmenorrheic pain; n = 155). We analyzed the characteristics of the groups and compared the cold, heat, deficiency, or excess pattern scores. Comparisons were performed using the independent t-test. We also performed multiple comparisons of each individual symptom between the groups to explore which symptoms appear with dysmenorrhea using the Bonferroni adjustment method.

RESULTS

There was a high positive correlation between deficiency pattern scores and excess pattern scores (p < 0.001). The cold, deficiency, and excess pattern scores were significantly higher in the dysmenorrhea group than in the non-dysmenorrhea group (p < 0.001). Twenty among the 76 pattern items showed significant differences between the groups (p < 0.001). Among all items, there was a large effect size only in sleep quality (mean difference 1.07, 95% confidence interval 0.75-1.39, p < 0.001).

CONCLUSIONS

Women with dysmenorrhea have higher cold, deficiency, and excess pattern scores than those without dysmenorrhea. The longitudinal observation of these symptoms needs to be evaluated using a clinical prospective study design in accordance with pattern differentiation in the future.

Acupuncture using pattern-identification for the treatment of insomnia disorder: a systematic review and meta-analysis of randomized controlled trials

Background

Insomnia symptoms are common, affecting almost 30% of the population of the population. Many use medications that may be ineffective and cause substantial harm. In complementary and alternative medicine, acupuncture is widely used to manage mental health problems. Acupuncture therapy emphasizes individualized treatment according to TCM pattern diagnosis. Although there are some systematic reviews that acupuncture has the benefit for insomnia, there is no systematic review on acupuncture using pattern identification. This review aimed for evaluating acupuncture efficacy using pattern-identification to treat insomnia.

Methods

We carried out a comprehensive review of randomized controlled trials (from 2000 to April 12, 2018), using PubMed, Cochrane CENTRAL, EMBASE, CINAHL, PsycINFO, CNKI, and 3 Korean (OASIS, NDSL, RISS4U) databases, comparing acupuncture using pattern identification (only) with medication in primary insomnia. Response rate and the Pittsburgh Sleep Quality Index (PSQI) were the primary outcomes. Risk of bias and publication biases were evaluated, and meta-analyses were conducted.

Results

Nineteen RCTs were included (11 manual acupuncture (1079 patients), 8 electro-acupuncture (442 patients)) of low quality. Meta-analyses of all studies reveled that acupuncture improved total effectiveness rate (Risk Ratio [RR] = 1.23, 95% confidence intervals [CIs]: 1.12-1.35, p < 0.00001; I² = 80%) and PSQI (MD = -1.92, 95% CI: -2.41-1.42, p < 0.00001; I² = 30%) compared to medication. Results of overall risk of bias assessments were unclear or high.

Conclusions

Acupuncture using pattern identification led to significantly improved total effectiveness rate compared to medication. With regard to PSQI, as compared to the control group, acupuncture using pattern identification was similar to medication. However, this study has limitations of high risk of bias, not using a standardized pattern-diagnosis-treatment and not comparing with standarized acupuncture without pattern identification.

Treating the patient not the symptoms: Acupuncture to improve overall health - Evidence, acceptance and strategies

Documented mechanisms of acupuncture suggest the possibility of whole body effects in addition to local and regional effects. Traditional theories of acupuncture predict whole body effects. Does this permit the possibility of applying treatment to target overall health improvement of the patient rather than the symptom? After introducing the term 'health improvement' this paper explores situations where it might be advantageous to do this, giving examples of how health authorities in some countries have proposed broader treatment approaches that focus on health improvement. It also discusses cases where acupuncture has been recommended as a treatment method in a number of these proposals and gives some clinical examples of this kind of whole body 'health improvement' targeted treatment effects. Given that health authorities have already recognised this potential for the application of acupuncture the author then explores evidence of more whole-body 'health improvement' effects from systematic reviews and examples of health experts recommending acupuncture to take advantage of them. Research strategies and foci are then proposed and explored to develop this evidence. What are the best treatment approaches to create these effects? By what mechanisms can 'health improvement' be produced? How can one measure these effects? It is likely that treatments based on 'pattern identification' (PI) may provide the best strategies for producing 'health improvement', thus PI-based acupuncture treatments are likely to be the best strategy for clinical research investigating these effects.

Danggwijagyaksan for climacteric syndrome in peri- and postmenopausal women with a blood-deficiency dominant pattern: study protocol for a randomized, double-blind, placebo-controlled pilot trial

Background

This study aims to explore the safety, efficacy, and feasibility of Danggwijagyaksan (DJS) for alleviating climacteric syndrome in peri- and postmenopausal women with a blood-deficiency dominant pattern.

Methods/design

This is a randomized, double-blind, placebo-controlled pilot clinical trial. A total of 34 women with climacteric syndrome who have signed informed consent forms will be registered in this study. Placebo or DJS will be randomly assigned to the participants in an equal proportion. The participants will visit the clinical trial center every 2 weeks and receive placebo or DJS granules. The treatment period is 4 weeks and the administration frequency is three times daily. Data will be collected from the participants at baseline, at week 5, and at week 9 after random allocation. The primary outcome measure will be the mean change in the Menopause Rating Scale from baseline to week 5. Secondary outcome measures will include the World Health Organization Quality of Life-BREF (WHOQOL-BREF) score, the Blood Deficiency Scoring System score, lean body mass, and blood tests, including serum follicle-stimulating hormone and estradiol concentration. To assess the safety of DJS, a laboratory test will be conducted before and after treatment and the participants will be asked about any occurrence of adverse events every visit. The recruitment rate, completion rate, and medication adherence will also be calculated, to assess feasibility.

Discussion

The findings of this study will provide the basis for a full-scale randomized controlled trial to confirm the safety and efficacy of DJS for the treatment of climacteric syndrome in peri- and postmenopausal women.

Trial registration

Clinical Research Information Service (CRIS), Republic of Korea, KCT0002387. Registered on 25 July 2017.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-018-2443-8) contains supplementary material, which is available to authorized users.

Perception of cold and heat pattern identification in diseases: a survey of Korean medicine doctors

Background

This study aimed to investigate the extent to which Korean Medicine doctors consider cold and heat pattern identification when prescribing herbal treatment for a disease.

Methods

A survey was sent by e-mail to 15,841 members of the Association of Korean Medicine for whom member information was registered. Of these, 699 (4.4%) members participated in the survey. The survey included questions regarding the frequency of use of cold and heat pattern identification in deciding a herbal treatment prescription, the diseases for which cold and heat pattern identification-related herbal treatment was most efficacious, the type of herbal treatment prescribed, and the duration of the treatment.

Results

Of the 699 respondents, 591 (84.5%) reported that they considered cold and heat when prescribing herbal treatment. The diseases for which consideration of cold and heat patterns was effective were, in order, menopausal disorder (124, 18.3%), chronic rhinitis (98, 14.5%), dyspepsia (94, 13.9%), hwa-byung (92, 13.6%), diarrhea (83, 12.3%), dysmenorrhea (61, 9.0%), headache (59, 8.7%), inflammation in the digestive tract (58, 8.6%), coldness in hands and feet (58, 8.6%), and atopic dermatitis (55, 8.1%). The typical treatment duration differed widely for different diseases: atopic dermatitis was most frequently treated for >2 months (38, 34.5%), whereas diarrhea was most frequently treated for ≤ 10 days (73, 43.6%).

Conclusion

These findings indicate that cold and heat pattern identification is a useful tool employed by Korean Medicine doctors. This study may provide a basis for clinical research investigating the effect of pattern identification-based treatment of diseases.

Electroacupuncture to treat gastroesophageal reflux disease: study protocol for a randomized controlled trial

Background

Gastroesophageal reflux disease lowers the quality of life and increases medical costs. Electroacupuncture has been used to ease symptoms and improve gastrointestinal motility in patients with gastroesophageal reflux disease. The main purposes of this study are to evaluate the efficacy and safety of this procedure.

Methods/design

This is a protocol for a randomized, patient-blinded, assessor-blinded, sham-controlled trial. Sixty participants with symptoms of gastroesophageal reflux disease, who have previously undergone standard treatment, will be recruited from August 2015 at Kyung Hee University Korean Medicine Hospital. The participants will be allocated to either the electroacupuncture (n = 30) or the sham electroacupuncture group (n = 30); the allocation will be concealed from both the participants and the assessors. The EA group will undergo penetrating acupuncture at 18 fixed points and two optional points chosen using the pattern identification for gastroesophageal reflux disease. Electrical stimulation will be applied at some of the acupoints. The sham electroacupuncture group will undergo nonpenetrating acupuncture without electrical stimulation at 18 nonspecific points, each of which will be only 2 cm away from the true acupoints used in the electroacupuncture group. In both groups, the procedure will be performed using the Park device. The treatment will last for 6 weeks (with two sessions each week), and the outcome will be evaluated at baseline, 3 weeks, and 6 weeks. The primary outcome will be the proportion of responders with adequate symptom relief, whereas the secondary outcomes will comprise the results of the Nepean dyspepsia index; the Korean gastrointestinal symptom rating scale; the EQ-5D™; levels of gastrin, motilin, and inflammatory cytokines; the perceived stress scale; the qi-stagnation questionnaire; the patient global impression of change; and the spleen qi deficiency questionnaire.

Discussion

The results of this trial will provide information about the efficacy and safety of electroacupuncture in the treatment of gastroesophageal reflux disease symptoms, as well as evidence regarding the use of electroacupuncture to treat gastroesophageal reflux disease in real clinical practice.

Trial registration

Clinical Research Information Service Identifier, KCT0001653. Registered on 12 October 2015.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-016-1371-8) contains supplementary material, which is available to authorized users.

Validation of the qi blood yin yang deficiency questionnaire on chronic fatigue

Background

Chronic fatigue (CF) reflects an imbalance of inter-organ functions or of the four essential physiological components qi, blood (xue), yin, and yang. CF can be subdivided into different patterns. However, there are no diagnostic methods for CF. This study aimed to clinically validate a pattern identification method by identifying correlations between CF and responses to the qi blood yin yang deficiency questionnaire (QBYY-Q).

Methods

Participants were recruited between May and June 2014 through the Kyung Hee University Korean Medicine hospital website and via posters and comprised 129 CF patients diagnosed with the United States Centers for Disease Control and Prevention (1994) criteria. Participants who had organic diseases that explained the CF were excluded. A total of 159 participants were asked to complete the QBYY-Q, the fatigue severity scale, and the Chalder fatigue scale. The latter two questionnaires were used to assess convergent validity with the QBYY-Q. Among the 129 CF participants, 70 and 59 had chronic fatigue syndrome and idiopathic chronic fatigue, respectively. Two Korean medical doctors independently assessed participants’ qi, blood, yin, and yang deficiency patterns using QBYY deficiency pattern identification guidelines. Based on the results of a preliminary study of the QBYY-Q, we selected 32 reliable items for symptoms corresponding to each deficiency pattern. The items were used to estimate internal consistency and construct validity. Multinomial logistic regression analysis was performed for scores on each deficiency pattern.

Results

The data were means and standard deviations or numbers of participants and proportions for continuous and categorical variables, respectively. A statistical significance level of P < 0.05 was assumed. The QBYY-Q showed satisfactory internal consistency. Explanatory factor analysis extracted two factors for each deficiency pattern. The percentages of explained variance for qi, blood, yin, and yang deficiency were 45.1, 58.0, 52.2, and 63.4 %, respectively. Each QBYY-Q deficiency score was positively associated with each corresponding deficiency pattern. Qi deficiency was used as a reference category. Odds ratios of blood, yin, and yang deficiency were 10.97, 10.69, and 14.64, respectively.

Conclusion

The QBYY-Q was suitable for estimating the influences of qi, blood, yin, and yang deficiencies in CF.

Trial registration This trial was registered with the Korean Clinical Trial Register (KCT0001199)

Electronic supplementary material

The online version of this article (doi:10.1186/s13020-016-0092-y) contains supplementary material, which is available to authorized users.

Genome wide classification and characterisation of CpG sites in cancer and normal cells

This study identifies common methylation patterns across different cancer types in an effort to identify common molecular events in diverse types of cancer cells and provides evidence for the sequence surrounding a CpG to influence its susceptibility to aberrant methylation. CpG sites throughout the genome were divided into four classes: sites that either become hypo or hyper-methylated in a variety cancers using all the freely available microarray data (HypoCancer and HyperCancer classes) and those found in a constant hypo (Never methylated class) or hyper-methylated (Always methylated class) state in both normal and cancer cells. Our data shows that most CpG sites included in the HumanMethylation450K microarray remain unmethylated in normal and cancerous cells; however, certain sites in all the cancers investigated become specifically modified. More detailed analysis of the sites revealed that majority of those in the never methylated class were in CpG islands whereas those in the HyperCancer class were mostly associated with miRNA coding regions. The sites in the Hypermethylated class are associated with genes involved in initiating or maintaining the cancerous state, being enriched for processes involved in apoptosis, and with transcription factors predicted to bind to these genes linked to apoptosis and tumourgenesis (notably including E2F). Further we show that more LINE elements are associated with the HypoCancer class and more Alu repeats are associated with the HyperCancer class. Motifs that classify the classes were identified to distinguish them based on the surrounding DNA sequence alone, and for the identification of DNA sequences that could render sites more prone to aberrant methylation in cancer cells. This provides evidence that the sequence surrounding a CpG site has an influence on whether a site is hypo or hyper methylated.

The comparative clinical study of efficacy of Gamisoyo-San (Jiaweixiaoyaosan) on generalized anxiety disorder according to differently manufactured preparations: multicenter, randomized, double blind, placebo controlled trial

ETHNOPHARMACOLOGICAL RELEVANCE

Gamisoyo-San (GSS) is a well-known Traditional Korean Medicine shown to be effective on mood disorders.

AIM OF THE STUDY

The purpose of this research is to examine the effect of Gamisoyo-San on generalized anxiety disorder by its differently manufactured preparations.

MATERIALS AND METHODS

Multicenter, randomized, double-blinded, placebo-controlled study was set for 147 patients with generalized anxiety disorder recruited from November 1st 2009 to December 16th 2010. They were given Gamisoyo-San individual extract mixture (extraction done for each crude materia medica separately) or Gamisoyo-San multi-compound extract (extraction done for whole materia medica at once) or controlled medication. Hamilton Rating Scale for Anxiety (HAM-A), Korean State-Trait Anxiety Inventory (K-STAI), Penn State Worry Questionnaire (PSWQ), Korean Beck Depression Inventroy (K-BDI), Symptom Checklist-90-Revised (SCL-90-R), and Korean WHO Quality of Life Scale Abbreviated Version (WHOQOL-BREF) were evaluated. We also applied Pattern Identification tool for 'JingJi and ZhengChong (, Traditional Korean Medicine term which correlates with generalized anxiety disorder)' to patients to evaluate different responses among 9 patterns.

RESULTS

HAM-A scores of Gamisoyo-San multi-compound extract group showed greater decrease compared to Gamisoyo-San individual extract mixture group and placebo group, but the difference was insignificant. WHOQOL-BREF scores of Gamisoyo-San multi-compound extract group showed significant increase compared to Gamisoyo-San individual extract mixture group and placebo group. In Heart blood deficiency pattern, the Gamisoyo-San multi-compound extract group showed significant decrease in K-BDI compared to the Gamisoyo-San individual extract mixture group.

CONCLUSION

Gamisoyo-San did not improve anxiety level of GAD patients. However, it can be useful to improve quality of life, and reduce depressive, obsessive-compulsive, somatic symptoms of generalized anxiety disorder. Gamisoyo-San multi-compound seemed more effective than Gamisoyo-San individual extract mixture, especially in Heart blood deficiency pattern.