Quantifying Liver Stagnation Spleen Deficiency Pattern for Diarrhea Predominate Irritable Bowel Syndromes Using Multidimensional Analysis Methods

Huang, Zhongyu; Hou, Zheng-kun; Liu, Xianhua; Liu, Fengbin; Wu, Yuefeng

doi:10.1155/2018/6467135

Cited by 11 publications

(15 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The liver ( gan in the five zang organs of TCM) Qi stagnation and spleen ( pi in the five zang organs of TCM) deficiency syndrome (LQSSDS) is a common syndrome pattern in clinical practice (Huang, Hou, Liu, Liu, & Wu, ). The LQSSDS is caused by depression or excessive psychological pressure leading to liver dysfunction in ensuring the smooth flow of Qi and spleen dysfunction in controlling digestion and transportation.…”

Section: Introductionmentioning

confidence: 99%

A combination of depression and liver Qi stagnation and spleen deficiency syndrome using a rat model

Qiu

et al. 2020

The Anatomical Record

View full text Add to dashboard Cite

A syndrome (Zheng in Chinese) plays a critical role in disease identification, diagnosis, and treatment in traditional Chinese medicine (TCM). Clinically, the liver Qi stagnation and spleen deficiency syndrome (LQSSDS) is one of the most common syndrome patterns. Over the past few decades, several animal models have been developed to understand the potential mechanisms of LQSSDS, but until now, simulation of the syndrome is still unclear. Recently, several studies have confirmed that an animal model combining a disease and a syndrome is appropriate for simulating TCM syndromes. Overlapping previous studies have reported that depression is highly associated with LQSSDS; hence, we attempted to develop a rat model combining depression and LQSSDS. We exposed the rats to different durations of chronic unpredictable mild stress (CUMS). Subsequently, the evaluation indicators at macrolevel consisted of behavioral tests including open field test, sucrose preference test, and forced swim test, food intake, body weight, white adipose tissue, fecal water content, visceral hypersensitivity, and small bowel transit, and the evaluation indicators at microlevel included changes of hypothalamic–pituitary–adrenal axis. Serum D‐xylose absorption was used to comprehensively confirm and assess whether the model was successful during the CUMS‐induced process. The results showed that rats exposed to 6‐week CUMS procedure exhibited significantly similar traits to the phenotypes of LQSSDS and depression. This study provided a new rat model for the LQSSDS and could potentially lead to a better understanding of the pathophysiology of LQSSDS and the development of new drugs for this syndrome.

show abstract

Section: Introductionmentioning

confidence: 99%

A combination of depression and liver Qi stagnation and spleen deficiency syndrome using a rat model

Qiu

et al. 2020

The Anatomical Record

View full text Add to dashboard Cite

show abstract

“…Three measurement properties are commonly validated by the developers of TCM diagnostic instruments: (i) content validity – it refers to whether the instrument covers a broad scope of accepted and relevant TCM diagnostic concepts, contains comprehensible diagnostic items, and demonstrates a high consistency between its diagnostic concepts and diagnostic questionnaire items; 19 , 36 , 37 , 38 (ii) structural validity – it assesses the strength of statistical relationships between TCM patterns, and the relevant diagnostic questionnaire items; 39 , 40 , 41 and (iii) test-retest reliability – it indicates the consistency of diagnostic results when the instrument is administered twice on the same patient over a while, assuming that the condition would stay stable during the period. 38 , 42 , 43 , 44 Yet, despite the significance of these measurement properties to pattern diagnosis, they were not rigorously validated among the existing TCM diagnostic instruments for FD.…”

Section: Discussionmentioning

confidence: 99%

“…As TCM pattern is a summary of pathological changes in a patient at a specific time point and is constantly changing, 1 such dynamic feature may not favor standard evaluation of test-retest reliability which requires patients to be stable for at least two weeks. 25 , 43 To understand the dynamic feature of TCM pattern, prognostic tests may be conducted to study the possible changes of pattern diagnosis along the course of the disease. For example, empirical evidence illustrated that the progression from impaired glucose tolerance to diabetes mellitus resembles the progression from spleen deficiency with dampness encumbrance to spleen-stomach dampness-heat, then eventually to yin and qi deficiency.…”

Section: Discussionmentioning

confidence: 99%

Evaluating traditional Chinese medicine diagnostic instruments for functional dyspepsia: A systematic review on measurement properties

Chung

Wong

et al. 2021

Integrative Medicine Research

View full text Add to dashboard Cite

Background Pattern diagnosis-guided treatments in Traditional Chinese Medicine (TCM) has been recognised by the eleventh revision of the International Classification of Diseases (ICD-11). Accurate pattern diagnosis requires reliable and valid diagnostic instruments that guide the collection of TCM clinical data without bias. This study synthesised the existing TCM diagnostic instruments for functional dyspepsia (FD) and appraised their quality regarding their development process and measurement properties. Methods Seven electronic databases were searched for validation studies on TCM diagnostic instruments for FD. Synthesis and appraisal of the included studies were performed following the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) Initiative guidelines adapted for TCM diagnostic instruments. Risk of bias assessment was conducted using the COSMIN Risk of Bias Checklist . Results Five studies were included, with five unique TCM diagnostic instruments for FD identified. All five diagnostic instruments were of inadequate quality in terms of their development process, implying a shortcoming in their relevance, comprehensibility, and comprehensiveness. Only the criterion validity of Stomach Qi Deficiency Pattern Assessment Scale was of sufficient quality and had no risk of bias in its validation. Conclusion The quality of TCM diagnostic instruments for FD warrants urgent improvements. None of them was considered reliable or valid for guiding TCM pattern diagnosis. To support the evidence base of the standardization of TCM patterns in ICD-11, TCM diagnostic instruments should be developed and validated rigorously under the COSMIN guidelines. Amendments should be made on the guidelines to accommodate the features and uniqueness of TCM diagnostic process.

show abstract

“…Full-information item factor analysis of the multidimensional model of the liver-stomach pattern was performed with assist of packages including mirt [ 22 ] and mirtCAT [ 23 ] in R statistical software, version 3.4.2. Fitting item design of the scale, graded response model with the Quasi-Monte Carlo EM algorithm was used for the estimation of the three-dimension model following the methodology introduced in a previous study [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

“…In a previous study, a research paradigm was proposed for quantifying typical TCM patterns of diarrhea-predominant irritable bowel syndromes by the use of SEM and MIRT [ 14 ]. Latent variable analysis methods were evaluated to help quantify TCM patterns with a nonlinear and multidimensional relationship.…”

Section: Introductionmentioning

confidence: 99%

Quantifying Liver‐Stomach Disharmony Pattern of Functional Dyspepsia Using Multidimensional Analysis Methods

Huang

Lyu

Hou

et al. 2020

Evidence-Based Complementary and Alternative Medicine

Self Cite

View full text Add to dashboard Cite

Purpose. This study aims to develop and validate a quantitative model for measuring severity of a typical traditional Chinese medicine (TCM) pattern for functional dyspepsia (FD) using multidimensional analysis methods including confirmatory factor analysis (CFA) and multidimensional item response theory (MIRT). Methods. A scale and theoretical models were constructed according to the definition of pathogenesis about “liver-stomach disharmony” patterns of FD. With data collected from 502 patients in a cross-section study, the theoretical model was validated with CFA, and the related validity and reliability were evaluated in Amos 21.0. By the use of the MIRT paradigm, psychometric properties of the scale were estimated and evaluated for pattern quantification. Results. A scale consisting of 12 items was constructed detecting three latent traits of the pattern. The theoretical model was evaluated to be with adequate consistency with clinical data as RMSEA < 0.05, CFI = 0.94, and χ2/Df = 2.29. As the correlation between symptoms and related pattern factors evaluated to be with adequate factor loading, the instrument is of preliminary interpretation. Most precision of assessment could be achieved for patients with moderate severity of the pattern as shown in test information and standard error functions. Conclusions. An instrument with an interpretable conceptual framework was developed for pattern quantification in TCM clinical practice. By constructing and evaluating both psychological and physical effects in a multidimensional model of the TCM pattern of FD, the paradigm raised in this article provided a valuable reference for interpreting complex diseases and theories such as FD and TCM patterns.

show abstract

Quantifying Liver Stagnation Spleen Deficiency Pattern for Diarrhea Predominate Irritable Bowel Syndromes Using Multidimensional Analysis Methods

Cited by 11 publications

References 14 publications

A combination of depression and liver Qi stagnation and spleen deficiency syndrome using a rat model

A combination of depression and liver Qi stagnation and spleen deficiency syndrome using a rat model

Evaluating traditional Chinese medicine diagnostic instruments for functional dyspepsia: A systematic review on measurement properties

Quantifying Liver‐Stomach Disharmony Pattern of Functional Dyspepsia Using Multidimensional Analysis Methods

Contact Info

Product

Resources

About