A Study of Clinical Characteristics of Female Patients with Cold Hypersensitivity on Hands and Feet

Jung-Yeon Kwon; Young-Ji Kim; Kyung-Hwan Kong; Chan-Yong Jeon; Ho-Yeon Go; You-me Ko; Kwon, Jung-Yeon; Kim, Young-Ji; Kong, Kyung-Hwan; Jeon, Chan-Yong; Go, Ho-Yeon; Ko, You-me

doi:10.13048/jkm.18016

JKM > Volume 39(2); 2018 > Article

Kwon, Kim, Kong, Jeon, Go, and Ko: A Study of Clinical Characteristics of Female Patients with Cold Hypersensitivity on Hands and Feet

Original Article

The Journal of Korean Medicine 2018; 39(2): 64-79.

Published online: June 30, 2018

DOI: https://doi.org/10.13048/jkm.18016

A Study of Clinical Characteristics of Female Patients with Cold Hypersensitivity on Hands and Feet

Jung-Yeon Kwon¹

, Young-Ji Kim¹

, Kyung-Hwan Kong¹

, Chan-Yong Jeon²

, Ho-Yeon Go¹

, You-me Ko³

¹Dep. of Korean Int. Med, College of Korean Medicine, Semyung University

²Dep. of Korean Int. Med, College of Korean Medicine, Gachon University

³Dep. of Science in Korean Medicine, Graduate School, Kyunghee University

Correspondence to: 공경환(Kyung-Hwan Kong), 충북 충주시 상방4길 63 세명대학교 충주한방병원 한방내과학교실, Tel: +82-43-841-1732, Fax: +82-43-856-1731, E-mail: kong124@hanmail.net

Correspondence to: 전찬용(Chan-Yong Jeon), 인천광역시 구월동 1200-1 가천대학교 부속 한방병원 한방내과학교실, Tel: +82-32-770-1300, Fax: +82-43-468-4021, E-mail: joncy@gachon.ac.kr

Received May 28, 2018 Revised June 19, 2018 Accepted June 19, 2018

Abstract

Objectives

This study was aimed to research clinical characteristics of female patients with cold hypersensitivity on the hands and feet compared with non-cold hypersensitivity group.

Methods

134 women patients were collected from 6 Korean medicine hospitals, and divided into 2 groups(cold hypersensitivity group and non-cold hypersensitivity group). This survey was composed of 19 questions related to clinical symptoms of cold hypersensitivity.

Results

We found out the differences between 2 groups in 10 questions among 19 questions in the survey results. (Body Type, Energy, Digestibility, Skin Type, Facial Complexion, Chill, Dry Mouth and Thirst, Preference between Coolness and Warmth, Thickness of Tongue Fur, Floating and Sinking of Pulse)

Conclusions

From these results, Patients with cold hypersensitivity on hands and feet have relative clinical characteristics as follows. They are relatively weak and lethargic. They have dry skin and look more pale. They feel chill easily and have dry mouth and thirst. They prefer warmth and have indigestion more. They had more various infirm and ill clinical characteristics compared with the other group from the view of Korean medicine.

Keywords: Korean Medicine, Oriental Medicine, Cold Hypersensitivity, Clinical Character

Table 1

Interview Questions

Questions	Answers
Body Type	Bulky / Thin / Average
Energy	Lethargic / Normal
Voice	Lethargic / Normal
Digestibility	Good(Normal) / Bad
Appetite	Hyperorexia / Anorexia / Average(Normal)
Stool Type	Constipation / Diarrhea / Normal
Facial Complexion	Pale Complexion / Reddened Complexion / Darkish Complexion / Yellow Complexion / Reddish Cheekbone / Normal
Skin Type	Normal Skin / Dry Skin
Dry Mouth and Thirst	Dry Mouth and Thirst / Normal
Chill	Normal / Chill
Upper Body Heat	Normal / Upper Body Heat
Preference between Coolness and Warmth	Prefer Coolness Prefer Warmth / Not Care
Response to Temperature	Dislike the Heat / Dislike the Cold / Dislike the Both / Both are fine
Tongue Body Color	Pale Tongue / Red Tongue / Crimson Tongue / Purple Tongue / Normal
Thickness of Tongue Fur	Thin / Thick / Little / No Fur / Normal
Moisture and Dryness of Tongue Fur	Greasy and slippery / Dry / Normal
Strength of Pulse	Replete Pulse / Average(Normal) / Vacuous Pulse
Floating and Sinking of Pulse	Floating Pulse / Normal / Sunken Pulse
Speed of Pulse	Slow Pulse / Normal / Rapid Pulse

Table 2

Physical Characteristics of Both Groups

	CG	NCG	P-Value
Age	36.70±11.99	29.84±7.38	.000*
Height	161.14±5.20	161.41±5.87	.783*
Weight	54.01±8.65	56.45±8.78	.107*
BMI	21.07±2.67	21.64±2.92	.239*
n(%)	70 (52.24%)	64 (47.76%)	134 (100%)

Values are mean ± SD

* Statistically significant by t-test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 3

Body Type

		CG	NCG	Total	P-Value
Body Type	Bulky	6 (8.6%)	9 (14.1%)	15 (11.2%)	.009*
	Thin	16 (22.9%)	3 (4.7%)	19 (14.2%)
	Average	48 (68.6%)	52 (81.3%)	100 (74.6%)
Total		70 (100.0%)	64 (100.0%)	134 (100.0%)

Values are number (%)

* Statistically significant by chi-square test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 4

Energy

		CG	NCG	Total	P-Value
Energy	Lethargic	14 (20.6%)	1 (1.6%)	15 (11.5%)	.002*
Energy	Normal	54 (79.4%)	62 (98.4%)	116 (88.5%)	.002*
Total		68 (100.0%)	63 (100.0%)	131 (100.0%)

Values are number (%)

* Statistically significant by chi-square test with Yates’ continuity correction

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 5

Voice

		CG	NCG	Total	P-Value
Voice	Lethargic	7 (10.3%)	1 (1.6%)	8 (6.1%)	.086*
Voice	Normal	61 (89.7%)	62 (98.4%)	123 (93.9%)	.086*
Total		68 (100.0%)	63 (100.0%)	131 (100.0%)

Values are number (%)

* Statistically significant by chi-square test with Yates’ continuity correction

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 6

Digestibility

		CG	NCG	Total	P-Value
Digestibility	Good (Normal)	51 (75.0%)	59 (93.7%)	110 (84.0%)	.008*
Digestibility	Bad	17 (25.0%)	4 (6.3%)	21 (16.0%)	.008*
Total		68 (100.0%)	63 (100.0%)	131 (100.0%)

Values are number (%)

* Statistically significant by chi-square test with Yates’ continuity correction

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 7

Appetite

		CG	NCG	Total	P-Value
Appetite	Hyperorexia	8 (11.4%)	5 (7.8%)	13 (9.7%)	.295*
	Anorexia	1 (1.4%)	4 (6.3%)	5 (3.7%)
	Average (Normal)	61 (87.1%)	55 (85.9%)	116 (86.6%)
Total		70 (100.0%)	64 (100.0%)	134 (100.0%)

Values are number (%)

* Statistically significant by Fisher’s exact test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 8

Stool Type

		CG	NCG	Total	P-Value
Stool Type	Constipation	15 (22.4%)	12 (19.0%)	27 (20.8%)	.742*
	Diarrhea	6 (9.0%)	8 (12.7%)	14 (10.8%)
	Normal	46 (68.7%)	43 (68.3%)	89 (68.5%)
Total		67 (100.0%)	63 (100.0%)	130 (100.0%)

Values are number (%)

* Statistically significant by chi-square test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 9

Facial Complexion

		CG	NCG	Total	P-Value
Facial Complexion	Pale Complexion	15 (21.7%)	6 (9.4%)	21 (15.8%)	.000*
	Reddened Complexion	7 (10.1%)	0 (0.0%)	7 (5.3%)
	Darkish Complexion	2 (2.9%)	0 (0.0%)	2 (1.5%)
	Yellow Complexion	15 (21.7%)	8 (12.5%)	23 (17.3%)
	Reddish Cheekbone	7 (10.1%)	4 (6.3%)	11 (8.3%)
	Normal	23 (33.3%)	46 (71.9%)	69 (51.9%)
Total		69 (100.0%)	64 (100.0%)	133 (100.0%)

Values are number (%)

* Statistically significant by Fisher’s exact test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 10

Skin Type

		CG	NCG	Total	P-Value
Skin Type	Normal Skin	12 (17.9%)	32 (50.0%)	44 (33.6%)	.000*
Skin Type	Dry Skin	55 (82.1%)	32 (50.0%)	87 (66.4%)	.000*
Total		67 (100.0%)	64 (100.0%)	131 (100.0%)

Values are number (%)

* Statistically significant by chi-square test with Yates’ continuity correction

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 11

Dry Mouth and Thirst

		CG	NCG	Total	P-Value
Dry Mouth and Thirst	Dry Mouth and Thirst	42 (63.6%)	15 (24.6%)	57 (44.9%)	.000*
Dry Mouth and Thirst	Normal	24 (36.4%)	46 (75.4%)	70 (17.2%)	.000*
Total		66 (100.0%)	61 (100.0%)	127 (100.0%)

Values are number (%)

* Statistically significant by chi-square test with Yates’ continuity correction

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 12

Chill

		CG	NCG	Total	P-Value
Chill	Normal	46 (67.6%)	58 (90.6%)	104 (78.8%)	.003^*
Chill	Chill	22 (32.4%)	6 (9.4%)	28 (21.2%)	.003^*
Total		68 (100.0%)	64 (100.0%)	132 (100.0%)

Table 13

Upper Body Heat

		CG	NCG	Total	P-Value
Upper Body Heat	Normal	42 (60.9%)	48 (75.0%)	90(67.7%)	.120*
Upper Body Heat	Upper Body Heat	27 (39.1%)	16 (25.0%)	43 (32.3%)	.120*
Total		69 (100.0%)	64 (100.0%)	133 (100.0%)

Values are number (%)

* Statistically significant by chi-square test with Yates’ continuity correction

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 14

Preference between Coolness and Warmth

		CG	NCG	Total	P-Value
Preference between Coolness and Warmth	Prefer Coolness	26 (37.1%)	35 (54.7%)	61 (45.5%)	.007*
	Prefer Warmth	37 (52.9%)	17 (26.6%)	54 (40.3%)
	Not Care	7 (10.0%)	12 (18.8%)	19 (14.2%)
Total		70 (100.0%)	64 (100.0%)	134 (100.0%)

Values are number (%)

* Statistically significant by chi-square test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 15

Response to Temperature

		CG	NCG	Total	P-Value
Response to Temperature	Dislike the Heat	8 (11.4%)	15 (23.4%)	23 (17.2%)	.073*
	Dislike the Cold	45 (64.3%)	28 (43.8%)	73 (54.5%)
	Dislike the Both	12 (50.0%)	12 (18.8%)	24 (17.9%)
	Both are fine	5 (7.1%)	9 (14.1%)	14 (10.4%)
Total		70 (100.0%)	64 (100.0%)	134 (100.0%)

Values are number (%)

* Statistically significant by chi-square test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 16

Tongue Body Color

		CG	NCG	Total	P-Value
Tongue Body Color	Pale Tongue	21 (30.0%)	10 (15.6%)	31 (23.1%)	.077*
	Red Tongue	7 (10.0%)	12 (18.8%)	19 (14.2%)
	Crimson Tongue	1 (1.4%)	0 (0.0%)	1 (0.7%)
	Purple Tongue	1 (1.4%)	0 (0.0%)	1 (0.7%)
	Normal	40 (57.1%)	42 (65.6%)	82 (61.2%)
Total		70 (100.0%)	64 (100.0%)	134 (100.0%)

Values are number (%)

* Statistically significant by Fisher’s exact test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 17

Thickness of Tongue Fur

		CG	NCG	Total	P-Value
Thickness of Tongue Fur	Thin	20 (28.6%)	17 (26.6%)	37 (27.6%)	.005*
	Thick	9 (12.9%)	1 (1.6%)	10 (7.5%)
	Little	18 (25.7%)	8 (12.5%)	26 (19.4%)
	No Fur	2 (2.9%)	6 (9.4%)	8 (6.0%)
	Normal	21 (30.0%)	32 (50.0%)	53 (39.6%)
Total		70 (100.0%)	64 (100.0%)	134 (100.0%)

Values are number (%)

* Statistically significant by Fisher’s exact test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 18

Moisture and Dryness of Tongue Fur

		CG	NCG	Total	P-Value
Moisture and Dryness of Tongue Fur	Greasy and slippery	3 (4.3%)	3 (4.7%)	6 (4.5%)	.869*
	Dry	9 (13.0%)	6 (9.4%)	15 (11.3%)
	Normal	57 (82.6%)	55 (85.9%)	112 (84.2%)
Total		69 (100.0%)	64 (100.0%)	133 (100.0%)

Values are number (%)

* Statistically significant by Fisher’s exact test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 19

Strength of Pulse

		CG	NCG	Total	P-Value
Strength of Pulse	Replete Pulse	4 (6.2%)	3 (4.8%)	7 (5.5%)	.276*
	Average (Normal)	40 (51.5%)	47 (74.6%)	87 (68.0%)
	Vacuous Pulse	21 (32.3%)	13 (20.6%)	34 (26.6%)
Total		65 (100.0%)	63 (100.0%)	128 (100.0%)

Values are number (%)

* Statistically significant by Fisher’s exact test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 20

Floating and Sinking of Pulse

		CG	NCG	Total	P-Value
Floating and Sinking of Pulse	Floating Pulse	13 (18.6%)	4 (6.3%)	17 (12.8%)	.019*
	Normal	31 (44.3%)	42 (66.7%)	73 (54.9%)
	Sunken Pulse	26 (37.1%)	17 (27.0%)	43 (32.3%)
Total		70 (100.0%)	63 (100.0%)	133 (100.0%)

Values are number (%)

* Statistically significant by chi-square test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

Table 21

Speed of Pulse

		CG	NCG	Total	P-Value
Speed of Pulse	Slow Pulse	8 (11.4%)	3 (4.7%)	11 (8.2%)	.365*
	Normal	55 (78.6%)	54 (84.4%)	109 (81.3%)
	Rapid Pulse	7 (10.0%)	7 (10.9%)	14 (10.4%)
Total		70 (100.0%)	64 (100.0%)	134 (100.0%)

Values are number (%)

* Statistically significant by chi-square test

CG: The group of patients with cold hypersensitivity on hands and feet

NCG: The group of patients without cold hypersensitivity on hands and feet

참고문헌

1. Lee SL, Lee KS, Song BK. Literature survey on women’s syndromes due to cold. J Korean Obstet Gynecol. 1996; 9:1. 55–80.

2. Yamamoto I. Treatment and background of coldness(1). Journal of Kampo Medicine. 1976; 23:259–65.

3. Hong WS. Jeonggyohwangjenaegyeongsomun. Seoul: Oriental Medicine Laboratory;1981. p. 169–72. p. 245

4. Kim CM. Diagnosis and treatment of cold hands/feet syndrome. Korean Journal of Family Medicine. 2004; 25:11. 273–7.

5. The Society of Korean Medicine Obstetrics and Gynecology. Oriental Obstetrics & Gynecology 2. Seoul: Eui Seong Dang Publishing Co;2012. p. 888–94.

6. Kim DH, Kim YS, Lee GS. Standardization of diagnosis of cold hypersensitivity of hands and feet by D.I.T.I. The Journal Of Oriental Gynecology. 2001; 14:2. 129–34.

7. Bae GM, Cho HS, Kim KK, Lee IS. Research of relationship on cold hypersensitivity for the patients in OB&GY of Dong Eui medical center. J Korean Obstet Gynecol. 2002; 15:2. 101–13.

8. Compilation board of dictionary of Korean medicine. Dictionary of Korean medicine. Seoul: Jungdam;2010. p. 312

9. Park JY, Leem JT, Park SK, Woo SK, Kwak SH, Jung WS, et al. The between Coldness of Hands and Feet and the Erythrocyte Deformability in Stroke Patients. Korean J Orient lnt Med. 2010; 31:3. 578–85.

10. Jang KH, Song HS, Lee DK, Kim S, Kim SW. A Study of Association between Cold Hypersensitivity and Orthostatic Hypotension(OH). Jof Oriental Medical Thermology. 2003; 2:1. 29–3.

11. Yu JS. Distribution of Sasang Constitution and Prescriptions of Patients with Coldness in Hands and Feet. J Sasang Constitut Med. 2016; 28:3. 225–32.

12. Ko SW, Park JJ, Kong KH, Go HY. Diagnostic Tool for Cold Sensation of Hands: A Preliminary Study. J Int Korean Med. 2015; 36:3. 228–35.

13. Han JY, Joe JH, Jang JB, Kim YS, Lee KS. Cold Stress Test for The Diagnosis of Cold Hypersensitivity on Hands. J of Oriental Medical Thermology. 2003; 2:1. 17–23.

14. Lee KS. A Clinical Evaluation of DITI and Neurometer for the Diagnosis of Cold Hypersensitivity. J of Oriental Medical Thermology. 2004; 3:1. 60–6.

15. Lee MJ, Kim EK, Lee JM, Cho JH, Jang JB, Lee KS, et al. Analysis of Heart Rate Variability in Cold Hypersensitivity Females Visiting Gangnam Hyung-Hee Korean Hospital. The Journal of Oriental Obstetrics & Gynecology. 2011; 24:3. 109–15.

16. Choi JH, Kim ES, Hwang JH, Lee JM, Lee CH, Cho JH, et al. A clinical study on patients with Cold Hypersensitivity on hands and feet and their autonomic nervous system function using of Heart Rate Variability(HRV). J of oriental medical thermology. 2006; 5:1. 1–13.

17. Yang YS, Masayaseu Gachita. Korean medicine treatment for Coldness Sterility Obsesity. Seoul: Gugil Media;2002. p. 75–82.

18. Kwon Y. Health book for home written by Korean medicine doctor. Seoul: Healty life;2003. p. 26–40.

19. Jae IS. Sanghallonyeokjeon. Seoul: Gomunsa;1991. p. 238–9.

20. Moon JJ. Sanghallonjeonghae. Seoul: Kyunghee University Publication;1996. 568:p. 608

21. Woo HL, Park YK, Kim JH, Park KS, Hwang DS, Lee JM, et al. Study on the Correlation between Digital Infrared Thermal Imaging-induced Severity of Cold Hypersensitivity of Hands and Feet and Heart Rate Variability. J Korean Obstet Gynecol. 2016; 29:3. 1–9.

22. Bea GM, Cho HS, Kim KK, Lee IS. Research of relationship on cold hypersensitivity for the patients in OB＆GY of Dong Eui Medical center. The Journal of Oriental Obstetrics & Gynecology. 2002; 15:2. 101–13.

23. Kim SJ, Lee SW, Lee YS. A Study on the Difference of Cold-heat Patterns between Health and Mibyeong Group. Journal of Society of Preventive Korean Medicine. 2017; 21:1. 49–56.

24. Kim JH, Ku BC, Kim JE, Kim YS, Kim KH. Study on Reliability and Validity of the ‘Qi Blood Yin Yang Deficiency Questionnaire’. Korean J Oriental Physiology & Pathology. 2014; 28:3. 346–54.

25. Kang BK, Heo TY, Yun KJ, Park TY, Lee JA, You SS, et al. Study II of Diagnosis Criteria for Qi deficiency in Stroke. Korean JOriental Physiology & Pathology. 2014; 28:1. 76–81.

26. You KW. Biwiimsanghak. Seoul: Traditional Medicine Laboratory;1993. p. 116–29.

27. Lee AR, Kim WI. The Retrospective Comparative Study of General Acupuncture Therapy and Hominis placenta Pharmacopuncture Therapy on Severe Dyspepsia. Korean Journal of Acupuncture. 2013; 30:4. 319–28.

28. Han GJ, Kim JS, Park JW, Ryu BH. Pattern Identification of 97 Functional Dyspepsia Patients and the Characteristics of Each Pattern Type. J Korean Oriental Med. 2011; 32:2. 42–62.

29. Lee BK. Korean Medicine Diagnosis. Seongnam: Seongbosa;2012. p. 70–95.

30. Kong JH. Susebowon. Debuk: Goengeopseogu-kyuhangongsa;1615. p. 249–52.

31. Danpawongyeon. Japbyeonggwangyo. Seoul: Seongbosa;1986. p. 49–54.

32. Chi SY, Lee MJ, Kim EK, Lee JM, Lee CH, Jang JB, et al. A Study on the Correlation of Cold Hypersensitivity and Common Health Indexes in Young Women. The Journal of Korean Obsterics & Gynecology. 2011; 24:4. 62–70.

33. Yoon SW, Ha JY, Lee KS. Clinical Research about the Correlation between Defecation Type and Cold Hypersensitivity of Lower Abdomen, Hand and Foot. Journal of oriental medical thermology. 2004; 17:2. 130–7.

34. Park JJ, Lee MS, Kong KH, Ko HY. Relationship between Heart Rate Variability and Cold-Heat Patternization in Patient with Chronic Constipation. Korean J Orient Int Med. 2012; 33:2. 209–21.

35. Baek TS, Park YJ, Park YB, Park JH, Im JJ. Health Test for Searching of Correlation and the Index of the Cold-heat Patternization Comparison of the Questionnaires for the Cold-heat Patternization and the Ordinary. The Journal of The Korea Institute of Oriental Medical Diagnostics. 2005; 9:2. 145–52.

36. Bae NS, Park YJ, Oh HS, Park YB. Preceding Studies for Questionnaires on Han-Yol Patternixation. The Journal of The Korean Institute of Oriental Medical Diagnostics. 2005; 9:1. 98–111.

37. Park SW, Nam DH. A Survey on Utilixation of Questionnaires for Assessing Statues of Yin Deficiency Syndrome. The Journal of the Society of Korean Medicine Diagnostics. 2014; 18:2. 63–74.

38. Korean Society Of Oriental Medical Physiology. Oriental Medical Physiology. Seoul: Kyunghee University Publication;1993. p. 84

39. Department of Pathology. Nationwide College of Korean Medicine. Korean Medicine Pathology. Seoul: Iljungsa;2002. 33:p. 163p. 164

40. Yangryeok. Junguijilbyeongyecheukhak. Seoul: Beopin Munhwasa;2001. p. 250–64.

41. Son JY, Kim JS. Diagnostic Values of Tongue Coating Thickness and Sterno-costal Angle in Functional Dyspepsia. J Int Korean Med. 2014; 35:2. 157–74.

42. Bae SC. Geumseok Hwangjenaegyeongsomun. Seoul: Seongbosa;1995. p. 20–168.

43. Department of Pathology, Nationwide College of Korean Medicine. Korean Medicine Pathology. Seoul: Hanui Munhwasa;2007. p. 323–24.

44. Park MS, Kim YM. Study on Clinical Disease of Qi Deficiency Pattern. Korean J Oriental Physiology & Pathology. 2013; 27:5. 487–96.

45. Lee NM. China Seoljindaejeon. Beijing: Won Publisher;1995. p. 24

46. Park MS, Kim YM. Study on Clinical Disease of Yang Deficiency Pattern. Korean J Oriental Physiology & Pathology. 2013; 27:2. 153–66.