A Symptom Differentiation based on Prospective pre-post intervention design and multiple regression analysis in Korean medicine - Focus on Yang Deficiency and Blood Heat Type Psoriasis -

Sundong Lee; Hyundo Kim; Seyoung Jung; Bo-in Kwon; Lee, Sundong; Kim, Hyundo; Jung, Seyoung; Kwon, Bo-in

doi:10.13048/jkm.23012

JKM > Volume 44(2); 2023 > Article

Lee, Kim, Jung, and Kwon: A Symptom Differentiation based on Prospective pre-post intervention design and multiple regression analysis in Korean medicine

Original Article

The Journal of Korean Medicine 2023; 44(2): 1-9.

DOI: https://doi.org/10.13048/jkm.23012

A Symptom Differentiation based on Prospective pre-post intervention design and multiple regression analysis in Korean medicine:

- Focus on Yang Deficiency and Blood Heat Type Psoriasis -

Sundong Lee¹

, Hyundo Kim²

, Seyoung Jung³

, Bo-in Kwon³^{, 4}^{, *}

¹Haeng-pa Korean Medical Clinic

²National university of health sciences

³College of Korean Medicine, Sangji University

⁴Research institute of Korean Medicine, Sangji University

Correspondence to: Bo-In Kwon, Department of Pathology, College of Korean Medicine, Sangji University, Wonju-si, Gangwon-do, 26339, Republic of Korea, Tel: +82-33-730-0662, Fax: +82-33-730-0654, E-mail: kbi34812@sangji.ac.kr

Received January 31, 2023 Revised February 12, 2023 Accepted February 21, 2023

Abstract

Objectives

To study symptom differentiation for yang deficiency and blood heat based on 117 psoriasis patients.

Methods

Obtained frequency analysis (%), mean (%), and OR, CL(P-value) with prospective pre-post intervention design and multiple regression analysis.

Results

There were no statistically significant differences as to sex, BMI, smoking and marital status, but there were statistically significant differences in variables of average age, gene history, and alcohol consumption (P<0.05). There were no statistically significant differences in psoriasis symptoms as to initial age of onset, morbidity span, area of the initial onset, and the progression of psoriasis during the last three months of each patient. However, the type of psoriasis showed a statistically significant difference (p=0.011). While there were no statistically significant differences as to common cold, condition of psoriasis after recovering from the cold, skin condition, exercise, and seasonality, irregular perspiration showed significant difference (p<0.00). When confounding factors have been controlled the blood heat patient group as the comparison group, multiple regression analysis showed OR, CI(95%) of 1.06(0.31–3.63) for men, 0.28(0.08–1.06) for aged 30 to 49,0 and 0.18(0.04–0.80) for aged 50 and older. it was 0.06(0.01–0.7) for gene history, 1.06(0.29–3.88) for drink alcohol, 19.90(2.53–156.7) for seasonality, and 10.28 (3.19–33.11) for perspiration problems. In these variables, Sex, age, smoking, and alcohol consumption showed no statistically significant results, but gene history(p=0.049), seasonality(p=0.005), and irregular perspiration (p=0.017) were statistically significant.

Conclusion

Family history, seasonality and irregular perspiration are the determining factors for yang deficiency and blood heat in psoriasis.

Keywords: prospective pre-post intervention design, multiple regression analysis, Psoriasis symptom differentiation, Yang deficiency, Blood heat, Korean Medicine

Acknowledgement

This research was supported by “Regional Innovation Strategy (RIS)” through the National Research Foundation of Korea(NRF) funded by the Ministry of Education(MOE)(2022RIS-005)

Table 1

Sociodemographic characteristics of psoriasis patients

unit: person(%)

Symptom Differentiation		Yang deficiency	Blood heat	p-value

Sociodemo-graphic characteristics
Gender	Male	37(50.68)	28(63.64)	0.172
Gender	Female	36(49.32)	16(36.36)	0.172

Age	0–29	13(17.81)	14(31.82)	0.057
	30–49	33(45.21)	22(50.00)
	Over 50	27(36.99)	8(18.18)

	Average	43.51±14.18	38.55±12.46	0.042

BMI	0–19.5	14(20.29)	4(9.52)	0.226
	19.5–25	38(55.07)	23(54.76)
	Over 25	17(24.64)	15(35.71)

	Average	22.66±3.12	23.58±3.67	0.350

gene history	Yes	11(15.07)	12(27.27)	0.044
	No	24(32.88)	31(70.45)
	No response	38(52.05)	1(2.27)

Alcohol consumption	Yes	35(47.95)	30(68.18)	0.033
Alcohol consumption	No	38(52.05)	14(31.82)	0.033

Smoking	No	21(28.77)	22(50.00)	0.058
	Yes	51(69.86)	22(50.00)
	No response	1(1.37)	0(0)

Marriage	Married	42(57.53)	18(40.91)	0.198
	Single	29(39.73)	25(56.82)
	No response	2(2.74)	1(2.27)

Table 2

Symptom(s) of psoriasis patients

unit: person(%)

Symptom Differentiation		Yang deficiency	Blood heat	p-value

Psoriasis symptoms
Age of initial onset	0~29	49(67.12)	32(72.73)	0.417
	30~49	18(24.66)	11(25.00)
	Over 50	6(8.22)	1(2.27)

	Average	26.46±15.43	24.81±10.85	0.502

Morbidity span	0~4 years	13(17.81)	7(15.91)	0.435
	5~9 years	10(13.70)	10(22.73)
	10~19 years	25(34.25)	17(38.64)
	Over 20 years	25(34.25)	10(22.73)

	Average	16.03±10.93	13.74±9.23	0.202

Area of initial onset	Scalp	6(8.22)	5(11.36)	0.332
	Face	5(6.85)	4(9.09)
	Body	7(9.59)	5(11.36)
	Arm	6(8.22)	10(22.73)
	Leg	27(36.99)	10(22.73)
	Palm	2(2.74)	2(4.55)
	Multiple	13(17.81)	6(13.64)
	No response	7(9.59)	2(4.55)

Progression during the last 3 months	Expanded	52(71.23)	34(77.27)	0.102
	Maintained	13(17.81)	6(13.64)
	Decreased	2(2.74)	4(9.09)
	No response	6(8.22)	0(0)

Current condition of psoriasis	1 location	2(2.74)	2(4.55)	0.939
	2–3 locations	6(8.22)	4(9.09)
	Several locations	27(36.99)	17(38.64)
	All over the body	38(52.05)	21(47.73)

Types of psoriasis	Plaque	67(91.78)	34(77.27)	0.011
	Pustular	0(0)	1(2.27)
	Mixed1)	5(6.85)	2(4.55)
	No response	1(1.37)	7(15.91)

1) Patients with mixed psoriasis have plaque, pustular and other types of psoriasis.

Table 3

Health Condition on Average of psoriasis patients

unit: person(%)

Symptom Differentiation		Yang deficiency	Blood heat	p-value

Health conditions
Common cold	Frequent	15(20.55)	7(15.91)	0.616
	Not frequent	53(72.60)	32(72.73)
	No response	5(6.85)	5(11.36)

Psoriasis after common cold	Exacerbate	15(20.55)	12(27.27)	0.592
	No effect	31(42.47)	15(34.09)
	No response	27(36.99)	17(38.64)

Skin condition	Normal	6(8.22)	4(9.09)	0.541
	Dryness	17(23.29)	14(31.82)
	Itchiness	13(17.81)	9(20.45)
	Hives	1(1.37)	0(0)
	Others	3(4.11)	0(0)
	Multiple conditions	32(43.84)	15(34.09)
	No response	1(1.37)	2(4.55)

Exercise	Regular	20(27.4)	12(27.27)	0.568
	No regular	51(69.86)	29(65.91)
	No response	2(2.74)	3(6.82)

Seasonality1)	Yes	53(72.6)	25(56.82)	0.059
	No	3(4.11)	7(15.91)
	No response	17(23.29)	12(27.27)

Perspiration2)	Irregular	53(72.6)	13(29.55)	<0.001
	Regular(normal)	15(20.55)	28(63.64)
	No response	5(6.85)	3(6.82)

1) Psoriasis improves in summers and exacerbates in winters.

2) Irregular perspiration is lower, non-existent, or more irregular before the occurrence of psoriasis than non-patients.

Table 4

Multiple Regression Analysis Results

Symptom Differentiation		OR	95%CI		p-value

Variables			Lowest	Highest
Gender	Male	1.06	0.31	3.63	0.921

Age	30–49	0.29	0.08	1.06	0.474
Age	50 and over	0.18	0.04	0.80	0.080

Gene history	Yes	0.06	0.01	0.7	0.049
Gene history	No response	0.46	0.15	1.47	0.423

Alcohol consumption	Yes	1.06	0.29	3.88	0.931
Smoking	No response	0.43	0.12	1.57	0.971

Types of psoriasis	No response	4.17	0.26	68.21	0.981
Types of psoriasis	Mixed	1.33	0.11	16.60	0.968

Seasonality	No response	0.93	0.28	3.13	0.043
Seasonality	No	19.90	2.53	156.69	0.005

Perspiration	No response	5.82	0.92	36.98	0.497
Perspiration	Irregular	10.28	3.19	33.11	0.017

- The comparison group was female, aged 0–29, no gene history, no drinking, no smoking, plaque psoriasis, seasonality, and regular(normal) perspiration

- Age and sex were controlled for confounding factors

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