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The Journal of Internal Korean Medicine > Volume 35(3); 2014 > Article
The Journal of Internal Korean Medicine 2014;35(3): 274-287.
기침에 대한 비내시경을 이용한 寒熱辨證의 임상적 가치평가
이희범, 박의근, 백현정, 이범준, 정승기, 정희재
경희대학교 한의과대학 폐계내과학교실
Clinical Values of Cold-Heat Pattern Diagnosis by the Nasal Endoscopy for Patients with Cough
Hee-beom Lee, Eui-keun Park, Hyun-jung Baek, Beom-joon Lee, Sung-ki Jung, Hee-jae Jung
Division of Allergy, Immune & Respiratory System, Dept. of Internal Medicine, College of Korean Medicine, Kyung-Hee University
Correspondence  Hee-jae Jung ,Tel: 02-958-9147, Fax: 02-958-9148, Email: hanfish@khmc.or.kr
  Published online: September 30, 2014.
ABSTRACT
Objectives:
This study was aimed to figure out an agreement between the diagnosis of nasal endoscopy and a preexisting questionnaire focusing on Cold-Heat pattern.

Methods:
52 patients with cough who met the criteria filled out a pattern questionnaire and the examiner looked at their nasal cavities through nasal endoscopy. According to the checked questionnaire results, the subjects were identified by 6 patterns. After examining subject's mucous membrane of oropharynx and nasal cavity through nasal endoscopy, we classified each to the Cold or Heat group. Correlation between questionnaire and nasal endoscopy results was analyzed.

Results:
In diagnosing Cold-Heat, there was no significant difference by McNemar test (p=0.227) between nasal endoscopy and the questionnaire, and the two methods agreed moderately (κ=0.428). The color of mucous membrane of oropharynx and the Cold-Heat pattern on questionnaire agreed slightly (κ=0.133). The color of mucous membrane of nasal cavity and the Cold-Heat pattern on questionnaire agreed fairly (κ=0.384). In the patients with cough related to upper respiratory tract, they got higher diagnosis accuracy than the patients with cough related to lower respiratory tract did. Similarly, external cough patients got higher diagnosis accuracy than internal cough patients did.

Conclusions:
To identify Cold or Heat, examining oropharynx and nasal cavity using nasal endoscopy is a meaningful method in patients with cough, showing that two diagnosis methods which use nasal endoscopy and questionnaire agreed moderately. Especially, it is more useful diagnosing patients with cough related to the upper respiratory tract than diagnosing the patients with cough related to the lower respiratory tract.
Key words: Cough, Nasal endoscopy, Cold-Heat pattern diagnosis, Korean Medicine diagnosis
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