Statistical analysis of hie (cold sensation) and hiesho (cold disorder) in kampo clinic

Abstract

A cold sensation (hie) is common in Japanese women and is an important treatment target in Kampo medicine. Physicians diagnose patients as having hiesho (cold disorder) when hie disturbs their daily activity. However, differences between hie and hiesho in men and women are not well described. Hie can be of three types depending on body part where patients feel hie. We aimed to clarify the characteristics of patients with hie and hiesho by analyzing data from new patients seen at the Kampo Clinic at Keio University Hospital between 2008 and 2013. We collected information about patients' subjective symptoms and their severity using visual analogue scales. Of 4,016 new patients, 2,344 complained about hie and 524 of those were diagnosed with hiesho. Hie was most common in legs/feet and combined with hands or lower back, rather than the whole body. Almost 30% of patients with hie felt upper body heat symptoms like hot flushes. Cold sensation was stronger in hiesho than non-hiesho patients. Patients with hie had more complaints. Men with hiesho had the same distribution of hie and had symptoms similar to women. The results of our study may increase awareness of hiesho and help doctors treat hie and other symptoms.

Figure 1

Hie and hiesho. In Japan hie (cold sensation) and hiesho (cold disorder) are different terms. While hie is the term used to describe the subjective, uncomfortable feeling of coldness, hiesho is the diagnosis given by physician to patients with cold sensation disturbing their daily living. Therefore, the first distinction is between normal and hie group. The hie group is subdivided into hiesho and non-hiesho.

Figure 2

Rate of non-hiesho and hiesho groups in each age group. Hie (cold sensation) and hiesho (cold disorder) were uncommon in children, but almost similarly present among young and old patients. We also can see that hie and hiesho were more common in women.

Figure 3

Frequency and severity of hie (cold sensation) by affected areas. The frequencies of binary answers of four parts of the body where patients felt hie were significantly higher in hiesho group except for hie of legs/feet as per the test for equal proportions (upper figure). Normalized visual analogue scales of hie of each body part of hiesho group were compared to non-hiesho group by Wilcoxon's rank sum test. Hie in every part of the body was significantly worse in hiesho group (lower figure).

Figure 4

Heat symptoms for non-hiesho and hiesho groups. The frequencies of binary answers about upper body heat symptoms, such as hot flushes and heat sensation of the face, were significantly common in patients with hie (cold sensation). All data were compared using the test for equal proportions.