Development and validation of Sasang Urination and Defecation Inventory (SUDI) for pathophysiological symptoms of Sasang typology

BACKGROUND: The pathophysiological symptom of Sasang typology is essential for getting clinical diagnosis and analyzing treatment effects. The clinical index for examining urination and defecation related symptoms were developed and validated with established clinical measures. METHODS: Questionnaire items of six subscales of Sasang Urination and Defecation Inventory (SUDI) were developed based on previous systematic reviews, and its clinical validity was examined with clinical measures of Urogenital Distress Inventory-6 (UDI-6), Overactive Bladder Symptom Score (OBSS), and ROME 3 criteria for Irritable Bowel Syndrome (ROME3-IBS) and Functional Constipation (ROME3-FC) using 48 healthy participants. The internal consistency of six subscales of SUDI were examined with Cronbach alpha. The Pearson correlation was used to examine correlation between SUDI and Western clinical measures, and the ANOVA was adopted to investigate differences among Sasang type groups in clinical measures. RESULTS: The SUDI-UCHR (problematic characteristics of urine) and SUDI-ANMD (defecation anomaly discomfort) were found to represent unique concept of traditional Korean medicine, however SUDI-IRRB (irritability of bowel movement) and SUDI-FCON (functional constipation) were similar with functional gastrointestinal disease of western medicine. SUDI-URET (ability to retain urine), SUDI-UDIS (urinary discomfort) and SUDI-ANMD of So-Yang type (7.95 ± 2.16, 14.33 ± 2.01, and 13.10 ± 2.57) are significantly different from those of So-Eum type (9.94 ± 2.54, 12.18 ± 2.96, and 10.59 ± 3.47, respectively). CONCLUSION: The pathophysiological symptoms of urination and defecation in Sasang typology were systematically scrutinized, and summarized into six subscales of SUDI in this study. The SUDI would be useful for analyzing clinical symptoms of Sasang typology along with integrative collaboration of traditional Korean and Western medicine.