Total bilirubin level as a biomarker for dampness-heat differentiation in traditional Korean treatment for jaundice

Objectives: Classifying the pattern of jaundice during diagnosis will significantly improve the outcome of common KM interventions. This study aimed at determining an objective index for accurately diagnosing heat and dampness KM patterns in patients with jaundice. Methods: We systematically reviewed laboratory findings from case reports published in the scientific literature of Korean medicine. Cases were classified as following either the heat or dampness pattern. Biochemical indices were compared using a Bayesian factor (BF) analysis and standard t-tests. Results: The laboratory findings of 32 patients were evaluated. The heat pattern was observed in 17 patients and the dampness pattern in 15. No significant differences were observed between the 2 groups in terms of white blood cell count (BF=1.659); hemoglobin concentration (BF=2.627); platelet count (BF=1.019); or levels of direct bilirubin (BF=1.453), aspartate aminotransferase (BF=1.226), alanine aminotransferase (BF=1.340), alkaline phosphatase (BF=2.344), or gamma-glutamyl transpeptidase (BF=2.782). However, total bilirubin levels were significantly higher in the dampness pattern group (BF=0.854, P-value=0.070). Conclusions: Patients with high total bilirubin levels may predominantly follow the dampness pattern, while those with low levels may predominantly follow the heat pattern. These results are expected to be useful for the development of timely and efficient KM treatments as well as new integrative therapeutic approaches for jaundice. However, further studies are essential to fully validate the utility of total bilirubin as a biomarker for differentiating between heat and dampness patterns.