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Background  This study aims to establish a diagnostic scoring scheme for  Shanghuo (Heatiness)  and to evaluate whether  Shanghuo  is associated with biochemical parameters of salivary lysozyme (LYZ), salivary secreted immunoglobulin (S-IgA), salivary amylase (AMS), and saliva flow rate (SFR).    Methods  We collected 121  Shanghuo  patients at the Affiliated Hospitals of Guangzhou University of Traditional Chinese Medicine in Guangdong Province, 60 cases as a  Shanghuo  recovered group, and 60 healthy cases as a healthy control group. The diagnostic scoring scheme was established by probability theory and maximum likelihood discriminatory analysis on the basis of epidemiology with the design of self-controlled clinical trial. Subsequently, we used the same methods to collect 120  Shanghuo  patients, 60  Shanghuo  recovered cases, and 60 healthy cases in both Hunan Province and Henan Province. The levels of LYZ, S-IgA, AMS, and SFR were tested when the patients suffered from  Shanghuo  or recovered, respectively.    Results  The diagnostic score table for  Shanghuo  syndrome was established first. In the retrospective tests, the sensitivity, specificity, accuracy, and positive likelihood ratio of the diagnostic score table were 98.9%, 93.5%, 97.5%, and 14.34%, respectively. In the prospective tests, the corresponding values were 94.9%, 85.7%, 91.7%, and 6.64%, respectively.  Shanghuo  was classified into three degrees based on the diagnostic scores, common  Shanghuo : 63–120; serious  Shanghuo : 121–150; very serious  Shanghuo : >150. A negative correlation was found between  Shanghuo  and S-IgA ( R  = -0.428;  P  = 0.000). The level of S-IgA was also affected by seasonal and regional factors. No significant correlations were found between  Shanghuo  and the levels of LYZ, AMS, and SFR.    Conclusions  In this study,  Shanghuo  could be diagnosed by the combination of the diagnostic score table and S-lgA level.

Quantization and diagnosis of Shanghuo (Heatiness) in Chinese medicine using a diagnostic scoring scheme and salivary biochemical parameters