Study on tongue image of ulcerative colitis patients with different syndromes based on image data processing
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摘要: 目的:通过图像数据化技术分析不同中医证型溃疡性结肠炎(UC)患者的舌象特征,为建立UC的中医客观化辨证评价体系提供技术支持。方法:以UC患者为主要研究对象,共纳入226例,其中大肠湿热证89例,脾气亏虚证46例,脾肾阳虚证18例,肝郁脾虚证40例及寒热错杂证33例,同时纳入健康对照者45例。使用TDA-1舌诊仪及中医舌诊分析系统TDAS V2.0采集并分析所有受试者的舌象指标,比较不同UC证型之间以及与健康对照组比较的舌象特征差异。结果:TB-r值:寒热错杂组、大肠湿热组>其余各组(P<0.05);TB-g值:大肠湿热组<其余各组(P<0.05);TB-b值:健康对照组<其余各组,大肠湿热组、寒热错杂组<脾气亏虚组、脾肾阳虚组(P<0.05);TC-b值:大肠湿热组<其余各组(P<0.05);TC-ENT值:健康对照组<其余各组,大肠湿热组>其余各组(P<0.05);TC-CON、TC-MEAN、TC-ASM值:健康对照组>其余各组,大肠湿热组<其余各组(P<0.05)。寒热错杂组、大肠湿热组舌质较其他组更偏红;大肠湿热组舌质较其他各组更偏紫红;UC各证型舌质较健康对照组更偏青。各证型组间比较,脾气亏虚组与脾肾阳虚组舌质较大肠湿热组及寒热错杂组更青;大肠湿热组舌苔较其他各组更黄、更腻,UC各证型舌苔较健康对照组更腻。结论:UC各证型之间及与健康对照者比较,舌象指数差异有统计学意义,其变化与各证型的特点基本相符。该舌象数据化的方法,对建立UC的中医客观化辨证评价体系具有一定的辅助参考价值。Abstract: Objective: To analyze the tongue image characeristics of ulcerative colitis(UC) patients with different TCM syndromes based on image data processing, and provide the technical support for the objectified diagnosis assessment system in TCM syndrome differentiation of UC.Methods: Patients with UC were taken as the main research subjects, and a total of 226 UC cases were included. Including 89 cases in large-instestinal damp-heat syndrome group(LDH), 46 cases in spleen-Qi deficiency syndrome group(SDS), 18 cases in spleen-kidney Yang deficiency syndrome group(SKYD), 40 cases in liver depression and spleen deficiency syndrome group(LDSD), 33 cases in cold-heat mixed syndrome(CHS). Meanwhile, 45 cases with normal tongue images were selected as the health control group(Control). The tongue images and image indexes were collected and analyzed by TDA-1 tongue diagnosis instrument and TDAS 2.0 Chinese medical tongue diagnosis analysis system, and the characteristics of tongue images between each group were compared.Results: TB-r value: IDH and CHS>other groups(P<0.05); TB-g value: IDH<other groups(P<0.05); TB-b value: Control<other groups, IDH and CHS<SDS and SKYD(P<0.05); TC-b value: IDH<other groups(P<0.05). TC-ENT value: Control<other groups, IDH>other groups(P<0.05); TC-CON, TC-MEAN, TC-ASM values: Control>other groups, IDH<other groups(P<0.05). The results suggested that, the tongue body color of IDH and CHS was redder compared with other groups; the tongue body color of IDH was more red-purple than which of other groups; the tongue body color of UC patients was bluer compared to Control; The tongue body color of SDS and SKYD were bluer than which of IDH and CHS; the tongue coating of IDH was more yellow and thicker compared with other groups; The tongue coating of UC patients was thicker than which of Control.Conclusion: There are significant differences in tongue image indexes of UC patients between different TCM syndrome groups. The variation was basically coincide with the characteristics of TCM syndromes in UC. This way of tongue image data processing can have assistant reference value to establish the objectified diagnosis assessment system in TCM syndrome differentiation of UC.
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