Study On The Common Character Of The Tongue Of Blood Stasis Of Five-viscera, Picture Processing And The Rule Of The Diagnosis Of The Tongue

The tongue of blood stasis(TBS)is very common in clinic.It is of great clinical significance for the diagnosis and judge of pathological conditions and prognosis of the blood stasis syndrome. It has made great progress on the research of syndrome of blood stasis,relating to the study on the tongue of it.This study took the TBS of five-viscera as the research object,discussed the clinical characteristic and the mechanism of formation of TBS and initially established the characteristic database of TBS of five-viscera by means of many kinds of modernized technologies such as image processing,information fusion,nervous network etc.and by the methods of literature research,clinical research,experimental study,image analysis of the tongue and so on,in order to realize the informationization,digitization,standardization of the diagnosis of TBS supported by the government fund.The thesis is divided into five parts.Part 1 Literature ResearchIt consists of three parts.Firstly,reorganized and studied systematically the literatures which were correlated with TBS of all times and in all countries.Secondly,Doctors in the modern age have studied on TBS from many angles such as clinical observation,experimental study,which occurred one after another in the body under the functions of all kinds of pathogenic factors.The majority of scholars thought the formation of TBS was the result of synthetic factors such as the change of hemodynamics,hemorheology and microcirculation disturbance etc.Thirdly,with the development of computer technology,picture processing and instrument of tongue,the digital research on the diagnosis of the tongue has made great achievement.Part 2 Clinical and Experimental Research on the TBS of Five Viscera.1 Clinical Research on TBS of five visceraObjective:to explore the clinical characteristics of TBSObject:Each 100 cases with liver,heart,spleen,lung and kidney of TBS,60 cases with the with TNBS were observed among patients who were selected on the clinical research,20 healthy cases as control.Method:The prospective study was made.The clinical observation and the automatic recognition and analysis of image by computer were combined.Results and Conclusions:Clinical observation showed that the tongue body of TBS manifested mainly as the pale purplish tongue,bluish and purplish tongue,on the tongue.It indicates that the formation of TBS in the internal disease was the result of abnormal transmission or the deficiency of Qi and blood. The tongue coating often manifested as the yellowish coating and thick and whitish coating, especially gray and black coating is often shown in the nephropathy,and serious abnormality of sublingual vein also existed in patients of TBS.It was thought that the observation of the tongue body had some significance for the diagnosis of TBS and its different pathogenesis of blood stasis; the observation of the tongue coating had important value for the diagnosis of different syndrome types in patients of TBS;And the synthetic observation of the color and luster,diameter,length of stem,shape of stem,filling degree of stem and outer zone of sublingual vein was an important index for the diagnosis of TBS,among which the color and luster of sublingual vein could be the reference to the syndrome differentiation for patients of TBS.2,Clinical Experimental StudyObjective:to explore the pathologic mechanism of TBSC on the molecular levelObject:Each 100 cases with liver,heart,spleen,lung and kidney of TBS,60 cases with the with TNBS were observed among patients who were selected on the clinical research,20 healthy cases as control.Method:hemospasia venous blood on fasting to examine the following indexes:(1)Nitri Oxide(NO):nitric acid reducing enzyme method;(2)Endothelin(ET),Thromboxane B₂(TXB₂),6-Keto-PGF_1α:RIA;(3)Hemorheology examination.Results and Conclusions:1 The balance of the levels of ET and NO was destroyed in the bodies of the patients with the syndrome of blood stasis,which manifested that the levels of ET,ET/NO was significantly higher than those in the control group,the level of NO was significantly lower than that in the control group,and the increase of the ET level was dominant.The degree of pathological changes in patients of TBS was more serious than that in patients of TNBS.It was inferred that the unbalance of the levels of ET and NO,especially the significantly increase of the ET level,was an important factor in the formation of TBS.It was thought that the levels of ET,NO and ET/NO could be used as the reference indexes of the diagnosis,observation of curative effect and analysis of prognosis for patients of TBS.2 The unbalance of the levels of TXA₂ and PGI₂ existed in the bodies of the patients the patients with the syndrome of blood stasis,,which manifested that the levels of TXB₂ and TXB₂/6-Keto-PGF_1αwere significantly higher than those in the control group(P＜0.05～P＜0.01),the level of 6-Keto-PGF_1αwas significantly lower than that in the control group,and the increase of the TXB₂ level was dominant.The risk of thrombosis in patients of TBS was higher than that in patients of TNBS.It was inferred that the unbalance of the levels of TXA₂ and PGI₂, especially the increase of the TXB₂ level,was the critical pathologic basis in the formation of TBSC.It was thought that the unbalance of the levels of TXA₂ and PGI₂ could reflect the pathologic essence of deficiency accompanied with blood stasis in patients of TBS,and the synthetic observation of the abnormal degree of the levels of TXB₂,6-Keto-PGF_1αand TXB₂/6-Keto-PGF_1αcould be used as an objective index for the diagnosis of TBSC.3 The condition of "viscosity","thickness","coagulation" and "aggregation" existed in blood in patients of TBS,and different syndrome types had the different tendency of "viscosity", "thickness","coagulation" and "aggregation".The increase of the activity of coagulation and aggregation was the common pathologic basis in different blood stasis syndrome types.It was inferred that the formation of TBS is the result of microcirculation disturbance in tongue due to abnormal change of hemorheology to a certain extent.It was thought that the examination of hemorheology could provide the reference to the diagnosis,syndrome differentiation and observation of curative effect for patients of TBSC.4 The formation of TBS was the result of microcirculation disturbance in tongue due to the functional disorder of all kinds of correlated physics and chemical factors.The injury of vascular endothelial cell caused by all kinds of factors was the original factor in the formation of TBS.The unbalance of the levels of ET and NO were the important factors for the formation of TBS.The unbalance of the levels of TXA₂ and PGI₂ was the critical pathologic basis in the formation of TBS.The microcirculation disturbance in tongue due to abnormal change of hemorheology was the last link in the formation of TBS.Part 3 Research on the Picture Processing of the TongueObjective:to explore the digitization,standardization of the diagnosis of the tongue.Method:To divide the image of tongue in the color-vector-pixel way,and to define the edge of the image of tongue with vague mathematics and to study the digitization,standardization on the sublingual vein in geometry.Results and Conclusions:The dividing of image of tongue is premier critical to deal with the image processing by computer.We adopt the color-vector pixel way to maintain the information of color and texture from color image of the tongue.The result is satisfying.We also use it to define the edge and the dental-print of the tongue.Additionally,In the former basis,we study the length and width of sublingual vein in geometry.The result is that it can clearly manifest the character of sublingual vein,and can lay the foundation for the study on the digitization,standardization of it.Part 4 Research on the rule of the Diagnosis of the TongueObjective:to explore the diagnosis rule to data mining the relativity between the character of the tongue and the clinic symptom in the database of the tongue.Method:self-learning of computer,data mining,and pattern recognition.Results and Conclusions:At the beginning,the article analyzed the characteristics of clinical diseases database in the Traditional Chinese Medicine(TCM)tongue intelligent diagnosis processing and the association rules hidden in it.According to these,the program modified the current association rule evaluation system.And then the article gave a detailed description of one new mining algorithms:the modified FP-growth algorithm. It drawn a complete flow chart of the program,and decided to realize the modified FP-growth algorithm using VC++ 6.0 and SQL Server 2000 as the development tools,and applied it to the case database successfully.At last,the article stated the results of tests of the program on clinical diseases database in the TCM tongue intelligent processing and the diagnosis association-rule mining hidden in it.The application result in make clear that,the algorithm this article expatiated can be accurate more and fitter.Part 5 SummaryThe innovation in this study is:(1)This study took TBS of five-viscera as a whole for the first time,explored the clinical characteristic and the mechanism of formation from different levels of entirety,molecule and so on,and provided the objective basis for the diagnosis,treatment,prognosis analysis of TBS(2)To divide the image of tongue in the color-vector-pixel way.It can be maintain the information of color and texture from color image of the tongue and raise the degree of accuracy.(3)To study the digitization,standardization on the sublingual vein in geometry.(4)To Established a suitable arithmetic rule for clinic diagnosis of TCM,and is convenient to data mining and application on the data of TCM.