Tongue Diagnosis Quantitative Diagnosis Of Hypertension And Tcm Syndrome Type

Tongue diagnosis is very important in traditional Chinese medicine. TCM believes that tongue proper and tongue coating are both related with body's physiological and pathological changes. At present, little evidence-based researches have been done to the tongue diagnosis, which caused it being short of veracity and objectivity. Computer-based technology of image analyzing adopted, this article tries to standardize tongue diagnosis of hypertension through analyzing tongue in different syndrome of hypertension.Objective: â‘ to analyze the relationship between hypertension and its different syndromes. â‘¡ to explore the relationship between tongue changes and dynamic BP. â‘¢ to discuss the relationship between RGB values of tongue picture and different syndromes of hypertension.Diagnostic standard:Western medicine standard: according to Chinese guide to protection and treatment of hypertension, 2004 edition, hypertension can be divided into three categories. â‘ the first level, the second level and the third level based on the value of BP. â‘¡Low-risk, medium-risk, high-risk and very high-risk hypertension based on risk factors. â‘¢spoon shaped hypertension and non-spoon shaped hypertension based on dynamic BP.Traditional Chinese medicine: four syndromes are provided by clinical research guide to new Chinese patent medicine, 2002 edition, they are â‘ syndrome of hyperactivity of liver fire, â‘¡syndrome of hyperactivity of yang due to yin deficiency, â‘¢syndrome of accumulation of turbid phlegm and dampness, and â‘£syndrome of deficiency of both yin and yang.Selective standard: primary hypertension conforming to the former diagnostic standard, excluding secondary hypertension.Case selection: 182 cases are selected with 71 cases are male and 111 cases are female. Their ages range from 18 to 91.Observation index: â‘ the relationship between hypertension and its different syndromes. â‘¡ the relationship between tongue changes and dynamic BP. â‘¢the color of tongue proper ( including slight white, slight red, crimson, dark red, purple and slight purple), and the color of tongue coating ( including white, slight yellow, yellow, and brown color). The characteristic changes of R, G, and B value and their average value, the value of R/G, R/B of the above-motioned colors are studied. And â‘£the relationship between RGB values of tongue picture and different syndromes of hypertension.Study method: to have the patient sit straightly facing natural light. DSC-W1 Sony digital camera is used to take tongue picture at a distance of 30 cm to the tongue, flash compulsory. SPSS 12.0 for Windows is used to analyze the data.Result:Syndrome differentiation: Syndrome of accumulation of turbid phlegm and dampness (SAPD)>syndrome of hyperactivity of yang due to yin deficiency (SHYYD)>syndrome of hyperactivity of liver fire (SHLF)>syndrome of deficiency of both yin and yang (SDBYY).Tongue color: dark tongue>purple tongue>slight red tongue>slight purple tonguocrimson tongue>slight white tongue.For syndrome of hyperactivity of liver fire: mauve tongue, thin yellow tongue coating.For syndrome of accumulation of turbid phlegm and dampness: dark red tongue, thick light yellow tongue coating, and fat and tooth-mark tongue.For syndrome of hyperactivity of yang due to yin deficiency: dark red tongue, thin white tongue coating, cracked tongue.For syndrome of deficiency of both yin and yang: light purple tongue, thin white tongue coating, cracked tongue.There are dark red tongue and slight yellow tongue in the entire first, second and third level of hypertension.For low-risk hypertension: slight red tongue and white and yellow tongue coating.For medial-risk hypertension: dark red tongue and slight yellow tongue coating.For high-risk hypertension: dark red tongue and yellow tongue coating.For very high-risk hypertension: dark red tongue and slight yellow tongue coating.For spoon shaped hypertension: slight red tongue and white tongue coationg.For non-spoon shaped hypertension: dark red tongue and slight yellow tongue coating.R of tongue: crimson red tongue> slight red tongue> slight white> dark red tongue> purple tongue> slight purple tongue.G of tongue: slight white> slight red tongue> dark red tongue> purple tonguocrimson red tongue> slight purple tongue.B of tongue: slight white> slight red tongue> crimson red tongue> purple tongue> dark red tongue> slight purple tongue.Average RGB of tongue: slight white> slight red tongue> crimson red tonguodark red tongue> purple tongue> slight purple tongue.R/G of tongue: purple tongue> crimson red tongue> dark red tongue> slight red tongue> slight purple tongue >slight white.R/B of tongue: crimson red tongue> slight red tongue> dark red tongue> slight purple tongue >purple tongue>slight white.R of tongue coating: white tongue coating> slight yellow tongue coating>yellow tongue coating>brown tongue coating.G of tongue coating: slight yellow tongue coating>white tongue coating> yellow tongue coating>brown tongue coating.B of tongue coating: white tongue coating> slight yellow tongue coating>yellow tongue coating>brown tongue coating.Average RGB of tongue coating: white tongue coating> slight yellow tongue coating>yellow tongue coating>brown tongue coating.R/G of tongue coating: white tongue coating>brown tongue coating>yellow tongue coating > slight yellow tongue coating.R/B of tongue coating: brown tongue coating>yellow tongue coating> slightyellow tongue coating > white tongue coating.In the study of relationship between RGB value of tongue proper and different syndromes of hypertension:For R value of tongue proper: SHYYD> SHLF> SAPD> SDBYY For G value of tongue proper: SAPD> SHLF> SHYYD> SDBYY For B value of tongue proper: SHLF > SAPD > SHYYD > SDBYY For RGB average value of tongue proper: SHLF > SAPD > SHYYD > SDBYY For R/G value of tongue proper: SHYYD > SDBYY > SAPD > SHLF In the study of relationship between RGB value of tongue coating and different syndromes of hypertension:For R value of tongue coating: SHYYD> SHLF> SAPD> SDBYY For G value of tongue coating: SAPD> SHLF> SHYYD> SDBYY For B value of tongue coating: SHYYD> SHLF> SDBYY> SAPD For RGB average value of tongue coating: SDBYY> SHYYD> SAPD> SHLF For R/G value of tongue coating: SAPD> SHYYD> SHLF> SDBYY Conclusion: the syndrome of accumulation of turbid phlegm and dampness are most commonly seen in these four syndromes which are in accordance with the TCM theory which believes that vertigo is always caused by turbid phlegm. The most commonly seen dark red or purple tongue indicates the characteristic of hypertension being blood stasis existing all the way in the whole progress of the disease.Different color of tongue proper and coating showing different RGB values indicates the realization of tongue color quantilization, which proves the feasibility of tongue speculation held by TCM.