Glossoscopy And Sphygmopalpation Study On Chronic Stable Angina

Objective:To observe characteristics of tongue coating color and thickness variation of patients with chronic stable angina. To observe meaningful objective tongue coating and pulse indicators on chronic stable angina patients.Methods:A total of103chronic stable angina patients were chosen for collecting tongue coating and pulse information using Shanghai Dawson Chinese medical instrument. Tongue coating collection used Sony digital camera(cybershot DSC-W1). Pulse collection used type Z-BOX digital pulse analyzer. Through tongue body dividing, tongue coating dividing, image analysis and calculation, it could produce thickness percentage and hue average value. Tongue coating dividing process involved two main steps:first was removing reflex points, second, was separating tongue and tongue coating. Then analyzed the distribution of thick or light tongue coating and the average value of RGB(R means red, G means green, B means blue) in different part of tongue coating, which including the whole tongue, middle of the tongue, tip of the tongue, back of the tongue, margin of the tongue. Comparing those different parts value one by one. For collected pulse information, first was formating pulse diagram, then extracting pulse parameters including h1, h3, h4, h5, tl, t, w, h3/hl, h4/hl, tl/t and w/t. Analyzed features of different pulse parameters which were h3/hl, h4, h5, w, tl, tl/t and those difference between left and right hand.Results:Among all the103cases,25with light tongue coating,76with thick tongue coating,1with few tongue coating,1with no tongue coating. RGB comparison in the different part of the tongue coat used repeated measures analysis of variance. The results showed significant difference of the R, G, and B value between the different tongue coating parts(P<0.05). Which pointed different type of syndrome of TCM among those chronic stable angina patients.The mean value and standard deviation of pulse parameters h3/hl, w, h4, h5, tl, tl/t were:10.25±27.00,0.10±1.05,109.16±158.12,-61.68±131.01,0.14±0.05,0.06±0.20with left hand, and5.74±18.54,-0.13±1.44,81.42±144.51,-56.36±130.14,0.13±0.04,0.08±0.05with right hand. Among above-mentioned pulse parameters, h3/hl reflects the vessel wall compliance and peripheral resistance. w reflects time of maintaining a high level of the state of the arterial pressure. h4reflects the value of diastolic. h5reflects the aorta and aorta elasticity function, tl reflects the rapid ejection period of the left ventricle, tl/t reflects the function of cardiac ejection. It showed that the variability of parameter h4and h5were strong, which meaned diastolic blood pressure, aortic elasticity and aortic valve function had significant difference in chronic stable angina patients.Comparison of left and right pulse parameters:Used by non-parametric Wilcoxon paired test, it showed that z data of W and h4were1.952and2.178, P value were0.047and0.029,0.05. Which meaned that comparison of left and right hand, there were significant difference.Conclusion:103cases of patients with chronic stable angina, the tongue coating was generally thick. Patients with chronic stable angina characterized by the coating’s color. Difference pulse between left and right hand showed the significance of pulse diagnosis guiding differential treatment for patients with chronic stable angina.