Quantitative Analysis Of Tongue Color In Patients With Rheumatoid Arthritis And Its Clinical Application

ObjectiveBased on the three basic color principle of chromaticity,we quantitatively analyzed the ratio of tongue color RGB(red green blue)to patients with rheumatoid arthritis.Through the analysis of the correlation between the RGB composition ratio of the tongue and the quality of life,the degree of pain and the degree of disease activity of the patients with rheumatoid arthritis,we explore the value of the composition ratio of tongue color RGB in patients with rheumatoid arthritis preliminarily.MethodThis study uses data collection and questionnaire research method,first select 120 rheumatoid arthritis patients and 120 healthy volunteers.Reserchers use the digital camera to collect the photos of tongue in a same lighting environment..Based on the RGB three primary colors principle,wo can use computer to analyze color proportion of RGB of tongue.For the patients with rheumatoid arthritis,We should detect their dynamic blood erythrocyte sedimentation rate(ESR),C reactive protein(CRP),tender joint count and Swollen joint count.Then,ask rheumatoid arthritis patients to fill in the questionnaire,collecting the message of their general situation and the VAS score,quality of life(HAQ score).At last,calculated the DAS28 score and the ratio of RGB.Excel 2016 is used to sort out the information of the questionnaire,and the data information is excavated with the SPSS 21 software.Results1.The(mean value,standard deviation)quantification and distribution of tongue RGB in rheumatoid arthritis group and control group were different.RA patients with tongue R ratio(21.00%-52.10%),in the range of the mean of 41.83%+ 7.25%;G ratio(20.00%-43.00%),in the range of the mean of 29.76%+ 4.75%;B ratio in the range(21.42%-43%),the average was 30.30%+ 3.96%;control group R than in the range of tongue(26.00-51.00),mean 42.52%+ 5.67%,G ratio(23.00-44.00),in the range of the mean of 31.43%+ 3.65%,B ratio(20.00%-40.00%),the mean in the range of 24.70%-0.94%.R%in the two groups had no significant difference(P>0.05),G%has significant difference(P<0.01),RA group,G%low,mean difference-1.67%,95%CI(-2.75%,-0.59%);B%was significantly different(P<0.01),rheumatoid arthritis group B%lower mean difference 2.61%.95CI(0.51%,1.61%).2.The RGB constituent ratio(mean value,standard deviation)of tongue in patients with different syndromes of rheumatoid arthritis has different quantitative results and quantitative distribution ranges:for rheumatic obstruction syndrome patients,R ratio is in the range of 42.32%-47.11%and mean±standard deviation is 43.23%± 0.77%,G ratio is in the range 23.47%-30.42%and mean ± standard deviation is 29.52%±1.65%;B ratio is in the range of 23.63%-29.67%,and mean ± standard deviation is 27.87%±1.56%;for cold dampness syndrome patients,R ratio is in the range of 24.00%-30.01%and mean ± standard deviation is 26.83%±2.64%,G ratio is in the range 40.00%-43.00%and mean ±standard deviation is 41.67%±1.37%;B ratio is in the range 23.00%-35.02%and mean ±standard deviation is 29.83%±4.62%;for patients of deficiency of Qi and Yin R syndrome,R ratio is in the range of 39.00%-49.95%and mean ± standard deviation is 42.99%± 2.18%,G ratio is in the range 25.02%-37.00%and mean standard deviation was 30%± 2.50%;B ratio is in the range of 24.00%-30.00%and mean ± standard deviation is26.97%± 1.90%;for the patients with liver and kidney yin deficiency syndrome,R ratio is in the range of 36.00%-49.17%;and mean±standard deviation is 43.63%± 4.96%,G ratio is in the range 24.43%-36.00%,and mean ± standard deviation is 29.54%± 3.96%;B ratio is in the range of 21.00%-28.00%,and mean±standard deviation is 26.83%± 1.62%;for the patients with dampness heat blockage syndrome,R ratio is in the range of 37.00%-52.10%,and mean±standard deviation is 46.49%± 4.09%,G ratio is in the range 26.00%-33.00%,and mean±standard deviation is 27.24%±2.82%;B ratio is in the range 20.00%-29.00%,and mean ± standard deviation is 26.27%± 2.33%;for the patients with phlegm and blood stasis syndrome,R ratio is in the range of 33.74%-48.29%,and mean±standard deviation is 44.67%± 3.97%,G ratio is in the range 23.00%-30.54%,mean±standard deviation is 27.75%± 1.64%;B ratio is in the range of 24.13%-39.18%,and mean±standard deviation is 27.85%±3.86%;for the patients with blood stasis syndrome,R ratio in the range of 21.00%-49.06%R,mean±standard deviation is 36.57%±8.79%,G ratio in the range 20.00%-43.00%,mean±standard deviation is 31.56%±5.66%;B ratio in the range of 24.54%-43.00%,mean ± standard deviation is 31.87%±4.82%.3.There was no significant correlation between the tongue and R%HAQ score(r =-0.326,P>0.05);no significant correlation with VAS score(P>0.05);positively correlated with ESR(r=0.315,P<0.01),positively correlated with CRP(r = 0.199,P<0.05);and DAS28(ESR)positive correlation(r = 0.515,P<0.01,R and DAS28(CRP)positive correlation(r = 0.557,P<0.01).For patients with rheumatoid arthritis,the degree disease activity increases with R proportion of tongue;R proportion of tongue can be used as an index for the evaluation of the degree of disease activity.4.The tongue of B%and HAQ score was positively correlated(r = 0.795,P<0.01),and the VAS score was positively correlated(r = 0.538,P<0.01),no significant correlation with ESR(r=-0.179,P=0.052),there was no correlation between B and CRP(r=-0.131,P=0.155 and DAS28(ESR);)no significant correlation(r=-0.319,P=0.061),B and DAS28(DRP)had no correlation(r=-0.338,P=0.057).For patients with rheumatoid arthritis,when B proportion of tongue downward,the increase of quality of life will decline,the degree of the pain will increased;B proportion of tongue can be used as an indicators of the quality of life assessment and the degree of pain.5.There was no significant correlation between tongue G%and HAQ score(P>0.05);no significant correlation with VAS score(P>0.05);negative correlation with ESR(r =-0.335,P<0.01),G had negative correlation with CRP(r =-0.268,P=0.003);and DAS28(ESR)were negative correlation(r =-0.519,P<0.01),G and DAS28(CRP)showed a significant negative correlation(r=-0.520,P<0.01).For patients with rheumatoid arthritis,the increase of G proportion of tongue will decreases the degree of disease activity.The G proportion can be used as an indicator of degree of disease activity.6.For tongues of patients with rheumatoid arthritis,the increase of B proportion suggests that the formation of blood stasis;when R ratio increases,the color of tongue will be more red,suggests a body is suffering from the excess heat or intrinsic Yin fluid loss;In clinical,it might be helpful to use blood circulation method to improve quality of life in patients with rheumatoid arthritis,reduce pain;it also helpful to use method of clearing heat and nourishing yin to delay the progression of the disease.ConclusionBased on the three color principle of chromaticity,it is feasible to quantify the composition ratio of tongue color RGB(red and green)in patients with rheumatoid arthritis.For patients with rheumatoid arthritis,there is a quantitative change in the composition ratio of tongue color RGB,and the quantified RGB composition of tongue color is of clinical value.