Analysis Of Clinical Tongue Picture Of Thromboangiitis Obliterans With Traditional Chinese Medicine

Thromboangiitis obliterans(TAO),an inflammatory obstructive disease of the distal extremities that is not arteriosclerotic,mainly affects the small and medium-sized vessels and nerves of the distal extremities,especially the vessels of the lower extremities.Due to vascular wall segment,non-suppurative inflammation with intraluminal thrombosis,obstruction causes limb ischemia and produces ischemic pain,which can cause ulcers,gangrene,and even lead to amputation.Treatment of thromboangiitis obliterans is difficult,the prognosis is poor,there are few clinical drugs in western medicine,and there are many localized contraindications to surgery.Traditional Chinese medicine(TCM)has definite advantages in the treatment of this disease.TCM treatment of this disease is mostly based on syndrome differentiation and treatment,local and overall involvement of the lesion,internal and external combination of repatriation medicine,taking individualized treatment plan for the patient’s constitution,to make up for the lack of modern medicine in improving symptoms,and TCM to achieve syndrome differentiation and exquisite development of individualized treatment plan requires the collection of four diagnostic information close to the nature of the patient’s condition,inspection in the four diagnostic methods is less affected by subjective factors,and inspection in particular,tongue diagnosis is unique,as one of the important advantages of syndrome differentiation and treatment of TCM tongue diagnosis,because of its intuitiveness,close relationship with viscera and meridians,has been paid attention to by clinicians have an irreplaceable role,but there is no specific clinical study on the relationship between TAO and TCM tongue image,how to combine TCM tongue diagnosis,effectively pre-treat thromboangiitis obliterans,reduce limb necrosis,amputation rate,will become an important content of TCM diagnosis and treatment.Purpose of Study:(1)For TAO patients General clinical data Of Comparative analysis of distribution characteristics;(2)What are the common characteristics of TAO patients on TCM tongue images(3)Interactive analysis of tongue image characteristics with clinical data of TAO patients to explore its clinical significance;Study Method:A total of 85 patients diagnosed with TAO between January 2013 and January 2020 in Dongfang Hospital of Beijing University of Chinese Medicine and Dongzhimen Hospital of Beijing University of Chinese Medicine and Shanxi Yikang Vasculitis Hospital(including outpatient clinics and wards)were investigated.Collect the four diagnostic information of patients,focusing on the data of tongue image,picture and imaging examination report,establish electronic and paper case database,invite vascular experts to screen and compare,and count the distribution characteristics of different tongue image characteristics through descriptive analysis.Study results:①Among the 85 TAO patients,the mean age of onset was 48.19±11.89 years,and there were significantly more males(83 cases)than females(2 cases)P<0.05,the mean smoking age of TAO patients with smoking history was 23.42±12.48 years,and 36.47%of TAO patients smoked between 21 years and 30 years;the top two occupational categories of TAO patients were:industrial production category accounted for 37.65%,and agricultural and forestry production category accounted for 24.71%.②Among the 85 TAO patients,the ranking of TCM syndrome differentiation counts was as follows:venation blood stasis>venation cold coagulation>venation damp-heat>qi and blood deficiency>venation stasis toxin;the ranking of clinical Fontaine stage counts was as follows:stage Ⅳ stage Ⅲ>stage Ⅱ,with stage Ⅳ patients ranked by necrosis grade counts:grade Ⅰ>grade Ⅲ>grade Ⅲ.③The proportion of tongue image in 85 TAO patients was ranked,tongue color:purple tongue 31.76%>light red tongue 21.18%>bluish tongue 20.00%>red tongue 17.65%>light white tongue 8.24%>crimson tongue 1.18%;tongue shape:fissured tongue 44.71%>fat tongue 18.82%>thin tongue 15.29%>toothed tongue 10.59%>prick tongue 4.71%>old tongue 3.53%>delicate tongue 2.35%;fur color:white fur 62.35%>yellow fur 36.47%>grayish black fur 1.18%;fur shape:thin fur 44.71%>thick fur 31.76%>partial fur 5.88%>little fur 15.29%;fur:greasy fur 62.00%>dry fur 29.41%>dry fur 16.47%>putrefaction.④85 TAO patients Clinical data and tongue image Data interaction comparison:With the aggravation of Fontaine stage and the increase of quantitative diagnostic grade of important clinical data of patients,the proportion of various high-frequency tongue image data in critical clinical data also increased.⑤Different smoking age groups in Fig.Papa There was a statistically significant difference in score P<0.05(adjusted),and smoking age was similarly positively correlated with Papa score.Study conclusion:Tongue characteristics:85 cases of thromboangiitis obliterans patients with purple tongue color distribution is the most common,clinical treatment of tongue to identify the causes of purple tongue formation after guiding medication;tongue shape distribution,especially fissured tongue is rare,suggesting that clinical one-sided use of blood circulation drugs,should be appropriate adjustment of compatibility according to the causes of fissured tongue;greasy fur,yellow fur accounted for a large proportion,in addition to blood stasis,cold coagulation factors,damp-heat and the incidence of thromboangiitis obliterans are also closely related;TCM tongue characteristics have a certain diagnostic value for thromboangiitis obliterans,the process and stage of the disease also have a potential clinical predictive value.In terms of risk factors,smoking age,and exertional occupation were associated with elevated TAO quantitative diagnostic scores.