| ObjectiveUnder the guidance of Chinese medicine theory,collect tongue image images of patients with diabetic nephropathy and conduct quantitative research on tongue image characteristics,analyze the correlation between each feature of the patient's tongue image and laboratory indicators,and explore the law of tongue images in patients with diabetic nephropathy.Tongue diagnosis provides more basis for the treatment of diabetic nephropathy.MethodsUsing a fixed light source tongue image collection device to collect tongue images of 142 diabetic patients and 61 diabetic nephropathy patients.According to the relevant principles of traditional Chinese medicine diagnosis,the characteristics of tongue quality and tongue fur are refined into 21 aspects for comprehensive and specific quantification Analysis.In terms of tongue quality,the tongue color is divided into three aspects:red tongue,purple tongue,and dark tongue;other characteristics of tongue quality are refined into tongue god,old tongue,thin tongue,large tongue,tooth marks,puncture,crack area,Crack depth,ecchymosis,etc.;in terms of tongue coating,the color of the coating is divided into three aspects:yellow coating,gray coating,and black coating.The other characteristics of the coating quality are refined into stripping,water sliding,thick coating,greasy coating,dry coating,Moss rot and other aspects.Using the RGB color model of colorimetry to quantify the characteristics of the tongue image of "tongue red","tongue purple","tongue dark" and"moss yellow" related to tongue color and 1 tongue color Expression,according to the principle of colorimetry,the degree of tongue redness is directly proportional to the value of R/R+G+B;the degree of tongue purple is inversely proportional to the value of G/R+G+B;the degree of tongue darkness is inversely proportional to the value of R+G+B;The tongue yellow degree is inversely proportional to the B/RGB value.Using the expert degree assignment method,the other 17 tongue image characteristics related to tongue quality and fur quality are quantified and expressed.(Because there are no tongue images showing moss rot,ash gray,and moss black in the cases included in this study,the three characteristics of moss rot,moss gray,and moss black are not involved in this study.)Simultaneous collection of patients with glycated hemoglobin(HbAlc),Total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),homocysteine(Hcy),creatinine(Cr),urea(Urea),Uric acid(UA),serum albumin(ALB)urine microalbumin(UM-alb),urine albumin to creatinine ratio(ACR)and other laboratory indicators.On the basis of quantification of tongue characteristics,descriptive statistics,double Variable correlation analysis,independent sample t test,chi-square test and other statistical methods were used to study the tongue features of patients with diabetic nephropathy,and the correlation between each tongue feature of diabetic nephropathy and laboratory indicators.Results1.In terms of tongue color and tongue purple,g/r+g+b values were lower in the diabetic nephropathy group(0.27 ± 0.02)than in the diabetic group(0.29± 0.02)with statistical significance,p=0.017;in terms of dark tongue,R+ G+B value had no significant difference between the two groups,p=0.090;in terms of tongue redness,R/R+G+ B There was no significant statistical difference between the two groups,p=0.096.2.The other features of tongue quality,the size of tongue body,were statistically significant in the diabetic nephropathy group(5.92±1.71)than the diabetic group(5.37 ±1.72),p=0.039;the area of tongue cracks,diabetic nephropathy group(2.61± 2.52)Higher than the diabetes group(1.73± 1.75)with statistical significance,p=0.016;other tongue characteristics:tongue god,old tongue,thin tongue,tooth marks,puncture,deep cracks,ecchymosis were not obvious between the two groups Statistical differences,all p>0.05.3.In terms of tongue fur,yellow fur,there was no statistically significant difference in B/R+G+B values between the diabetic nephropathy group and the diabetic group,p=0.791.In terms of fur quality characteristics,fur stripping,water slide,thick fur,and fur There was no statistical difference in the degree of greasiness and furiness between the two groups,both p>0.05.4.In the part of the correlation study of tongue color characteristics,in terms of dark tongue,the R +G+B value of patients with diabetic nephropathy was negatively correlated with glycated hemoglobin,r=-0.352,p=0.019;the R+G+B value of patients with diabetic nephropathy was the same as Cystine value is negatively correlated,r=-0.549,p=0.004.In other color features,R/RGB value,G/RGB value and glycated hemoglobin,urine microalbumin,creatinine,urea,uric acid,total cholesterol,glycerin Triester,Low-density lipoprotein,high-density lipoprotein,homocysteine,albumin,24-hour urine protein quantification,urine albumin to creatinine ratio and other laboratory indicators have no correlation,all p>0.05.5.In the part of the correlation study of other characteristics of tongue quality,in terms of tooth marks,the degree of tooth marks in patients with diabetic nephropathy was positively correlated with urine microalbumin,r=0.504,p=-0.047;positively correlated with uric acid,r=0.262,p=0.049.In terms of pricks,the degree of dents in patients with diabetic nephropathy is negatively correlated with 24-hour urine protein quantification,r=-0.331,p=0.025.In terms of ecchymosis,the degree of ecchymosis is negatively correlated with albumin,r=-0.271,p=0.049;the degree of ecchymosis was negatively correlated with the 24-hour urine protein r=-0.306,p=0.39.In terms of other tongue characteristics,tongue god,old tongue,thin tongue,large tongue,crack area and crack depth With glycated hemoglobin,urine microalbumin,creatinine,urea,uric acid,total cholesterol,triglycerides,low density lipoprotein,high density lipoprotein,homocysteine,albumin,24-hour urine protein quantification,urine albumin No correlation with laboratory indicators such as creatinine ratio,all p>0.056.Part of the correlation study of tongue coating characteristics,the degree of fur coating and glycated hemoglobin,urine microalbumin,creatinine,urea,uric acid,total cholesterol,triglycerides,low density lipoprotein,high density lipoprotein,homocysteine,There is no correlation between laboratory indexes such as albumin,24-hour urinary protein quantification,urine albumin to creatinine ratio,p>0.05.The degree of fur coating is positively correlated with uric acid,r=0.067,p=0.038;the degree of fur coating is related to total cholesterol Positive correlation r=0.106,p=0.004.Features of tongue coating:stripping,water slipping,dryness and glycated hemoglobin,urinary microalbumin,creatinine,urea,uric acid,total cholesterol,triglycerides,low density lipoprotein,high Laboratory indexes such as density lipoprotein,homocysteine,albumin,24-hour urine protein quantitation,urine albumin to creatinine ratio were not related,all p>0.05Conclusion1 The tongue image of patients with diabetic nephropathy exhibits a more purple tongue color,a larger tongue body,and a larger tongue crack area compared with diabetic patients.2.The degree of tongue darkness in patients with diabetic nephropathy is positively correlated with glycated hemoglobin and homocysteine values.3.The degree of tooth marks in patients with diabetic nephropathy is positively correlated with urine microalbumin and uric acid,and the degree of tooth marks on the tongue can indicate the diagnostic factors of traditional Chinese medicine for the control of urine protein and uric acid.4.The degree of greasiness in patients with diabetic nephropathy is positively correlated with total cholesterol.To a certain extent,greasy greasy can be used as a predictive factor for the hyperlipidemia of diabetic nephropathy.5.The degree of fur coat thickness is positively correlated with uric acid.The fur coat thickness can be used as a predictive index for hyperuricemia in patients with diabetic nephropathy,and it can provide a reference for the clinic to a certain extent. |
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