Infrared Thermal Imaging Characteristics Of ITP Patients And Their Correlation With TCM Syndrome Characteristics

Objective:To summarize the distribution characteristics of TCM syndromes in adult patients with immune thrombocytopenia(ITP),and to evaluate the differences of infrared thermography characteristics(non-uniform level and average temperature of target area)between adult ITP patients and normal subjects,as well as their correlation with TCM syndromes.The aim is to provide a new method for assessing adult ITP conditions and guiding precise treatment,and to provide a visual basis for TCM diagnosis and treatment of ITP.Methods:1.ITP patients who met the inclusion criteria were collected from the main outpatient department and the international outpatient department of Dongzhimen from June 2019 to January 2021.Basic information of all cases and TCM four diagnosis information were collected to analyze the distribution characteristics of TCM syndrom in adult ITP patients.2.The application of Beijing yue days photoelectric technology co.,LTD production of HIR-2000 type infrared heat meter on the ITP group and normal control group of infrared thermal imaging image acquisition,and then use the yanshan university institute of biomedical engineering professor wen-xue hong team research and development of image recognition processing software for image information processing,statistical analysis of the level of uniformity,the average temperature and the platelet count,bleeding score,as well as between various syndromes of the difference of infrared thermal images.Results:1.General situation:A total of 45 patients in the ITP group meeting the inclusion criteria were collected(patients with platelet count<30×109/Lwere ITP group A,patients with platelet count?30×109/Lwere ITP group B),and 45 patients were normal control.In the ITP group,there were 15 male patients and 30 female patients,with a mean age of 40.44±14.49 years,a mean course of disease of 24.07±20.94 months,and a median of 18.00 months.There were 5 newly diagnosed ITP,5 persistent ITP,27 chronic ITP,2 severe ITP,and 6 refractory ITP.The highest platelet count was 86±1 09/L,the lowest was 5×109/L,the mean was 44.40×109/L,and the median was 42.00×109/L.Bleeding propensity score 0,1,2,3,4,5 were 20,17,6,2,0,0,respectively.There were 25 bleeding events,including 18 skin bleeding(72%)and 7 mucosal bleeding(28%).There was no deep organ bleeding(no visceral and central nervous system fatal bleeding).There was a negative correlation between platelet count and bleeding tendency score(r=-0.782,P<0.01).2.TCM syndromes:There were 13 single syndromes,accounting for 28.9%of the total number of cases.In order of percentage,the syndromes were blood heat mismanagement,Qi without blood intake,blood stasis,Yin deficiency and fire swelling(Qi without blood intake and blood stasis accounted for the same proportion);A total of 29 cases were combined with the two syndromes,accounting for 64.44%of the total number of cases.In order of the percentage,the two syndromes were in the order of Qi without blood intake+blood stasis internal obstruction syndrome,Qi without blood intake+Yin deficiency and fire swelling syndrome,blood stasis internal obstruction syndrome+blood heat mismanagement syndrome.One case,accounting for 6.67%of the total number of cases,was the combination of the three syndrome,which was the syndrome of Qi without blood intake+the syndrome of Yin deficiency with fire and the syndrome of blood stasis.Frequency of single syndrome:The highest frequency of single syndrome was Qi without blood consumption(34 times,75.56%),followed by internal obstruction of blood stasis(24 times,53.33%),intense fire of Yin deficiency(16 times,35.56%),and mismanagement of blood heat(6 times,13.33%).Syndrome differentiation of zang-fu organs:syndrome of spleen disease accounted for the highest proportion,followed by syndrome of liver disease,syndrome of lung disease,syndrome of heart disease and syndrome of kidney disease.The difference in frequency of syndrome types of zang-fu organs was statistically significant,and the frequency of syndrome types of spleen disease was significantly higher than other dialectical syndromes of zang-fu organs(X2=51.667,P<0.01)3.Level of infrared thermal imaging target area heterogeneity:the heterogeneity of the ITP group in the 10 measured target areas is greater than that of the normal control group,that is,the ITP group has worse infrared thermal imaging homogeneity than the normal control group.The level of heterogeneity in 9 target areas(upper focal,middle focal,lower focal,forehead,proximal upper extremity,both palms,proximal lower extremity,distal lower extremity,and spinal region)in ITP group A was higher than that in ITP group BThe non-homogeneity order of infrared heat map in the trifocal area in the normal control group was as follows:upper focus,middle focus BBB>d lower focus,while the non-homogeneity order of infrared heat map in the target area in the ITP group was as medium focus,er focus and r focus(P<0.05).In the ITP group,the heterogeneity of the three target areas(upper focal,middle focal and lower focal)was negatively correlated with platelet count by bivariate correlation analysis(P<0.01).There was a significant positive correlation between the level of non-homogeneity in upper focal area,middle focal area and lower focal area and the score of bleeding tendency(P<0.01).Comparison and analysis of the non-homogeneity level of infrared thermal imaging in the target area among various syndromes in ITP group showed that the non-homogeneity level of blood heat misalignment syndromes was the highest,with statistical differences in 5 target areas(upper focal,middle focal,lower focal,palm and distal lower extremity)(P<0.05).The level of inhomogeneity of blood stasis syndrome was the least,and there was statistical significance in three areas(upper focus,middle focus and lower focus)(P<0.05).Blood stasis resistance card has two areas(proximal limb,spinal area)level of non uniformity than other syndromes(P>0.05),the largest gas not taken the fact there are three areas(forehead,spinal area)of non uniformity than other certificate level minimum(P>0.05),Yin deficiency syndrome has a fire area(lower limbs distal)level of the non uniformity of minimum(P>0.05).Comparison and analysis of the heterogeneity level of infrared thermal imaging of the target region among various viscera syndromes in the ITP group showed that the heterogeneity level of ITP patients with liver disease syndromes was higher than that of other viscera syndromes,among which 5 regions(upper focal,middle focal,lower focal forehead,palm)were statistically different from some syndromes(P<0.05).Heart syndrome in lower limb proximal non uniformity levels than other viscera syndrome is high,and there are statistically significant difference in liver disease syndrome(P<0.05),heart syndrome in seven areas non uniformity levels than other viscera syndrome,five area(the upper energizer,upper and lower,forehead,proximal upper limbs)with some syndrome are statistically significant(P<0.05);The heterogeneous level of the syndromes of spleen disease in the palm region was lower than that of other viscera syndromes(P<0.05).The heterogeneity level of pulmonary syndromes in the proximal upper extremity was higher than that of other viscera syndromes(P<0.05).Nephrotic syndromes were more heterogeneous in the spinal region than in other viscera syndromes(P<0.05).Infrared thermal imaging figure 4.The average temperature of the target area:ITP group of infrared thermal imaging figure in target area were greater than the normal control group,the average temperature in seven target area(the trunk,on coke,coke,proximal upper limbs,upper limbs distal,palms,distal limb)non uniformity levels than the normal control group,difference has statistical significance(P<0.05).There was no statistically significant difference in the average temperature between ITP group A and ITP group B(P>0.05).The average temperature of the three focal area in the normal control group was:lower focal,middle focal BBB>upper focal;In ITP group,upper focus,middle focus BBB>d lower focus,and the differences were not statistically significant.Bivariate correlation analysis was used to test the correlation between average temperature in the target area of the infrared thermal imaging and platelet count and bleeding propensity score in ITP patients,and the results showed no correlation between average temperature and platelet count and bleeding propensity score(P>0.05).There was no statistical difference in the average temperature of TCM syndromes and viscera syndromes in the target area measured in this study(P>0.05).Conclusion:1.Fever,Qi deficiency and blood stasis are the three important pathological factors in adult ITP patients,and the dysfunction of the spleen and viscera is the key TCM pathogenesis of ITP.2.The non-homogeneity of infrared thermal imaging in adult ITP patients was correlated with platelet count,bleeding score and TCM syndromes,but the average temperature in the target area measured in this study was not correlated with platelet count,bleeding score and TCM syndromes.In conclusion,the characteristics of infrared thermal imaging in ITP patients and its correlation with TCM syndromes are certain,and infrared thermal imaging technology may become one of the auxiliary examination and efficacy evaluation tools for ITP in the future.