| ObjectiveThis study explored the distribution and characteristics of tongue features in patients with Parkinson’s disease,and in-depth studied the relationship between tongue features and H-Y stage of Parkinson’s disease,TCM syndrome types and MDS-UPDRS score,in order to better provide the theoretical basis for syndrome differentiation of Parkinson’s disease.MethodsThrough observation and research,the basic information,tongue characteristics,course of disease,H-Y stage,motor subtype,MDS-UPDRS score and TCM syndrome type of 150 patients with Parkinson’ s disease were collected clinically.SPSS23.0 was used for statistical analysis of the relevant data and the tongue characteristics of patients with Parkinson’s disease were explored based on the results.Results1.150 patients with Parkinson’s disease were included,the ratio of male to female was 1.42:1.According to age group,60-69 years old has the largest number of cases,accounting for 37.3%,followed by 50-59 years old,accounting for 28.7%,70-79 years old accounting for 28.0%,which is close to 50-59 years old,and the prevalence of Parkinson’ s disease patients younger than 50 years old and older than 80 years old is obviously reduced.Most patients have a course of disease within 10 years,mainly in 5-10 years,accounting for 34.7%,and only 4.0%have a course of disease greater than 20 years.2.There were 82 patients with tremor Parkinson’ s disease,accounting for 54.7%,45 patients with rigidity and hypokinesia,accounting for 30%,and 23 patients with mixed type,accounting for 15.3%.In the H-Y staging of Parkinson’s disease patients,tremor type is the main type of H-Y classification in stage 1,1.5,2 and 2.5,and the main types of TCM syndrome are endogenous wind-yang type and phlegm-heat type,with low MDS-UPDRS score.In stage 3,stage 4 and stage 5,the type of H-Y is mainly rigidity and hypokinesia,and the TCM syndrome types are mainly deficiency of yang-qi,deficiency of marrow-sea and deficiency of qi,with higher MDS-UPDRS scores.The mixed type was mostly distributed in stage 3,and the MDS-UPDRS score was in the middle.After examination and analysis,there is a correlation between H-Y stage and sports subtype in patients with Parkinson’ s disease(P<0.05).MDS-UPDRS score was correlated with H-Y stage(P<0.05).MDS-UPDRS score was correlated with sports subtypes(P<0.05),MDS-UPDRS score is correlated with TCM syndrome types(P<0.05).There is a correlation between TCM syndrome types and H-Y stages(P<0.05).There is a correlation between TCM syndrome types and sports subtypes(P<0.05).3.Distribution characteristics of tongue features:The first three tongue colors were pale red(56.7%),red(19.3%)and blue(16.0%);The top three tongue shapes were cracked tongue(34%),fat tongue(16.0%)and Rongrun tongue(12.0%).The color of coating in the top three was white coating(50%),yellow coating(33%)and combination of yellow and white coating(14.7%).The first three types of coating were thin coating(54%),greasy coating(24%)and thick coating(13.3%).In statistical analysis,MDS-UPDRS score was correlated with tongue color(P<0.05).There was no correlation between MDS-UPDRS score and tongue shape(P<0.05).MDS-UPDRS score had no correlation with moss color(P<0.05).There was no correlation between MDS-UPDRS score and moss quality(P<0.05).4.H-Y stage and tongue:①Distribution of tongue color in H-Y stage:there were more pale red tongues in the early and middle stages;Pale tongue was more in stages 4 and 5.There were more red tongues in stages 3 and 4.There were more blue tongues in stages 2 and 3.The difference in the distribution of tongue color and H-Y stage was statistically significant in patients with Parkinson’s disease(P<0.05),and there was a correlation between tongue color and H-Y stage(P<0.05).②Distribution of tongue shape in H-Y stages:The proportion of cracked tongue in each stage was high;There were more sterculia in stages 1 and 2.Thin thin tongue is less common;The delicate tongue mainly appear in that middle and late stage;The aged tongue concentrates appear in stage 2 and stage 3;Ecchymosis tongue mainly appeared in stage 3;Tongue-pricking mainly occurred in stages 1,2 and 2.5;Tooth-marked tongue mainly appeared in stage 1 and 3.The distribution differences of tongue shape and H-Y stage in patients with Parkinson’ s disease were statistically significant(P<0.05),and there was a correlation between tongue shape and H-Y stage(P<0.05).③ Moss color distribution in H-Y stages:White Moss had the highest proportion in each stage;The proportion of yellow liverworts in the early and middle stages was second only to that of white liverworts.The yellow-white facies and moss were mainly distributed in stages 2,3 and 4.There were few cases of grayish black moss,which appeared in Stages 3 and 4.The difference in the distribution of moss color and H-Y stage was statistically significant in patients with Parkinson’ s disease(P<0.05),and there was a correlation between the moss color and H-Y stage(P<0.05).④ Mossy distribution in H-Y stages:the proportion of thin moss in each stage was the highest;Greasy coating and thick coating mainly appeared in stage 3 and 4.There were few cases of moist coating,dry coating,peeling and rancid coating.The peeling and rancid coating mainly occurred in Stages 3 and 4.The difference in the distribution of moss quality and H-Y stage was statistically significant in patients with Parkinson’ s disease(P<0.05),and there was a correlation between the moss quality and H-Y stage(P<0.05).5.TCM syndrome and tongue:① Distribution of tongue color in TCM syndrome types:The proportion of pale red is the highest among all the syndrome types;The pale white color mainly appears in the qi and blood deficiency type.The red tongue was mainly distributed in the internal stirring type of wind-yang and the stirring type of phlegm and hot wind.Green tongue is mainly distributed in the yang deficiency syndrome.There were significant differences in tongue color and TCM syndrome type distribution of PD patients(P<0.05),and there was a correlation between tongue color and TCM syndrome type(P<0.05).② Distribution of tongue shape in TCM syndrome types:The proportion of cracked tongue in each type is high;Fat tongue mainly appears in yang deficiency type;Tooth-marked tongue and delicate tongue mainly appeared in qi and blood deficiency type and marrow sea deficiency type.The aged tongue was mainly distributed in yang deficiency syndrome and phlegm-hot wind stirring syndrome.The tongue with point-needling and ecchymosis mainly appeared in the wind-yang internal movement type.The distribution differences of tongue shape and TCM syndrome types in patients with Parkinson’ s disease were statistically significant(P<0.05),and there was a correlation between tongue shape and TCM syndrome types(P<0.05).③Distribution of coating color in TCM syndrome types:White coating is mainly distributed in yang qi deficiency type,qi and blood deficiency type and marrow sea deficiency type;The yellow moss mainly appeared in the wind-yang internal movement type and phlegm-hot wind movement type.Yellow-white facies with coating mainly appeared in yang deficiency type,qi and blood deficiency type and phlegm-hot wind moving type.There were few cases of grayish black moss.There were significant differences in the color of coating and the distribution of TCM syndrome types in patients with Parkinson’ s disease(P<0.05),and there was a correlation between the color of coating and the TCM syndrome types(P<0.05).④ Distribution of coating quality in TCM syndrome types:The proportion of thin coating in each type was the highest;The greasy coating and thick coating were mainly distributed in the phlegm-hot wind moving type and yang qi deficiency and decline type.Putrid fur mainly appeared in the phlegm-hot wind moving type.Desquamation is mainly manifested in yang deficiency syndrome and marrow sea deficiency syndrome.There were significant differences in the distribution of the coating quality and TCM syndrome type in patients with Parkinson’ s disease(P<0.05),and there was a correlation between the coating quality and TCM syndrome type(P<0.05).ConclusionAmong the patients with Parkinson’ s disease investigated in this study,the early stage of H-Y stage was dominated by tremor,and the MDS-UPDRS score was low.The tongue features of pale red tongue,cracked tongue and thin white coating were more common,suggesting that the vital qi was still sufficient and the pathogens were mild.The syndrome differentiation of phlegm-hot wind stirring and wind-yang internal stirring was the majority.In the middle and late stage,the patients were mainly of tonic hypochondriac type and mixed type,with a high MDS-UPDRS score.The tongue manifestations including blue tongue,pale white tongue,cracked tongue,tender tongue,and yellow and white tongue with concurrent coating were more common,suggesting that the righteous qi was deficient and the pathogens were exuberant.The syndromes according to syndrome differentiation were mostly yang qi deficiency,marrow and sea deficiency,and qi and blood deficiency syndrome.In patients with Parkinson’ s disease,tongue is correlated with H-Y staging and TCM syndrome differentiation,and the difference is statistically significant.Tongue is one of the bases for judging H-Y staging and TCM syndrome differentiation. |
