| Purpose:This study focused on patients with diabetic retinopathy and observed the correlation between different evidence patterns and tongue parameters in patients with diabetic retinopathy by analyzing the target cases using the TCM lookout information collection management system of Huimagu Technology to provide objective indicators for clinicians to use TCM to diagnose and treat the disease and improve the accuracy of TCM diagnosis.Material and method:In this study,72 patients with diabetic retinopathy who attended the National Metabolic Disease Management Center(MMC),Department of Endocrinology,Affiliated Hospital of Liaoning University of Chinese Medicine from October 1,2020 to March 1,2022 were mainly selected and divided into Qi-Yin two deficiency group,Liver-Kidney deficiency group and Yin-Yang two deficiency group according to the following TCM classification criteria,among which 26 cases were in the Qi-Yin two deficiency group,26 cases in the Liver-Kidney deficiency group and 26 cases in the Yin-Yang two deficiency group.Patients were screened by a professional physician,and those who were eligible for the study were selected for enrollment.The patients’tongue images were collected using the"TCM Visual Diagnosis Information Collection Management System"provided by Wise Medical Valley Technology:under the specific lighting conditions designed,professional digital image acquisition equipment was deployed,and the International Commission on Illumination(ICI)Under the designed lighting conditions,the professional digital image acquisition equipment is equipped with a number of color calibration techniques,such as the color difference formula and support vector machine,dynamic shape model,etc.,to standardize the collection and analysis of Chinese medicine characteristic tongue facial information and generate quantitative tongue data.Patients were collected at 2:00 p.m.,10 min after rinsing with warm water,with the subject in a sitting position,with the lower jaw placed on the lingual fixation frame of the sampling instrument,the face sufficiently close to the fixation frame to prevent light leakage,the facial muscles relaxed,the mouth naturally opened to its maximum position,the tongue naturally extended out of the mouth,the tongue surface spreading without curling,and the tongue tip naturally downward,and the fixation position was maintained for 3-4s.Tongue pictures were taken and then processed by the system using an automatic method combined with manual correction of the tongue segmentation path to extract tongue diagnosis parameters.The tongue diagnosis parameters were exported in Excel format,which are the color and quality parameters of the tongue body and tongue coating,with 18 parameters,including the L,a,and b indices of the tongue texture and tongue coating at the tip and root of the tongue,moss quality(thin,thick,and greasy moss),sublingual ligament(normal or dark,even with bruises),punctures(presence or absence),tooth marks(presence or absence),cracks(presence or absence),and petechiae(presence or absence).Finally,the collected results were statistically analyzed using SPSS 26.0 with one-way ANOVA and LSD posthoc test for continuous type variables,i.e.,tongue color,L,a,and b for tonguetipand tongue root in tongue color,and chi-square test for categorical variables,i.e.,color of tongue color,mossy texture of tongue and sublingual ligament,punctures,tooth marks,fissures,and petechiae.Results:The general data showed 72 patients meeting the criteria,aged 32-70 years,with a mean of(52.97±19.08)years,52 males and 20 females,with a male to female ratio of 1:0.384.The results of tongue color analysis showed that the three statistics of L,a and b in the tip of the tongu were analyzed comparatively,in which the amount of a was significantly different among the three groups P<0.05,and further post hoc tests showed that the liver and kidney deficiency group was greater than the qi and yin deficiency group than the yin and yang deficiency group,while the amount of L and b were not significantly different among the three groups,P>0.05;the three statistics of L,a and b in the root of the tongue were analyzed comparatively.Further posthoctests showed that the L amount was greater in the Yin-Yang two deficiency group than in the Qi-Yin two deficiency group than in the Liver-Kidney deficiency group,and the a amount was also significantly different in the three groups,P<0.05.Further post hoc tests showed that the Liver-Kidney deficiency group was greater than the Qi-Yin two deficiency group than the Yin-Yang two deficiency group,which was consistent with the tongue tip results.b amount did not exist among the three groups,P>0.05.significant difference,P>0.05.The result of tongue color c~2=2.971,P>0.05,indicated that there was no statistical difference in the color of tongue color among the three groups.The three statistics of tonguecolorin tongue tip L,a and b were analyzed comparatively,among which,the L amount was significantly different among the three groups,P<0.05,and further post hoc tests showed that the liver and kidney deficiency group was greater than the qi and yin deficiency group than the yin and yang deficiency group,while the a and b amounts were not significantly different among the three groups,P>0.05;the three statistics of tongue root L,a and b were analyzed comparatively,among which,the L The further post hoc test showed that the liver and kidney deficiency group was greater than the qi-yin two deficiency group than the yin-yang two deficiency group,while the a and b amounts were not significantly different among the three groups,P>0.05,and the results were consistent with the tongue tip part.The results of moss quality showed c~2=3.810,P>0.05,indicating that there was no statistical difference between the three groups in terms of moss quality.The results of sublingual ligament showed c~2=1.967,P>0.05,indicating that there was no statistical difference in the sublingual ligament between the three groups.The puncture results showed c~2=0.407,P>0.05,indicating that there was no statistical difference between the three groups on puncture.The results of dentition analysis showed c~2=1.254,P>0.05,indicating that there was no statistical difference between the three evidence types on dentition.The fissure results showed c~2=0.763,P>0.05,indicating that there was no statistical difference between the three groups on fissure.Since there were no patients with petechiae in this sample,there was a high probability of no petechiae in all three evidence types.Conclusion:1.The a-value of tongue color and L-value of tongue moss color in the liver and kidney deficiency group were the highest among the three groups,so their tongue color was the reddest and their tongue moss color was the brightest,and their L-value of tongue root was the lowest among the three groups,so their tongue root was the darkest.2.The a and L values of the tongue quality and the L value of the tongue moss of the qi-yin two deficiency group were located between the other two groups.3.The a-value of tongue color and L-value of tongue moss color in the Yin-Yang two deficiency group are the lowest among the three groups,so their tongue color is the lightest and their tongue moss color is the darkest,and the L-value of their tongue root is the highest among the three groups,so their tongue root color is the brightest. |
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