| Objective:By evaluating the weakness level of patients with coronary heart disease,and observing the qualitative and quantitative results of TCM syndrome elements and tongue image in patients with coronary heart disease,the distribution characteristics of TCM syndrome elements and tongue image in patients with coronary heart disease at different weakness levels were summarized,so as to summarize the pathogenesis of TCM in patients with coronary heart disease complicated with weakness syndrome or pre-weakness state.Materials and Methods:A total of 210 inpatients with definite diagnosis of coronary heart disease from 2021.10 to 2022.11 in the Department of Cardiology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were selected as subjects by crosssectional study.Patients’ basic information,TCM syndrome element information,tongue image,etc.,were collected,weakness level was evaluated and graded by combining FRIED weakness scale,which was divided into three groups: non-weakness group,pre-weakness group,and weakness group.Syndrome element distribution was investigated and assigned with syndrome element information score table,and the integral of syndrome element was calculated.Objective color RGB chrominance space and HSV measurement were carried out in 5 partitions,and the average value of each partition was taken.The database was imported into SPSS27.0data statistical software.All results were statistically significant with P<0.05.Finally,the distribution of TCM syndrome elements and tongue features in patients with coronary heart disease were summarized.Results:1 Syndrome1.1 Analysis results of site syndrome elementsThe site syndrome elements of 210 patients all included the heart(100%),and the proportions of the rest were spleen(23.2% in 49 cases),kidney(17.5% in 37 cases),liver(5.7% in 12 cases)and lung(0.9% in 2 cases).The results of difference analysis showed that in the distribution of TCM syndrome elements in the three groups with different weakness levels,there were statistical differences between the spleen and kidney(P<0.05).Pairwise comparison showed that the proportion of deficiency damage in the spleen and kidney in the weakness group was significantly higher than that in the other two groups(P<0.05).1.2 Analysis results of pathogenic syndrome elements(1)Analysis results of the proportion difference of single pathogenic syndrome elements showed that qi deficiency,phlegm turbidity,Yin deficiency,fire,qi stagnation and blood deficiency had statistical significance among the three groups(P<0.05).Pairwise comparison results showed that qi deficiency,Yin deficiency and blood deficiency were higher in the weakness group than in the other two groups.The proportion of fiery and qi stagnation in the pre-weakness group was higher than the other two groups.The proportion of sputum turbidity in coronary heart disease patients without debilitating state was higher than that in the other two groups.(2)The difference analysis results of the combination of pathogenic syndrome elements were as follows:In the non-weakness group,coronary heart disease patients with only one syndrome element accounted for the highest proportion among the three groups,and the proportion of three syndrome elements in the weakness group and the pre-weakness group was higher than that in the non-weakness group.The results of comparative analysis on the virtual-real nature of syndrome elements suggested that pure solid syndrome elements accounted for the highest proportion in the non-weakness group.The proportion of pure deficiency syndrome elements in the weakness group was much higher than that in the other two groups.The proportion of syndrome elements in the weakness group and the pre-weakness group was higher than that in the non-weakness group.The above results were P<0.05.2 Tongue features2.1 Results of qualitative analysis(1)Tongue color characteristics: The proportions of crimson tongue,lavender tongue and purple tongue among the three groups were statistically significant(P<0.05).There was no statistical difference in the proportion of pale tongue,pale red tongue and red tongue among the three groups.Paired comparison results indicated that the proportion of purple tongue and lilac tongue in the weakness group was higher than that in the other two groups,and the proportion of purple tongue in the pre-weakness group and the non-weakness group was higher than that in the weakness group,and the differences were statistically significant(P<0.05).(2)Tongue shape characteristics: The proportions of tender tongue,cracked tongue,punctured tongue,and petechial/petechial tongue were significantly different among the three groups(P<0.05).Paired comparison results indicated that the proportion of tender tongue and petechial tongue in the weakness group was higher than that in the other two groups,the proportion of cracked tongue in the non-weakness group was the least,and the proportion of punctured tongue in the preweakness group was higher than that in the other two groups,and the difference was statistically significant(P<0.05).(3)Moss color characteristics: the proportion of white moss in the weakness group was higher than that in the other two groups,and the proportion of yellow moss in the pre-weakness group was higher than that in the other two groups,and the differences were statistically significant(P<0.05).(4)Moss characteristics: the proportion of thick moss was the highest in the weakness group;The greasy moss in the non-enervating group was higher than that in the other two groups.The proportion of peeling moss was the highest in the weakness group,and the above results were P<0.05.2.2 Quantitative analysis results(1)Quantitative analysis of tongue color features of different languishing groups based on RGB and HSV color space models: The values of R+B/R+G+B in zone 1 and zone 4 of the tongue tip and the middle of the tongue were higher in the non-weakness group than in the other two groups(P<0.05),indicating that the color was purple.Moreover,the values of G in zone 1,G and V in zone 4 were higher in the weakness group than in the other two groups(P<0.05),indicating that the color was lilac and bright.The tongue root represented the renal region in the 5-zone method.The values of R,G,B,V,R+B/R+G+B,R/R+G+B in the renal region in the weakness group were higher than those in the other two groups(P<0.05),indicating that the tongue color in the renal region in the weakness coronary heart disease patients was more purple and brighter.In addition,the value of H in the non-weakness group was higher than that in the other two groups except for zone 3 and 5(P<0.05),suggesting that the color difference in the non-weakness group was significant in the other three zones.Conclusion:1.There are differences in the distribution of syndrome elements in patients with coronary heart disease combined with different degrees of weakness.In the non-weakness group,solid syndrome elements of phlegm and turbidities were more common;in the pre-weakness group,deficiency,Yin deficiency,blood deficiency and deficiency of spleen and kidney were more common.Blood stasis accounted for a higher proportion among the three groups,indicating that blood stasis ran through the development of coronary heart disease combined with different degrees of weakness.2.Tongue color and tongue quality are different in patients with coronary heart disease with different levels of weakness.In the non-weakness group,purple tongue caused by blood stasis is often seen,which indicates that such patients have more substance bodies,more Yang,and mainly solid evil.Weakness group is more likely to see the hot point of the zang fu tongue,or see Yin liquid phase on the lack of cracked tongue;Compared with the other two groups,the tongue color in the tongue root of the weakness group,namely the kidney area,was more reddish and brighter.The color in the middle of the weakness group was more lavender and brighter,indicating that the tongue body was delicate,the accumulation of Yang deficiency and water moisture resulted in the bright tongue image,and the tongue quality was more tender tongue,cracked tongue,and pechymosis tongue.The condition of the patients with weakness coronary heart disease was complicated,and both deficiency and solid were emphasized.3.There are differences in coating color and coating quality in patients with coronary heart disease with different levels of weakness.The tongue coating of patients with coronary heart disease in the weakness group was more likely to show the lack of gastric Yin.Weakness and non-weakness group of patients with tongue coating mainly to yellow thick greasy coating,more can be caused by phlegm turbidness,qi stagnation fire. |
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