基于图像特征的不同证型非小细胞肺癌患者舌象研究

Study on tongue image of non-small cell lung cancer patients with different syndromes based on image features

目的:以非小细胞肺癌(NSCLC)患者的舌象图像特征为主要研究内容,分析不同中医证型NSCLC患者的舌象图像特征,为建立融合舌象图像特征的中西医结合肺癌病证诊断体系提供技术支持。方法:以NSCLC患者为研究对象,共纳入单一证型者497例次,包括气虚证组80例次、阴虚证组110例次、痰湿证组172例次、血瘀证(兼其他证)组135例次,另选取正常舌象者163例作为健康对照组。采用TDA-1小型舌诊仪、TDAS 3.0中医舌诊分析系统采集所有受试者的舌象图像特征指标,分析不同中医证型NSCLC患者的舌象图像指标特征。结果:与健康对照组相比,气虚证组TB-H、TC-H升高(P<0.05),TB-S、TC-S、TC-a降低(P<0.05);阴虚证组TB-Cr、TC-R、TC-G、TC-B、TC-Y、TC-Cr、TC-H、TC-I、TC-L、perAll升高(P<0.05);痰湿证组TB-H、TC-G、TC-B、TC-Y、TC-H、TC-I、TC-L、TC-b、perAll升高(P<0.05),TB-S、TC-S、TC-a降低(P<0.05);血瘀证组TB-Cr、TB-H、TC-G、TC-H、TC-b、perAll升高(P<0.05),TB-S、TC-Cb、TC-a降低(P<0.05)。与气虚证组相比,阴虚证组TB-B、TB-Cr、TB-S、TB-a、TC-R、TC-G、TC-B、TC-Cr升高(P<0.05),TB-H降低(P<0.05);痰湿证组TC-G、TC-B、TC-R、perAll升高(P<0.05);血瘀证组TB-Cr、TC-R升高(P<0.05),TB-b降低(P<0.05)。与阴虚证组相比,痰湿证组TB-Cr、TB-S、TC-Cr、TC-a、perPart降低(P<0.05)。与痰湿证组相比,血瘀证组TB-b降低(P<0.05)。结果提示:与健康对照组相比,气虚证组的NSCLC患者舌色偏淡,舌苔偏白;阴虚证组患者舌色偏红,舌苔稍有增厚;痰湿证组患者舌苔最厚;血瘀证组患者舌色向青紫舌变化。与气虚证组相比,阴虚证组患者舌色偏红,舌苔偏厚;痰湿证组患者舌苔较厚;血瘀证组患者舌色偏紫。4个证型组中,气虚证组患者舌色较淡,痰湿证组患者舌苔最厚,血瘀证组患者舌色偏青紫色。结论:不同证型NSCLC患者的舌象图像特征存在差异,客观化的舌象图像特征指标能够在一定程度上反映中医证候的特征,故其可能为NSCLC中医临床辨证诊断及治疗提供客观量化依据。

Objective: To analyze the tongue image characteristics of non-small cell lung cancer(NSCLC) patients with different Chinese medical syndromes based on the tongue image characteristics of NSCLC patients, and provide the technical support for the establishment of integrated traditional Chinese and western medicine lung cancer disease and syndrome diagnosis system which associated with tongue image characteristics. Methods: Patients with NSCLC were taken as the research subjects, and a total of 497 cases with single syndrome type were included,including 80 cases in qi-deficiency syndrome group,110 cases in yin-deficiency syndrome group,172 cases in phlegm-dampness syndrome group,and 135 cases in blood-stasis syndrome (combined with other syndromes) group.Meanwhile,163cases with normal tongue image were selected as the healthy control group.The characteristic indexes of tongue image in all subjects were collected by TDA-1 tongue diagnosis instrument and TDAS 3.0 Chinese medical tongue diagnosis analysis system,and the characteristic indexes of tongue image in NSCLC patients with different Chinese medical syndromes were analyzed.Results:Compared with the healthy control group,the values of TB-H and TC-H in the qi-deficiency syndrome group were increased (P<0.05),and the values of TB-S,TC-S and TC-a were decreased (P<0.05);the values of TB-Cr,TC-R,TC-G,TC-B,TC-Y,TC-Cr,TC-H,TC-I,TC-L and perAll in the yin-deficiency syndrome group were increased (P<0.05);the values of TB-H,TC-G,TC-B,TC-Y,TC-H,TC-I,TC-L,TC-b and perAll in the phlegm-dampness syndrome group were increased (P<0.05),and the values of TB-S,TC-S and TC-a were decreased(P<0.05);the values of TB-Cr,TB-H,TC-G,TC-H,TC-b and perA ll in the blood-stasis syndrome group were increased (P<0.05),and the values of TB-S,TC-Cb and TC-a were decreased (P<0.05).Compared with the qi-deficiency syndrome group,the values of TB-B,TB-Cr,TB-S,TB-a,TC-R,TC-G,TC-B and TC-Cr in the yin-deficiency syndrome group were increased (P<0.05),and the value of TB-H was decreased (P<0.05);the values of TC-G,TC-B,TC-R and perAll in the phlegm-dampness syndrome group were increased (P<0.05);the values of TB-Cr and TC-R in the blood-stasis syndrome group were increased (P<0.05),and the value of TB-b was decreased (P<0.05).Compared with the yin-deficiency syndrome group,the values of TB-Cr,TB-S,TC-Cr,TC-a and perP art in the phlegm-dampness syndrome group were decreased (P<0.05).Compared with the phlegm-dampness syndrome group,the value of TB-b in the blood-stasis syndrome group was decreased (P<0.05).The results suggested that,compared with the healthy control group,the tongue color of NSCLC patients in the qi-deficiency syndrome group was pale and the tongue coating was white;the tongue color of the patients in the yin-deficiency syndrome group was red and the tongue coating was slightly thickened;the tongue coating of the patients in the phlegm-dampness syndrome group was the thickest;the tongue color of the patients in the blood-stasis syndrome group changed to purple tongue.Compared with the qi-deficiency syndrome group,the tongue color of the patients in the yin-deficiency syndrome group was red and the tongue coating was thicker;the tongue coating of the patients in the phlegm-dampness syndrome group was obviously thicker;the tongue color of the patients in the blood-stasis syndrome group was purple.Among the four syndrome groups,the tongue color of the patients in the qi-deficiency syndrome group was lighter,the tongue coating of the patients in the phlegm-dampness syndrome group was the thickest,and the tongue color of the patients in the blood-stasis syndrome group was bluish-purple.Conclusion:There are differences in the tongue image characteristics of NSCLC patients with different syndromes.The objective tongue image characteristic indexes can reflect the characteristics of Chinese medical syndromes to a certain extent,so it may provide the objective quantitative basis for clinical syndrome differentiation and diagnosis and treatment on NSCLC.