不同中医证型糖尿病高危足患者舌诊图像参数分析

Analysis of tongue diagnosis image parameters in patients with high risk diabetic foot of different TCM syndromes

目的分析不同中医证型糖尿病高危足患者的舌诊图像参数特征,为其中医辨证提供客观化依据。方法采用Smart TSM-I舌面信息采集分析仪拍摄糖尿病高危足3种常见中医分型(寒凝瘀阻证、热毒伤阴证、气血两虚证)患者的舌象照片,利用分析软件识别并提取舌质、舌苔的图像参数,并据此分析不同中医证型的特征参数。结果①舌质图像参数:与气血两虚证比较,寒凝瘀阻证患者舌质整体、舌中部及舌尖部H值升高(P<0.05),舌尖部B值降低(P<0.05),热毒伤阴证患者舌尖部R值、B值、V值降低(P<0.05);与热毒伤阴证比较,寒凝瘀阻证患者舌根部、舌中部H值升高(P<0.05)。②舌苔图像参数:与气血两虚证比较,寒凝瘀阻证患者舌苔整体颜色B值、H值,以及舌根部苔色H值升高(P<0.05),热毒伤阴证患者舌尖部苔色G值降低(P<0.05)。结论不同证型糖尿病高危足患者的舌诊图像参数存在一定的差异,可反映不同证型糖尿病高危足的中医病机,为其整体辨证、脏腑辨证提供部分客观依据。

Objective To provide objective basis for TCM syndrome differentiation by analyzing the characteristics of tongue diagnosis image parameters in patients with high risk diabetic foot of different TCM syndromes.Methods The smart TSM-I tongue-and-face diagnostic machine was used to take photos of tongue images of patients with high risk diabetic foot in three common TCM syndromes(cold coagulation and stasis stagnation syndrome,heat toxin injuring yin syndrome and qi-blood dual deficiency syndrome).The image parameters of tongue body and tongue coating were identified and extracted by analysis software,and the characteristic parameters of different TCM syndromes were analyzed accordingly.Results①Image parameters of tongue body:compared with the condition in patients with qi-blood dual deficiency syndrome,the H value of the whole tongue body,the middle part and the tip of the tongue increased(P<0.05)and the B value of the tip of the tongue decreased(P<0.05)in patients with cold coagulation and blood stasis syndrome,and the R value,B value and V value of the tip of the tongue in patients with heat toxin injuring yin syndrome decreased(P<0.05);Compared with the condition in patients with heat toxin injuring yin syndrome,the H value of tongue root and middle part of tongue in patients with cold coagulation and blood stasis syndrome increased(P<0.05).②Image parameters of tongue coating:compared with the condition in patients with qi-blood dual deficiency syndrome,the B value,H value of the overall color of tongue coating and H value of tongue root color in patients with cold coagulation and blood stasis syndrome increased(P<0.05),while the G value of tongue tip color in patients with heat toxin injuring yin syndrome decreased(P<0.05).Conclusion There are some differences in tongue diagnosis image parameters of patients with high risk diabetic foot of different syndromes,which can reflect TCM pathogenesis of high risk diabetic foot of different syndromes and provide some objective basis for the holistic and visceral syndrome differentiation.