脾阳虚证、肾阳虚证亚健康人群的舌诊图像特征分析

Analysis on tongue diagnosis image features of sub-healthy people with spleen-yang deficiency syndrome or kidney-yang deficiency syndrome

目的:分析脾阳虚证、肾阳虚证亚健康人群的舌诊图像特征,探讨舌诊图像数字化、量化特征值在脾阳虚证、肾阳虚证健康状态辨识中的诊断价值。方法:纳入亚健康脾阳虚证者1 450例、肾阳虚证者1 666例及健康者1 844例,分别设为脾阳虚组、肾阳虚组、健康组。采用便携式中医智能诊断仪采集受试者的舌诊图像信息,比较各组受试者的舌象特征分布及舌色、苔色等舌诊图像特征参数。结果:(1)与健康组比较,肾阳虚组受试者舌淡白、舌暗红比率升高(P<0.05),脾阳虚组受试者舌暗红比率亦升高(P<0.05),肾阳虚组、脾阳虚组受试者舌淡红、舌红、苔白比率均降低(P<0.05),苔黄比率均升高(P<0.05);与脾阳虚组比较,肾阳虚组受试者舌淡白比率升高(P<0.05),舌红、舌暗红比率降低(P<0.05)。(2)与健康组比较,脾阳虚组受试者舌裂纹、舌体胖、舌苔厚比率升高(P<0.05),肾阳虚组受试者舌体胖、舌苔厚比率亦升高(P<0.05);与脾阳虚组比较,肾阳虚组受试者舌体胖比率升高(P<0.05),舌苔厚比率降低(P<0.05)。(3)与健康组比较,脾阳虚组、肾阳虚组受试者的舌色L值均升高(P<0.05),舌色a值、b值均降低(P<0.05);与脾阳虚组比较,肾阳虚组受试者舌色L值升高(P<0.05),舌色a值降低(P<0.05)。(4)与健康组比较,肾阳虚组受试者苔色L值升高(P<0.05),苔色a值和b值均降低(P<0.05),脾阳虚组受试者苔色b值升高(P<0.05);与脾阳虚组比较,肾阳虚组受试者苔色L值升高(P<0.05),苔色a值和b值均降低(P<0.05)。结论:舌诊图像特征参数可作为脾阳虚证、肾阳虚证亚健康人群证候鉴别诊断与健康状态辨识的客观化参考指标,为亚健康人群的中医健康管理提供新的思路与方法。

Objective: To analyze the tongue diagnosis image features of sub-healthy people with spleen-yang deficiency syndrome or kidney-yang deficiency syndrome, and explore the diagnostic value of tongue diagnosis image digital and quantitative features in the health status identification of spleen-yang deficiency syndrome and kidney-yang deficiency syndrome. Methods: A total of 1 450 sub-healthy subjects with spleen-yang deficiency syndrome, 1 666 sub-healthy subjects with kidney-yang deficiency syndrome and 1 844 healthy subjects were included and set as spleen-yang deficiency group, kidney-yang deficiency group and healthy group, respectively. The tongue diagnosis image information of the subjects was collected by the portable Chinese medical intelligent diagnostic instrument. The tongue image feature distribution and the tongue image feature parameters such as tongue color and coating color were compared among these groups. Results:(1)Compared with the healthy group, the ratios of pale tongue and dark red tongue in the kidney-yang deficiency group were increased(P<0.05), the ratio of dark red tongue in the spleen-yang deficiency group was also increased(P<0.05), the ratios of light red tongue,red tongue and white coating in the kidney-yang deficiency group and spleen-yang deficiency group were decreased( P<0.05),and the ratio of yellow coating was increased( P<0.05). Compared with the spleen-yang deficiency group,the ratio of pale tongue in the kidney-yang deficiency group was increased( P < 0. 05),and the ratios of red tongue and dark red tongue were decreased( P <0.05).(2)Compared with the healthy group,the ratios of fissured tongue,fat tongue body and thick coating in the spleen-yang deficiency group were increased( P < 0. 05),and the ratios of fat tongue body and thick coating in the kidney-yang deficiency group were also increased( P<0.05). Compared with the spleen-yang deficiency group,the ratio of fat tongue body in the kidney-yang deficiency group was increased( P<0.05),and the ratio of thick coating was decreased( P< 0.05).(3)Compared with the healthy group,the L value of tongue color in the spleen-yang deficiency group and kidney-yang deficiency group was increased( P< 0.05),and the a and b values of tongue color were decreased( P<0.05). Compared with the spleen-yang deficiency group,the L value of tongue color in the kidney-yang deficiency group was increased( P<0.05),and the a value of tongue color was decreased( P < 0. 05).(4) Compared with the healthy group,the L value of coating color in the kidney-yang deficiency group was increased( P<0.05),and the a and b values of coating color were decreased( P<0.05),the b value of coating color in the spleen-yang deficiency group was increased( P<0.05). Compared with the spleen-yang deficiency group,the L value of coating color in the kidney-yang deficiency group was increased( P<0.05),and the a and b values of coating color were decreased( P<0.05). Conclusion: The characteristic parameters of tongue diagnosis image can be used as the objective reference indexes for syndrome differentiation and diagnosis and health status identification in sub-healthy people of spleen-yang deficiency syndrome and kidney-yang deficiency syndrome,which provides a new idea and method for Chinese medical health management in sub-healthy people.