肝胃不和证和脾胃虚弱证脾胃系患者的舌象特征分析

Analysis of Tongue Features in Patients with Disharmony Between Liver and Stomach and Weakness of Spleen and Stomach

目的探究两种不同证型脾胃系患者的舌象特征差异,将计算机视觉技术融入中医辨识理论,为其科学决策提供理论依据。方法收集消化科专家门诊患者的舌象及四诊信息,其中肝胃不和型47例,脾胃虚弱型40例,提出舌象分区模型并将其划分为7个区域,通过观察两种证型患者舌色、舌形、苔质苔色、舌下脉络特征,并结合数值分析计算其颜色参数RGB、HSV的数值,从而获得不同证型患者的舌象特征信息。结果肝胃不和型患者以淡红舌为主,多伴裂纹、齿痕、淡黄厚腻苔,舌下脉络偏青紫、长粗,结节迂曲明显;脾胃虚弱型患者以淡紫胖大舌为主,多伴裂纹、齿痕、淡黄腻苔,舌下脉络异常特征不明显。与肝胃不和组相比,脾胃虚弱组舌象及舌下脉络颜色参数R、G、B和V的数值整体较高(P<0.05),颜色偏明亮、淡白。结论分区模型能够量化不同证型患者的舌象特征,一定程度上提高了舌象诊断的准确性及证候辨识的参照性。

Objective To explore the difference of tongue characteristics of patients with two different types of spleen stomach system by integrating computer vision technology into TCM identification theory, so as to provide theoretical basis for scientific decision-making. Methods Digestive department expert outpatient service patient’s tongue and diagnostic information were collected, including 47 cases of disharmony between liver and stomach and 40 cases of weakness of spleen and stomach. A regionalization model of tongue image was proposed and divided into 7 regions. By observing the tongue color, tongue shape, tongue fur color and the characteristics of sublingual vein of patients with two syndrome types, the color parameters RGB and HSV values were calculated by numerical analysis, so as to obtain the information of tongue image characteristics of patients with different types. Results The patients with disharmony between liver and stomach were mainly light red tongue, with cracks, teeth marks and light yellow thick greasy fur. The sublingual veins were purplish, long and thick, with obvious tortuous nodules;the patients with spleen and stomach weakness were mainly light purple fat tongue, with cracks, teeth marks and light yellow greasy fur. The abnormal characteristics of sublingual veins were not obvious. Compared with the liver stomach disharmony group, the values of R,G, B and V of tongue picture and sublingual vein color parameters in the spleen stomach weakness group were higher(P<0.05), with bright, pale color.Conclusion The regionalized model can quantify the tongue characteristics of patients with different syndromes, which improves the accuracy of tongue diagnosis and the reference-making of syndrome identification to a certain extent.