基于人工智能舌镜技术的颈椎病患者舌象特征定性描述研究

Qualitative description of the c haracteristics of tongue manifestations in patients with cervical spondylosis based on artificial intelligence tongue mirror technology

目的:分析颈椎病患者的舌象特征。方法:以2020年6月至2022年3月在上海中医药大学附属曙光医院就诊的颈椎病患者为研究对象。运用人工智能舌镜软件采集受试者舌图(拍摄设备为iPhoneXR手机),利用岐黄数据AI工作站V2.0对采集到的舌图进行解读、判别,分析舌象特征,定性分析参数包括舌色、舌形、苔色、苔质、舌下络脉。结果:①一般情况。共纳入201例颈椎病患者,男66例、女135例;年龄19~85岁,中位数49岁;病程3d至10年,其中病程≤3个月者占31.34%;颈型颈椎病39例,神经根型颈椎病75例,脊髓型颈椎病17例,椎动脉型颈椎病30例,交感神经型颈椎病38例,食管型颈椎病2例;气血亏虚证42例,痰湿阻络证63例,肝肾不足证27例,气滞血瘀证28例,风寒湿证41例;舌象正常者23例,异常者178例。②颈椎病患者舌象的总体特征。纳入的201例颈椎病患者的舌色以淡红(82例,40.80%)、暗红(51例,25.37%)为主;在舌形方面,大部分患者有齿痕(139例,69.15%),部分患者也存在胖(68例,33.83%)、裂纹(42例,20.90%)、娇嫩(37例,18.41%)等舌形异常;苔色以白色(146例,72.64%)为主;苔质多薄(99例,49.25%)、润(123例,61.19%),部分患者表现为腻苔(98例,48.76%);舌下络脉色泽多为暗红(128例,63.68%),主干长度和宽度多正常(145例,72.14%;166例,82.59%)。③不同证候颈椎病患者的舌象特征。气血亏虚证患者舌色为淡(25例,59.52%)或淡红(17例,40.48%),有齿痕(37例,88.10%);苔色多为白色(39例,92.86%),苔质薄(36例,85.71%)、润(37例,88.10%);舌下络脉色泽暗红(35例,83.33%),主干长度和宽度多正常(36例,85.71%;42例,100.00%)。痰湿阻络证患者舌色多为淡红(28例,44.44%),有齿痕(46例,73.02%);苔色多为白色(25例,39.68%)和黄白相兼(25例,39.68%),苔质稍厚(32例,50.79%)或极厚(31例,49.21%)、腻(58例,92.06%)、润(39例,61.90%);舌下络脉色泽暗红(38例,60.32%),主干长度和宽度多正常(46例,73.02%;55例,87.30%)。肝肾不足证患者舌色多为红(14例,51.85%);苔色多为白色(21例,77.78%),苔质少(13例,48.15%)或薄(11例,40.74%)、润(17例,62.96%);舌下络脉色泽暗红(18例,66.67%),主干长度和宽度多正常(20例,74.07%;24例,88.89%)。气滞血瘀证患者舌色多为暗红(21例,75.00%),多有齿痕(16例,57.14%);苔色多为白色(22例,78.57%),苔质薄(18例,64.29%)、润(22例,78.57%);舌下络脉色泽紫黑(16例,57.14%),主干长度和宽度多正常(22例,78.57%;23例,82.14%)。风寒湿证患者舌色多为淡红(31例,75.61%),多有齿痕(30例,73.17%);苔色多为白色(39例,95.12%),苔质薄(34例,82.93%)、滑(33例,80.49%);舌下络脉色泽紫黑(35例,85.37%),主干长度和宽度多正常(37例,90.24%;40例,97.56%)。结论:颈椎病患者的舌象具有舌色淡红、有齿痕、舌苔薄白而润、舌下络脉正常等特征,提示颈椎病患者多存在气虚,兼有风寒、痰湿的证候。

Objective:To analyze the characteristics of tongue manifestations in patients with cervical spondylosis.Methods:Patients with cervical spondylosis admitted to Shuguang Hospital afiliated to Shanghai Univesity of Taditional Chinese Medieine from June 2020 to March 2022 were enrolled as research subjects.The arificial itelligencge tongue miror software was employed to ollet the tongue images which were taken by iPhone XR.The Qihuang Data AI Workstation V2.0 was used to interpret and disc rimi nate the tongue images,and to analyze the characteristics of tongue manifestat ions.The parameters,such as tongue color,tongue form,fur color,fur texture,and sublingual veins,were qualitatively analyzed.Results:①General information.A total of 201 patients with cerv ical spondylosis were enolled,including 66 males and 135 females.The age ranged from 19 to 85 years,with a median of 49 years.The course of disease ranged from 3 days to 10 years,and 31.34%of patients had the course of disease of≤3 months.In terms of cervical spondylosis cassification,there were 39 a ses of neck type,75 cases of nerve root type,17 cases of spinal cord type,30 cases of vertebral artery type,38 cases of sympathetic nerve type,and 2 cases of esophagus type.In terms of traditional Chinese medicine(TCM)syndrome,there were 42 cases of deficiency of qi and!bood,63 cases of phlegm-dampness blocking ollateals,27 cases of liver and kidney suficiency,28 cases of qi stagnat ion and blood stasis,and 41 cases of wind,cold,and dampness.In terms of tongue manifestations,there were 23 normal cases and 178 abnormal cases.2General characteristics of tongue manifestations in patients with cervical spondylosis.The tongues of 201 patients with cervical spondylosis were mainly light red(n=82,40.80%)and dull red(n=51,25.37%).In terms of tongue form,most patients showed teeth-marked tongues(n=139,69.15%),and some patients also showed abnormal tongue forms,such as fat tongues(n=68,33.83%),isured tongues(n=42,20.90%),and tender tongues(n=37,18.41%).The tongue fur was mainly white(n=146,72.64%).In terms of fur texture,the tongue fur was mainly thin(n=99,49.25%)and moist(n=123,61.19%),flloweld by greasy fur(n=98,.48.76%).The sublingual veins was mostly dark red(n=128,63.68%),and the length and width of the main trunk were mostly normal(n=145,72.14%;n=166,82.59%).③Tongue manifest ation characteristics of patients with cervical spondylosis of diferent TCM syndromes.The tongues of patients with q and blood deficeney syndrome were pale(n=25,59.52%)or light red(n=17,40.48%)with tooth maks(n=37,88.10%).The tongue fur was mostly white(n=39,92.86%),thin(n=36,85.71%),and moist(n=37,88.10%).The sublingual veins were dark red(n=35,83.33%),and the length and width of the main trunk were mostly normal(n=36,85.71%;n=42,100.00%).The tongues of patients with phlegm-dampness blocking ollaterals syndrome were light red(n=28,44.44%0)with toth marks(n=46,73.02%).The tongue fur was mostly white(n=25,39.68%),mixed yellw and white(n=25,39.68%),slightly thick(n=32,50.79%)or extremely thick(n=31,49.21%),greay(n=58,92.06%),and moist(n=39,61.90%).The sublingual veins were dark ned(n=38,60.32%),and the lengh and width of the main trunk were mostly normal(n=46,73.02%;n=55,87.30%).The tongues of patients with liver and kidney suficiency syndrome were red(n=14,51.85%).The tongue fur was mosly white(n=21,77.78%),ess(n=I3,48.15%)or thin(n=11,40.74%),and moist(n=17,62.96%).The sublingual veins were dark red(n=18,66.67%),and the length and width of the main trunk were mosly normal(n=20,74.07%;n=24,88.89%).The tongues of patients with qi stagnation and blood stasis syndrome were dull red(n=21,75.00%)with tooth marks(n=16,57.14%).The tongue fur was mostly white(n=22,78.57%),thin(n=18,64.29%),and moist(n=22,78.57%).The sublingual veins were purple-black(n=16,57.14%),and the length and width of the main trunk were mostly normal(n=22,78.57%;n=23,82.14%).The tongues of patients with w ind-oold-dampness syndrome were light red(n=31,75.61%)with tooth marks(n=30,73.17%).The tongue fur was mostly white(n=39,95.12%),thin(n=34,82.93%),and slippery(n=33,80.49%).The sublingual veins were purple-black(n=35,85.37%),and the length and width of the main trunk were mostly normal(n=37,90.24%;n=40,97.56%).Conclusion:The tongue manifestations of patients with cervical spondylosis are characterized by light red tongues with tooth marks and thin,white and moist tongue fur,and normal sublingual veins,which suggest that patients with cervical spondylosis mostly have qi deficiency combined with wind-oold and phlegm-dampness syndromes.