4949例学龄前儿童亚健康体质调查与舌象特征定量研究

Traditional Chinese Constitution Survey and Quantitatively Tongue Image Research on Sub-health Constitution of 4949 Preschool Children

目的探讨不同体质的儿童中医临床诊断有意义的舌象客观定量化指标,为临床诊疗的评价提供客观依据及新的研究思路。方法对3~6岁幼儿园儿童进行了儿童体质辨识信息采集工作,采用道生四诊仪(DS01-B)进行舌象采集,并对舌象进行图像处理,提取舌象定量影像组学参数和颜色空间参数。通过逻辑回归分析,分析舌象定量参数与体质间的潜在关系。结果共纳入4949例不同体质的儿童作为研究对象,参与舌象采集的儿童,肝火体最多,占38.5%。舌的高通量影像组学参数与体质有着密切的联系,气虚体的高影响因素为:舌象的苔一阶最大值、苔一阶平均绝对偏差、苔一阶中位数苔一阶最小值、苔一阶鲁棒性平均绝对偏差、苔灰度共生特征Idm、苔灰度区域特征最小面积低灰度值、舌灰度区域特征最小面积低灰度值、舌相邻灰度差矩阵复杂度。对Lab模型拟合的似然比假设检验的显著性水平P=0.477。结论不同中医体质与舌象影像组学参数存在相关性,不同体质的儿童与舌的Lab颜色空间无显著性关系,舌象参数可为不同中医体质临床诊断提供客观依据。

Objective To explore the meaningful objective quantitative indexes of tongue image in clinical diagnosis of children with different physique,so as to provide objective basis and new research ideas for the evaluation of clinical diagnosis and treatment.Methods The information collection of children's physique identification was carried out for kindergarten children aged 3-6.The tongue image was collected by Daosheng four diagnostic instrument(DS01-B)and the tongue image was processed to extract the quantitative image omics parameters and color space parameters of tongue image.Through logistic regression analysis,the potential relationship between quantitative parameters of tongue image and physique was analyzed.Results A total of 4949 children with different constitutions were included as the research objects.Among the children participating in tongue image collection,the number of the children with liver fire syndrome was the most,accounting for 38.5%.The high-throughput imaging parameters of tongue were closely related to body constitution.The high influencing factors of the children with Qi deficiency syndrome included the first-order maximum of tongue image,the first-order average absolute deviation of tongue image,the first-order median of tongue image,the first-order minimum of tongue image,the first-order robust average absolute deviation of tongue image,the gray level symbiotic feature Idm of tongue,the low gray level value of the minimum area of gray level characteristics of tongue image,the minimum area of tongue gray area features low gray value and the complexity of adjacent gray difference matrix.The significance level of likelihood ratio hypothesis test of Lab model fitting was P=0.477.Conclusion There is a correlation between different TCM constitutions and tongue imaging parameters and there is no significant relationship between children with different constitutions and Lab color space of tongue.Tongue imaging parameters can provide an objective basis for clinical diagnosis of different TCM constitutions.