Correlation Between Helicobacter pylori Infection and Tongue Manifestations:A Meta-analysis

Objective To analyze the relationship between Helicobacter pylori(H.pylori)infection and the manifestations of the tongue.Methods Without language restrictions,we searched databases including CAJD,CBMdisc,CDFD,CMFD,PubMed,Cochrane,and EMBASE and made meta-analysis for all literature we have collected.Results Six studies with 975 patients and 50 healthy people in total were included in the analytic pool.There were significant differences in the numbers of H.pylori infections between patients with thin and thick tongue coatings(OR=2.02,95%CI 1.32–3.07,P=0.001).In yellow tongue subgroup,there was a significant difference between patients with thick and thin coatings(OR=2.09,95%CI 1.16–3.77,P=0.01).There was a significant difference in the prevalence of H.pylori infection between patients with yellow and white coatings(OR=2.86,95%CI 2.10–3.90,P<0.001).The frequency of H.pylori infection was significantly increased in patients with red and purple tongues compared with those with pale red tongues(OR=3.42,95%CI 2.40–4.88,P<0.001;OR=7.51,95%CI 3.57–15.79,P<0.001).Conclusion Red or purple tongues and yellow tongues with thick coatings are indicators of a risk of H.pylori infection in patients with GI symptoms.Our study shows that tongue manifestations could serve as a feasible predictor of H.pylori infection in patients with GI symptoms,and determination of the exact association between tongue manifestations and H.pylori infection could enable an understanding of the objectivity of TCM.Long-term and rigorous controlled trials are needed in the future to evaluate the correlating factors.

Study on the Tongue Manifestations for the Blood-Stasis and Toxin Syndrome in the Stable Patients of Coronary Heart Disease

Objective： To explore the tongue manifestations for the blood-stasis and toxin syndrome in the stable patients of coronary heart disease （CHD） according to the acute cardiovascular events （ACEs） in one-year follow-up which based on the pathogenesis hypothesis of ＂blood-stasis and toxin causing catastrophe＂. Methods： Totally 254 stable CHD cases were enrolled after diagnosed by coronary angiography, their tongue appearances were recorded by the digital camera of uniform type, 29 cases with ACEs during one-year follow-up were assigned in ACEs group. The non-ACEs were matched in proportion of 2：1 according to the gender, age （± 2.5 years）, diabetes mellitus history and previous acute coronary syndrome hospitalization history in the non-ACEs group, and 54 cases were eligibly included. The differences of tongue appearance between the ACEs and non-ACEs group were compared. Results： Fifteen cases manifested with bluish tongue （including bluish-grounding or bluish purple tongue）, among which 11 cases （37.9%） in the ACEs group and four cases （7.4%） in the non-ACEs group, and there was significant difference （P〈0.002）. Twenty six cases showed yellow tongue coating in the non-ACEs group, which was significantly higher than that in the ACEs group （48.1 vs. 10.3%, P=0.001）. The tongue of sticky greasy coating was more frequently occurred in the non-ACEs group than that in the ACEs group （66.7% vs. 41.4%, P=0.026）. The proportion of purplish-red sublingual vessel was higher in the ACEs group than that in the non-ACEs group （41.4% vs. 20.4%, P=0.041）. Odd ratio （OR） analysis showed that the patients with bluish tongue, purplish-red sublingual vessel, dry-greasy or dirty greasy coating were more likely to experience ACEs during one- year follow-up （OR： 11.67, 95%CI： 3.34-40.81, P〈0.001; OR： 2.76, 95%CI： 1.02-7.44, P〈0.05; OR： 3.12, 95%, CI： 0.89-10.92, P=0.066）. Conclusions： The bluish tongue （including bluish-grounding or bluish purple tongue） and purplish-red sublingual vessel were potential tongue manifestations of blood-stasis and toxin. The tongue coating changing from sticky greasy to dry greasy or dirty greasy was also probably a tongue manifestation of ＂transforming toxin＂, which need demonstration by further study.

Microbial community structure of different tongue fur types in patients with chronic gastritis

OBJECTIVE:To explore the correlation between tongue and oral microbiota,we studied the microbial community structure of different tongue coating types in patients with chronic gastritis.METHODS:16S rDNA gene sequencing and bioinformatics analysis were used to study the dynamic changes and correlation of microbial flora in patients with chronic gastritis,healthy people,and patients with different tongue fur.In addition,it was also discussed between the severity of gastritis and the microflora of tongue fur.RESULTS:The microbial diversity of tongue fur in patients with chronic gastritis was significantly different from healthy controls.There were significant changes in bacterial communities’diversity and relative abundance between extra tongue fur in patients but not in healthy people.Oral bacteria with relative abundance>1%and P<0.05 among different tongue fur flora were dominant bacteria,including 12 phyla such as Bacteroidetes,Proteobacteria and Firmicutes,and 256 genera such as Neisseria,Prevotella_7 and Haemophilus.CONCLUSIONS:The changes in oral flora in patients with chronic gastritis were related to tongue fur.Therefore,the significant microbiota might enlighten further study on the correlation between tongue inspection and oral microbiota in patients with chronic gastritis.

Study on the Correlation of Tongue Manifestation with Fibrinogen and Neutrophil in Acute Cerebral Infarction Patients

Objective： To investigate the correlation of tongue manifestation with the fibrinogen level and the neutrophil count in blood of acute cerebral infarction patients. Methods： A total of 200 patients with first unilateral cerebral infarction in Neurology Department of Xuanwu Hospital from March, 2008 to February, 2009 were recruited in this study. The correlation of the tongue fur color and texture with the blood fibrinogen level and the neutrophil count was analyzed in these patients. Results： The level of fibrinogen and neutrophil count in thick fur group were significantly higher than that in thin fur group （P〈0.05）. There was no statistical difference in the level of fibrinogen and neutrophil count found between moist fur and dry fur. Statistical significance existed in the level of fibrinogen between the greasy tongue fur group and non-greasy tongue fur group （P〈0.05）. The level of fibrinogen and the neutrophil count were compared among different fur color groups, revealing that the level of fibrinogen in yellowish fur group was higher than that of white fur group and normal value with statistical significance （P〈0.05） with neutrophil count in yellowish fur group being significantly higher than that in white fur group. Conclusion： Our results suggested that the change of tongue manifestation was associated with the level of fibrinogen and the neutrophil count in the blood of cerebral infarction patients.

A Pilot Study on the Relationship between Tongue Manifestation and the Degree of Neurological Impairment in Patients with Acute Cerebral Infarction

Objective： To discuss the relationship between tongue manifestation and the degree of neurological impairment in the patients with acute cerebral infarction. Methods： Two hundred patients with first unilateral cerebral infarction were recruited. The relationship between different tongue manifestation and National Institute of Health Stroke Scale （NIHSS） were analyzed. Results： NIHSS scores in the patients from different tongue color groups were analyzed and further analysis demonstrated that the NIHSS score was higher in the patients with red or bluish-purple tongue than that of those with the pink （P〈0.01）. On tongue fur, the NIHSS score in the patients with thick fur was higher than that of those with the thin （P=0.003）. NIHSS score in patients with slippery, moist or dry fur was significant different （P=0.003）, Further analysis demonstrated that the NIHSS score was higher in the patients with dry fur than that of those with moist fur, and had statistical significance （P=0.01）. The NIHSS score was higher in patients from greasy fur group than that of the non-greasy （P=0.002）. There was significant difference of NHISS score in the patients with different fur color （P=0.000）, and further analysis demonstrated that the NHISS score in white-yellow, yellow fur group were higher than that of the white （P=0.06 or 0.000）. Conclusion： The changes of tongue manifestation might be associated with the degree of neurological impairment in the patients with acute cerebral infarction.

A Pilot Study on the Correlation of Tongue Manifestation with the Site of Cerebral Infarction in Patients with Stroke

Objective：To discuss the correlation of tongue manifestation with the site of cerebral infarction in patients with acute cerebral infarction.Methods：From March 2008 to February 2009,200 cases of hospitalized patients with first unilateral cerebral infarction were chosen in the Department of Neurology,Xuanwu Hospital.The correlation of different tongue color,fur texture,fur color with the site of cerebral Infarction was analyzed.Results：The site of cerebral infarction in patients were compared between different tongue color by Chisquare test（P=0.314）,and further correspondence analysis demonstrated that there was correlation between red tongue and cortical-subcortical infarction group.The site of cerebral infarction in patients were compared between thick fur group and thin fur group,cortical-subcortical infarction occurred more frequently in the former（P=0.0008）.The site of cerebral infarction in patients were compared between dry fur group,moist fur group and smooth fur group,correspondence analysis demonstrated there was correlation between dry fur and cortical-subcortical group.The site of cerebral infarction in the patients were compared between white fur group,white-yellow fur group and yellow fur group（P=0.010）,and correspondence analysis demonstrated there was correlation between white fur and brainstem infarction;white-yellow fur has relationship with cortical infarction;subcortical infarction was weakly related with white-yellow fur;there was closer relationship between yellow fur and cortical-subcortical infarction.Conclusion：The change of tongue manifestation was associated with the site of cerebral infarction in patients,providing a new combining site for diagnosing cerebrovascular diseases by integrative medicine.