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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:

第35卷

期數(shù):

2023年02期

頁碼:

10-14,29

欄目:

臨床研究

出版日期:

2023-02-20

文章信息/Info

Title:

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

作者:

王玉鵬¹; 杜國慶²; 鄧真³; 李正言¹; 熊軼喆¹; 王翔¹; 龐堅²; 周敏⁴; 詹紅生²

(1.上海中醫(yī)藥大學(xué)附屬曙光醫(yī)院,上海 201203; 2.上海中醫(yī)藥研究院骨傷科研究所,上海 201203; 3.上海市寶山區(qū)中西醫(yī)結(jié)合醫(yī)院,上海 201999; 4.上海中醫(yī)藥大學(xué),上海 201203)

Author(s):

WANG Yupeng¹; DU Guoqing²; DENG Zhen³; LI Zhengyan¹; XIONG Yizhe¹; WANG Xiang¹; PANG Jian²; ZHOU Min⁴; ZHAN Hongsheng²

1.Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China 2.The Institute of Traumatology and Orthopedics Affiliated to Shanghai Academy of Traditional Chinese Medicine,Shanghai 201203,China3.Shanghai Baoshan Hospital of Integrated Chinese and Western Medicine,Shanghai 201999,China4.Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China

關(guān)鍵詞:

頸椎病;  舌診;  人工智能;  定性描述

Keywords:

cervical spondylosis;  tongue inspection;  artificial intelligence;  qualitative description

摘要:

目的:分析頸椎病患者的舌象特征。方法:以2020年6月至2022年3月在上海中醫(yī)藥大學(xué)附屬曙光醫(yī)院就診的頸椎病患者為研究對象。運用人工智能舌鏡軟件采集受試者舌圖(拍攝設(shè)備為iPhone XR手機),利用岐黃數(shù)據(jù)AI工作站V2.0對采集到的舌圖進行解讀、判別,分析舌象特征,定性分析參數(shù)包括舌色、舌形、苔色、苔質(zhì)、舌下絡(luò)脈。結(jié)果:①一般情況。共納入201例頸椎病患者,男66例、女135例; 年齡19～85歲,中位數(shù)49歲; 病程3 d至10年,其中病程≤3個月者占31.34%; 頸型頸椎病39例,神經(jīng)根型頸椎病75例,脊髓型頸椎病17例,椎動脈型頸椎病30例,交感神經(jīng)型頸椎病38例,食管型頸椎病2例; 氣血虧虛證42例,痰濕阻絡(luò)證63例,肝腎不足證27例,氣滯血瘀證28例,風(fēng)寒濕證41例; 舌象正常者23例,異常者178例。②頸椎病患者舌象的總體特征。納入的201例頸椎病患者的舌色以淡紅(82例,40.80%)、暗紅(51例,25.37%)為主; 在舌形方面,大部分患者有齒痕(139例,69.15%),部分患者也存在胖(68例,33.83%)、裂紋(42例,20.90%)、嬌嫩(37例,18.41%)等舌形異常; 苔色以白色(146例,72.64%)為主; 苔質(zhì)多薄(99例,49.25%)、潤(123例, 61.19%),部分患者表現(xiàn)為膩苔(98例,48.76%); 舌下絡(luò)脈色澤多為暗紅(128例,63.68%),主干長度和寬度多正常(145例,72.14%; 166例,82.59%)。③不同證候頸椎病患者的舌象特征。氣血虧虛證患者舌色為淡(25例,59.52%)或淡紅(17例,40.48%),有齒痕(37例,88.10%); 苔色多為白色(39例,92.86%),苔質(zhì)薄(36例,85.71%)、潤(37例,88.10%); 舌下絡(luò)脈色澤暗紅(35例,83.33%),主干長度和寬度多正常(36例,85.71%; 42例,100.00%)。痰濕阻絡(luò)證患者舌色多為淡紅(28例,44.44%),有齒痕(46例,73.02%); 苔色多為白色(25例,39.68%)和黃白相兼(25例,39.68%),苔質(zhì)稍厚(32例,50.79%)或極厚(31例,49.21%)、膩(58例,92.06%)、潤(39例,61.90%); 舌下絡(luò)脈色澤暗紅(38例,60.32%),主干長度和寬度多正常(46例,73.02%; 55例,87.30%)。肝腎不足證患者舌色多為紅(14例,51.85%); 苔色多為白色(21例,77.78%),苔質(zhì)少(13例,48.15%)或薄(11例,40.74%)、潤(17例,62.96%); 舌下絡(luò)脈色澤暗紅(18例,66.67%),主干長度和寬度多正常(20例,74.07%; 24例,88.89%)。氣滯血瘀證患者舌色多為暗紅(21例,75.00%),多有齒痕(16例,57.14%); 苔色多為白色(22例,78.57%),苔質(zhì)薄(18例,64.29%)、潤(22例,78.57%); 舌下絡(luò)脈色澤紫黑(16例,57.14%),主干長度和寬度多正常(22例,78.57%; 23例,82.14%)。風(fēng)寒濕證患者舌色多為淡紅(31例,75.61%),多有齒痕(30例,73.17%); 苔色多為白色(39例,95.12%),苔質(zhì)薄(34例,82.93%)、滑(33例,80.49%); 舌下絡(luò)脈色澤紫黑(35例,85.37%),主干長度和寬度多正常(37例,90.24%; 40例,97.56%)。結(jié)論:頸椎病患者的舌象具有舌色淡紅、有齒痕、舌苔薄白而潤、舌下絡(luò)脈正常等特征,提示頸椎病患者多存在氣虛,兼有風(fēng)寒、痰濕的證候。

Abstract:

Objective:To analyze the characteristics of tongue manifestations in patients with cervical spondylosis.Methods:Patients with cervical spondylosis admitted to Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2020 to March 2022 were enrolled as research subjects.The artificial intelligence tongue mirror software was employed to collect the tongue images which were taken by iPhone XR.The Qihuang Data AI Workstation V2.0 was used to interpret and discriminate the tongue images,and to analyze the characteristics of tongue manifestations.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 cervical spondylosis were enrolled,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 classification,there were 39 cases 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 blood,63 cases of phlegm-dampness blocking collaterals,27 cases of liver and kidney sufficiency,28 cases of qi stagnation 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%),fissured 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%),followed 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 manifestation characteristics of patients with cervical spondylosis of different TCM syndromes.The tongues of patients with qi and blood deficiency syndrome were pale(n=25,59.52%)or light red(n=17,40.48%)with tooth marks(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 collaterals syndrome were light red(n=28,44.44%)with tooth marks(n=46,73.02%).The tongue fur was mostly white(n=25,39.68%),mixed yellow and white(n=25,39.68%),slightly thick(n=32,50.79%)or extremely thick(n=31,49.21%),greasy(n=58,92.06%),and moist(n=39,61.90%).The sublingual veins were dark red(n=38,60.32%),and the length 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 sufficiency syndrome were red(n=14,51.85%).The tongue fur was mostly white(n=21,77.78%),less(n=13,48.15%)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 mostly 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 wind-cold-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-cold and phlegm-dampness syndromes.

備注/Memo

備注/Memo:

基金項目:國家自然科學(xué)基金項目(81804114); 2022年全國名老中醫(yī)藥專家傳承工作室建設(shè)項目(國中醫(yī)藥人教函〔2022〕75號); 上海市2020年度“科技創(chuàng)新行動計劃”醫(yī)學(xué)創(chuàng)新研究專項項目(20MC1920600); 上海市臨床重點專科建設(shè)項目-中醫(yī)骨傷科(shslczdzk03901); 上海申康醫(yī)院發(fā)展中心重大臨床研究項目(SHDC2020CR1051B) 通訊作者:詹紅生 E-mail:[email protected]

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更新日期/Last Update: 1900-01-01