| Objective: To observe the tongue characteristics during the progression of LEAD in diabetic patients by using objective tongue diagnosis based on digital technology.To study the correlation and clinical significance between the progression of LEAD and tongue image objectification indicators in diabetic patients.Methods: The general medical history and laboratory examination indexes of the patients were collected by inquisition of medical history and laboratory examination,and the objective data of tongue image was collected by tongue diagnostic instrument.A total of 404 cases meeting the standards of intake and discharge in this study were collected,which were divided into four groups by Fontaine’s staging: stage I group,stage II group,stage III group and stage IV group.SPSS25.0 software was used to compare and analyze the changes and relationships among the general data,laboratory examination indexes and tongue image objectivation indexes among each group.Results: 1.Comparison of general data between groups: there were significant statistical differences in age,duration of diabetes,history of diabetic peripheral neuropathy,history of diabetic retinopathy,history of diabetic nephropathy,history of hypertension,BMI,WBC,GRAN,RBC,BUN,Cys-C,ALB,TC,TG,LDL-C and Hcy between the groups(P < 0.05).2.There were significant statistical differences in ABI among groups(P< 0.05),which showed a decreasing trend with the progression of LEAD.3.Objective indicators of tongue image between groups were compared as follows:(1)There were statistically significant differences in tongue color indexes in TN-H,TN-I,TN-S,TN-L,TN-a,TN-Y and TN-Cr values(P< 0.05);(2)There were statistically significant differences in tongue texture indexes in TN-CON、TN-ASM,TN-MEAN and TN-ENT values(P < 0.05).(3)There were significant differences in tongue coating color in TF-H,TF-I,TF-S,TF-L,TF-Y and TF-Cr values(P < 0.05).(4)There were statistical differences in tongue coating texture indexes in TF-ASM,TF-ENT and TF-MEAN values(P < 0.05).(5)There was statistical difference in the index of tongue coating thickness in per All values(P < 0.05).4.Correlation analysis of objectification index of tongue image and DLEAD-Fontaine’s stage shows that:(1)Dl EAD-fontaine’s staging was positively correlated with TN-S,TN-b,TN-ASM,TN-S,TF-ASM,per All,and negatively correlated with TN-H,TN-I,TN-L,TN-a,TN-Y,TN-Cr,TN-CON,TN-ENT,TN-MEAN,TF-H,TF-I,TF-L,TF-Y,TF-Cr,TF-CON,TF-ENT,TF-MEAN,per Part;(2)ABI values were positively correlated with TN-H,TN-I,TN-L,TN-a,TN-Y,TN-Cr,TN-CON,TN-MEAN,TF-H,TF-I,TF-L,TF-a,TF-Y,TF-Cr,TF-CON,TF-ENT,TF-MEAN,per Part,and negatively correlated with TN-S,TF-S,TF-ASM,per All.5.In the independent risk factor analysis study of DLEAD-Fontaine’s stage,it was found that the duration of diabetes(OR=1.07,95%CI: 1.03-1.11),LDL-C(OR=1.67,95%CI: 1.32-2.10),HCY(OR=1.05,95%CI: 1.01-1.10),smoking history(OR=1.77,95%CI:1.01-3.10),a history of diabetic peripheral neuropathy(OR=2.43,95%CI =1.45-4.06)and a history of hypertension(OR=2.32,95%CI: 1.43-3.75)were independent risk factors for Dl EAD-Fontaine’s staging.Conclusion: 1.The duration of diabetes,LDL-C,Hcy,smoking history,history of diabetic peripheral neuropathy,and history of hypertension were independent risk factors for DLEAD progress.2.As DLEAD progresses,the tongue becomes darker,bluish and more delicate in texture.The tongue coating is more thick,greasy and dark.It suggested that with the progress of DLEAD,Qi deficiency,blood stasis,phlegm and dampness were gradually aggravated in pathogenesis,and the disease was also gradually aggravated.3.There is a certain correlation between objectification parameters of tongue image and DLEAD-Fontaine’s stage and ABI value.Objective indicators of tongue diagnosis can not only be used as one of the objectification reference methods to judge the severity,prognosis and efficacy evaluation of DLEAD patients,but also have a certain significance for the prevention and treatment of DLEAD in traditional Chinese medicine. |
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