| Purpose:To explore the characteristics of the tongue images of patients with phlegm and blood stasis syndrome and in-depth To analyze its differences in different age groups,to provide evidence and reference for the accurate differentiation of phlegm and blood stasis syndrome,and to provide a basis for clinical application of tongue images to guide the prevention and treatment of coronary heart disease with phlegm and blood stasis syndrome in different age groups.Material and method:In this study,inpatients with stable angina pectoris(also known as exertional angina pectoris)who were admitted to the Department of Cardiology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from November 2020 to November 2021 were selected as the inpatient diagnosis,and the included cases were divided into phlegm and blood stasis.Mutual connection syndrome group and control group,non-phlegm and blood stasis syndrome group.According to the WHO age classification standard: the groups of phlegm and blood stasis syndrome were divided into middle-aged group,young elderly group,and old-aged group.After admission,the general information and tongue images of the patients were collected.The tongue images were qualitatively analyzed in terms of tongue color,tongue shape,moss color and moss quality by the method of on-site evaluation by experts.Adobe Photoshop 2020 color extraction tool was used to extract the RGB and HSV color space values of tongue texture and tongue coating area in 5 partitions respectively.Semi-quantitative analysis of tongue shape and degree of tongue coating was carried out by expert degree assignment method.The proportion of each tongue feature,the score of expert degree assignment,and the R,G,B,H,S,and V values of tongue color and moss color were obtained.Finally,the SPSS24.0 statistical software was used to process,and the characteristics of tongue images of phlegm and blood stasis syndrome and their differences among different age groups were obtained.Results:1.Research results on the characteristics of tongue image between the phlegm and blood stasis syndrome group and the non-phlegm stasis syndrome group1.1 Characterization analysis results(1)Characteristics of tongue color: The proportions of red tongue,crimson tongue,purple tongue and dark purple tongue in the phlegm-stasis syndrome group were higher than those in the non-phlegm-stasis syndrome group(P<0.05).(2)Characteristics of tongue shape: The proportion of fat tongue and cracked tongue in the phlegm and blood stasis group was higher than that in the non-phlegm and blood stasis group(P<0.05).(3)Characteristics of fur color: the ratio of yellow fur in the phlegm and blood stasis group was higher than that in the non-phlegm and blood stasis group(P<0.05).(4)Characteristics of fur quality: The proportion of greasy fur,thick fur,and dry fur in the phlegm-stasis syndrome group was higher than that in the non-phlegm-stasis-stasis syndrome group(P<0.05).1.2 Quantification analysis results(1)Quantitative analysis results of tongue color characteristics based on RGB and HSV color space models: It can be seen that the G and B values of the tongue tip and the middle of the tongue in the phlegm and blood stasis syndrome group are higher than those in the non-phlegm and blood stasis syndrome group(P<0.05).The V values at the tip of the tongue and the middle of the tongue were lower than those in the non-phlegm and blood stasis group(P<0.05).Quantitative analysis results of moss color characteristics: in the phlegm and blood stasis syndrome group,the R and G values of the moss color components in the middle of the tongue and the base of the tongue were greater than those in the non-phlegm and blood stasis syndrome group,and the S value was lower than that in the non-phlegm and blood stasis syndrome group(P<0.05).(2)Quantitative analysis of the characteristics of tongue shape and fur quality based on the expert degree assignment method: The degree of fatness,cracks and prickling of the tongue in the phlegm and blood stasis syndrome group was higher than that in the non-phlegm and blood stasis syndrome group(P<0.01)..Thick fur and greasy fur on the tongue of the phlegm and blood stasis syndrome group were higher than those of the non-phlegm and blood stasis syndrome group(P<0.01).2.Research results of tongue characteristics in different age groups with blood stasis syndrome2.1 Characterization analysis results(1)Tongue color characteristics: The proportions of red tongue,crimson tongue,lilac tongue and purple tongue in the three age groups with phlegm and blood stasis syndrome were significantly different(P<0.05).The pairwise comparison results suggest that the proportion of red tongue in the middle-aged group is higher than that of the other two groups,the proportion of lilac tongue in the young elderly group is higher than that of the other two groups,and the proportion of crimson tongue and purple tongue in the elderly group is higher than that of the other two groups(P<0.05).(2)Tongue shape characteristics: The proportions of dentate tongue,fat big tongue,cracked tongue,old tongue and tender tongue were significantly different among the three age groups(P<0.05).The pairwise comparison results showed that the proportion of dentate tongue in the middle-aged group was higher than that in the young elderly group,the proportion of fat big tongue in the older-aged group was lower than that of the other two groups,and the proportions of cracked tongue,old tongue,and tender tongue in the older-aged group were all higher than the other two groups(P<0.05).(3)Characteristics of fur color: the proportion of white fur and pale yellow fur was significantly different among the three age groups(P<0.05).Pairwise comparison results showed that the proportion of white fur in the middle-aged group was higher than that in the other two groups,and the light yellow fur in the elderly group was higher than that in the other two groups(P<0.05).(4)Characteristics of fur quality: In the phlegm and blood stasis syndrome group,the proportion of greasy fur in the three age groups was the highest,and the difference in the proportion of greasy fur among the three age groups was statistically significant(P<0.05).Pairwise comparison results indicated that the proportion of greasy fur in the elderly group was lower than that in the other two groups(P<0.05).(5)Regional characteristics of tongue coating distribution in different age groups: The proportion of tongue coating distributed on the whole tongue,tongue tip,tongue edge,tongue middle and tongue base was significantly different among the three age groups(P<0.05).The pairwise comparison results showed that the proportion of tongue coating distributed on the whole tongue and the edge of the tongue was higher in the young elderly group than in the other two groups;The proportion of roots in the elderly group was higher than that in the other two groups(P<0.05).2.2 Quantification analysis results(1)Quantitative analysis results of tongue color characteristics of different age groups in the phlegm and blood stasis syndrome group based on RGB and HSV color space models: The R value of the tongue tip in the middle-aged group was greater than that of the young elderly group and the older groups(P <0.05),the overall V value of the tongue was greater than that of the other two groups(P<0.05),and the color G and B values of the middle and base of the tongue in the elderly group were greater than those in the middle-aged and the young elderly group(P<0.05).Quantitative analysis results of moss color characteristics: It can be seen that the V value of the fur color in the middle of the tongue in the middle-aged group is greater than that the young elderly group and the older groups(P<0.05),The R and G values of fur color at the root of tongue in the elderly group were higher than those in the middle-aged group and the young elderly group(P < 0.05),the V value was lower than that of middle-aged group and the young elderly group(P<0.05).(2)Quantitative analysis results of tongue shape and moss quality of different age groups in the phlegm and blood stasis syndrome group based on the expert degree assignment method: There are significant differences in the degree of cracks among the three age groups.The elderly group had the highest degree(P<0.05).Conclusion:1.Coronary heart disease group with phlegm and blood stasis syndrome group and non-phlegm and blood stasis syndrome group have differences in tongue quality and tongue coating.Compared with patients non-phlegm and blood stasis syndrome,the tongue color of patients with phlegm and blood stasis syndrome is more likely to appear red tongue,crimson tongue,purple tongue and dark purple tongue and the brightness is darker,and the tongue body is more prone to fat and cracks.more severe.The tongue coating is more yellow,the color saturation of the coating is lower and lighter,and the thick coating,greasy coating and dry coating are more likely to appear,and the thick and greasy coating is even worse.2.Coronary heart disease with phlegm and blood stasis syndrome different age groups have differences in tongue quality and tongue coating.(1)The tongue color of the middle-aged group was red and bright,the tongue body was fat and tooth marks,the tongue coating was greasy,and the color was brighter,and the tongue coating was mainly distributed in the tip of the tongue and the middle of the tongue,which were the middle-jiao and upper-jiao.(2)The young elderly group had lilac tongue,the tongue shape was fat and big,the tongue coating was mostly greasy,and the tongue coating was mostly distributed in the liver and gallbladder area at the edge of the tongue and the spleen and stomach area in the middle of the tongue.The disease location is mostly in the heart,liver,spleen and other organs.(3)In the elderly group,purple tongue with heavier blood stasis and crimson tongue with yin deficiency and fire were found.The tongue is darker and purplish,more prone to cracked tongue,and the tongue base is yellowish and darker,and is mostly distributed in the kidney and bladder areas of the lower-jiao at the heel of the tongue.3.RGB and HSV color models can reflect the phlegm and blood stasis syndrome of coronary heart disease and the objective characteristics and differences of tongue images between different age groups to a certain extent,and their objective parameters can restore the clinical phenomenon of TCM syndrome differentiation,which is similar to that of traditional Chinese medicine.Therefore,the objective parameters of tongue diagnosis RGB and HSV can be used as one of the objective reference indicators for TCM syndrome differentiation. |
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