A Longitudinal Study On Tongue Images And Efficacy Indicators In Patients With Phlegm And Blood Stasis Syndrome Undergoing PCI For Acute Myocardial Infarctio

Purpose:To explore the changes of syndrome score,curative effect index,tongue image,lips and their color characteristic parameters at three different time points before and after coronary intervention(PCI)in patients with phlegm and blood stasis syndrome of acute myocardial infarction(AMI),and integrate computer vision technology into the clinical curative effect evaluation system of traditional Chinese medicine,so as to provide a theoretical basis for its objective development.Material and method:43 cases of AMI patients with phlegm and blood stasis syndrome diagnosed in cardiology ward and undergoing PCI were collected.The general data and operation records were recorded by case series report method,and the changes of syndrome score,blood routine,myocardial enzyme spectrum and other curative indexes at three different time points before,24 hours after and 7 days after PCI were collected.The tongue and lip pictures were taken,and the characteristics were analyzed by expert assignment method.The tongue and lip images were analyzed by image processing technology The characteristic differences of lip color characteristic parameters RGB and HSV values,so as to obtain the changes of tongue image,lip and curative effect indexes of AMI patients with phlegm and blood stasis syndrome at different time points before and after PCI.Results:1.The study included male patients,smoking and drinking history,hypertension and type 2diabetes.Most types of AMI are acute inferior myocardial infarction,and the diseased vessels are mainly lad and RCA.Gensini scores are mainly distributed between 32-54 zones.2.The changes of chest pain,chest tightness,palpitation,shortness of breath,mental fatigue and dark lips at different time points in the "syndrome score table for curative effect evaluation of coronary heart disease and angina pectoris(phlegm and blood stasis syndrome)" were statistically significant(P < 0.05);Palpitation,shortness of breath,mental fatigue and dark purple lips decreased with the progress of observation time.3.Among the laboratory related efficacy indexes,leukocyte count,neutrophil percentage and c Tn I increased within 24 hours after PCI compared with those before PCI and 7 days after PCI(P < 0.01).CK-MB was higher before PCI and decreased gradually with the progress of observation time.4.The tongue characteristics of AMI patients with phlegm and blood stasis syndrome were dark within 24 hours after PCI;The values of color characteristic parameters R,G,B,h and V were lower than those before and 7 days after operation(P < 0.05),especially the values of R,B and V were more obvious(P < 0.01),which was consistent with the characteristic parameters of sublingual choroid;The thickness and greasiness of fur decreased gradually with the progress of observation time,and the values of color characteristic parameters R and s decreased gradually(P < 0.05);The red degree of lips decreased gradually with the progress of observation time,the values of color characteristic parameters R and B decreased gradually(P < 0.05),and the value of V increased significantly(P < 0.01).Conclusion:The changes of tongue image,lips and their color characteristic parameters reflect the curative effect at different time points before and after PCI to a certain extent,which provides a new idea and method for establishing a clinical curative effect evaluation system with the objective characteristics of traditional Chinese medicine.