| Purpose:To explore the distribution rules of TCM syndrome elements and tongue image characteristics in patients with coronary heart disease accompanied by anxiety,summarize the distribution characteristics of TCM syndrome elements and tongue image among groups with different degrees of coronary heart disease accompanied by anxiety,and summarize the pathogenesis of TCM in patients with coronary heart disease accompanied by different degrees of anxiety.Material and method:In this study,inpatients diagnosed with coronary atherosclerotic heart disease were selected from the first Department of Cardiology and the Fifth Department of Cardiology in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from October 2021 to November 2022.A total of 240 subjects were collected according to the inclusion and exclusion criteria.All subjects were evaluated by Hamilton Anxiety Scale(HAMA),and were divided into groups according to the HAMA results,including 108 cases of coronary heart disease without anxiety state group(later called control group)and 132 cases of coronary heart disease with anxiety state group(later called test group)(72 cases of mild group,60 cases of moderate and severe group).General data,TCM syndrome elements information and tongue images were collected after admission.The tongue image was qualitatively analyzed from the aspects of tongue color,shape,color and quality by expert evaluation method.The Open CV algorithm was used to calculate the objective color RGB chrominance space and HSV for 5 areas of tongue image.Finally,SPSS22.0 statistical software was used for processing,and the distribution rules of TCM syndrome elements and tongue features of coronary heart disease accompanied by anxiety state were obtained,as well as the differences among groups with different levels of anxiety.Results:Distribution of TCM syndrome elements in experimental group and control group1.1 The distribution of syndrome elements in disease location(1)Distribution of syndrome elements in single site: the proportion of syndrome elements in liver in single site in experimental group was significantly higher than that in control group(P< 0.01).(2)Distribution of syndrome elements in multiple combination disease sites: the proportions of heart + liver and heart + liver + spleen in multiple combination disease sites in experimental group were higher than those in control group(P < 0.05).1.2 Distribution of pathogenic syndrome elements(1)Distribution of single syndrome elements: the proportion of blood stasis,qi stagnation and fire(heat)of single syndrome elements in experimental group was higher than that in control group(P < 0.05),but the proportion of qi deficiency and blood deficiency was lower than that in control group(P < 0.05).(2)Distribution of multi-combination syndromes: the proportions of multi-combination syndromes Qi-stagnation + blood stasis,qi-stagnation + blood stasis +Yin deficiency,qi-stagnation + blood stasis + Yin deficiency + fire(heat)in experimental group were higher than those in control group(P < 0.05).2.Distribution of TCM syndrome elements in different groups of coronary heart disease accompanied by anxiety state2.1 Distribution of disease location syndrome elements(1)Distribution of single site syndrome elements: The proportion of single site syndrome element liver in moderate and severe group was significantly higher than that in mild group(P< 0.01).(2)Distribution of syndrome elements of multi-combination disease location: there was no statistical significance in the distribution of syndrome elements of multi-combination disease location between the two groups.2.2 Distribution of pathogenic syndrome elements(1)Distribution of single syndromes: The proportion of single syndromes qi stagnation in moderate and severe group was higher than that in mild group(P < 0.05),while the proportion of qi deficiency was lower than that in mild group(P < 0.05).(2)Distribution of multi-combination syndromes: the proportion of multi-combination syndromes of qi stagnation + blood stasis in moderate and severe group was higher than that in control group(P < 0.05).3.Tongue characteristics of experimental group and control group3.1 Results of qualitative analysis(1)Tongue color characteristics: the proportions of red tongue and purple tongue in experimental groups were higher than those in control group(P < 0.05).(2)Tongue shape characteristics: The proportions of tongue with tooth marks and fat tongue in experimental group were higher than those in control group(P < 0.05).(3)Color characteristics: There was no statistical significance in the proportion of white,light yellow and yellow moss between the two groups.(4)Moss characteristics: the proportion of thick and greasy moss in test group was higher than that in control group(P < 0.05).3.2 Results of quantitative analysisQuantitative analysis results of tongue color features based on RGB and HSV color space models: It can be seen that H value in 5 zones of experimental group was lower than that in control group(P < 0.05),R and R/R+G+B values in zones 1,2,4 and 5 of experimental group were higher than that in control group(P < 0.05),R+B/R+G+B values in zones 2 and 5 of experimental group were higher than that in control group(P < 0.05),and V value in zone 5 of experimental group was lower than that in control group(P < 0.05).4.Tongue features of coronary heart disease associated with anxiety state among groups of different degrees4.1 Results of qualitative analysis(1)Tongue color characteristics: The proportion of light red tongue and red tongue in mild group was higher than that in moderate and severe group(P < 0.05).The proportion of Jiang tongue and Jiang purple tongue in moderate and severe group was higher than that in mild group(P < 0.05).(2)Tongue shape characteristics: The proportions of marked tongue,cracked tongue and punctured tongue in moderate and severe group were higher than those in mild group(P < 0.05).(3)Moss color characteristics: the proportion of white moss in mild group was significantly higher than that in moderate and severe group(P < 0.01),and the proportion of light yellow moss in moderate and severe group was higher than that in mild group(P < 0.05).(4)Moss characteristics: The proportion of thick and greasy moss in moderate and severe group was higher than that in mild group(P < 0.05).4.2 Results of quantitative analysisQuantitative analysis results of tongue color characteristics based on RGB and HSV color space models showed that H values in zone 1,3 and 4 of moderate-severe group were higher than those in mild group(P < 0.05),and V values in zone 4 and 5 of moderate-severe group were lower than those in mild group(P < 0.01).Conclusion:1.In patients with coronary heart disease accompanied by anxiety,single disease location syndromes are mainly liver;multi-combination disease location syndromes are mainly heart +liver,heart + liver + spleen;single disease syndromes are mainly blood stasis,qi stagnation and fire(heat);multi-combination disease syndromes are mainly Qi stagnation + blood stasis,Qi stagnation + blood stasis + Yin deficiency,Qi stagnation + blood stasis + Yin deficiency +fire(heat).(1)In the mild group of patients with anxiety,the single disease syndrome was mainly Qi deficiency;(2)In the moderate and severe group,the single location syndrome was dominated by liver,the single disease syndrome was dominated by qi stagnation,and the multi-combination disease syndrome was dominated by qi stagnation + blood stasis.2.There were differences in tongue quality and tongue coating among different groups of anxiety state associated with coronary heart disease.Compared with the control group,the tongue color of the experimental group is more likely to appear red tongue,purple tongue,tongue shape is more likely to appear tooth marks tongue,fat tongue,moss more likely to appear thick,greasy moss.And the tongue coating is distributed in the lower part of the tongue,the brightness is darker.(1)The tongue color of the mild group is more likely to appear light red tongue,red tongue,and white moss.(2)Tongue color of moderate and severe group is more likely to appear Jiang tongue,purple tongue,tongue shape is more likely to appear tooth mark tongue,crack tongue,punctured tongue,color is more likely to appear light yellow moss,moss quality is more likely to appear thick,greasy moss,and tongue coating distribution in the middle of the tongue spleen and stomach area and tongue root kidney area,brightness is darker. |
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