| Paper one A Quantitative Study on Characteristics of the Collaterals in Sclera-conjunctiva of Qi Deficiency and Blood Stasis Syndrome in Convalescent Stroke Based on the Theory of Diagnosis by Inspecting EyesPurpose: Based on the theory diagnosis by inspecting eyes of Peng's eye acupuncture,using bulbar conjunctiva microcirculation(BCM)quantitative analysis of modern medicine,observing the characteristics of collaterals in sclera-conjunctiva between healthy volunteers group and the group of patients with Qi deficiency and blood stasis syndrome in convalescent stroke.Analyzing the difference between two groups by using quantitative indexes,in order to provide the quantitative morphological basis for the theory of diagnosis by inspecting eyes.Method: 71 patients of Qi deficiency and blood stasis syndrome in convalescent stroke were screened from the Rehabilitation center of affiliated hospital of Liaoning university of Traditional Chinese medicine(TCM).And they were included as Qi deficiency and blood stasis syndrome group.At the same time,70 healthy volunteers were screened from family members of the teachers and students of Liaoning university of TCM and the patients' family members.70 cases were included as healthy volunteers group.Gender and age of subjects were registered respectively in the microcirculation image analysis system.The distribution of the collaterals in sclera-conjunctiva and the local microcirculation images of the two groups were recorded by microcirculation detector,according to the division of the acupoint area in the theory of diagnosis by inspecting eyes.The subjects of the two groups were compared in gender,age,abnormal frequency of the collaterals in sclera-conjunctiva in each acupoint area of the eyes,and the number of microvessels,the diameter of venule and arteriole,the ratio of venule and arteriole,the integral of clarity,net structure,irregular diameter of vessels,uneven edge,irregular distribution of vessels,cystic dilatation,micro hemangioma,ischemic area,blood color of the collaterals in sclera-conjunctiva.And the comprehensive score and sub-scores of the collaterals in sclera-conjunctiva were calculated and compared between the two groups,according to the comprehensive quantitative evaluation method of Tian's bulbar conjunctival microcirculation.The variation of the quantitative index of the collaterals in sclera-conjunctiva was compared with the variation of the collaterals in sclera-conjunctiva of the Qi deficiency and blood deficiency syndrome in the theory of Peng's diagnosis by inspecting eyes.Statistical Product and Service Solutions(SPSS)26.0 software was used for statistical analysis of data.Result:1.The abnormal frequency of the collaterals in sclera-conjunctiva in the Qi deficiency and blood stasis syndrome group were significantly higher than that in the healthy volunteers group(P<0.05).While there was no significantly different between the left eye and the right eye in the same group(P>0.05).2.The abnormal frequency in area 7(the Spleen and Stomach region)of the collaterals in sclera-conjunctiva of the Qi deficiency and blood stasis syndrome group was significantly higher than that of the healthy subjects group(P<0.05).There was no significant difference in abnormal frequency in other regions(P>0.05).3.The comprehensive score of the Spleen and Stomach region of the collaterals in sclera-conjunctiva of the Qi deficiency and blood stasis syndrome group was significantly higher than that in the healthy volunteers group(P<0.05).4.Comparison of quantitative indexes of the collaterals in sclera-conjunctiva in the Spleen and Stomach region between the two groups: The number of microvessels and the diameter of venule in the Qi deficiency and blood stasis syndrome group were significantly lower than those in the healthy group(P<0.05).There was no significant difference in the diameter of arteriole and the ratio of venule and arteriole between the two groups(P>0.05).The integral of clarity and the number of microvessels of the Qi deficiency and blood stasis syndrome group was significantly lower than that in healthy volunteers group(P<0.05).The abnormal degree of diameter of vessels,blood color and the distribution of vessels of the Qi deficiency and blood stasis syndrome group was higher than that in healthy volunteers group(P<0.05).The number of micro hemangioma and ischemic area of the Qi deficiency and blood stasis syndrome group were significantly more than that in the other group(P<0.05).There was no significant difference between the two groups in the net structure,uneven edge and cystic dilatation of the collaterals in sclera-conjunctiva(P>0.05).5.Comparison of quantitative score of collaterals in sclera-conjunctiva in the Spleen and Stomach region between the two groups: The quantitative score of Qi deficiency and blood stasis syndrome group was significantly higher than that of the healthy group in the the integral of clarity,microvascular number,the diameter of venule and arteriole,irregular diameter of vessels,irregular distribution of vessels,micro hemangioma,ischemic area and blood color(P<0.05).There was no significant difference between the two groups in the net structure,the ratio of venule and arteriole,uneven edges and cystic dilatation score of the collaterals in sclera-conjunctiva(P>0.05).Preliminary Conclusion:1.The collaterals in sclera-conjunctiva of the Spleen and Stomach region of the patients with Qi deficiency and blood stasis syndrome in convalescent stroke was different from that of the healthy volunteers.2.The characters of collaterals in sclera-conjunctiva in Spleen and Stomach region on patients with Qi deficiency and blood stasis syndrome in convalescent stroke:(1)General character: The surface of sclera-conjunctiva and collaterals on it in Spleen and Stomach region were fuzzy and poor developing.And collaterals was mainly light red.(2)Shape character of collaterals: The collaterals were slim and often irregular diameter of vessels.The shape of collaterals was abnormal.And petechiae was often seen on the collaterals.(3)Distribution character of collaterals: The number of collaterals decreased.The areas of ischemic and no collaterals distribution increased.3.All those changes of quantitative index of collaterals in sclera-conjunctiva of patients with Qi deficiency and blood stasis syndrome in convalescent stroke collected by conjunctiva microcirculation detector was the same as professor Peng's description of paleness color,thinness and little black spot of collaterals in the theory of diagnosis by inspecting eyes..The study can provide some objective quantitative evidence for the theory.Paper two The Study on Intelligent Diagnostic Model of Qi Deficiency and Blood Stasis Syndrome in the Convalescent Stroke Based on the Theory of Diagnosis by Inspecting EyesPurpose: In this study,the patients of Qi deficiency and blood stasis syndrome in convalescent stroke were used as research objects.Based on the theory of diagnosis by inspecting eyes,the microcirculation image analysis system was used to collect the quantitative data of the collaterals in sclera-conjunctiva.Combined the quantitative data with clinical data,the syndrome diagnosis model of Qi deficiency and blood stasis syndrome of apoplexy was constructed.The accuracy of the diagnostic model in predicting syndrome types was evaluated and the characteristic variables of Qi deficiency and blood stasis syndrome was screened.The study would provide methods and basis for more effective and accurate syndrome differentiation and treatment of the stroke.Method: According the inclusion criteria,a total of 71 cases of convalescent patients with Qi deficiency and blood stasis syndrome of stroke were included as the Qi deficiency and blood stasis syndrome group,and 118 cases of non-qi deficiency and blood stasis syndrome were included as the non-qi deficiency and blood stasis syndrome group.Based on the theory of diagnosis by inspecting eyes,the microcirculation image analysis system was used to collect the quantitative data of the collaterals in sclera-conjunctiva.The patients of general data(gender,age,educational background,disease course),physical data(height,weight),neurological function evaluation data(National Institute of Health stroke scale,NHISS)and the symptoms data of TCM were collected.All the collected data was entered into the database by double entry method,the quantitative data of the collaterals in sclera-conjunctiva,general data,physical data,neurological function evaluation data and symptoms data of TCM were compared between the two groups.The comparability of the two groups of patients and the specificity of the quantitative data of the collaterals in sclera-conjunctiva and the TCM symptoms data were analyzed.And the difference of the collaterals in sclera-conjunctiva were compared and analyzed with the diagnosis theory by inspecting eyes.The syndrome diagnosis model of Qi deficiency and blood stasis syndrome in convalescent stroke was constructed by using the quantitative data of white eyeball complex,general data,physical data,neurological function evaluation data and symptoms data of TCM.Because of the problems of high-dimensional,high-order,nonlinear,fuzzy and difficult to measure the importance of each factor in the above five kinds of observational data,the random forest algorithm in the field of machine learning was introduced into the diagnosis model of Qi deficiency and blood stasis syndrome in the convalescent stroke.The random forest algorithm was used to construct an intelligent diagnosis model of Qi deficiency and blood stasis syndrome in the convalescent stroke.And the research subjects were randomly divided into training sets and test sets in a ratio of 2:1,which were 127 cases and 62 cases.The intelligent diagnosis model was obtained by training the training set.Then the test set was used to verify the diagnosis model,and the accuracy of the model prediction and the area under the ROC curve(AUC value)were analyzed.Mean Decrease Accuracy and Mean Decrease Gini were used to observe the importance of observation indicators on whether the recovery period of stroke was characterized by Qi deficiency and blood stasis syndrome.And the top 10 variables were selected as the characteristic variables of Qi deficiency and blood stasis syndrome.Result:1.There was no significant difference in general data,physical data and neurological function evaluation data(NHISS)between the two groups(P>0.05).In the comparison of the symptom data of TCM,the severity of shortness of breath and fatigue and spontaneous sweating in the Qi deficiency and blood stasis syndrome group was significantly higher than that in the non-qi deficiency and blood stasis syndrome group(P<0.05).In the comparison of the quantitative data of collaterals in sclera-conjunctiva,there was no significant difference in the total score between the two groups(P>0.05).While the number of microvessels and the diameter of venule and arteriole of the Qi deficiency and blood stasis syndrome group were significantly less than that in the non-qi deficiency and blood stasis syndrome group(P<0.05).The integral of clarity and the net structure of the Qi deficiency and blood stasis syndrome group was significantly lower than that in the non-qi deficiency and blood stasis syndrome group(P<0.05).The number of micro hemangioma and ischemic area of the Qi deficiency and blood stasis syndrome group were significantly more than that in the other group (P<0.05).And the abnormal degree of blood color was higher than that in the other group(P<0.05).2.The OOB error of this model was 21.26%,so the model had strong generalization ability.For the test data,the predictive Accuracy of the model was 88.71%,the Specificity of the Qi deficiency and blood stasis syndrome was 87.18%,and the Sensitivity was 91.30%.For the full sample,the total predictive Accuracy was 96.30%,the Specificity of Qi deficiency and blood stasis syndrome was 95.76%,and the Sensitivity was 97.18%.The test data prediction model has an accuracy of 0.89,and the AUC value was 0.959>0.9,which has a high prediction accuracy.3.In this study,two methods,Mean Decrease Accuracy and Mean Decrease Gini,were used to observe the importance of independent variables for the model.The results of the two calculation methods all showed that the quantitative indicators of the collaterals in sclera-conjunctiva accounted for the largest proportion,among which the parameters of the blood color,the number of microvessels,the diameter of venule and arteriole contributed a great deal to the model.Preliminary Conclusion:1.In the study,it was found that the number of blood vessels,the diameter of venule and arteriole of the collaterals in sclera-conjunctiva of Qi deficiency and blood stasis syndrome in the convalescence stroke were significantly reduced compared with those with non-qi deficiency and blood stasis syndrome.The integral of clarity and the net structure of Qi deficiency and blood stasis syndrome were significantly lower than those with non-qi deficiency and blood stasis syndrome.While the number of microhemangiomas,ischemic areas and the abnormal degree of blood color abnormality were significantly increased compared with those with non-qi deficiency and blood stasis syndrome.All those changes of quantitative index of collaterals in sclera-conjunctiva of patients with Qi deficiency and blood stasis syndrome in convalescent stroke collected by BCM detector were basically consistent with professor Peng's description of paleness color,thinness and little black spot of collaterals in the theory of diagnosis by inspecting eyes.In the comparison of other clinical data,there was significant difference in the severity of shortness of breath and asthenia and spontaneous sweating.It was suggested that the quantitative data of the collaterals in sclera-conjunctiva may serve as the basis for syndrome differentiation of Qi deficiency and blood stasis.2.The prediction accuracy of the intelligent diagnosis model of Qi deficiency and blood stasis syndrome of stroke was relatively high,which can significantly improve the objectivity and accuracy of the syndrome differentiation in the stroke.The intelligent diagnosis model provided a simple and feasible scheme for the syndrome differentiation of stroke and some theoretical basis for the establishment of remote artificial intelligence TCM diagnosis and treatment platform.3.Through the comparison of the importance of the observation indicators,it was found that the quantitative parameters of the collaterals in sclera-conjunctiva had the highest contribution in the construction of the diagnostic model,indicating that the quantitative parameters of the collaterals in sclera-conjunctiva had important significance in the diagnosis of Qi deficiency and blood stasis syndrome in convalescence stroke.That is to say,the theory of diagnosis by inspecting eyes played an important role in the syndrome differentiation.The study also provided some ideas for the research of other TCM syndromes diagnosis.Conclusion:1.The collaterals in sclera-conjunctiva of the Spleen and Stomach region of the patients with Qi deficiency and blood stasis syndrome in convalescent stroke was different from that of the healthy volunteers.The main performance in the collaterals of sclera-conjunctiva were dropping of the clarity of the collaterals,the light red color of the collaterals,decreasing of the number of the collaterals and the diameter of vein and arteriole,increase of irregular diameter of vessels and arteriole,irregular distribution of vessels,micro hemangioa and the ischemic area of the collaterals.2.The collaterals in sclera-conjunctiva of the Spleen and Stomach region of the patients with Qi deficiency and blood stasis syndrome in convalescent stroke was also different from that of the patients with non-qi deficiency and blood stasis syndrome.The main performance in the collaterals of sclera-conjunctiva were dropping of the clarity of the collaterals,the light red color of the collaterals,decreasing of the number of the collaterals and the diameter of vein and arteriole and increase of micro hemangioa and the ischemic area of the collaterals.While the collaterals in sclera-conjunctiva of the patients with non-qi deficiency and blood stasis syndrome had more net structure.3.All those changes of quantitative index of collaterals in sclera-conjunctiva of patients with Qi deficiency and blood stasis syndrome in convalescent stroke collected by conjunctiva microcirculation detector was basically consistent with professor Peng's diagnosis theory by inspecting eyes.The study can provide abundant quantitative morphological basis for the theory.4.The prediction accuracy of the intelligent diagnosis model of Qi deficiency and blood stasis syndrome of stroke was relatively high,which can significantly improve the objectivity and accuracy of the syndrome differentiation in the stroke.The intelligent diagnosis model provided an accurate and objective feasible scheme for the identification of apoplexy syndrome.5.The quantitative parameters of the collaterals in sclera-conjunctiva had important significance in the diagnosis of Qi deficiency and blood stasis syndrome in convalescence stroke.That is to say,the theory of diagnosis by inspecting eyes played an important role in the syndrome differentiation.Objective quantification of the theory of diagnosis by inspecting eyes was a method with high reliability and feasibility in the syndrome differentiation. |
PDF Full Text Request