A Clinical Study Based On Lab Colour Model To Explore The Changes In Tongue Appearance Of Patients With Wilson’s Disease With Damp-heat Internalization In Gandou Decoction

ObjectivesTo study the characteristics of changes in tongue parameters before and after the treatment of patients with Wilson disease(WD)by Gandou decoction,and to explore the role of tongue parameters in the clinical efficacy evaluation of Chinese medicine in the treatment of WD.MethodsOne hundred and twenty patients with damp-heat internalized WD who met the inclusion criteria of this project and were hospitalized in the Brain Disease Center of Anhui Provincial Hospital from December 2021 to December 2022 were selected,and all included subjects were randomly divided into a treatment group of 60 cases and a control group of 60 cases.The control group was given DMPS to expel copper,while the treatment group was combined with Gandou decoction on the basis of the control group.The treatment regimen was 6 days of continuous copper expulsion treatment and2 days of calcium supplementation,executing 4 courses of treatment for a total of 32 days.The DS01-A Tongue and Pulse Information Acquisition Body Identification System(built-in Lab color model)of Dao Sheng Company was used to photograph the tongue images of patients at the time of admission and at the time of discharge,and the parameters of the photographed tongue images were calculated,and the SPSS26.0software was used to conduct statistics on the tongue parameters to observe the TCM clinical efficacy,TCM evidence score and alanine aminotransferase(ALT),before and after treatment in the treatment group and the control group,aspartate aminotransferase(AST),prealbumin(PA),albumin(ALB),total bile acid(TBA),collagen type IV(CIV),hyaluronic acid(HA),laminin(LN),and precollagen type III N-terminal peptide(PIIINP)levels,and analyzed the characteristics of changes in tongue parameters(LabL value,Lab-a value,and Lab-b value)before and after treatment.Results1.Clinical efficacy:(1)TCM syndrome score and efficacy: the total TCM syndrome score of the two groups after treatment was significantly decreased compared with that before treatment(P<0.01),and the decrease was more significant in the treatment group(P<0.01);After treatment,the total effective rate was 93% in the treatment group and 86% in the control group,and the curative effect of the treatment group was better than that of the control group(P<0.05).(2)Biochemical indices of liver function: the levels of ALT,AST,TBA,CIV,HA,LN and PIIINP were significantly decreased after treatment(P<0.01),while the levels of ALB and PA were significantly increased(P<0.01).The treatment group was better than the control group in improving the levels of AST,PA,HA,CIV and PIIINP(P<0.05),and significantly better than the control group in improving the levels of ALT,ALB,TBA and LN(P<0.01).2 Analysis of tongue image parameter change:(1)Change analysis of tongue parameters: after treatment,tongue color,tongue shape,coat color and coat substance were significantly changed compared with before(P<0.05),and after treatment,the coat color was significantly improved between the two groups(P<0.05),while the tongue color,tongue shape and coat substance were not significantly changed before and after treatment(P>0.05).After treatment,the Lab-L value and the Lab-L value of the whole tongue were significantly increased(P<0.05),while the Lab-a value,Lab-b value,Lab-a value and the Lab-b value of the whole tongue were significantly decreased(P<0.05).The treatment group had an advantage in improving the parameters of the whole tongue(P<0.05).(2)Analysis of changes in tongue tip parameters: After treatment,Lab-L value and LabL value of tongue tip and coated tongue tip significantly increased(P<0.05),while Laba value,Lab-b value,Lab-a value and coated tongue tip significantly decreased(P<0.05).Comparison between groups was statistically significant except for the tip of the tongue Lab-b value(P>0.05),and the treatment group had more advantages in improving the tip of the tongue parameter.(3)Analysis of the changes of parameters in the tongue: After treatment,the Lab-L value and Lab-L value in the tongue were significantly increased(P<0.05),while the Lab-a value,Lab-b value,Lab-a value and Lab-b value in the tongue were significantly decreased(P<0.05).The treatment group had an advantage in improving the parameters of the whole tongue(P<0.05).(4)Analysis of tongue edge parameter change: After treatment,the left Lab-L value of tongue,the right Lab-L value of tongue,the left Lab-L value of moss and the right LabL value of moss significantly increased(P<0.05).The left Lab-a value of the tongue,the left Lab-b value of the tongue,the right Lab-a value of the tongue,the right Lab-b value of the tongue,the left Lab-a value of the tongue,the left Lab-a value of the tongue,the left Lab-b value of the moss,the right lab-A value of the moss,and the right Lab-b value of the moss significantly decreased(P<0.05).The treatment group had more advantages in improving the parameters of the tongue.(5)Analysis of changes in tongue root parameters: After treatment,Lab-L value and Lab-L value of tongue root were significantly increased(P<0.05),while Lab-a value,Lab-b value,Lab-a value and Lab-b value of tongue root were significantly decreased(P<0.05).The comparison between groups had statistical significance except for Lab-L value and Lab-b value of tongue root(P>0.05),and the treatment group had more advantages in improving tongue root parameters.ConclusionThe tongue information and parameters of damp-heat internalized WD patients changed significantly after treatment with Gandou decoction,and the tongue parameters can be used as a new index for clinical efficacy evaluation in TCM.