| ObjectiveTo analyze the tongue image characteristics of different pain levels,pain etiology,pain nature,and break-through cancer pain in patients with cancer pain,to summarize the laws of tongue image parameters and provide objective reference data for tongue image of cancer pain.MethodsThis study began on December 1,2020 and ended on January 31,2023.A total of 120 cancer pain patients who met the inclusion criteria were selected from the Hematology and Oncology Department of Dongzhimen Hospital,Beijing University of Chinese Medicine.Use the TFDA-1 digital tongue diagnostic instrument to collect tongue images of subjects and process them using an objective measurement program for tongue diagnosis.One is to use Matlab software to process the tongue color and fur color in tongue images,and obtain objective parameters for the R value,G value,B value,L value,a value,b value,H value,S value,and V value of tongue color and fur color;The second is to use a joint local global tongue image multi label classification algorithm developed by Professor Cai Yiheng’s team from Beijing University of Technology to simultaneously extract crack and tooth mark labels,and obtain crack index and tooth mark index.Apply analysis of variance or non-parametric tests to analyze the overall pattern of tongue imaging in cancer pain patients and the differences in tongue imaging characteristics among different pain classifications.Results1.Objective characteristics of tongue imaging in patients with cancer pain with different pain severity scoresA total of 120 patients with cancer pain were included and divided into a mild pain group of 62 cases,a moderate pain group of 46 cases,and a severe pain group of 12 cases based on the pain intensity score.Compared with the mild pain group,the moderate pain group had higher tongue color R+B/R+G+B,G+B/R+G+B values,lower R+G+B,R/R+G+B,and a values,and higher tooth mark index,indicating that the tongue color had more purple and cyan components,less white and red components,and more obvious tooth mark characteristics.Compared with the mild pain group,the tongue color R+B/R+G+B,G+B/R+G+B,and S values in the severe pain group are higher,while the R+G+B,R/R+G+B,and a values are lower.The tooth mark index and crack index are higher,indicating that the tongue color has more purple and cyan components,deeper colors,fewer white and red components,and more obvious tooth mark and crack characteristics.Compared with the moderate pain group,the severe pain group has a-higher tongue color R+B/R+G+B,S values,and a higher tooth mark index,indicating that there are more purple.components in the tongue color,deeper colors,and more obvious features of tooth marks on the tongue surface.2.Objective Characteristics of Tongue Imaging in Cancer Pain Patients with break-through cancer pain120 patients with cancer pain were divided into an break-through cancer pain group of 42 cases and a non break-through cancer pain group of 78 cases based on whether the outbreak of pain occurred.Compared with the break-through cancer pain group,the non break-through cancer pain group had higher tongue color R+G+B,G+B/R+G+B,and L values,while R/R+G+B,R+B/R+G+B,and S values were lower.The tooth mark index was lower,indicating that the non break-through cancer pain group had an increase in white and blue components,a brighter brightness,a decrease in red and purple components,a lighter color,and less obvious tooth mark characteristics on the tongue surface.3.Objective characteristics of tongue imaging in patients with cancer pain caused by different causes of painAccording to the distribution of pain causes,120 patients with cancer related pain were divided into a cancer related pain group of 89 cases,an anti-cancer treatment related pain group of 20 cases,and a non-cancer related pain group of 11 cases.Compared with the cancer related pain group,the anti-cancer treatment related pain group has a higher tongue color R+B/R+G+B value,a lower V value,a higher coating color b and S value,and a higher crack index and tooth mark index,indicating an increase in purple components of tongue color,a darker brightness,an increase in yellow components of coating color,a deeper color,and more obvious features of tongue surface cracks and tooth marks.Compared with the cancer related pain group,the non-cancer factor pain group had a higher tooth scar index,indicating more distinct tooth scar characteristics.Compared with the pain group related to anti-cancer treatment,the non-cancer factor pain group has a higher tongue color V value,lower R+B/R+G+B value,lower fur color b and S value,and lower crack index,indicating a brighter tongue color,a decrease in purple component,a decrease in yellow component of for color,a lighter color,and less obvious tongue crack characteristics.4.Analysis of tongue imaging characteristics of cancer pain patients with different pain properties120 patients with cancer pain can be divided into 45 cases of physical pain,20 cases of visceral pain,15 cases of neuropathic pain,11 cases of psychogenic pain,and 29 cases of mixed pain according to the nature of the pain.Compared with the physical pain group,the psychogenic pain group has a lower crack index and a higher tooth mark index,indicating that the tongue surface crack feature is not obvious,while the tooth mark feature is obvious;The mixed pain group had a higher tooth mark index,indicating a more pronounced feature of tongue tooth marks.Compared with the visceral pain group,the psychogenic pain group has a lower crack index and a higher tooth mark index,indicating that the characteristics of tongue surface cracks are not obvious,while the tooth mark characteristics are obvious;The mixed pain group had a higher tooth mark index,indicating a more pronounced feature of tongue tooth marks.Compared with neuropathic pain,the psychogenic pain group has higher tongue color R/R+G+B,a,and S values,lower G+B/R+G+B values,higher coating color b values,and higher tooth mark index,indicating that the tongue color has more red components,darker colors,fewer cyan components,more yellow components,and more obvious tooth mark characteristics on the tongue surface;The mixed pain group had a higher crack index and tooth mark index,indicating more obvious features of tongue surface cracks and tooth marks.Compared with the psychogenic pain group,the mixed pain group has a higher tongue color G+B/R+G+B value,lower R/R+G+B and a values,and a higher crack index,indicating that there are more cyan components and less red components in the tongue color,and the characteristics of tongue surface cracks are more obvious.Conclusions1.Overall tongue imaging characteristics of patients with cancerous painMultiple pale purple tongues,pale white and yellowish fur,and dentate tongue,generally in line with the pathogenesis characteristics of blood stasis,heat toxicity,and spleen deficiency and dampness.2.Characteristics of tongue images in different pain classificationsThe higher the pain rating,the more blue and purple tongues,cracked tongues,and dentated tongues,and the more severe the degree of blood stasis,yin deficiency,and spleen deficiency with excessive dampness.When the break-through cancer pain occurs,the more crimson purple tongue and dentate tongue,the more severe the degree of blood stasis and spleen deficiency dampness.The pain associated with anti-tumor treatment is mostly dark purple tongue,light white,light yellow fur,cracked tongue,dentate tongue,blood stasis,heat toxicity,yin deficiency,and spleen deficiency with excessive dampness.Psychogenic pain often has a red tongue and yellow fur,and the degree of heat toxicity is more severe;Mixed pain often results in a blue purple tongue,cracked tongue,and dentate tongue,with a greater degree of blood stasis,yin deficiency,and spleen deficiency with excessive dampness. |
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