[1]王玉鹏,杜国庆,邓真,等.基于人工智能舌镜技术的颈椎病患者舌象特征定性描述研究[J].中医正骨,2023,35(02):10-14,29.
　WANG Yupeng,DU Guoqing,DENG Zhen,et al.Qualitative description of the characteristics of tongue manifestations in patients with cervical spondylosis based on artificial intelligence tongue mirror technology[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(02):10-14,29.
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基于人工智能舌镜技术的颈椎病患者舌象特征定性描述研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年02期
页码:
10-14,29
栏目:
临床研究
出版日期:
2023-02-20

文章信息/Info

Title:
Qualitative description of the characteristics of tongue manifestations in patients with cervical spondylosis based on artificial intelligence tongue mirror technology
作者:
王玉鹏1; 杜国庆2; 邓真3; 李正言1; 熊轶喆1; 王翔1; 庞坚2; 周敏4; 詹红生2
(1.上海中医药大学附属曙光医院,上海 201203; 2.上海中医药研究院骨伤科研究所,上海 201203; 3.上海市宝山区中西医结合医院,上海 201999; 4.上海中医药大学,上海 201203)
Author(s):
WANG Yupeng1; DU Guoqing2; DENG Zhen3; LI Zhengyan1; XIONG Yizhe1; WANG Xiang1; PANG Jian2; ZHOU Min4; ZHAN Hongsheng2
1.Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China 2.The Institute of Traumatology and Orthopedics Affiliated to Shanghai Academy of Traditional Chinese Medicine,Shanghai 201203,China3.Shanghai Baoshan Hospital of Integrated Chinese and Western Medicine,Shanghai 201999,China4.Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China
关键词:
颈椎病;  舌诊;  人工智能;  定性描述
Keywords:
cervical spondylosis;  tongue inspection;  artificial intelligence;  qualitative description
摘要:
目的:分析颈椎病患者的舌象特征。方法:以2020年6月至2022年3月在上海中医药大学附属曙光医院就诊的颈椎病患者为研究对象。运用人工智能舌镜软件采集受试者舌图(拍摄设备为iPhone XR手机),利用岐黄数据AI工作站V2.0对采集到的舌图进行解读、判别,分析舌象特征,定性分析参数包括舌色、舌形、苔色、苔质、舌下络脉。结果:①一般情况。共纳入201例颈椎病患者,男66例、女135例; 年龄19～85岁,中位数49岁; 病程3 d至10年,其中病程≤3个月者占31.34%; 颈型颈椎病39例,神经根型颈椎病75例,脊髓型颈椎病17例,椎动脉型颈椎病30例,交感神经型颈椎病38例,食管型颈椎病2例; 气血亏虚证42例,痰湿阻络证63例,肝肾不足证27例,气滞血瘀证28例,风寒湿证41例; 舌象正常者23例,异常者178例。②颈椎病患者舌象的总体特征。纳入的201例颈椎病患者的舌色以淡红(82例,40.80%)、暗红(51例,25.37%)为主; 在舌形方面,大部分患者有齿痕(139例,69.15%),部分患者也存在胖(68例,33.83%)、裂纹(42例,20.90%)、娇嫩(37例,18.41%)等舌形异常; 苔色以白色(146例,72.64%)为主; 苔质多薄(99例,49.25%)、润(123例, 61.19%),部分患者表现为腻苔(98例,48.76%); 舌下络脉色泽多为暗红(128例,63.68%),主干长度和宽度多正常(145例,72.14%; 166例,82.59%)。③不同证候颈椎病患者的舌象特征。气血亏虚证患者舌色为淡(25例,59.52%)或淡红(17例,40.48%),有齿痕(37例,88.10%); 苔色多为白色(39例,92.86%),苔质薄(36例,85.71%)、润(37例,88.10%); 舌下络脉色泽暗红(35例,83.33%),主干长度和宽度多正常(36例,85.71%; 42例,100.00%)。痰湿阻络证患者舌色多为淡红(28例,44.44%),有齿痕(46例,73.02%); 苔色多为白色(25例,39.68%)和黄白相兼(25例,39.68%),苔质稍厚(32例,50.79%)或极厚(31例,49.21%)、腻(58例,92.06%)、润(39例,61.90%); 舌下络脉色泽暗红(38例,60.32%),主干长度和宽度多正常(46例,73.02%; 55例,87.30%)。肝肾不足证患者舌色多为红(14例,51.85%); 苔色多为白色(21例,77.78%),苔质少(13例,48.15%)或薄(11例,40.74%)、润(17例,62.96%); 舌下络脉色泽暗红(18例,66.67%),主干长度和宽度多正常(20例,74.07%; 24例,88.89%)。气滞血瘀证患者舌色多为暗红(21例,75.00%),多有齿痕(16例,57.14%); 苔色多为白色(22例,78.57%),苔质薄(18例,64.29%)、润(22例,78.57%); 舌下络脉色泽紫黑(16例,57.14%),主干长度和宽度多正常(22例,78.57%; 23例,82.14%)。风寒湿证患者舌色多为淡红(31例,75.61%),多有齿痕(30例,73.17%); 苔色多为白色(39例,95.12%),苔质薄(34例,82.93%)、滑(33例,80.49%); 舌下络脉色泽紫黑(35例,85.37%),主干长度和宽度多正常(37例,90.24%; 40例,97.56%)。结论:颈椎病患者的舌象具有舌色淡红、有齿痕、舌苔薄白而润、舌下络脉正常等特征,提示颈椎病患者多存在气虚,兼有风寒、痰湿的证候。
Abstract:
Objective:To analyze the characteristics of tongue manifestations in patients with cervical spondylosis.Methods:Patients with cervical spondylosis admitted to Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2020 to March 2022 were enrolled as research subjects.The artificial intelligence tongue mirror software was employed to collect the tongue images which were taken by iPhone XR.The Qihuang Data AI Workstation V2.0 was used to interpret and discriminate the tongue images,and to analyze the characteristics of tongue manifestations.The parameters,such as tongue color,tongue form,fur color,fur texture,and sublingual veins,were qualitatively analyzed.Results:①General information.A total of 201 patients with cervical spondylosis were enrolled,including 66 males and 135 females.The age ranged from 19 to 85 years,with a median of 49 years.The course of disease ranged from 3 days to 10 years,and 31.34% of patients had the course of disease of≤3 months.In terms of cervical spondylosis classification,there were 39 cases of neck type,75 cases of nerve root type,17 cases of spinal cord type,30 cases of vertebral artery type,38 cases of sympathetic nerve type,and 2 cases of esophagus type.In terms of traditional Chinese medicine(TCM)syndrome,there were 42 cases of deficiency of qi and blood,63 cases of phlegm-dampness blocking collaterals,27 cases of liver and kidney sufficiency,28 cases of qi stagnation and blood stasis,and 41 cases of wind,cold,and dampness.In terms of tongue manifestations,there were 23 normal cases and 178 abnormal cases.②General characteristics of tongue manifestations in patients with cervical spondylosis.The tongues of 201 patients with cervical spondylosis were mainly light red(n=82,40.80%)and dull red(n=51,25.37%).In terms of tongue form,most patients showed teeth-marked tongues(n=139,69.15%),and some patients also showed abnormal tongue forms,such as fat tongues(n=68,33.83%),fissured tongues(n=42,20.90%),and tender tongues(n=37,18.41%).The tongue fur was mainly white(n=146,72.64%).In terms of fur texture,the tongue fur was mainly thin(n=99,49.25%)and moist(n=123,61.19%),followed by greasy fur(n=98,48.76%).The sublingual veins was mostly dark red(n=128,63.68%),and the length and width of the main trunk were mostly normal(n=145,72.14%; n=166,82.59%).③Tongue manifestation characteristics of patients with cervical spondylosis of different TCM syndromes.The tongues of patients with qi and blood deficiency syndrome were pale(n=25,59.52%)or light red(n=17,40.48%)with tooth marks(n=37,88.10%).The tongue fur was mostly white(n=39,92.86%),thin(n=36,85.71%),and moist(n=37,88.10%).The sublingual veins were dark red(n=35,83.33%),and the length and width of the main trunk were mostly normal(n=36,85.71%; n=42,100.00%).The tongues of patients with phlegm-dampness blocking collaterals syndrome were light red(n=28,44.44%)with tooth marks(n=46,73.02%).The tongue fur was mostly white(n=25,39.68%),mixed yellow and white(n=25,39.68%),slightly thick(n=32,50.79%)or extremely thick(n=31,49.21%),greasy(n=58,92.06%),and moist(n=39,61.90%).The sublingual veins were dark red(n=38,60.32%),and the length and width of the main trunk were mostly normal(n=46,73.02%; n=55,87.30%).The tongues of patients with liver and kidney sufficiency syndrome were red(n=14,51.85%).The tongue fur was mostly white(n=21,77.78%),less(n=13,48.15%)or thin(n=11,40.74%),and moist(n=17,62.96%).The sublingual veins were dark red(n=18,66.67%),and the length and width of the main trunk were mostly normal(n=20,74.07%; n=24,88.89%).The tongues of patients with qi stagnation and blood stasis syndrome were dull red(n=21,75.00%)with tooth marks(n=16,57.14%).The tongue fur was mostly white(n=22,78.57%),thin(n=18,64.29%),and moist(n=22,78.57%).The sublingual veins were purple-black(n=16,57.14%),and the length and width of the main trunk were mostly normal(n=22,78.57%; n=23,82.14%).The tongues of patients with wind-cold-dampness syndrome were light red(n=31,75.61%)with tooth marks(n=30,73.17%).The tongue fur was mostly white(n=39,95.12%),thin(n=34,82.93%),and slippery(n=33,80.49%).The sublingual veins were purple-black(n=35,85.37%),and the length and width of the main trunk were mostly normal(n=37,90.24%; n=40,97.56%).Conclusion:The tongue manifestations of patients with cervical spondylosis are characterized by light red tongues with tooth marks and thin,white and moist tongue fur,and normal sublingual veins,which suggest that patients with cervical spondylosis mostly have qi deficiency combined with wind-cold and phlegm-dampness syndromes.

参考文献/References:

[1] 中华外科杂志编辑部.颈椎病的分型、诊断及非手术治疗专家共识(2018)[J].中华外科杂志,2018,56(6):401-402.
[2] 詹红生.颈椎相关疾病手法诊疗及研究中的若干问题探讨[J].中医正骨,2018,30(3):1-3.
[3] 李灿东,方朝义.中医诊断学[M].北京:中国中医药出版社,2021:104-127.
[4] 颜建军,李东旭,郭睿,等.基于深度学习和随机森林的齿痕舌分类研究[J].中华中医药学刊,2022,40(2):19-22.
[5] 江智泉,周作建,鲍剑洋,等.人工智能背景下的中医舌诊客观化研究概述[J].计算机时代,2022,355(1):1-4.
[6] 郭仪,许斌,胡楠.人工智能在辅助中医临床领域的研究现状与展望[J].中华中医药学刊,2021,39(6):76-78.
[7] 孙忠人,游小晴,韩其琛,等.人工智能在中医药领域的应用进展及现状思考[J].世界科学技术-中医药现代化,2021,23(6):1803-1811.
[8] 李军,胡晓娟,周昌乐,等.基于随机森林算法的糖尿病舌象特征分析和诊断模型研究[J].中华中医药杂志,2022,37(3):1639-1643.
[9] BLANPIED P R,GROSS A R,ELLIOTT J M,et al.Neck pain:revision 2017[J].J Orthop Sports Phys Ther,2017,47(7):A1-A83.
[10] COHEN S P,HOOTEN W M.Advances in the diagnosis and management of neck pain[J].BMJ,2017,358:j3221.
[11] 中医康复临床实践指南·项痹(颈椎病)制定工作组.中医康复临床实践指南·项痹(颈椎病)[J].康复学报,2020,30(5):337-342.
[12] 詹红生,冷向阳,谭明生.中医骨伤科学[M].2版.北京:人民卫生出版社,2021:311.
[13] 灵枢经[M].北京:人民卫生出版社,2005:45-48.
(收稿日期:2022-06-12 本文编辑:李晓乐)

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81804114); 2022年全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号); 上海市2020年度“科技创新行动计划”医学创新研究专项项目(20MC1920600); 上海市临床重点专科建设项目-中医骨伤科(shslczdzk03901); 上海申康医院发展中心重大临床研究项目(SHDC2020CR1051B) 通讯作者:詹红生 E-mail:zhanhongsheng2010@163.com
更新日期/Last Update: 1900-01-01