摘要
目的探讨结直肠癌术后患者的舌象特征及多元Logistic回归模型下有意义的舌象特征。方法纳入213例结直肠癌术后患者,使用TFDA-1型数字舌面诊仪采集患者舌象图像,分析气虚证、阴虚证、痰湿证、血瘀证患者舌象特征的差异,并使用多元Logistic回归分析不同证型的差异性舌象指标。结果在舌苔指数中,perAll的分布趋势为阴虚证<气虚证<血瘀证<痰湿证,perPart的分布趋势为痰湿证>气虚证>血瘀证。在纹理指标中,CON、ENT、MEAN的分布趋势为痰湿证>阴虚证>气虚证>血瘀证,ASM的分布趋势为痰湿证<阴虚证<血瘀证<气虚证。在Lab颜色空间中,TB-L的分布趋势为痰湿证>气虚证>血瘀证,TB-a的分布趋势为痰湿证<血瘀证<气虚证<阴虚证,TB-b的分布趋势为阴虚证>气虚证>痰湿证>血瘀证,TC-L的分布趋势为血瘀证<气虚证<阴虚证<痰湿证,TC-a的分布趋势为阴虚证>气虚证>血瘀证>痰湿证,TC-b的分布趋势为阴虚证>气虚证>血瘀证。在多元Logistic回归模型中,相较气虚证,TB-L与TC-a降低,辨证为阴虚证的概率越高;TB-b、TC-a下降,TC-b上升,辨证为痰湿证的概率越高;TB-b、TC-L下降,纹理指标主成分1升高,辨证为血瘀证的概率越高。结论结直肠癌术后患者不同证型的舌象图像特征存在一定规律,可为中医辨证提供客观化的参考依据。
Objective To investigate the tongue image characteristics of patients in postoperative colorectal cancer and significant tongue image features using a multinomial Logistic regression model.Methods Totally 213 postoperative patients with colorectal cancer were included.TFDA-1 digital tongue diagnostic instrument was used to collect the tongue images of patients,and the statistical differences of tongue image characteristics of patients with qi deficiency syndrome,yin deficiency syndrome,phlegm dampness syndrome and blood stasis syndrome were analyzed.Multiple Logistic regression was used to analyze the different tongue image indexes of different syndrome types.Results In the tongue coating index,perAll had the following distribution order:yin deficiency syndrome<qi deficiency syndrome<blood stasis syndrome<phlegm-dampness syndrome,and perPart had the following distribution order:phlegm-dampness syndrome>qi deficiency syndrome>blood stasis syndrome.In the texture indexes,CON,ENT and MEAN had the following distribution order:phlegm-dampness syndrome>yin deficiency syndrome>qi deficiency syndrome>blood stasis syndrome.ASM had the following distribution order:phlegm dampness syndrome<yin deficiency syndrome<blood stasis syndrome<qi deficiency syndrome.In the Lab color space,TB-L had the following distribution order:phlegm-dampness syndrome>qi deficiency syndrome>blood stasis syndrome.TB-a had the following distribution order:phlegm-dampness syndrome<blood stasis syndrome<qi deficiency syndrome<yin deficiency syndrome.TB-b had the following distribution order:yin deficiency syndrome>qi deficiency syndrome>phlegm-dampness syndrome>blood stasis syndrome.TC-L had the following distribution order:blood stasis syndrome<qi deficiency syndrome<yin deficiency<phlegm-dampness syndrome.TC-a had the following distribution order:yin deficiency syndrome>qi deficiency syndrome>blood stasis syndrome>phlegm-dampness syndrome.TC-b had the following distribution order:yin deficiency syndrome>qi deficiency syndrome>blood stasis syndrome.In the multinomial Logistic regression model,compared with the qi deficiency syndrome,the probability of being diagnosed with the yin deficiency syndrome increased when TB-L and TC-a decreased.Additionally,the probability of being diagnosed with the phlegm-dampness syndrome increased when TB-b and TC-a decreased and TC-b increased;TB-b and TC-L decreased,principal component 1 of texture index increased,and the probability of syndrome differentiation as blood stasis syndrome was higher.Conclusion The tongue image characteristics of different TCM syndromes in postoperative colorectal cancer patients exhibit certain patterns,which can serve as an objective reference for TCM differentiation and diagnosis.
作者
楼锦娣
石玉琳
许晓妍
江涛
许家佗
LOU Jindi;SHI Yulin;XU Xiaoyan;JIANG Tao;XU Jiatuo(School of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;The Office of Academic Affairs,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《中国中医药信息杂志》
2025年第9期135-140,共6页
Chinese Journal of Information on Traditional Chinese Medicine
基金
国家自然科学基金(82305090、82104738)
国家中医药管理局高水平中医药重点学科建设项目中医诊断学(ZYYZDXK-2023069)
上海市科学技术委员会启明星培育项目(22YF1448900)
上海市卫生健康委员会科研项目(20234Y0168、20244Y0129)
中国博士后科学基金面上项目(2023M732337)。
关键词
结直肠癌术后
证型
舌象特征
多元LOGISTIC回归
postoperative colorectal cancer
TCM syndromes
tongue image characteristics
multinomial Logistic regression
