Segawa Makoto, Iizuka Norio, Ogihara Hiroyuki, Tanaka Koichiro, Nakae Hajime, Usuku Koichiro, Hamamoto Yoshihiko
Department of Kampo Medicine, Yamaguchi University Hospital, Ube, Japan.
Yamaguchi Health Examination Center, Yamaguchi, Japan.
Front Med Technol. 2021 Dec 22;3:760542. doi: 10.3389/fmedt.2021.760542. eCollection 2021.
Tongue examination is an important diagnostic method for judging pathological conditions in Kampo (traditional Japanese medicine), but it is not easy for beginners to learn the diagnostic technique. One reason is that there are few objective diagnostic criteria for tongue examination findings, and the educational method for tongue examination is not standardized in Japan, warranting the need for a tongue image database for e-learning systems that could dramatically improve the efficiency of education. Therefore, we constructed a database comprising tongue images whose findings were determined on the basis of votes given by five Kampo medicine specialists (KMSs) and confirmed the educational usefulness of the database for tongue diagnosis e-learning systems. The study was conducted in the following five steps: development of a tongue imaging collection system, collection of tongue images, evaluation and annotation of tongue images, development of a tongue diagnosis e-learning system, and verification of the educational usefulness of this system. Five KMSs evaluated the tongue images obtained from 125 participants in the following eight aspects: (i) tongue body size, (ii) tongue body color, (iii) tongue body dryness and wetness, (iv) tooth marks on the edge of the tongue, (v) cracks on the surface of the tongue, (vi) thickness of tongue coating, (vii) color of tongue coating, and (viii) dryness and wetness of tongue coating. Medical students (MSs) were given a tongue diagnosis test using an e-learning system after a lecture on tongue diagnosis. The cumulative and individual match rates (%) (individual match rates of 100% (5/5), 80% (4/5), and 60% (3/5) are shown in parentheses, respectively) were as follows: (i) tongue body size: 92.8 (26.4/26.4/40.0); (ii) tongue body color: 83.2 (10.4/20.8/52.0); (iii) tongue body dryness and wetness: 88.8 (13.6/34.4/40.8); (iv) tooth marks on the edge of the tongue: 88.8 (6.4/35.2/47.2); (v) cracks on the surface of the tongue: 96.8 (24.0/35.2/37.6); (vi) thickness of tongue coating: 84.8 (7.2/21.6/56.0); (vii) color of tongue coating: 88.0 (15.2/37.6/35.2); and (viii) dryness and wetness of tongue coating: 74.4 (4.8/19.2/50.4). The test showed that the tongue diagnosis ability of MSs who attended a lecture on tongue diagnosis was almost the same as that of KMSs. We successfully constructed a tongue image database standardized for training specialists on tongue diagnosis and confirmed the educational usefulness of the e-learning system using a database. This database will contribute to the standardization and popularization of Kampo education.
舌诊是判断汉方（传统日本医学）病症的重要诊断方法，但初学者学习该诊断技术并不容易。原因之一是舌诊结果的客观诊断标准较少，且日本的舌诊教育方法不规范，因此需要一个舌图像数据库用于电子学习系统，这可以显著提高教育效率。因此，我们构建了一个数据库，其中包含根据五位汉方医学专家（KMS）的投票确定结果的舌图像，并证实了该数据库对舌诊电子学习系统的教育实用性。该研究按以下五个步骤进行：舌成像采集系统的开发、舌图像的采集、舌图像的评估与标注、舌诊电子学习系统的开发以及该系统教育实用性的验证。五位KMS从以下八个方面对从125名参与者处获得的舌图像进行评估：（i）舌体大小，（ii）舌体颜色，（iii）舌体干湿程度，（iv）舌边齿痕，（v）舌面裂纹，（vi）舌苔厚度，（vii）舌苔颜色，以及（viii）舌苔干湿程度。在进行舌诊讲座后，医学生（MS）使用电子学习系统进行舌诊测试。累积和个体匹配率（%）（括号内分别显示个体匹配率为100%（5/5）、80%（4/5）和60%（3/5））如下：（i）舌体大小：92.8（26.4/26.4/40.0）；（ii）舌体颜色：83.2（10.4/20.8/52.0）；（iii）舌体干湿程度：88.8（13.6/34.4/40.8）；（iv）舌边齿痕：88.8（6.4/35.2/47.2）；（v）舌面裂纹：96.8（24.0/35.2/37.6）；（vi）舌苔厚度：84.8（7.2/21.6/56.0）；（vii）舌苔颜色：88.0（15.2/37.6/35.2）；以及（viii）舌苔干湿程度：74.4（4.8/19.2/50.4）。测试表明，参加舌诊讲座的医学生的舌诊能力与汉方医学专家几乎相同。我们成功构建了一个用于舌诊专家培训的标准化舌图像数据库，并证实了使用该数据库的电子学习系统的教育实用性。该数据库将有助于汉方教育的标准化和普及。
