Morita Akira, Murakami Aya, Noguchi Keigo, Watanabe Yuki, Nakaguchi Toshiya, Ochi Sadayuki, Okudaira Kazuho, Hirasaki Yoshiro, Namiki Takao
Department of Japanese-Oriental (Kampo) Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
Faculty of Pharmacy, Center for Pharmaceutical Education, Yokohama University of Pharmacy, Yokohama, Japan.
Front Med (Lausanne). 2022 Mar 3;8:790542. doi: 10.3389/fmed.2021.790542. eCollection 2021.
In tongue diagnosis, a dark purple tongue and enlarged sublingual vein are important findings of Oketsu (blood stasis). However, the association between the tongue color and the sublingual vein has not been reported. This study investigated the association between the tongue color values and the sublingual vein width using tongue image analyzing system (TIAS) for the objective assessment of blood stasis.
A total of 38 patients (age 68.7 ± 11.3 years, 14 men and 24 women) who visited the Department of Kampo Medicine at Chiba University Hospital were included. Physical findings, blood test results, blood stasis score from medical records, and tongue images obtained with TIAS were analyzed. The patients were classified into two groups: patients with a sublingual vein width of ≤2.5 mm (20 patients) and those with a width of >2.5 mm (18 patients). The physical findings and the blood test results of the two groups were analyzed by Wilcoxon's rank-sum test or χ-test, whereas logistic regression analysis was used to determine the association between the tongue color values and sublingual vein width. Receiver operating characteristic (ROC) analysis was used to differentiate blood stasis.
The color values significantly related to the sublingual vein width (mm) were the P1-L and P4-L (darkness of the tongue edge and tongue apex) and the P1-b and P2-b (blueness of the tongue edge and tongue posterior). The area under the curve was greater for the combination of the tongue color values and the sublingual vein width than that for either of them.
This study demonstrated an objective evaluation of blood stasis in the tongue of patients with dark-blue discoloration and an enlarged sublingual vein. In addition, the combination of the tongue color and the sublingual vein is expected to facilitate a more reliable diagnosis of blood stasis.
在舌诊中，紫暗舌和舌下静脉怒张是瘀血（恶血）的重要表现。然而，舌色与舌下静脉之间的关联尚未见报道。本研究使用舌图像分析系统（TIAS），通过调查舌色值与舌下静脉宽度之间的关联，以客观评估瘀血情况。
纳入千叶大学医院汉方医学科就诊的38例患者（年龄68.7±11.3岁，男性14例，女性24例）。分析体格检查结果、血液检查结果、病历中的瘀血评分以及TIAS获取的舌图像。患者分为两组：舌下静脉宽度≤2.5mm的患者（20例）和宽度>2.5mm的患者（18例）。两组的体格检查结果和血液检查结果采用Wilcoxon秩和检验或χ检验进行分析，而逻辑回归分析用于确定舌色值与舌下静脉宽度之间的关联。采用受试者工作特征（ROC）分析来鉴别瘀血。
与舌下静脉宽度（mm）显著相关的颜色值为P1-L和P4-L（舌边和舌尖的暗度）以及P1-b和P2-b（舌边和舌后的蓝色度）。舌色值与舌下静脉宽度联合的曲线下面积大于二者单独的曲线下面积。
本研究证明了对舌色深蓝且舌下静脉怒张患者的瘀血情况进行客观评估。此外，舌色与舌下静脉联合有望促进瘀血的更可靠诊断。
