Li Jun, Cui Longtao, Tu Liping, Hu Xiaojuan, Wang Sihan, Shi Yulin, Liu Jiayi, Zhou Changle, Li Yongzhi, Huang Jingbin, Xu Jiatuo
School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Shanghai Collaborative Innovation Center of Health Service in Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Evid Based Complement Alternat Med. 2022 Jul 5;2022:7684714. doi: 10.1155/2022/7684714. eCollection 2022.
The prevalence of diabetes increases year by year, posing a severe threat to human health. Current treatments are difficult to prevent the progression of diabetes and its complications. It is imperative to carry out individualized treatment of diabetes, but current diagnostic methods are difficult to specify an individualized treatment plan.
Clarify the distribution law of tongue features of the diabetic population, and provide the diagnostic basis for individualized treatment of traditional Chinese medicine (TCM) in the treatment of diabetes.
We use the TFDA-1 tongue diagnosis instrument to collect tongue images of people with diabetes and accurately calculate the color features, texture features, and tongue coating ratio features through the Tongue Diagnosis Analysis System (TDAS). Then, we used K-means and Self-organizing Maps (SOM) networks to analyze the distribution of tongue features in diabetic people. Statistical analysis of TDAS features was used to identify differences between clusters.
The silhouette coefficient of the K-means clustering result is 0.194, and the silhouette coefficient of the SOM clustering result is 0.127. SOM Cluster 3 and Cluster 4 are derived from K-means Cluster 1, and the intersections account for (76.7% 97.5%) and (22.3% and 70.4%), respectively. K-means Cluster 2 and SOM Cluster 1 are highly overlapping, and the intersection accounts for the ratios of 66.9% and 95.0%. K-means Cluster 3 and SOM Cluster 2 are highly overlaid, and the intersection ratio is 94.1% and 82.1%. For the clustering results of K-means, TB-a and TC-a of Cluster 3 are the highest ( < 0.001), TB-a of Cluster 2 is the lowest ( < 0.001), and TB-a of Cluster 1 is between Cluster 2 and Cluster 3 ( < 0.001). Cluster 1 has the highest TB-b and TC-b ( < 0.001), Cluster 2 has the lowest TB-b and TC-b ( < 0.001), and TB-b and TC-b of Cluster 3 are between Cluster 1 and Cluster 2 ( < 0.001). Cluster 1 has the highest TB-ASM and TC-ASM ( < 0.001), Cluster 3 has the lowest TB-ASM and TC-ASM ( < 0.001), and TB-ASM and TC-ASM of Cluster 2 are between the Cluster 1 and Cluster 3 ( < 0.001). CON, ENT, and MEAN show the opposite trend. Cluster 2 had the highest Per-all ( < 0.001). SOM divides K-means Cluster 1 into two categories. There is almost no difference in texture features between Cluster 3 and Cluster 4 in the SOM clustering results. Cluster 3's TB-L, TC-L, and Per-all are lower than Cluster 4 ( < 0.001), Cluster 3's TB-a, TC-a, TB-b, TC-b, and Per-part are higher than Cluster 4 ( < 0.001).
The precise tongue image features calculated by TDAS are the basis for characterizing the disease state of diabetic people. Unsupervised learning technology combined with statistical analysis is an important means to discover subtle changes in the tongue features of diabetic people. The machine vision analysis method based on unsupervised machine learning technology realizes the classification of the diabetic population based on fine tongue features. It provides a diagnostic basis for the designated diabetes TCM treatment plan.
糖尿病患病率逐年上升,对人类健康构成严重威胁。目前的治疗方法难以阻止糖尿病及其并发症的进展。开展糖尿病个体化治疗势在必行,但目前的诊断方法难以制定个体化治疗方案。
明确糖尿病患者舌象特征的分布规律,为中医个体化治疗糖尿病提供诊断依据。
我们使用TFDA - 1舌诊仪采集糖尿病患者的舌象图像,并通过舌诊分析系统(TDAS)准确计算颜色特征、纹理特征和舌苔比例特征。然后,我们使用K均值和自组织映射(SOM)网络分析糖尿病患者舌象特征的分布。利用TDAS特征进行统计分析以识别聚类之间的差异。
K均值聚类结果的轮廓系数为0.194,SOM聚类结果的轮廓系数为0.127。SOM聚类3和聚类4源自K均值聚类1,其交集分别占(76.7% 97.5%)和(22.3%和70.4%)。K均值聚类2和SOM聚类1高度重叠,交集占比分别为66.9%和95.0%。K均值聚类3和SOM聚类2高度重叠,交集比例分别为94.1%和82.1%。对于K均值聚类结果,聚类3的TB - a和TC - a最高(<0.001),聚类2的TB - a最低(<0.001),聚类1的TB - a介于聚类2和聚类3之间(<0.001)。聚类1的TB - b和TC - b最高(<0.001),聚类2的TB - b和TC - b最低(<0.001),聚类3的TB - b和TC - b介于聚类1和聚类2之间(<0.001)。聚类1的TB - ASM和TC - ASM最高(<0.001),聚类3的TB - ASM和TC - ASM最低(<0.001),聚类2的TB - ASM和TC - ASM介于聚类1和聚类3之间(<0.001)。CON、ENT和MEAN呈现相反趋势。聚类2的Per - all最高(<0.001)。SOM将K均值聚类1分为两类。在SOM聚类结果中,聚类3和聚类4的纹理特征几乎没有差异。聚类3的TB - L、TC - L和Per - all低于聚类4(<0.001),聚类3的TB - a、TC - a、TB - b、TC - b和Per - part高于聚类4(<0.001)。
TDAS计算得到的精确舌象特征是表征糖尿病患者疾病状态的基础。无监督学习技术与统计分析相结合是发现糖尿病患者舌象特征细微变化的重要手段。基于无监督机器学习技术的机器视觉分析方法实现了基于精细舌象特征的糖尿病患者分类。它为制定糖尿病中医治疗方案提供了诊断依据。