Abstract
AimIn 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.MethodsA 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 χ2-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.ResultsThe 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.ConclusionThis 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.
Highlights
Tongue diagnosis in Kampo medicine based on its color and shape is useful for understanding the general condition of patients
The assessment of tongue color is considered to be influenced by environmental conditions, such as light source and room temperature, as well as the subjective judgment of the physician based on knowledge and experience
We have developed a tongue image analyzing system (TIAS) to support tongue diagnosis [4, 5]
Summary
Tongue diagnosis in Kampo medicine based on its color and shape is useful for understanding the general condition of patients. We have developed a tongue image analyzing system (TIAS) to support tongue diagnosis [4, 5]. It is possible to quantify the tongue color using the sublingual vein and the L∗a∗b∗ color system, which is a color space data set developed by the Commission Internationale de l’Éclairage. This is useful for training and the objective evaluation of tongue findings, which are important in Kampo medicine. We have previously reported the usefulness of TIAS beyond the field of Kampo medicine [6] and highlighted its potential usefulness as a non-invasive screening tool for gastric cancer [7]
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