Abstract
Tongue coating is one of the important foundations of tongue diagnosis in traditional Chinese medicine (TCM) and plays an important role in reflecting the occurrence, development, and prognosis of the disease. However, its material basis is still poorly understood. In this study, a urinary metabonomic method based on gas chromatography coupled to mass spectrometry (GC/MS) was developed. The distinct clustering in metabolic profile was observed from Group A (thick yellow coating in patients with chronic hepatitis B), Group B (thick white coating in patients with chronic hepatitis B), and Group C (thin white coating with healthy humans) using orthogonal projections to latent structures (OPLS). Based on the variable of importance in the project (VIP) values, some significantly changed metabolites have been identified. These changes were related to the disturbance in energy metabolism, amino acid metabolism, nucleotide metabolism, and gut microflora, which were helpful to understand the material basis leading to the formation of tongue coating. This study demonstrated that tongue coating may have an objective material basis.
Highlights
Tongue coating is one of the direct objective foundations for traditional Chinese medicine (TCM) clinical diagnosis and treatment, so it is of great importance for syndrome differentiation, determining the treating principle, prescribing a formula, and predicting the prognosis [1]
We studied on urine metabolic profiles of two different tongue coatings in patients with chronic hepatitis B using gas chromatography coupled to mass spectrometry (GC/MS) based on metabonomic method
17 significantly changed metabolites have been found and identified, which indicated that the material basis leading to the formation of the tongue coating was related to energy metabolism, amino acid metabolism, nucleotide metabolism, and gut microflora
Summary
Tongue coating is one of the direct objective foundations for TCM clinical diagnosis and treatment, so it is of great importance for syndrome differentiation, determining the treating principle, prescribing a formula, and predicting the prognosis [1]. TCM holds that the tongue coating is formed by the evaporation of stomach qi and is closely related to the conditions of the body organs function, qi, and blood [2, 3]. Properties, and variations of pathogens can be revealed through observation of tongue [4]. As is stated in Danxi’s Experience on Medicine (Danxi-XinFa), “To want knowing the internal conditions of the body, the external manifestations of the body should be observed, to diagnose the external parts of the body may know the internal conditions. Based on the above analysis, we speculated that the body of the patient with the appearing tongue coating in TCM has the material basis that triggers a series of symptoms and reasoned that some changes of the material basis led to alterations of the tongue coating in TCM
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