The tongue features associated with type 2 diabetes mellitus

Medicine (United States) - Tập 98 Số 19 - Trang e15567 - 2019
Po-Chi Hsu1,2, Heng‐Hsiung Wu3,4, Yu‐Chuen Huang2, Hen‐Hong Chang1,4, Tsung-Chieh Lee5, Yiping Chen6, John Y. Chiang7,8, Lun-Chien Lo1,2
1Department of Chinese Medicine, China Medical University Hospital, Taichung,
2School of Chinese Medicine, China Medical University, Taichung,
3Department of Chinese Medicine, China Medical University Hospital Taipei Branch, Taipei,
4School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung,
5Department of Chinese Medicine, Changhua Christian Hospital, Changhua,
6Department of Medical Research, China Medical University Hospital, Taichung,
7Department of Computer Science and Engineering, National Sun Yat-Sen University, Kaohsiung,
8Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung.

Tóm tắt

Abstract Diabetes mellitus (DM) is a public problem closely associated with numerous oral complications, such as coated tongue, xerostomia, salivary dysfunction, etc. Tongue diagnosis plays an important role in clinical prognosis and treatment of diabetes in the traditional Chinese medicine (TCM). This study investigated discriminating tongue features to distinguish between type 2 DM and non-DM individuals through non-invasive TCM tongue diagnosis. The tongue features for 199 patients with type 2 DM, and 372 non-DM individuals, serving as control, are extracted by the automatic tongue diagnosis system (ATDS). A total of 9 tongue features, namely, tongue shape, tongue color, fur thickness, fur color, saliva, tongue fissure, ecchymosis, teeth mark, and red dot. The demography, laboratory, physical examination, and tongue manifestation data between 2 groups were compared. Patients with type 2 DM possessed significantly larger covering area of yellow fur (58.5% vs 22.5%, P < .001), thick fur (50.8% vs 29.2%, P < .001), and bluish tongue (P < .001) than those of the control group. Also, a significantly higher portion (72.7% vs 55.2%, P < .05) of patients with long-term diabetics having yellow fur color than the short-term counterparts was observed. The high prevalence of thick fur, yellow fur color, and bluish tongue in patient with type 2 DM revealed that TCM tongue diagnosis can serve as a preliminary screening procedure in the early detection of type 2 DM in light of its simple and non-invasive nature, followed by other more accurate testing process. To the best of our knowledge, this is the first attempt in applying non-invasive TCM tongue diagnosis to the discrimination of type 2 DM patients and non-DM individuals.

Từ khóa


Tài liệu tham khảo

Yang, 2010, Prevalence of diabetes among men and women in China, N Engl J Med, 362, 1090, 10.1056/NEJMoa0908292

Engelgau, 2004, The evolving diabetes burden in the United States, Ann Inter Med, 140, 945, 10.7326/0003-4819-140-11-200406010-00035

Wild, 2004, Global prevalence of diabetes: estimates for the year 2000 and projections for 2030, Diabetes Care, 27, 1047, 10.2337/diacare.27.5.1047

Cade, 2008, Diabetes-related microvascular and macrovascular diseases in the physical therapy setting, Phys Ther, 88, 1322, 10.2522/ptj.20080008

Kitada, 2010, Molecular mechanisms of diabetic vascular complications, J Diabetes Investig, 1, 77, 10.1111/j.2040-1124.2010.00018.x

Nazir, 2018, The burden of diabetes, its oral complications and their prevention and management, Open Access Maced J Med Sci, 6, 1545, 10.3889/oamjms.2018.294

Lo, 2013, Tongue diagnosis of traditional Chinese medicine for rheumatoid arthritis, Afr J Tradit Complement Altern Med, 10, 360

Lo, 2013, Breast cancer index: a perspective on tongue diagnosis in traditional chinese medicine, J Tradit Complement Med, 3, 194, 10.4103/2225-4110.114901

Liao, 2014, Diabetes with pyogenic liver abscess–A perspective on tongue assessment in traditional Chinese medicine, Complement Ther Med, 22, 341, 10.1016/j.ctim.2013.12.009

Lo, 2015, TCM tongue diagnosis index of early-stage breast cancer, Complement Ther Med, 23, 705, 10.1016/j.ctim.2015.07.001

Hsu, 2016, The association between arterial stiffness and tongue manifestations of blood stasis in patients with type 2 diabetes, BMC Complement Altern Med, 16, 324, 10.1186/s12906-016-1308-5

Lee, 2016, Traditional Chinese Medicine for metabolic syndrome via TCM pattern differentiation: tongue diagnosis for predictor, Evid Based Complement Alternat Med, 2016, 1971295, 10.1155/2016/1971295

Huang, 2017, The Relationship between ischemic stroke patients with and without retroflex tougongue: a retrospective study, Evid Based Complement Alternat Med, 2017, 3195749, 10.1155/2017/3195749

Gao, 2013, A pilot study on the relationship between tongue manifestation and the degree of neurological impairment in patients with acute cerebral infarction, Chin J Integr Med, 19, 149, 10.1007/s11655-012-1152-5

Liu, 2014, A pilot study on the correlation of tongue manifestation with the site of cerebral infarction in patients with stroke, Chin J Integr Med, 20, 823, 10.1007/s11655-014-1685-x

Feng, 2011, Study on the tongue manifestations for the blood-stasis and toxin syndrome in the stable patients of coronary heart disease, Chin J Integr Med, 17, 333, 10.1007/s11655-011-0615-4

Yu, 2017, Objective research on tongue manifestation of patients with eczema, Technol Health Care, 25, 143, 10.3233/THC-171316

Anastasi, 2009, Understanding diagnostic reasoning in TCM practice: tongue diagnosis, Altern Ther Health Med, 15, 18

Jung, 2012, Review on the current trends in tongue diagnosis systems, Integr Med Res, 1, 13, 10.1016/j.imr.2012.09.001

Lo, 2012, The Study on the agreement between automatic tongue diagnosis system and traditional Chinese medicine practitioners, Evid Based Complement Alternat Med, 2012, 505063

Kim, 2014, Tongue diagnosis system for quantitative assessment of tongue coating in patients with functional dyspepsia: a clinical trial, J Ethnopharmacology, 155, 709, 10.1016/j.jep.2014.06.010

Lo, 2012, Visual agreement analyses of traditional chinese medicine: a multiple-dimensional scaling approach, Evid Based Complement Alternat Med, 2012, 516473, 10.1155/2012/516473

Jiang, 2005, Therapeutic wisdom in traditional Chinese medicine: a perspective from modern science, Trends Pharmacol Sci, 26, 558, 10.1016/j.tips.2005.09.006

Negrato, 2010, Buccal alterations in diabetes mellitus, Diabetol Metab Syndr, 2, 3, 10.1186/1758-5996-2-3

Tomooka, 2018, Yellow tongue coating is associated with diabetes mellitus among Japanese non-smoking men and women: the toon health study, J Epidemiol, 28, 287, 10.2188/jea.JE20160169

Lopez-Pintor, 2016, Xerostomia, hyposalivation, and salivary flow in diabetes patients, J Diabetes Res, 2016, 4372852, 10.1155/2016/4372852

Vasconcelos, 2010, Comparative study of the concentration of salivary and blood glucose in type 2 diabetic patients, J Oral Sci, 52, 293, 10.2334/josnusd.52.293

Bernardi, 2007, Study of the buffering capacity, pH and salivary flow rate in type 2 well-controlled and poorly controlled diabetic patients, Oral Health Prev Dent, 5, 73

Tong, 2012, Treatment of diabetes using traditional Chinese medicine: past, present and future, Am J Chinese Med, 40, 877, 10.1142/S0192415X12500656

Jiang, 2012, Integrating next-generation sequencing and traditional tongue diagnosis to determine tongue coating microbiome, Sci Rep, 2, 936, 10.1038/srep00936

Ye, 2016, Bacillus as a potential diagnostic marker for yellow tongue coating, Sci Rep, 6, 32496, 10.1038/srep32496

Thông tin
Thông tin xuất bản

Medicine (United States)

Tập 98 Số 19

e15567

Thông tin tác giả