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1.
PLoS One ; 19(3): e0296070, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38452007

RESUMEN

BACKGROUND: Tongue diagnosis in traditional Chinese medicine (TCM) provides clinically important, objective evidence from direct observation of specific features that assist with diagnosis. However, the current interpretation of tongue features requires a significant amount of manpower and time. TCM physicians may have different interpretations of features displayed by the same tongue. An automated interpretation system that interprets tongue features would expedite the interpretation process and yield more consistent results. MATERIALS AND METHODS: This study applied deep learning visualization to tongue diagnosis. After collecting tongue images and corresponding interpretation reports by TCM physicians in a single teaching hospital, various tongue features such as fissures, tooth marks, and different types of coatings were annotated manually with rectangles. These annotated data and images were used to train a deep learning object detection model. Upon completion of training, the position of each tongue feature was dynamically marked. RESULTS: A large high-quality manually annotated tongue feature dataset was constructed and analyzed. A detection model was trained with average precision (AP) 47.67%, 58.94%, 71.25% and 59.78% for fissures, tooth marks, thick and yellow coatings, respectively. At over 40 frames per second on a NVIDIA GeForce GTX 1060, the model was capable of detecting tongue features from any viewpoint in real time. CONCLUSIONS/SIGNIFICANCE: This study constructed a tongue feature dataset and trained a deep learning object detection model to locate tongue features in real time. The model provided interpretability and intuitiveness that are often lacking in general neural network models and implies good feasibility for clinical application.


Asunto(s)
Redes Neurales de la Computación , Lengua , Medicina Tradicional China/métodos
2.
J Tradit Complement Med ; 12(5): 505-510, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36081819

RESUMEN

Background and aim: Stroke is a major cause of disability worldwide, and ischemic stroke is the most common type of stroke. The prevention and treatment of ischemic stroke remain a challenge worldwide. Traditional Chinese medicine (TCM) is often sought to provide an alternative therapy for the prevention and rehabilitation intervention of ischemic stroke in Taiwan. Therefore, this study explored the pivotal variables of tongue diagnosis among acute ischemic stroke and healthy participants in middle and older age. Experimental procedure: This was a cross-sectional and case-controlled study. Data were collected from 99 patients with acute ischemic stroke and 286 healthy participants who received tongue diagnoses at Changhua Christian Hospital (CCH) from September 1, 2014, to December 31, 2016. Tongue features were extracted using the automatic tongue diagnosis system. Nine tongue features, including tongue shape, tongue color, fur thickness, fur color, saliva, tongue fissures, ecchymoses, teeth marks, and red spots were analyzed. Results and conclusion: Objective image analysis techniques were used to identify significant differences in the many tongue features between patients with acute ischemic stroke and individuals without stroke. According to the logistic regression analysis, pale tongue color (OR:5.501, p = 0.001), bluish tongue color (OR:4.249, p = 0.014), ecchymoses (OR:1.058, p < 0.001), and tongue deviation angle (OR:1.218, p < 0.001) were associated with significantly increased odds ratios for acute ischemic stroke. The research revealed that tongue feature abnormalities were significantly related to the occurrence of ischemic stroke.

3.
Artículo en Inglés | MEDLINE | ID: mdl-34987592

RESUMEN

INTRODUCTION: Breast cancer (BC) is the most common cancer in women and patients with BC often undergo complex treatment. In Taiwan, nearly 80% of patients with BC seek traditional Chinese medicine (TCM) during adjuvant chemotherapy to relieve discomfort and side effects. This study investigated tongue features and pattern differentiation through noninvasive TCM tongue diagnosis in patients with BC. MATERIALS AND METHODS: This cross-sectional, case-controlled, retrospective observational study collected patient data through a chart review. The tongue features were extracted using the automatic tongue diagnosis system (ATDS). Nine tongue features, including tongue shape, tongue color, fur thickness, fur color, saliva, tongue fissures, ecchymoses, teeth marks, and red dots, were analyzed. Results and Discussion. Objective image analysis techniques were used to identify significant differences in the many tongue features between BC patients and non-BC individuals. A significantly larger proportion of patients with BC had a small tongue (p < 0.001), pale tongue (p < 0.001), thick fur (p < 0.001), yellow fur (p < 0.001), wet saliva (p < 0.001), thick tongue fur (p < 0.001), fissures (p=0.040), and ecchymoses in the heart-lung area (p=0.013). According to logistic regression, small tongue shape, pale tongue color, yellow fur color, wet saliva, and the amounts of fissures were associated with a significantly increased odds ratio for BC. CONCLUSIONS: This study showed significant differences in tongue features, such as small tongue shape, pale tongue color, thick fur, yellow fur color, wet saliva, fissure, and ecchymoses in the heart-lung area in patients with BC. These tongue features would imply yin deficiency, deficiencies of blood, stagnation of heat, and phlegm/blood stasis in TCM theory. There is a need to investigate effective and safe treatment to enhance the role of TCM in integrated medical care for patients with BC.

4.
Medicine (Baltimore) ; 100(9): e25037, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655979

RESUMEN

BACKGROUND: Traditional Chinese medicine (TCM) tongue diagnosis plays an important role in differentiation of symptoms because the tongue reflects the physiological and pathological condition of the body. The automatic tongue diagnosis system (ATDS), which noninvasively captures tongue images, can provide objective and reliable diagnostic information. Chronic kidney disease (CKD) currently is an important global public health problem and contributor to morbidity and mortality from non-communicable diseases. Thus, it is interesting to analyze and probe the relationship between tongue examination and CKD. METHODS: This protocol is a cross-sectional, case-controlled observational study investigating the usefulness of the ATDS in clinical practice by examining its efficacy as a diagnostic tool for CKD. Volunteers over 20 years old with and without CKD will be enrolled. Tongue images will be captured and the patients divided into 2 groups: CKD group and healthy group. Nine primary tongue features will be extracted and analyzed, including tongue shape, tongue color, tooth mark, tongue fissure, fur color, fur thickness, saliva, ecchymosis, and red dots. RESULT: The results of this study will systematically evaluate tongue manifestations of patients and examine its efficacy as an early detection and diagnosis of CKD. DISCUSSION: The aim of this protocol is to investigate discriminating tongue features to distinguish between CKD and normal people, and establish differentiating index to facilitate the noninvasive detection of CKD. TRIAL REGISTRIES: ClinicalTrials.gov; Identifier: NCT04708743.


Asunto(s)
Medicina Tradicional China/métodos , Insuficiencia Renal Crónica/complicaciones , Enfermedades de la Lengua/diagnóstico , Lengua/patología , Adulto , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Masculino , Enfermedades de la Lengua/etiología , Enfermedades de la Lengua/patología , Adulto Joven
5.
Medicine (Baltimore) ; 98(51): e18350, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31860990

RESUMEN

This study, an important groundwork for clinical tongue diagnosis and future traditional Chinese medicine (TCM) research, tested the hypothesis that some tongue features vary significantly between different gender and age groups by utilizing an automatic tongue diagnosis system (ATDS).A cross-sectional study of 1487 participants from a community-based population was performed. Study subjects with ages ranging from 20 to 92 were categorized into 3 groups: <40, 40 to 64, and ≥65 years old, and the subjects were also stratified according to gender. Tongue images were collected at the end of each normal health examination routine to further derive the relevant tongue features of every participant by using the ATDS developed by our team. There were a total of nine tongue features that were identified: tongue shape, tongue color, fur thickness, fur color, saliva, tongue fissure, ecchymosis, teeth mark, and red dot. The corresponding tongue features, demography, and physical/laboratory examination data were compared between different gender and age groups.Our study showed that, compared to females, males had enlarged tongue shape, thicker fur, more fissures and fewer teeth marks (all P < .001), and also had more red tongue color (P = .019), normal saliva (P = .001), more red dots (P = .005) and yellower fur (P = .014). In females, increasing age was associated with more enlarged tongue shape, thicker fur, yellower fur, more saliva, fissures and fewer teeth marks (all P < .001), more ecchymoses (P = .009), and more red tongue color (P = .023). These associations of age with more fissures, fewer teeth marks, fewer red dots (P < .001), median tongue shape (P = .029), and wet saliva (P = .014) were also evident in males, but other relationships were not clearly evident.Even though most of the common tongue features derived from a community-based population are consistent with TCM theory, yet some significantly gender- and age-dependent tongue characteristics were identified. These disparities in tongue features associated with gender or age shall be prudently taken into consideration in clinical tongue diagnosis and future TCM research.


Asunto(s)
Lengua/anatomía & histología , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento , Estudios Transversales , Femenino , Humanos , Masculino , Medicina Tradicional China , Persona de Mediana Edad , Caracteres Sexuales , Taiwán , Adulto Joven
6.
Medicine (Baltimore) ; 98(19): e15567, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31083226

RESUMEN

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.


Asunto(s)
Diabetes Mellitus Tipo 2/diagnóstico , Medicina Tradicional China , Estudios de Cohortes , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Lengua/patología , Enfermedades de la Lengua/complicaciones , Enfermedades de la Lengua/epidemiología , Enfermedades de la Lengua/patología
7.
Complement Ther Med ; 23(5): 705-13, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26365451

RESUMEN

OBJECTIVES: This paper investigates discriminating tongue features to distinguish between early stage breast cancer (BC) patients and non-breast cancer individuals through non-invasive traditional Chinese medicine (TCM) tongue diagnosis. DESIGN: The tongue features for 67 patients with 0 and 1 stages of BC, and 70 non-breast cancer individuals are extracted by the automatic tongue diagnosis system (ATDS). A total of nine tongue features, namely, tongue color, tongue quality, tongue fissure, tongue fur, red dot, ecchymosis, tooth mark, saliva, and tongue shape are identified for each tongue. Features extracted are further sub-divided according to the areas located, i.e., spleen-stomach, liver-gall-left, liver-gall-right, kidney, and heart-lung areas. This study focuses on deriving significant tongue features (p<0.05) to discriminate early-stage BC patients from non-breast cancer individuals. RESULTS: The Mann-Whitney test shows that the amount of tongue fur (p=0.024), maximum covering area of tongue fur (p=0.009), thin tongue fur (p=0.009), the average area of red dot (p=0.049), the maximum area of red dot (p=0.009), red dot in the spleen-stomach area (p=0.000), and red dot in the heart-lung area (p=0.000) demonstrate significant differences. The data collected are further classified into two groups. The training group consists of 57 early-stage BC patients and 60 non-breast cancer individuals, while the testing group is composed of 10 early-stage BC patients and 10 non-breast cancer individuals. The logistic regression by utilizing these 7 tongue features with significant differences in Mann-Whitney test as factors is performed. In order to reduce the number of tongue features employed in prediction, tongue features with the least amount of significant difference, namely, maximum area of red dot and average area of red dot, are removed progressively. The tongue features of the testing group are employed in the aforementioned three models to test the power of significant tongue features identified in predicting early-stage BC. An accuracy of 80%, 80% and 90% is reached on non-breast cancer individuals by applying the 7, 6 and 5 significant tongue features obtained through Mann-Whitney test, respectively, while 60%, 60% and 50% is reached on the corresponding early-stage BC patients. CONCLUSION: The TCM tongue diagnosis can serve as a preliminary screening procedure in the early detection of BC 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 early-stage BC patients and non-breast cancer individuals.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Medicina Tradicional China/métodos , Lengua/patología , Adolescente , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Modelos Teóricos , Adulto Joven
8.
J Tradit Complement Med ; 3(3): 194-203, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24716178

RESUMEN

Breast cancer (BC) ranks second in the cancer fatality rate among females worldwide. Mammogram, ultrasound, magnetic resonance imaging (MRI), blood testing, and fine needle aspiration biopsy are usually applied to discriminate BC patients from normal persons. False-negative results, undetectable calcifications, movement-incurred blurry image, infection, and sampling error are commonly associated with these traditional means of diagnosis. Traditional Chinese medicine (TCM) covers a broad range of medical practices sharing common theoretical concepts. Tongue diagnosis plays an important role in TCM. Organ conditions, properties, and variation of pathogens can be revealed through observation of tongue. In light of this observation, this paper investigates discriminating tongue features to distinguish between BC patients and normal people, and establishes differentiating index to facilitate the non-invasive detection of BC. The tongue features for 60 BC patients and 70 normal persons were extracted by the Automatic Tongue Diagnosis System (ATDS). The Mann-Whitney test showed that the amount of tongue fur (P = 0.007), tongue fur in the spleen-stomach area, maximum covering area of tongue fur, thin tongue fur, the number of tooth marks, the number of red dots, red dot in the spleen-stomach area, red dot in the liver-gall-left area, red dot in the liver-gall-right area, and red dot in the heart-lung area demonstrated significant differences (P < 0.05). The tongue features of the testing group were employed to test the power of significant tongue features identified in predicting BC. An accuracy of 80% was reached by applying the seven significant tongue features obtained through Mann-Whitney test. To the best of our knowledge, this is the first attempt in applying TCM tongue diagnosis to the discrimination of BC patients and normal persons.

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