摘要
目的通过收集乳腺癌不同中医证型、不同临床分期、不同分子分型舌象图像数据信息,观察其与舌象特征的相关性,为乳腺癌的舌象客观化研究提供参考数据。方法选取2019年6月—2021年1月期间于北京中医药大学东直门医院血液肿瘤科就诊的乳腺癌患者,使用TFDA-1型数字舌诊仪采集乳腺癌患者舌象图片,以Matlab为图像处理系统,采用RGB和HSV颜色模型测量程序对所采集舌象图片的颜色参数进行测量,分别测出:R、G、B、H、S、V。另外以R、G、B为基础计算出紫色系数P、黄色系数Y。采用SPSS 20.0统计学软件对不同中医证候、不同临床分期、不同分子分型乳腺癌患者的舌象颜色参数进行分析比较。结果(1)不同证候乳腺癌患者舌象客观化结果:(1)舌色客观化参数:与气虚证、痰湿证比:气滞证、血瘀证舌H、舌B、舌P升高;热毒证舌H、舌R、舌P、舌V升高;阴虚证舌H、舌R、舌B、舌P、舌V均升高。与气虚证比较,痰湿证舌H、舌P升高。(2)苔色客观化参数:与气虚证比较,其余五组苔H降低,气滞证、热毒证、血瘀证苔R、苔Y、苔V升高,痰湿证苔S降低。与气滞证比较,痰湿证、血瘀证、阴虚证苔H升高,苔Y降低,痰湿证苔S降低。与热毒证比较,痰湿证、血瘀证、阴虚证苔H升高,苔Y降低,痰湿证苔R、苔S,苔V降低。与痰湿证比较,血瘀证、阴虚证苔H升高,苔S升高。(2)不同分期乳腺癌患者舌象客观化结果:(1)在舌色客观化参数中,与Ⅱ期、Ⅳ期比较,Ⅰ期舌P升高。(2)在苔色客观化参数中,与Ⅳ期比较,Ⅱ期、Ⅲ期苔R、苔V升高。(3)不同分子分型乳腺癌患者舌象客观化结果:(1)在舌色客观化参数中,不同分子分型乳腺癌患者在舌R、舌G、舌B、舌P、舌H、舌S、舌V这7项指标上均未表现出显著性差异。(2)在苔色客观化参数中,与Her2过表达型和三阴型比较,Luminal A型、Luminal B型苔R、苔V升高。结论(1)在不同证候中,RGB和HSV颜色模型能够在一定程度上反映不同证候乳腺癌的舌象客观化特点,大部分客观化参数能够还原中医辨证的临床视角,且与中医理论契合。(2)在临床分期中,舌P、苔R、苔V能够反映不同分期乳腺癌的舌色、苔色情况,一定程度上可为不同分期乳腺癌的舌象特点提供客观化参考依据。(3)在分子分型中,苔R、苔V能够反映受体阳性与受体阴性乳腺癌患者苔色情况,一定程度上可为受体阳性与受体阴性乳腺癌患者的苔色特点提供客观化参考依据。
Objective To study the correlation between different TCM syndromes,different clinical stages and different molecular types of breast cancer by collecting tongue image data information,so as to provide reference data for the objective study on tongue image of breast cancer.Methods The breast cancer patients who visited the Department of Hematology and Oncology,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine from June 2019 to January 2021 were selected,and the tongue images of breast cancer patients were collected using the TFDA-1 digital tongue diagnostic apparatus,and Matlab was used for image processing.The system uses the RGB and HSV color model measurement procedures to measure the color parameters of the collected tongue images,and respectively measure:R,G,B,H,S,V.In addition,the purple coefficient P and the yellow coefficient Y are calculated based on R,G,and B.SPSS 20.0 statistical software was used to analyze and compare the tongue color parameters of breast cancer patients with different TCM syndromes,clinical stages and molecular types.Results(1)Objective results of tongue images in breast cancer patientswith different TCM syndromes:(1)Objective parameters of tongue color:Compared with Qi deficiency syndrome and phlegm dampness syndrome,tongue H,tongue B and tongue P of Qi stagnation syndrome and blood stasis syndrome increased;tongue H,tongue R,tongue P and tongue V of heat toxin syndrome increased;tongue H,tongue R,tongue B,tongue P and tongue V of Yin deficiency syndrome increased.Compared with Qi deficiency syndrome,tongue H and tongue P of phlegm dampness syndrome increased.(2)Objective parameters of tongue coating color:Compared with Qi deficiency syndrome,the tongue coating H in the other five groups decreased,the tongue coating R,Y and V in Qi stagnation syndrome,heat toxicity syndrome and blood stasis syndrome increased,and the tongue coating S in phlegm dampness syndrome decreased.Compared with Qi stagnation syndrome,the tongue coating H in phlegm dampness syndrome,blood stasis syndrome and Yin deficiency syndrome increased,the tongue coating Y decreased,and the tongue coating S in phlegm-dampness syndrome decreased.Compared with the heat toxin syndrome,the tongue coating H increased and the tongue coating Y decreased in the phlegm-dampness syndrome,blood stasis syndrome and Yin deficiency syndrome,and the tongue coating R,S and V decreased in the phlegm dampness syndrome.Compared with phlegm dampness syndrome,the tongue coating H and S increased in blood stasis syndrome and Yin deficiency syndrome.(2)Objective results of tongue images in breast cancer patients at different clinical stages:(1)In objective parameters of tongue color,Compared with stageⅡand stageⅣ,the tongue P of breast cancer patients at stage I was increased.(2)In objective parameters of tongue coating color,compared with stageⅣ,the tongue coating R and tongue coating V of breast cancer patients at stage II and stageⅢincreased.(3)Objective results of tongue images in breast cancer patients with different molecular subtypes:(1)There were no significant differences in tongue R,tongue G,tongue B,tongue H,tongue S and tongue V among different Luminal types in objective parameters of tongue color.(2)In objective parameters of tongue coating color,compared with the Her2 positive type and the Triple negative type,tongue coating R and tongue coating V of Luminal A and Luminal B were increased.Conclusions(1)In different syndromes,RGB and HSV color models can reflect the objective characteristics of tongue image in different syndromes of breast cancer to a certain extent.Most of the objective parameters can restore the clinical perspective of TCM syndrome differentiation,and are consistent with TCM theory.fit.(2)In clinical staging,tongue P,coating R,and coating V can reflect the tongue color and coating color of breast cancer in different stages,and to a certain extent can provide an objective reference for the characteristics of tongue image in different stages of breast cancer.(3)In molecular typing,moss R and moss V can reflect the moss color of patients with receptor-positive and receptor-negative breast cancer,and to a certain extent can provide information on the moss color characteristics of receptor-positive and receptor-negative breast cancer patients.
作者
王静
贾玫
姜琳
关静
沈洋
WANG Jing;JIA Mei;JIANG Lin;GUAN Jing;SHEN Yang(The First Clinical Medical College of Beijing University of Chinese Medicine,Beijing 100700;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;College of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029)
出处
《世界中西医结合杂志》
2022年第1期116-122,共7页
World Journal of Integrated Traditional and Western Medicine
基金
国家重点研发计划中医药现代化研究重点专项(2017YFC1703302)。
关键词
乳腺癌
舌象
客观化
颜色模型
Breast Cancer
Tongue Image
Objectification
Color Model
