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We ship to any location in the United States. Detailed Seller Information. List this Seller's Books. Payment Methods accepted by seller. AbeBooks Bookseller Since: 21 February The processing flow of ATDS analysis. These features are extracted by ATDS to further generate detailed information regarding length, area, moisture, and number of relevant tongue features.
The experience of TCM practitioners and multiple professional opinions are integrated to forge the final classification based on the aforementioned characteristics of tongue features derived.
The tongue features in different groups were analyzed and compared using independent t test for continuous variables and chi-square test or Fisher exact for categorical variables. Furthermore, one-way analysis of variance ANOVA was applied to compare difference between group means. A total of participants of the control group and patients with type 2 DM were enrolled in the study.
The clinical characteristics of the patients with type 2 DM were as follows: mean age The patients with type 2 DM had significantly higher degrees of variations in BMI and AC sugar levels but significantly lower changes in total cholesterol than those in the control group.
The mean BMI The cholesterol level in control group was significantly higher than the type 2 DM one In terms of fur thickness, the proportion of thick fur in type 2 DM group was significantly higher than the control counterpart In type 2 DM group, The proportion of dry mouth in the type 2 DM group was higher than that in control 8. There were fewer red dots in the type 2 DM group than those of control one No significant difference in tongue shape between the type 2 DM and the control groups was observed.
Comparison of tongue features between patients with type 2 diabetes mellitus DM and control subjects. The tongue features of control group and type 2 DM group.
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Control group: A pink tongue, thin, and white fur. Type 2 DM group: B bluish tongue, thick, and yellow fur. A significant difference in fur color was identified among these 2 subgroups. The remaining tongue features did not vary significantly between these 2 subgroups. No tongue feature was identified to significantly link to the amount of blood glucose level between these 2 subgroups. To the best of our knowledge, this is the first study to apply ATDS to thoroughly investigate the tongue features associated with type 2 DM.
The tongue appearance is a crucial indicator in the TCM assessment. Studies have shown that tongue diagnosis played an important role in clinical prognosis and treatment of diabetes. In light of the aforementioned observation, the differences in tongue features between type 2 DM and control groups were performed. Moreover, the tongue features in different diabetic duration and blood glucose level were analyzed and compared in this study.
Most diabetic patients are found to have oral manifestations, e. Tongue fur represents the retention of exfoliated mucosa cells, debris, and proliferation of microorganisms, especially on the tongue's surface.
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Our previous study revealed that The thick fur is usually accompanied with patterns of phlegm-dampness and blood stasis. Another study revealed that yellow tongue coating was associated with higher prevalence of DM and tended to be linked with pre-diabetes. The presence of xerostomia and hyposalivation is often encountered among DM patients. These studies showed higher prevalence of xerostomia in DM patients in relation to non-DM population, ATDS classified the amount of saliva into dry, normal, and wet categories based on the proportion of tongue area covered by saliva.
Different stratification regarding the amount of saliva might be employed shall the need arise in the future. We speculate that the tongue features of type 2 DM patients with poor control or prolonged duration would show more significant changes, such as red tongue color, thick fur, yellow fur, and dry saliva.
The result demonstrated that significantly higher portion of patients with prolonged diabetic duration possessed yellow fur color than the counterparts with shorter sick period. Yellow fur color usually results from poor oral hygiene as food and bacteria can accumulate on the filiform papillae on the surface.
According to TCM theory, yellow fur color mirrors an interior heat pattern and the deeper yellow color indicates an even more severe heat condition. Understanding and interpreting these tongue manifestations of type 2 DM are important for both theoretical and clinical applications. This study applied ATDS, a modern instrument with high degree of consistency, to derive tongue features automatically to reduce human vision bias.
western tongue diagnosis
However, there were several limitations in our study. First, some participants might have comorbidity, such as hypertension, hyperlipidemia, etc. These comorbidities and vascular complications may affect the tongue appearance and the features extracted, although there is not enough evidence to support the above statement. Secondly, the sublingual collateral vessels have not yet been analyzed. Abnormal collateral vessels may be associated with vascular complications. The association between diabetic vascular complications and tongue features will be explored in our future research.
This study showed that significantly high prevalence of thick fur, yellow fur color, and bluish tongue in patients with type 2 DM compared with those in the control group. In the future, observing the tongues of patients with different diseases as comparators to show that the findings we have made are either unique to type 2 DM or statistically more prevalent in type 2 DM. The authors would like to thank Miss Li-Jyun Deng, and all of the colleagues who helped contribute to this study. The authors are grateful to the anonymous reviewers for their valuable comments. Chiang, and Lun-Chien Lo led the writing of the manuscript.
Atlas of Chinese Tongue Diagnosis, Volume 2
All authors commented on the analytic plan and interpretation, and contribution to the editing and final approval of the manuscript. Chiang, Lun-Chien Lo. The authors declare that they have no competing interests. National Center for Biotechnology Information , U. Journal List Medicine Baltimore v. Medicine Baltimore. Published online May John Y.
Find articles by John Y. Author information Article notes Copyright and License information Disclaimer. Published by Wolters Kluwer Health, Inc. The work cannot be changed in any way or used commercially without permission from the journal. Abstract Diabetes mellitus DM is a public problem closely associated with numerous oral complications, such as coated tongue, xerostomia, salivary dysfunction, etc.
Keywords: automatic tongue diagnosis system, tongue features, traditional Chinese medicine, type 2 diabetes mellitus. Introduction With the rapid increase in population growth, aging, obesity, and inactivity of lifestyle, diabetes mellitus DM has become the major burden of adult public health.
Methods 2. Ethics approval and consent to participate An observational cross-sectional and clinical cohort study was conducted. Open in a separate window. Figure 1. Table 1 Demography of study participants. Table 2 Comparison of tongue features between patients with type 2 diabetes mellitus DM and control subjects. Figure 2. Discussion To the best of our knowledge, this is the first study to apply ATDS to thoroughly investigate the tongue features associated with type 2 DM.
Atlas of Chinese Tongue Diagnosis Vol 1 / Edition 1
Conclusions This study showed that significantly high prevalence of thick fur, yellow fur color, and bluish tongue in patients with type 2 DM compared with those in the control group. Prevalence of diabetes among men and women in China. N Engl J Med ; — The evolving diabetes burden in the United States. Ann Inter Med ; — Global prevalence of diabetes: estimates for the year and projections for Diabetes Care ; 27 — Diabetes-related microvascular and macrovascular diseases in the physical therapy setting.
Phys Ther ; 88 — Molecular mechanisms of diabetic vascular complications.