Tongue diagnosis system for quantitative assessment of tongue coating in patients with functional dyspepsia: A clinical trial
Tongue diagnosis system for quantitative assessment of tongue coating in patients with functional dyspepsia: A clinical trial
复制标题
DOI：
10.1016/j.jep.2014.06.010
复制
发表时间：
2014-08-08
影响因子：
5.4
通讯作者：
Kim, Jinsung
中科院分区：
文献类型：
--
作者：
Kim, Juyeon;Han, Gajin;Kim, Jinsung
人种药理学相关性：舌诊是东方医学中观察人体生理和病理变化的重要手段。然而，由于各种外界因素和主观因素的影响，传统的舌诊方法，包括直接观察舌象，都存在一定的局限性。因此，本研究通过评估舌诊系统（TDS）与评估员使用传统方法建立的金标准之间的一致性，探讨了舌诊系统（TDS）作为评估舌苔厚度（TCT）的诊断工具的有效性。材料和方法：本研究设计为前瞻性临床试验，包括60名功能性消化不良患者。TDS用于在30分钟间隔内捕获舌图像两次，以评估其可重复性。用TDS测量舌苔百分比，根据现有的诊断标准将TCT分为无苔、薄苔或厚苔。在两次TDS检查后，定量测量舌苔重量，并使用Pearson相关性分析实际舌苔量与TDS测量的舌苔百分比之间的相关性。在收集所有60例患者的舌图像后，由5名训练有素的评估员使用常规方法评估舌苔，以建立评估TCT的金标准，这使我们能够评估TDS与金标准之间的诊断一致性。2周后，TCT评价重复相同的评估员使用相同的图像，但在一个随机order.Results：TDS和金标准之间的协议，用于评价TCT几乎是完美的（加权Kappa，0.840），是TDS的再现性（加权Kappa，0.851）。TDS法测定的舌苔百分率与舌苔重量呈显著正相关（r=0.442，p < 0.001）。评定者内部可靠性的水平范围从实质性到几乎完美（加权Kappa范围，0.777-0.923）。5名评估者的评分者间信度为中等（加权Kappa值为0.563）。结论：TDS可作为临床TCT客观、规范评价的诊断工具。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Ethnopharmacological relevance: Tongue diagnosis is a significant procedure to examine the physiological and pathological changes of the human body in oriental medicine. However, the conventional method of tongue diagnosis including direct observation of tongue has limitations because of various external factors and subjective factors. Therefore, the current study investigated the usefulness of the tongue diagnosis system (TDS) as a diagnostic tool for evaluating tongue coating thickness (TCT) by assessing the agreement between the TDS and a gold standard established by assessors using the conventional method.Materials and methods: The present study was designed as a prospective clinical trial including 60 patients with functional dyspepsia. The TDS was used to capture tongue images twice within a 30-min interval to assess its reproducibility. Tongue coating percentage was measured by the TDS, and TCT was classified as either no coating, thin coating, or thick coating according to the existing diagnostic criteria. After both TDS examinations, the weight of tongue coating was quantitatively measured, and the correlation between the actual quantity of tongue coating and the percentage of the coating measured by the TDS was analyzed using Pearson's correlation. After collecting tongue images in all 60 patients, tongue coating was evaluated using a conventional method by 5 well-trained assessors to establish the gold standard for evaluating TCT, which allowed us to assess the diagnostic agreement between the TDS and the gold standard. After 2 weeks, TCT evaluation was repeated by the same assessors using the same images but in a random order.Results: The agreement between the TDS and the gold standard for evaluating TCT was almost perfect (weighted kappa, 0.840), as was the reproducibility of the TDS (weighted kappa, 0.851). The percentage of tongue coating measured by the TDS was significantly correlated with the weight of tongue coating (r=0.442, p < 0.001). The levels of intra-rater reliability ranged from substantial to almost perfect (range of weighted kappa, 0.777-0.923). The inter-rater reliability of 5 assessors was moderate (weighted kappa, 0.563).Conclusions: The present study demonstrated that the TDS can be used as a diagnostic tool for the objective and standardized evaluation of TCT in actual clinical practice. (C) 2014 Elsevier Ireland Ltd. All rights reserved.