Tongue diagnosis system for quantitative assessment of tongue coating in patients with functional dyspepsia: A clinical trial

Tongue diagnosis is an important procedure in traditional Korean medicine (TKM). In particular, tongue coating thickness (TCT) is deemed to show the progression of the disease. However, conventional tongue diagnosis has limitations because of various external factors. Therefore, it is necessary to investigate the availability of tongue diagnosis system (TDS) in the assessment of TCT. This study has been designed as a prospective clinical trial involving 60 patients with functional dyspepsia. Tongue images will be obtained by TDS twice with a 30 min interval. The system will measure the percentage of TCT and classify it as either no coating, thin coating, or thick coating according to the existing diagnostic criteria. After finishing the collection of 60 patients' tongue images, TCT on the images will be simultaneously evaluated by the conventional method to establish the gold standard for assessing TCT by 5 well-trained clinicians. The evaluation will be repeated by the same clinicians after 2 weeks, but the order of the images will be changed. This trial is expected to provide clinical evidence for the availability of TDS as a diagnostic tool and to contribute to the standardization of the diagnosis system used in TKM. This trial is registered with ClinicalTrials.govNCT01864837.

Download Full-text

Biology of the Tongue Coating and Its Value in Disease Diagnosis

Complementary Medicine Research ◽

10.1159/000479024 ◽

2017 ◽

Vol 25 (3) ◽

pp. 191-197 ◽

Cited By ~ 2

Author(s):

Shipeng Sun ◽

Huamin Wei ◽

Ruili Zhu ◽

Bo Pang ◽

Shuming Jia ◽

...

Keyword(s):

Vascular Endothelial Cells ◽

Disease Diagnosis ◽

Diagnostic Tools ◽

Vascular Endothelial ◽

Tongue Coating ◽

Tongue Diagnosis ◽

Material Basis ◽

Close Relationship ◽

Fundamental Research ◽

Diagnosis Tool

Tongue diagnosis is one of the most important diagnostic tools in traditional Chinese medicine and has been verified for thousands of years. However, its subjectivity and repeatability has been disputed continuously. The tongue coating as the primary coverage of tongue diagnosis provides more objectivity and reproducibility due to its relatively clear molecular basis; it also has a close relationship with many system diseases and may be used as a potentially valuable disease diagnostic tool. This article describes the material basis of the tongue coating, including its biology (epithelial cells, blood cells, vascular endothelial cells, and bacteria) and its metabolites; moreover, we summarize the diseases that are most correlated with the tongue coating. This will be valuable not only for fundamental research of tongue diagnosis but also for the diagnosis and differential diagnosis of disease. We suppose that the tongue coating could serve as a valuable auxiliary diagnosis tool in many diseases, and more research should focus on how to colligate the various information about the tongue and provide useful information for disease diagnosis.

Download Full-text

The Herbal Formula CBD Improves Sleep Quality Dependent on Oral Microbial Type and Tongue Diagnostic Features in Insomnia

10.21203/rs.3.rs-54133/v1 ◽

2020 ◽

Author(s):

Min-Jee Kim ◽

Shambhunath Bose ◽

Na Rae Shin ◽

Meng Yang ◽

Ojin Kwon ◽

...

Keyword(s):

Sleep Quality ◽

Clinical Laboratory ◽

Heart Function ◽

Primary Insomnia ◽

Autonomic Nerve ◽

Oral Microbiota ◽

Tongue Coating ◽

Open Label ◽

Diagnostic Features ◽

Tongue Diagnosis

Abstract Background Cheonwangbosim-dan (CBD) is a traditional Korean herb formula that has been widely prescribed for insomnia patients with a heart-yin deficiency (HYD) pattern. Several studies have recently reported that heart function and insomnia are interrelated, and others have explored associations between insomnia, oral microbiota, and tongue diagnosis. This study aimed to evaluate the effects of CBD on primary insomnia, tongue diagnosis, and oral microbiota. We conducted a prospective, open-label clinical trial on primary insomnia. At baseline, 56 patients with primary insomnia were assigned to two groups, a HYD group and a non-HYD (NHYD) group. Members of these groups took CBD for 6 weeks. Primary and secondary outcomes including Pittsburgh Sleep Quality Indices (PSQIs), Insomnia Severity Indices (ISIs), actigraphy results, cardiac function, autonomic nerve function, clinical laboratory results, tongue features, and oral microbiota were collected from all subjects at after 0, 3, or 6 weeks of treatment. Additionally, PSQI and ISI were determined by telephone follow-up 10 weeks after study commencement.Results During the study, PSQIs and ISIs decreased significantly in both groups. However, the PSQI reduction observed in the HYD group was greater than in the NHYD group and sleep times as determined by actigraphy, that is, total bedtimes (TBTs) and total sleep times (TST), increased only in the HYD group. As sleep quality improved, the amount of tongue coating increased at the posterior tongue, where heart function appears. At baseline, the HYD and NHYD group had a specific oral microbiota (Veillonella at genus level), but no significant change was observed after taking CBD. Additionally, subjects were divided into two oral microbiota types (‘orotype’). The genera Prevotella, Veillonella or Neisseria were abundant in each orotype. The reduction in PSQI in the orotype 1 during the 6-week treatment period was greater than in orotype 2.Conclusions Taking together, CBD was effective in primary insomnia patients with a HYD pattern and CBD increased the amount of tongue coating. In addition, oral microbiota distributions were different in patients with a HYD or a NHYD pattern. The study shows CBD could be used to treat primary insomnia in patients with a HYD pattern as determined using tongue diagnosis and oral microbiota distributional patterns.

Download Full-text