Characteristics of Tongue Images in 3 384 Patients with Advanced Colorectal Cancer
Objective To explore the distribution pattern of tongue images in patients with advanced colorectal cancer(ACRC)under different clinical factors and their significant implications for syndrome differentiation,providing ref-erences for the clinical diagnosis and treatment of ACRC in traditional Chinese medicine(TCM).Methods A total of 3 384 ACRC patients treated at the Oncology Department of Xiyuan Hospital,China Academy of Chinese Medical Sci-ences,by Professor Yang Yufei from January 1,2017,to September 30,2022,were selected as the research participants.General demographic information,tongue image data,and diagnosis and treatment information of the 3 384 patients were collected and organized.The characteristics of tongue images in ACRC patients were explored,and the differences in tongue images among ACRC patients under different clinical factors were analyzed.Descriptive statistical analysis was conducted on the data using SPSS 26.0 statistical software,and differences in count data were mainly compared using the Chi-square test or Fisher's exact test.Results A total of 3 384 cases of ACRC were analyzed,including 1 891 males and 1 493 fe-males,with a male-to-female ratio of 1.27∶1.The average age was 60.90±25.66 years,with a tendency for males to be younger than females.Tongue manifestations primarily included dark red tongue,red tongue,and pale-dark tongue.Tongue abnormalities mainly consisted of teeth marks,cracked tongue,and tongue ecchymosis,while tongue coating abnor-malities were predominantly greasy coating and thick coating.The correlation analysis results showed significant statistical differences in tongue color(dark red,pale-dark),tongue shape(teeth marks),tongue coating color(yellow,white),and tongue coating texture(thick,greasy,slippery)with the site of onset;significant statistical differences in tongue color(pale red,pale-dark),tongue shape(tender,swollen,teeth marks),tongue coating color(yellow,white),and tongue coating tex-ture(greasy,moist,slippery,none)with the initial diagnosis status(initial advanced stage,non-initial advanced stage);significant statistical differences in tongue color(dark red),tongue shape(tender,thin),tongue coating color(yellow coat-ing,white coating),and tongue coating texture(thin coating,thick coating,greasy coating)with metastatic sites(liver metas-tasis/lung metastasis);significant statistical differences in tongue color(purple,pale-dark),tongue shape(cracked,ec-chymosis,tender,teeth marks),and tongue coating texture(greasy,thick)with gene mutation status(RAS,BRAF gene mu-tation/wild type);significant statistical differences in tongue color(red),tongue shape(cracked,teeth marks,ecchymo-sis),and tongue coating color(yellow,white)with microsatellite status.Conclusion ACRC patients exhibit a mixture of deficiency and excess tongue images,indicating varying degrees of spleen deficiency,phlegm dampness,yin deficiency,blood stasis,and heat pathogens.The tongue image characteristics of ACRC under different clinical factors demonstrate cer-tain regularity,which can provide references for the clinical diagnosis and treatment of ACRC in TCM.
Advanced Colorectal CancerTongue Image FeaturesClinical FeaturesTraditional Chinese Medicine Pathogenesis
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