Objective Tongue images screening and endoscopic screening in areas with high incidence of esophageal cancer were combined to analyze the characteristics of tongue images under different physiological states in process of esophageal carcinoma carcinogenesis,and to explore the characteristics of tongue images and the pathogenesis of traditional Chinese medicine(TCM)in the transformation from precancerous lesions of esophagus to early esophageal squamous cell carcinoma.Methods A total of 18 954 patients who completed endoscopic screening and tongue images screening from 2017 to 2021 in Cixian County of Hebei Province,Yanting County of Sichuan Province,and Yangcheng County of Shanxi Province were enrolled.Twelve tongue image features were extracted by Daosheng Tongue Diagnostic Instrument(DS01-B)under a unified standard light source environment.SPSS 24.0 software was used for data analysis,and multivariate Logistic regression was used to control multiple confounding factors.The differences of tongue image features of esophageal precancerous lesions,early esophageal cancers,and pathological normal subjects were compared.Results The distribution analysis of tongue images showed that the proportions of purple tongue in the esophageal precancerous lesion group and the early esophageal cancer group were higher than that in the pathological normal group,and its proportion in the early esophageal cancer group was higher than that in the esophageal precancerous lesion group.The logistic regression analysis results showed that the OR values of purple tongue in the esophageal precancerous lesion group and the early esophageal cancer group were 1.82(95%CI:1.45～2.28,P＜0.001)and 2.14(95%CI:1.51～3.05,P＜0.001),respectively.Red tongue and fissured tongue had high proportions in the precancerous lesion group,while the proportions in the early esophageal cancer group were slightly lower than those in the esophageal precancerous lesion group.Logistic regression analysis results showed that the OR values were 1.44(95%CI:1.25～1.66,P = 0.003)and 1.49(95%CI:1.30-1.72,P＜0.001),respectively.Other statistically significant tongue image features were incorporated into multivariate Logistic regression analysis,and the results were consistent with the previous analysis.Conclusion The proportions of purple tongue,red tongue,and fissured tongue in the esophageal precancerous lesion group were higher than those in the pathological normal group.The proportion of purple tongue in the early esophageal cancer group was higher than that in the esophageal precancerous lesion group,while the proportions of red tongue and fissured tongue were slightly lower than those in the esophageal precancerous lesion group,reflecting the TCM pathogenesis of the transformation from yin deficiency and dryness-heat to blood stasis in the process of esophageal cancer.
关键词
早期食管癌/癌前病变/舌象/中医病机/大数据
Key words
early esophageal cancer/precancerous lesions/tongue image/mechanism of traditional Chinese medicine/big data
维普
万方数据