Tongue Diagnosis of Traditional Chinese
Medicine for Rheumatoid Arthritis
Lun-Chien Lo1, Hong-Jen Lin2, Tsung-Lin Cheng3, Chia-Yun Chen1, Mark C. Hou1,
John Y. Chiang4, Hen-Hong Chang5
1 Department of Chinese Medicine, Changhua Christian Hospital, Taiwan
2 Department of Traditional Chinese Medicine, China Medical University Hospital, Taiwan
3Department of Mathematics and Institute of Statistics and Information Science,
National Changhua University of Education, Taiwan
4 Department of Computer Science and Engineering, National Sun Yat-sen University, Taiwan
5 Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease with
unknown etiology that causes the immune system to attack the joints (synovium) with
chronic inflammation. According to the traditional Chinese medicine (TCM), RA is in
the category of Impediment disease (“Bi” syndrome) that means poor circulation of
Qi and blood (stasis). Tongue diagnosis is an important method in TCM to detect
blood stasis.
In this study, 74 RA patients were recruited via rheumatology outpatient clinic and
examined by experienced rheumatology physician. Pictures of tongue and sublingual
vessels were photographed in a darkroom, using a Canon digital camera, under
standardized temperature color and cold light. Data and signs of tongue were
measured by utilizing image processing technique to extract relevant features and
classify different patterns.
The subjects included 62 females and 12 males with mean age of 49.86±13.81
years , the average morbidity period was 4.56±3.92 years, the mean rheumatoid
factor(RF) was 225.3±373.8 IU/mL and the mean erythrocyte sedimentation rate
(ESR) 40.9±31.9m/hr. Combining image analysis of tongue with laboratory data, we
found that the RF is statistically significantly correlated to the diagnosis of stasis
macule of tongue by using ANOVA. (P=0.007). Besides, about 91% of the patients
have tongues with sublingual vessels with abnormal findings.
Stasis macule and abnormal sublingual vessels indicate blood stasis in Traditional
Chinese Medicine. RF is an important factor of RA and it induced immune complex
which may cause extra-articular manifestations such as vasculitis. Due the some
manifestation of blood stasis was similar to vasculitis in RA and RF was statistically
significant with stasis maclue of tongue, we thought RF has relations with blood stasis
in TCM.