應用標準化舌象特徵知識與客製化APP於中醫舌診案例收集

Applying Standardized Tongue Features Knowledge and Customized APP for TCM Tongue Diagnosis Case Collection

10.6285/MIC.202309_12(2).0011

邱宏彬(Hung-Pin Chiu)；葉明憲(Ming-Hsien Yeh)；張自隆(Tzu-Lung Chang)；林迺衛(Nai-Wei Lin)；林柏伸(Po-Shen Lin)；葉家舟(Chia-Chou Yeh)

中醫 ； 辨證 ； 舌診 ； 客製化APP ； 病例報告 ； traditional Chinese medicine (TCM) ； syndrome differentiation ； tongue diagnosis ； customized APP ； case reports

管理資訊計算

12卷2期（2023 / 09 / 01）

136 - 146

繁體中文;英文

應用舌診所取得的舌象資訊，可以有效的提升中醫辨證論治的效果。但是，在當前臨床環境中，完整舌診案例的紀錄和收集仍存在相當大的侷限性。本研究利用智慧型行動裝置的優勢研發一個輔助中醫舌診APP系統，藉由其提供的標準化舌象特徵與病機知識，輔助中醫師結合其診斷經驗，進行舌診評估和案例紀錄，以克服目前舌診的諸多限制。當中醫師診斷病人時，APP能適時提示所有舌象之病機描述，以協助中醫師進行辨證，並能以一致性文字和圖像的形式記錄完整的舌診診斷經驗，這不僅有利於診斷教學，而且可供後續資料分析之用。本研究採用三個不同出處之30例病例報告，並從這些醫案中擷取舌頭影像、舌象特徵及其辨證描述，來驗證本系統的舌診診斷結果。結果顯示使用本輔助APP的診斷結果與這些醫案具有相當高的符合度。本研究的結果可以輔助中醫師進行更有效精準的辨證論治，對幫助臨床診斷具有重要價值。

Applying the tongue features information obtained by the tongue diagnosis can effectively improve the effect of TCM syndrome differentiation and treatment. However, in the current clinical environment, there are still considerable limitations in recording and collecting complete tongue diagnosis cases. This study develops an assisted APP system for TCM tongue diagnosis. With the standardized tongue characteristics and pathogenesis knowledge provided by it, it assists TCM doctors to combine their diagnostic experiences for tongue diagnosis evaluation and case recording to overcome many current limitations of tongue diagnosis. When a doctor diagnoses a patient, the APP can prompt the pathogenesis descriptions of all the tongue features to assist the doctor in syndrome differentiation, and can record the complete experience of tongue diagnosis in the form of consistent text and images, which is not only beneficial for diagnostic teaching, and can be used for subsequent data analysis. In this study, 30 case reports from three different sources were used, and the tongue images, tongue characteristics and syndrome differentiation descriptions were extracted from these case reports to verify the tongue diagnosis results of the system. The results show that the diagnostic results using the assisted APP have a high degree of agreement with these medical cases. The results of this study can assist TCM doctors to conduct more effective and accurate syndrome differentiation, which is of great value in helping clinical diagnosis.

1. Lo, L. C.,Cheng, T. L.,Chiang, J. Y.,Damdinsuren, N.(2013).Breast cancer index: a perspective on tongue diagnosis in traditional Chinese medicine.Journal of Traditional and Complementary Medicine,3(3),194-203.
   連結：
2. Chiu, C. C.(2000).A novel approach based on computerized image analysis for traditional Chinese medical diagnosis of the tongue.Computer Methods and Programs in Biomedicine,61,77-89.
3. Jeon, Y. J.,Kim, K. H.,Ryu, H. H.,Lee, J.,Lee, S. W.,Kim, J. Y.(2009).Development of the tongue diagnosis system by using surface coating mirror.The 13th International Conference on Biomedical Engineering
4. Jung, C. J.,Jeon, Y. J.,Kim, J. Y.,Kim, K. H.(2012).Review on the current trends in tongue diagnosis systems.Integrative Medicine Research,1(1),13-20.
5. Liang, K.,Huang, X.,Chen, H.,Qiu, L.,Zhuang, Y.,Zou, C.,Bai, Y.,Huang, Y.(2020).Tongue diagnosis and treatment in traditional Chinese medicine for severe COVID-19: a case report.Annals of Palliative Medicine,9(4),2400-2407.
6. Lin, P. S.,Lin, N. W.,Yeh, M. H.,Yeh, C. C.,Chiu, H. P.(2020).Improving fuzzy syndrome differentiation for deficiency syndromes in traditional Chinese medicine.Proceedings of International Conference on Consumer Electronics,Taoyuan, Taiwan:
7. Lo, L. C.,Chen, Y. F.,Chen, W. J.,Cheng, T. L.,Chiang, J. Y.(2012).The study on the agreement between automatic tongue diagnosis system and traditional Chinese medicine practitioners.Evidence-Based Complementary and Alternative Medicine,2012,505063.
8. Lo, L. C.,Hou, M. C. C.,Chen, Y. L.,Chiang, J. Y.,Hsu, C. C.(2009).Automatic tongue diagnosis system.The 2nd International Conference on Biomedical Engineering and Informatics,Tianjin, China:
9. Pang, B.,Zhang, D.,Wang, K. Q.(2005).The bi-elliptical deformable contour and its application to automated tongue segmentation in Chinese medicine.IEEE Transactions on Medical Imaging,24,946-956.
10. Zhang, Bob,Zhang, Han(2015).Significant geometry features in tongue image analysis.Evidence-Based Complementary and Alternative Medicine,2015,897580.
11. 馬建中(1982).中醫診斷學.台北:國立編譯館.
12. 劉癑,陸小左(2005)。便攜式舌像儀的研製。天津中醫學院學報
13. 蘇振隆(2006)。中醫舌診標準化之研究總報告。中醫藥年報，24(6)，299-334。