关键词: 糖尿病, 中医辨证, 面诊, 舌诊, 实验室指标

Abstract: Background　The etiology and pathogenesis of diabetes are complex.We intensively studied and summarized TCM-based tongue and face diagnosis techniques to make better use of them to diagnose diabetes conveniently，effectively and reliably.Objective　To investigate pre- and post-treatment changes in tongue and face diagnosis parameters derived from corresponding images and their associations with laboratory indices in patients with type 2 diabetes.Methods　From September 2017 to December 2018，320 diabetic patients' tongue and face diagnosis parameters derived from images（taken by DKF-ⅡFace Digital Detector and DKF-ⅡTongue Digital Detector developed by Shanghai University of Traditional Chinese Medicine），and laboratory indices（plasma blood glucose，glycosylated hemoglobin，cholesterol，triacylglycerol，high-density lipoprotein，low-density lipoprotein，blood urea nitrogen，blood creatinine，blood uric acid） were collected.Canonical correlation analysis was used to analyze the associations of tongue and face diagnosis parameters with laboratory indices.The paired t-test was used to analyze pre- and post-treatment changes in tongue and face diagnosis parameters in 35 of the participants.Results　The canonical correlation coefficient between tongue diagnosis parameters and laboratory parameters was 0.919（P<0.05）.The overall level of tongue diagnosis parameters were mainly influenced by the R value of tongue color，the characteristic value of rotten grease and the characteristic value of thickness of the tongue fur（canonical correlation coefficients were -0.808， -0.791，-0.750，P<0.05）.And the overall level of laboratory indices were mainly influenced by cholesterol，glycosylated hemoglobin and triacylglycerol（canonical correlation coefficients were -0.643，-0.590，-0.569，P<0.05）.The canonical correlation coefficient between the of face diagnosis parameters and laboratory indices was 0.834（P<0.05）.The reference of tongue diagnosis was mainly affected by the Y of face（canonical correlation coefficient was 0.732，P<0.05）.And the laboratory indices were mainly affected by the fasting blood glucose and glycosylated hemoglobin（canonical correlation coefficients were 0.737 and 0.397，P<0.05）.Compared with pre-treatment，the characteristic value of prick and G value of tongue color in 35 diabetic patients decreased after treatment（P<0.05），but other tongue and face diagnosis parameters did not（P>0.05）.Conclusion　 Tongue and face diagnosis parameters may be associated with clinical biochemical indices in type 2 diabetic patients to some extent，indicating that the former two may be used as TCM-based auxiliary predictive parameters for clinical diagnosis and outcome.The pre- and post-treatment changes in tongue and face diagnosis parameters show that tongue diagnosis parameters may be also used as an efficacy evaluation method in these patients.

Key words: Diabetes mellitus, TCM syndrome differentiation, Facial inspection, Tongue inspection, Laboratory indexes