Tongue inspection

a protocol to integrate neurology and traditional Chinese medicine

Autores/as

  • Gislaine Cristina Abe MD, MS, Traditional Chinese Medicine Outpatient Clinic, Division of Neuromuscular Disease Research, Department of Neurology, Universidade Federal de São Paulo‒UNIFESP, São Paulo-SP, Brazil.
  • Paulo Eduardo Ramos PT, PhD, Traditional Chinese Medicine Outpatient Clinic, Division of Neuromuscular Disease Research, Department of Neurology, Universidade Federal de São Paulo‒UNIFESP, São Paulo-SP, Brazil.
  • Sissy Veloso Fontes PT, PhD, Department of Neurology, Universidade Federal de São Paulo‒ UNIFESP
  • Márcia Pradella Hallinan MD, PhD, Department of Psychobiology, Universidade Federal de São Paulo‒ UNIFESP, São Paulo-SP, Brazil.
  • Acary Souza Bulle Oliveira MD, PhD, Division of Neuromuscular Disease Research, Department of Neurology, Universidade Federal de São Paulo‒UNIFESP, São Paulo-SP, Brazil.

DOI:

https://doi.org/10.34024/rnc.2014.v22.8093

Palabras clave:

Medicine, Traditional Chinese, Tongue, Diagnosis, Integrative medicine, Neurology

Resumen

Background. Tongue inspection (TI) is important for diagnosis and prognosis in traditional Chinese medicine (TCM). Tongue evalua­tion models vary among countries; however, no systematic protocol is in place. Objective. To propose a systematic protocol for TI to be used in neurology. Method. 1) A review of the books in English, Portuguese, and Spanish, and of papers in English, Portuguese, Span­ish, and French retrieved from the databases Pubmed, Lilacs, and Cochrane Library using the following descriptors: tongue, diagnosis, prognosis, traditional Chinese medicine; 2) Selection of the major tongue characteristics; search for a tongue examination protocol, and search for descriptions of features related to prognostic assessment. Results. In total, 26 articles were selected; however, none of them provided information pertaining to the object of the present study, or the information was inaccurate and vague. The same occurred with the Western medicine books, as none of them outlined a protocol. A TCM-based TI protocol was prepared, comprising four levels of severity and complexity. Conclusion: A systematic TI protocol was created for use in integrative medicine (Western and Chinese medi­cine), eliminating the divergent points and simplifying the items to be assessed during tongue inspection.

Métricas

Cargando métricas ...

Referencias

Chen ZL. Brief history of tongue inspection. Chin Med J (Engl) 1987;100:38-44.

Laskin DM, Giglio JA, Riper ET. Differential diagnosis of tongue lesions. Oral Pathology 2003;34:331-42.

McKee HR, Escott E, Damm D, Kasarskis E. Macroglossia in Amyotrophic Lateral Sclerosis . JAMA Neurol 2013;70:1432-5. http://dx.doi.org/10.1001/jamaneurol.2013.3138

Atsumi T, Miyatake T. Morphometry of the degenerative process in the hypoglossal nerves in amyotrophic lateral sclerosis. Acta Neuropathol 1987;73:25-31. http://dx.doi.org/10.1007/BF00695498

Misawa S, Noto Y, Shibuya K, Isose S, Sekiguchi Y, Nasu S, et al. Ultrasonographic detection of fasciculations markedly increases diagnostic sensitivity ofALS. Neurology 2011;77:1532-7. http://dx.doi.org/10.1212/WNL.0b013e318233b36a

Abe GC, Ramos PE, Fontes SV, Yonamine B, Mello CADS, Quadros AJ, et al. Poliomielite e síndrome pós-pólio pela medicina traditional chinesa: da fisiopatologia ao diagnóstico. Rev Neurocienc 2011;19:365-81.

Ichikawa H, Terayama R, Yamaai T, Repentigny YD, Kothary R, Sugimoto T. Dystonin deficiency reduces taste buds and fungiform papillae in the anterior part of the tongue. Brain Res 2007;1129:142-6. http://dx.doi.org/10.1016/j.brainres.2006.04.044

Gardiner J, Barton D, Vanslambrouck JM, Braet F, Hall D, Marc J, et al. Defects in tongue papillae and taste sensation indicate a problem with neurotrophic support in various neurological diseases. Neuroscientis 2008; 14:240-50. http://dx.doi.org/0.1177/1073858407312382

Kim M, Cobbin D, Zaslawski C. Traditional Chinese medicine tongue inspection: an examination of the inter- and intrapractitioner reliability for specific tongue characteristics. J Altern Complement Med 2008;14:527-36.

http://dx.doi.org/10.1089/acm.2007.007910. Zhang GG, Singh B, Lee W, Handwerger B, Lao L, Berman B. Improvement of agreement in TCM diagnosis among TCM practitioners for persons with the conventional diagnosis of rheumatoid arthritis: effect of training. J Altern Complement Med 2008;14:381-6. http://dx.doi.org/10.1089/acm.2007.0712

Zhang GG, Singh B, Lee W, Handwerger B, Lao L, Berman B. Improvement of agreement in TCM diagnosis among TCM practitioners for persons with the conventional diagnosis of rheumatoid arthritis: effect of training.

J Altern Complement Med 2008;14:381-6. http://dx.doi.org/10.1089/acm.2007.0712

Abe GC, Yonamine BTS, Mello CS, Ramos PE, Conde MS, Oliveira ASB. Acupuncture for treating persistent pain in Brazilian para-athletes. Med Acupun 2014;26:50-6. http://dx.doi.org/10.1089/acu.2013.1014

Fei ZF, Gu YD. Mirror of health: tongue diagnosis in Chinese Medicine. 2th ed. Beijing: People´s Medical Publishing House; 2007, 214p.

Yamamura Y, Yamamura ÉS. Tongue energetic propaedeutics and Chinese pulsology. São Paulo: Center for Study and Research in Chinese Medicine; 2009, 578p.

Maciocia G. Tongue diagnosis in Chinese medicine. São Paulo: Roca; 2003, 224p.

O’Brien KA, Abbas AND, Zhang J, Guo ZX, Luo R, Bensoussan A, et al. Understanding the reliability of diagnostic variables in a Chinese Medicine examination. J Altern Complement Med 2009;15:727-34. http://dx.doi.org/10.1089/acm.2008.0554

Anastasi JK, Currie LM, Kim GH. Understanding diagnostic reasoning in TCM practice: tongue diagnosis. Altern Ther Health Med 2009;15:18-28.

Chen ZL, Xie JW, Chen JM, Xu DS, Wang PZ, Shen JZ, et al. An analysis on tongue features of 5403 healthy subjects. J Tradit Chin Med 1982;2:151-6.

Su W, Xu ZY, Wang ZQ, Xu JT. Objectified study on tongue images of patients with lung cancer of different syndromes. Chin J Integr Med 2011;17:272-6. http://dx.doi.org/10.1007/s11655-011-0702-6

Lim KS, Hew YC, Lau HK, Lim TS, Tan CT. Bulbar signs in normal population. Can J Neurol Sci 2009;36:60-4.

Lin SC, Chen MF, Li TC, Hsieh YH, Liu SJ. The distribution of Yin-Deficient symptoms and their relationship on survival rate in cancer patients with Yin-Deficiency. Am J Chin Med 2008;36:655-63. http://dx.doi.org/10.1142/S0192415X08006120

Jiang M, Zha Q, Lu C, He Y, Lu A. Association between tongue appearance in Traditional Chinese Medicine and effective response in treatment of rheumatoid arthritis. Complement Ther Med 2011;19:115-21. http://dx.doi.org/10.1016/j.ctim.2011.05.002

Chen ZL, Hu QF. Recent development in research on tongue inspection. Chin Med J (Engl) 1986;99:444-56.

Chiu CC. A novel approach based on computerized image analysis for traditional Chinese medical diagnosis of the tongue. Comput Methods Programs Biomed 2000;61:77-89. http://dx.doi.org/10.1016/S0169-2607(99)00031-0

Pham B, Cai Y. Visualization Techniques for tongue Analysis in Traditional Chinese Medicine. In The Medical Imaging 2004: Visualization, Image Guided Procedures and Display, 14-19th February, San Diego, California (http://eprints.qut.edu.au/448/).

Pang B, Zhang D, Li N, Wang K. Computerized tongue diagnosis based on Bayesian networks. IEEE Trans Biomed Eng 2004;51:1803-10. http://dx.doi.org/10.1109/TBME.2004.831534

Zhang GG, Lee WL, Lao L, Bausell B, Berman B, Handwerger B. The variability of TCM pattern diagnosis and herbal prescription on rheumatoid arthritis patients. Altern Ther Health Med. 2004 Jan-Feb;10(1):58-63.

Zhang GG, Lee W, Bausell B, Lao L, Handwerger B, Berman B. Variability in the traditional Chinese medicine (TCM) diagnoses and herbal prescriptions provided by three TCM practitioners for 40 patients with rheumatoid arthritis. J Altern Complement Med 2005;11:415-21. http://dx.doi.org/10.1089/acm.2005.11.415

Zhang H, Wang K, Zhang D, Pang B, Huang B. Computer aided tongue diagnosis system. Conf Proc IEEE Eng Med Biol Soc 2005;7:6754-7. http://dx.doi.org/10.1109/IEMBS.2005.1616055

Zhang D, Pang B, Li N, Wang K, Zhang H. Computerized diagnosis from tongue appearance using quantitative feature classification. Am J Chin Med. 2005;33(6):859-66. http://dx.doi.org/10.1142/S0192415X05003466

Wu J, Zhang Y, Bai J. Tongue area extraction in tongue diagnosis of traditional Chinese medicine. Conf Proc IEEE Eng Med Biol Soc 2005;5:4955-7. http://dx.doi.org/10.1109/IEMBS.2005.1615586

Liu Z, Zhang D, Yan J-Q, Li Q-L, Tang Q-L. Classification of hyperspectral medical tongue images for tongue diagnosis. Comp Med Imag Graph 2007;31:672-8. http://dx.doi.org/10.1016/j.compmedimag.2007.07.008

Fang F, Liu P, Wang H, Zhang L, Zhang J, Gao Y, et al. Studies of keratins in tongue coating samples of hepatitis B patients by mass spectrometry. Rapid Commun Mass Spectrom 2009;23:1703-9. http://dx.doi.org/10.1002/rcm.4060

Mao J, Hou Y, Shang H, Wang H, Wang X, Zhao Y, et al. Study on the evaluation of the clinical effects of traditional Chinese medicine in heart failure by complex intervention: protocol of SECETCM-HF. Trials 2009;10:122. http://dx.doi.org/10.1186/1745-6215-10-122

Lu A-P, Chen K-J. Integrative Medicine in clinical practice: from pattern differentiation in Traditional Chinese Medicine to disease treatment.Chin J Integr Med 2009;15(2):152. http://dx.doi.org/10.1007/s11655-009-0152-6

Yan Z, Wang K, Li N. Computerized feature quantification of sublingual veins from color sublingual images. Comput Meth Prog Biomed 2009;93:192-205.

Sun DZ, Liu L, Jiao JP, Wei PK, Jiang LD, Xu L. Syndrome characteristics of traditional Chinese medicine: summary of a clinical survey in 767 patients with gastric cancer. Zhong Xi Yi Jie He Xue Bao 2010;8:332-40. http://dx.doi.org/10.3736/jcim20100406

Publicado

2014-01-23

Número

Sección

Artigos Originais

Cómo citar

1.
Abe GC, Ramos PE, Fontes SV, Hallinan MP, Oliveira ASB. Tongue inspection: a protocol to integrate neurology and traditional Chinese medicine. Rev Neurocienc [Internet]. 2014 Jan. 23 [cited 2025 Dec. 16];22(2):201-14. Available from: https://periodicos.unifesp.br/index.php/neurociencias/article/view/8093