• The Journal of Internal Korean Medicine
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• v.33 no.1
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• pp.1-13
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• 2012

Background : In oriental medicine, the status of the tongue is an important indicator to diagnose the condition of one's health, such as physiological and the clinicopathological changes of internal organs. A tongue diagnosis is not only convenient but also non-invasive, and therefore widely used in Oriental medicine. However, the tongue diagnosis is greatly affected by examination circumstances, patient's posture, and doctor's diagnosis criteria. Objectives : This study was designed to assure the necessity for standardization of tongue diagnosis based on diagnostic criteria of tongue coating thickness (TCT). Methods : Thirty tongue photographs were acquired and analyzed by digital tongue diagnosis system (DTDS) which measured the percentage of TCT on the tongue surface. Fifteen oriental medical doctors evaluated TCT in 30 photographs. Afterward, the 15 assessors were trained for diagnostic criteria of TCT and evaluated the photographs again. The intraclass correlation coefficient (ICC) was used to obtain the agreement rate among the 15 assessors and the agreement rate between assessors' TCT scores and DTDS values. Results : The agreement rate among the 15 assessors after training was higher than before training. The agreement rate between assessors' TCT scores and DTDS values after training was also higher than before training. Furthermore, the difference of the agreement rate between before and after training was significant (p<0.05). Conclusions : The standardization of diagnostic criteria of TCT increased the agreement rate among the assessors and the agreement rate between assessors' TCT scores and DTDS values. Therefore, the standardization of diagnostic criteria is expected to contribute to the objectification and quantification of the tongue diagnosis system.

• The Journal of Korean Medicine
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• v.31 no.1
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• pp.23-29
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• 2010

Objective: The aim of this prospective, case-controlled study was to assess the difference of the amount of tongue coating between halitosis and non-halitosis patients using a digital tongue diagnosis system (DTDS). Methods: Sixty-five patients complaining of oral malodor were recruited for the study. The level of volatile sulfur compounds (VSC) in the oral cavity of the patients was measured by a portable gas chromatography. All patients were then divided into two groups, the halitosis group ($H_2S{\geq}1.5ng$/10ml, or $CH_3SH{\geq}0.5ng$/10ml) and the non-halitosis group ($H_2S$<1.5ng/10ml and $CH_3SH$<0.5ng/10ml), according to the VSC level criteria published by Tonzetich. Tongue images of the two groups were acquired and analyzed by DTDS, followed by the analysis of the tongue coating scores. Results: The tongue coating scores of the halitosis group were significantly higher than of the non-halitosis group (P=0.033). Furthermore, the difference of the posterior tongue coating between the two groups was more significant (P=0.000). Conclusions: Halitosis patients were shown to have a thicker tongue coating than those in the non-halitosis group. Moreover, the posterior dorsum of the tongue should be observed more cautiously when dealing with halitosis patients. Also, the progress and state of the patient's symptom of halitosis as diagnosed objectively by the portable gas chromatography could also possibly be analyzed instead by the DTDS tongue coating score.

• The Journal of Korean Medicine
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• v.32 no.2
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• pp.42-62
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• 2011

Objective: This study was designed to identify and explore the pathological patterns of functional dyspepsia (FD) patients. We also evaluated the usefulness of the Pattern Identification Questionnaire by comparing it with other assessment tools for FD. Methods: We recruited 97 FD patients based on the Rome III criteria for FD diagnosis. The pathological patterns of the subjects were determined by the Pattern Identification Questionnaire. Their dyspepsia-related symptoms were assessed using the Gastrointestinal Symptom Questionnaire (GIS) and the Pyeongwi-san (Pingwei-san) Patternization Questionnaire. Depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and quality of life with the Functional Dyspepsia-Related Quality of Life (FD-QoL) Questionnaire. Tongue coating was measured by the Digital Tongue Diagnosis System (DTDS). Results: The male to female ratio was 1:1.1, and the forties and fifties age groups were largest in number. The spleen deficiency and phlegm-dampness pattern was the most common pattern found among the FD patients. No significant differences in the GIS, BDI, FD-QoL, and DTDS scores were found among the five pattern types. All pattern types showed significant correlation with GIS, Pyeongwi-san Patternization Questionnaire, and FD-QoL scores. Conclusions: Pattern Identification Questionnaire can not only identify the pathological pattern types of FD patients but also evaluate the severity of their symptoms. Compared to conventional assessment tools for FD, it could enable a more dynamic evaluation of FD patients reflecting the severity of dyspeptic symptoms and the quality of life. Further studies on the Pattern Identification of FD patients are anticipated in order to improve the diagnosis and therapy for Korean FD patients.