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. 2012 Nov;18(11):1038-44.
doi: 10.1089/acm.2010.0706.

Alteration of the tongue manifestation reflects clinical outcomes of peptic ulcer disease

Hwang-Huei Wang  1 , Chun-Hsu Pan, Ping-Ping Wu, Shu-Fang Luo, Hung-Jen Lin, Chieh-Hsi Wu
Affiliations

Alteration of the tongue manifestation reflects clinical outcomes of peptic ulcer disease

Hwang-Huei Wang et al. J Altern Complement Med. 2012 Nov.

Abstract

Objectives: This study investigated whether the tongue inspection technique in Traditional Chinese Medicine (TCM) can be used as a noninvasive auxiliary diagnostic tool to differentiate the subtypes of peptic ulcer disease (PUD) and as an indicator of therapeutic efficacy.

Subjects and methods: A total of 198 outpatients from the China Medical University Hospital were recruited. The control group comprised 50 healthy adults. The remaining 148 patients were diagnosed with gastric ulcer, duodenal ulcer, or Helicobacter pylori (Hp) infection using upper gastrointestinal (GI) endoscopy, biopsy, and Campylobacter-like organism test. Tongue appearance was evaluated by a physician experienced in clinical Chinese medicine. Images of the tongue were immediately recorded using a high-resolution digital camera system.

Results: The affected group of 148 patients received an 8-week course of ulcer therapy. Of these, 108 patients infected with Hp were subjected to triple therapy in the first week. Forty-nine of these 108 cases infected with Hp completed secondary examination of upper GI endoscopy and tongue inspection. Forty-one of 49 cases (83.7%) were fully cured of Hp infection. These results showed that the color of the tongue body did not change in the cured patients; however, tongue fur was markedly thinner with a color change to white (p<0.05), while sublingual veins with engorgement (p<0.05) and blood stasis (p<0.01) improved after the ulcer healed and Hp was eradicated.

Conclusions: TCM tongue inspection can be potentially used as a noninvasive auxiliary diagnostic method and as an indicator for clinical outcomes for patients with PUD.

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Figures

FIG. 1.
FIG. 1.
Typical examples of the tongue manifestation. (A) A light red tongue (+1) covered with white-thin fur (+1). (B) A red tongue (+3) covered with white-slimy fur (+5). (C) A dark red tongue (+5) covered with yellow-slimy fur (+8). (D) A light red tongue (+1) covered with yellow-thin fur (+4). (E) A tongue with sublingual engorgement (+2). (F) A tongue with blood stasis (+3). Arrows indicated the stasis speckles around the sublingual vein.
FIG. 2.
FIG. 2.
Representative changes of the tongue manifestation in patients with peptic ulcer disease. (A) Before Helicobacter pylori (Hp) therapy, the patient possessed a light red tongue (+2) with yellow-slimy fur (+7), engorged sublingual veins (+2), and blood stasis (+1). (B) After successful Hp eradication, this patient was found to have a light red tongue (+1) with white-thin fur (+2) and engorged sublingual veins (+1).
See this image and copyright information in PMC

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