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설진의 표준화를 위한 제언 : 설태 후박의 진단기준을 중심으로

A Proposal for Standardization of Tongue Diagnosis Based on Diagnostic Criteria of Tongue Coating Thickness

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초록

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.

Abstract

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.

참고문헌 (32)

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