Study on the Use of Traditional Chinese Medicine Diagnostic Tools to Assist in Identifying the Clinical Characteristics of Inflammatory Bowel Disease and Research on Metabolic Plastids of Tongue Coating

During participant enrollment, questionnaires are administered by research personnel. Participants are instructed to complete the questionnaires independently based on their subjective perceptions, with efforts made to minimize external interference that may influence their responses. Questionnaire results are scored and categorized according to the established scoring criteria.

The Gastrointestinal Symptom Rating Scale (GSRS) assesses 15 common gastrointestinal symptoms grouped into five symptom domains: abdominal pain, diarrhea, gastroesophageal reflux, indigestion, and constipation. Each item is rated on a 7-point Likert scale ranging from "no discomfort" to "very severe discomfort," with participants self-assessing the severity of their gastrointestinal symptoms over the preceding week. Higher scores indicate greater symptom severity.

The GSRS provides a brief yet comprehensive assessment of common gastrointestinal symptoms and demonstrates good internal consistency and psychometric validity. The reported Cronbach's alpha values range from 0.74 to 0.85, and the test-retest reliability ranges from 0.55 to 0.70.

The Hospital Anxiety and Depression Scale (HADS) consists of 14 items, with 7 items assessing anxiety (HADS-A) and 7 items assessing depression (HADS-D), each scored separately. Items are rated on a 4-point scale ranging from 0 to 3, with higher scores indicating greater severity of anxiety or depression. According to the original authors' recommendations, scores of 7 or below indicate no anxiety or depression, scores of 8-10 suggest possible anxiety or depression, and scores of 11 or higher indicate a high likelihood of clinically significant anxiety or depression.

The assessment consists of eight clinical variables, including subjective symptoms over the preceding week (such as abdominal pain severity and overall well-being), objective measures (such as the use of antidiarrheal medications and percentage change in body weight), and laboratory parameters. After individual component scores are recorded, a weighted calculation is applied to generate the total score. Higher scores indicate greater disease activity, with a CDAI score of less than 150 indicating disease remission and a score greater than 450 indicating extremely severe disease activity.

The partial Mayo (pMayo) scoring index primarily records stool frequency, rectal bleeding, and physician's global assessment in patients with ulcerative colitis. Each component is scored on a scale of 0 to 3, yielding a total score ranging from 0 to 9, with higher scores indicating greater disease activity. The pMayo score demonstrates a specificity of 0.84 for identifying disease remission and a sensitivity of 0.71.

Tongue images are captured from a frontal view with the participant's head stabilized on the tongue diagnostic examination platform. Each participant is instructed to protrude the tongue naturally during image acquisition. After image capture, the images are transmitted to a computer for processing. The photographs are first calibrated using a standard color reference card to correct pixel color deviations, and tongue features are subsequently analyzed using a computer-assisted interpretation system to support Traditional Chinese Medicine tongue diagnosis. The assessed tongue features include:

1. Tongue shape: small, medium, or enlarged.
2. Tongue color: pale, light red, red, or purplish.
3. Tongue body features: red dots, petechiae/ecchymosis, teeth marks, and fissures.
4. Coating color: white or yellow.
5. Coating thickness: scant, thin, or thick.
6. Saliva (moisture): scant, normal, or excessive.
7. Sublingual collateral veins: normal or abnormal.

The listening diagnostic device is based on a computerized acoustic analysis system that provides functions for voice signal analysis and management of participants' voice data. The core technology involves recording a one-second sustained vowel sound (e.g., /a/) to quantify acoustic parameters and perform model-based analyses. Medical research and published studies have demonstrated that the derived parameters are capable of distinguishing deficiency-related constitutional characteristics among different participants, making this system a practical diagnostic tool for rapid constitutional assessment during Traditional Chinese Medicine clinical syndrome differentiation.

Clinical pulse signals are analyzed using time-domain methods to evaluate pulse position, rate, rhythm, and waveform characteristics The system automatically interprets Traditional Chinese Medicine syndrome patterns to assist physicians in clinical diagnosis and syndrome differentiation.

Using the pulse diagnostic device, objective and quantifiable parameters can be obtained, including pulse waveform data, blood pressure (systolic/diastolic), heart rate (beats per minute), cardiac arrhythmia indices (number of irregular heartbeats within a five-minute period), heart rate variability (HRV; overall autonomic nervous system activity), low-frequency power (LF; sympathetic nervous system activity), high-frequency power (HF; parasympathetic nervous system activity), and the LF/HF ratio, which reflects the balance between sympathetic and parasympathetic nervous system activity.