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One of the principal diagnostic methods in Traditional Chinese Medicine (TCM) is the inspection of the tongue. This method involves examination of the shape, size, color, and texture of the tongue body and coat and helps reveal the state of organ functions and progression of conditions. Literature on tongue observations for patients who have human immunodeficiency virus (HIV) is minimal. The goal of this study was to provide a clinical "snapshot" of initial tongue assessments of 159 patients living with HIV, who participated in an acupuncture clinical trial for chronic nausea. The aim was to explore the similarities and differences observed in tongue assessments. This study was part of a prospective, randomized, controlled, double-blinded (subjects and evaluators), parallel-groups, acupuncture clinical trial for treating chronic nausea. The study was conducted at a large urban New York City academic health center. The patients in this study were 159 individuals who had HIV infections and who had histories of chronic nausea for ≥3 months. Initial tongue assessments were recorded for seven basic characteristics: (1) tongue color; (2) tongue shape; (3) tongue body quality; (4) coat color; (5) coat weight; (6) coat surface; and (7) tongue action. The overall tongue picture seen in these patients was that the tongue was swollen and toothmarked, had a pink body with cracks, and had a thick, dry white coat. The HIV disease itself and the use of long term medications affect the Blood, Qi, Yin, and Yang. The observation of the tongue provides a window into the process of the disease and, ultimately, insight for clinical care. This sample population snapshot illustrates the complex processes seen in long-term chronic conditions managed by pharmacologic medications.
One of the principal diagnostic methods in Traditional Chinese Medicine (TCM) is the inspection of the tongue. This method involves examination of the shape, size, color, and texture of the tongue body and coat and helps reveal the state of organ functions and progression of conditions. Literature on tongue observations for patients who have human immunodeficiency virus (HIV) is minimal. The goal of this study was to provide a clinical "snapshot" of initial tongue assessments of 159 patients living with HIV, who participated in an acupuncture clinical trial for chronic nausea. The aim was to explore the similarities and differences observed in tongue assessments. This study was part of a prospective, randomized, controlled, double-blinded (subjects and evaluators), parallel-groups, acupuncture clinical trial for treating chronic nausea. The study was conducted at a large urban New York City academic health center. The patients in this study were 159 individuals who had HIV infections and who had histories of chronic nausea for ≥3 months. Initial tongue assessments were recorded for seven basic characteristics: (1) tongue color; (2) tongue shape; (3) tongue body quality; (4) coat color; (5) coat weight; (6) coat surface; and (7) tongue action. The overall tongue picture seen in these patients was that the tongue was swollen and toothmarked, had a pink body with cracks, and had a thick, dry white coat. The HIV disease itself and the use of long term medications affect the Blood, Qi, Yin, and Yang. The observation of the tongue provides a window into the process of the disease and, ultimately, insight for clinical care. This sample population snapshot illustrates the complex processes seen in long-term chronic conditions managed by pharmacologic medications.
A group of 23 patients with partial atrophic change of the tongue was examined for candidiasis. All of them reported pain in the tongue on eating hot or spicy food. The intensity of the tongue pain was evaluated before and after treatment using a visual analogue scale. Of the 23 patients, 10 (43.5%) had predisposing factors for candidiasis such as diabetes mellitus and anaemia. In the culture examination, candidal species were isolated in 65.2%, all Candida albicans. Direct cytological examination performed in 10 of the 23 patients revealed fungal pseudohyphae in 8 patients. After antifungal treatment, tongue pain had disappeared or improved markedly in 82.6%. Simultaneously, the filiform papilla of the atrophic site was observed to have begun to regenerate in these patients. Candida infection should be suspected in patients with partial atrophic tongue associated with pain on eating.
Atrophic tongue associated with pain at eating, even though it is mild atrophic change, has a high probability of being a candida-induced lesion. Long disease duration and no benefit by topical steroids are suggestive and diagnostic factors of this disease.
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