Integrated Application Platform of TCM Diagnosis and Treatment

Equipment based on the Integration of Hardware and Software

Junwen

Wang

1,* a

, Zhuang Guo

and Shiqing Qiu

Institute of basic theory of traditional Chinese medicine, Chinese Academy of traditional Chinese medicine, Beijing, China

Department of Computing, Beijing Institute of Graphic Communication, Beijing, China

Keywords:

TCM Diagnostic Equipment, TCM Testing, Multi-Source Information Fusion, Four-Diagnosis Integration.

Abstract: In terms of hardware, the integrated application platform of TCM diagnosis and treatment equipment is based

on TCM diagnostic equipment such as telescopic apparatus, pulse diagnostic apparatus, infrared apparatus

and meridian apparatus from different manufacturers, and the laboratory of key TCM technology and

equipment is established to carry out empirical research on the dismantling and rearrangement of TCM basic

theory concepts, and to provide TCM diagnosis for TCM clinical trials based on the integrated application

and data collection of TCM diagnosis equipment. In terms of software, the platform establishes the data

interface of each device and the multi-source information fusion algorithm that simulates the four diagnoses

of TCM with the ontology of TCM engineering field as the core; it is valuable for the collection of TCM

objective diagnosis information, efficacy evaluation and big data analysis.

1 INTRODUCTION

Traditional Chinese medicine emphasizes "four-

diagnosis integration", in which inspection, listening

and smelling, inquirying and pulse diagnosis are all

important elements of Chinese medicine diagnosis

and inheritance. In ancient times, Chinese medicine

practitioners did not have modern testing technology,

so they used to diagnose and judge the efficacy of the

treatment based on their experience with the four-

diagnoses of inspection, listening and smelling,

inquirying and pulse diagnosis. With the

development of modern science and technology,

researchers hope to use TCM diagnostic equipment to

help TCM doctors diagnose diseases and objectively

record the information of the process. TCM

diagnostic equipment refers to instruments,

equipment, apparatus, materials and other items

(including the required software) applied under the

guidance of TCM theory, and is medical equipment

developed by applying modern science and

technology and methods (Cui, Xu 2018). Its R&D

activities are closely related to the demand situation

of TCM clinical use.

https://orcid.org/0000-0001-5460-2507

https://orcid.org/0000-0002-7051-5056

https://orcid.org/0000-0001-5866-9469

Since the 1970s, the research on the

objectification and instrumentation of diagnosis

methods such as pulse diagnosis and tongue diagnosis

in TCM was started in China, which laid an important

foundation for TCM equipment-assisted diagnosis

(Zhuo, Zhang 2014). At present, there are a total of

14 enterprises producing TCM diagnostic equipment

in China, and the listed products that have gotten the

approval include tongue instrument, pulse

instrument, infrared instrument, meridian detector,

etc. Since TCM is concerned with holistic concept, it

needs to synthesize and integrate new results of

various diagnostic studies, and adopt some new

diagnostic algorithms to integrate multiple sources of

information together to achieve intelligent four-

diagnosis integration, or four-diagnosis fusion, which

is a model more in line with traditional TCM theory.

At present, the objective information collection

technology of four-diagnosis of TCM and the

corresponding intelligent devices have made great

progress, and the combination with artificial

intelligence technology is an inevitable trend, but

there are still many problems to be solved: most

algorithms are based on single source information,

Wang, J., Guo, Z. and Qiu, S.

Integrated Application Platform of TCM Diagnosis and Treatment Equipment based on the Integration of Hardware and Software.

DOI: 10.5220/0011195800003438

In Proceedings of the 1st International Conference on Health Big Data and Intelligent Healthcare (ICHIH 2022), pages 5-10

ISBN: 978-989-758-596-8

such as facial diagnosis, tongue diagnosis or pulse

diagnosis to make analytical judgments; a large

number of excellent cutting-edge deep learning

methods are applied due to the lack of objective

collection data difficulties. This may be due to the

lack of subjective understanding of the holistic view

of TCM theory by the developers of smart devices, or

to the lack of standard high-quality labeled TCM data

with multiple sources of information, resulting in

poor accuracy in the integrated processing of multiple

sources of information (Qi, Li 2017). The collection

of TCM diagnostic learning samples requires finding

suitable automated methods, such as using portable

devices, to facilitate the collection of large data

training samples and to promote the objective

collection of information from the four TCM

diagnoses as well as to simulate the traditional TCM

thinking pattern of the four-diagnosis integration.

Based on the TCM diagnostic equipment such as

telescopic apparatus, pulse apparatus, infrared

apparatus, meridian apparatus, etc. from different

manufacturers, this study establishes a laboratory for

key TCM technology and equipment, and develops a

software platform to link the communication

interfaces of each equipment to form an integrated

software and hardware TCM diagnostic equipment

application platform; and carries out data-based

empirical research based on the dismantling and

rearrangement of basic TCM theories and concepts.

Meanwhile, we provide technical support in TCM

diagnostic equipment for TCM clinical trials.

2 THEORETICAL RESEARCH:

RESEARCH ON OBJECTIVE

MEASUREMENT

The theoretical basis of the integrated application of

TCM diagnosis and treatment equipment is to

propose a TCM engineering concept system that can

be measured by modern science and technology, so

that the measurement signal of the instrument can be

interfaced with the basic theoretical system of TCM

through the interface of measurement elements and

evidence, in order to solve the problem of difficult

interface between the theoretical system of TCM and

modern science and technology.

In this study, we reviewed the literature related to

TCM diagnosis, sorted out the TCM basic theories

and diagnostic concepts such as etiology,

pathogenesis, location and nature of disease, and

acupuncture concepts such as meridians and

acupoints, selected appropriate measurement objects,

and established a system of measurement variables.

The instrumental measurement objects of TCM

symptoms are defined as the smallest measurement

units, described as measurement elements in TCM

language and as measurement variables in

engineering language. The measurement variables are

logically independent and have clear boundaries, and

the measurement variables and values are

distinguished.

Based on the concept of "evidence element" in

modern TCM diagnosis, we systematized the types of

TCM evidence variables in the literature and

constructed a system of five types of measurement

variables: positioning variables, physiological

variables, pathogenic variables, school measurement

variables and specialist measurement variables, as

shown in the following table.

Table 1: The system of TCM concepts used for

measurement.

Variable type Measured Variable

Variable type 1

Heart, liver, spleen, lung, kidney,

stomach, gall bladder, small

intestine, large intestine, bladder,

tri

iao, ......

Variable type 2

Essence, spirit, qi, blood, fluid, yin,

yang ......

Variable type 3

wind,cold, heat, humidity, dryness,

fire,epidemic,phlegm, food, insects

......

Variable type 4

Wei, Qi, Ying, and Blood

components;

Chest and diaphragm [upper jiao],

lesser abdomen [lower jiao], spleen

and stomach [middle jiao]; ......

Variable type 5

eyes (meatus, blood, qi, wind, and

water chakras), ears, nose, pharynx,

and teeth; ......

Added

Variable

……

3 SOFTWARE PLATFORM: TCM

MULTIMODAL DATA

COLLECTION SYSTEM

A TCM multimodal data acquisition system PC and

APP for doctors and a WeChat app for patients were

developed to collect data and signals measured by

TCM diagnostic equipment and various instruments.

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

3.1 Multimodal Data Acquisition

System PC Side and APP

(Physician Side)

The PC side and APP of the multimodal collection

system include several basic functions such as case

management, decision support, data statistics, and

physician information on the one hand, and on the

other hand can link the communication ports of TCM

diagnostic equipment such as camera, microphone,

pulse diagnostic instrument, and can support sub-visit

case management such as initial consultation and

follow-up consultation.

The diagram shows the home page with four

modules: camera, microphone, pulse diagnostic

instrument, and case; the device then takes pictures of

the designated areas to complete the collection of data

in order to provide good conditions for treatment,

such as eyes, ears, and tones. Finally, the pulse

instrument is connected to upload the collected signal

data and display it to form the overall information to

complete the final data collection.

The TCM multimodal APP can be downloaded at:

http://124.70.72.144:802/download/download.html

Homepage of TCM multimodal data acquisition system

physician w

ebsite can be visited at：

http://124.70.72.144:802

Figure 1: The whole process of TCM multimodal data

acquisition system APP.

Figure 2: Homepage of TCM multimodal data acquisition

system physician.

3.2 Data Collection Applet (Patient

Side)

After the patient logs into the applet, the tongue

image, facing and voice are captured and submitted

for analysis according to the standard practices

provided by the system, and a self-assessment

questionnaire is also provided for the patient to record

and report symptoms. The applet side can be a

complement and extension of the physician side,

allowing the collection of tongue image, facing and

voice in an out-of-hospital setting, and in clinical

studies, saving the time of filling out questionnaires

on site.

Figure 3: Diagnosis and Methodology Hessian Applet.

Integrated Application Platform of TCM Diagnosis and Treatment Equipment based on the Integration of Hardware and Software

4 HARDWARE SELECTION:

INTEGRATED APPLICATION

OF TCM DIAGNOSIS

EQUIPMENT

In terms of hardware, the TCM diagnosis equipment

integrated application platform is based on TCM

diagnostic equipment such as telescope, pulse

diagnostic instrument, infrared instrument and

meridian instrument from different manufacturers to

carry out research on TCM diagnosis equipment

integrated application, and at the same time to provide

technical support in TCM diagnosis equipment for

TCM clinical trials.

At present, the platform has established a TCM

key technology equipment laboratory in the basic

theory research of TCM at the Chinese Academy of

Traditional Chinese Medicine, and replicated this

laboratory as a model and center to establish a sub-

center in the Wuhan Hongshan District Chinese

Hospital. The sub-center is configured with the same

equipment according to the demand and carries out

clinical trials or accumulation of clinical real-world

data simultaneously.

4.1 Platform Hardware: Testing

Principle and Algorithm Model of

TCM Diagnostic Equipment

4.1.1 Visual Diagnosis Instrument

Thanks to the rapid development of Computer Vision

(CV) technology, tongue, face, and eye diagnostic

instruments are more frequently used, and their

detection principles are mostly based on the theory of

TCM holographic partition diagnosis to analyze the

photos taken by the instruments and provide reference

for disease diagnosis by identifying disease

characteristics under specific holographic partitions.

It provides reference for disease diagnosis by

identifying disease characteristics in specific

holographic zones. Due to the intuitive features and

high consensus of tongue analysis, the accuracy of the

intelligent model can reach 85%; however, due to the

existence of different TCM diagnostic theories,

further data collection is needed to train the intelligent

model for facial diagnosis and visual diagnosis.

Figure 4: Facial diagnostic instrument.

4.1.2 Pulse Detection

Compared with the lookout type instruments, the

pulse instrument differs greatly in various aspects

such as the principle. Based on pressure-pressure

detection, as well as different detection principles

such as photoelectricity and ultrasound and different

sensors, respectively, a variety of pulse diagnosis

instruments have appeared on the market, such as the

BYS-14 four-conductor pulse instrument, YGJ

medical manager multi-functional identification

instrument and so on. The current application is the

pressure type pulse diagnosis instrument which is

similar to the intuitive feeling of Chinese medicine.

Its algorithm principle is based on the pressure-

pressure signal collected by the sensor for time

domain and frequency domain analysis, and is

classified and calculated by calculating pulse

position, pulse rate, pulse rhythm, pulse force,

tension, fluency, and other characteristic indicators,

using the 28 pulse signs of Chinese medicine such as

floating and sinking latency as labels.

Figure 5: Instrument of pulse.

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

4.1.3 Infrared Meter

The detection target of infrared meter is human body

surface temperature, which performs computerized

thermal state analysis and image processing on the

collected infrared images of human body to achieve

rapid spatial localization and quantification of TCM

organs, meridians and acupuncture points. Its

algorithm model first divides the five internal organs

and twelve meridians areas on the human body

surface according to the TCM holographic theory,

and then analyzes the temperature distribution. At

present, the clinical application of infrared instrument

includes "treating the untreated disease", primary

screening of major diseases, monitoring of chronic

diseases, special examination, and observation and

evaluation of therapeutic efficacy.

Figure 6: Human body infrared detector.

4.1.4 Meridian Instrument

Due to the slow progress of meridian research, there

are concerns about the testing principle of meridian

instrument in TCM. However, this does not seem to

affect the use of meridians by TCM doctors to guide

clinical diagnosis and perform efficacy evaluation.

The meridian point diagnostic model of the TCM

meridian instrument diagnoses the status of qi, blood,

yin and yang, physiology and pathology of human

organs and determines the functional and

pathological changes in the human body by

measuring the bio-current values and integrating

index information of specific meridian points in the

human body. The information that can be collected

and analyzed includes the changes of resistance,

voltage, capacitance and temperature values of 48

holographic points, such as the 12 original meridian

points and the 'holographic naked points' of human

organs and organs (such as the sensitive points on the

inner and outer back of the feet).

Figure 7: TCM meridian detector.

5 PLATFORM SERVICE:

OBJECTIVE MEASUREMENT

INDEX OF TCM

Starting from the existing equipment, the integrated

application platform of TCM diagnosis and treatment

equipment compares and fuses the objective testing

information with the original four diagnostic

information subjectively observed and textually

recorded by doctors, so as to increase the objective

testing indicators for TCM diagnosis, identification

and efficacy evaluation on the one hand, and to

establish an engineering interface suitable for cross-

fertilization of medical industry for TCM equipment

research on the other hand. The objective indexes

supporting the collection include：

Table 2: Objective measurement index of TCM.

Information source Collection tool Collection of information Collection of indicators

Face diagnosis

image

Intelligent Body

Recognition Instrument

(

Dawson

)

Frontal human face, each

gender, age, unobstructed

color ima

Face-hand holographic zoning

colors: heart, liver, spleen, lungs,

kidne

Tongue Diagnosis

Images

Tongue Diagnostic

Instrument (Dawson)

Frontal tongue image,

sublingual ligament image

Color of tongue,redness at the tip,

petechiae and petechiae, moss color,

moss thickness, moss

reasiness,

Integrated Application Platform of TCM Diagnosis and Treatment Equipment based on the Integration of Hardware and Software

moss decay, moss peeling, tongue

fatness, tooth marks, punctures,

cracks, etc.

Pulse Information

Pulse Diagnostic

Instrument (Dawson)

Sensor array type and number

of points, pulse cycle

waveform pattern (data

len

th is about 10s

)

Pulse position, pulse rate, pulse

rhythm, pulse force, tension, fluency

Meridian

Information

Meridian Detector

(

Hainda

)

Electrical impedance value of

acu

uncture

oints

12 meridian acupuncture point

electrical im

edance

Infrared thermal

image

Infrared detector

(Jiangshan)

Infrared thermal image of

face or whole body

Face-hand holographic zoning

temperature: heart, liver, spleen,

lung, kidney; whole body to be

zoned b

meridian

oints.

Using these research indicators shown in Table 5,

clinical real-world researchers of TCM can collect

evaluation indicators suitable for the characteristics

of traditional Chinese medicine to evaluate the

curative effect of traditional Chinese medicine

diagnosis and treatment in order to guide disease

diagnosis and treatment activities, or as evidence-

based evidence. Researchers can choose an

appropriate one according to their needs, and then

select one or several indicators. Or they can also

choose to comprehensively utilize several equipment

or all equipment, and then select some indicators of

different equipment for joint diagnosis. These devices

makes the objective quantification of TCM diagnosis

possible.

6 CONCLUSIONS

At present, the development of traditional Chinese

medicine is at a great opportunity of "climate,

favorable location, and harmony", and the

development of clinical diagnosis and treatment

equipment of traditional Chinese medicine will also

usher in a period of opportunity for leapfrog

development.(Yang, Hu 2021).Modern TCM

equipment can detect more and more information,

fuse subjective and objective

multi-source

information together, interpret the collected signals in

accordance with the TCM way of thinking, and

establish an information-comparison assisted

diagnosis model, which is more in line with the

holistic concept of traditional TCM. It is expected to

promote TCM equipment to truly add objective

testing indicators for TCM doctors to diagnose

diseases, identify and classify or evaluate the efficacy

(Wang 2021); at the same time, it also facilitates

TCM doctors to accumulate objective data and

provide objective tools for the research of TCM

efficacy evidence. It is more conducive to processing

and analyzing the "big data" generated by the

increasing number of new devices in the future.

FUNDINGS

Beijing Natural Science Foundation of China

(7192140); National Natural Science Foundation of

China (82074334); CACMS Innovation Fund

(CI2021A00113); basic research business expenses

of Chinese Academy of traditional Chinese medicine

(YZ-202015); CACMS Special program for training

excellent young talents (zz13-yq-110);

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ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare