Open Access Research article

Metabolic markers and microecological characteristics of tongue coating in patients with chronic gastritis

Zhu-Mei Sun1, Jie Zhao1, Peng Qian1, Yi-Qin Wang1, Wei-Fei Zhang1, Chun-Rong Guo1, Xiao-Yan Pang2, Shun-Chun Wang1, Fu-Feng Li1* and Qi Li3*

Author Affiliations

1 Shanghai University of Traditional Chinese Medicine, Cai Lun Road, Pu dong district, Shanghai 201203, China

2 School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Life Sciences Building 800 Dong chuan Road, Shanghai 200240, China

3 Department of Medical Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, People's Republic of China

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BMC Complementary and Alternative Medicine 2013, 13:227  doi:10.1186/1472-6882-13-227

Published: 17 September 2013



In Traditional Chinese Medicine (TCM), tongue diagnosis has been an important diagnostic method for the last 3000 years. Tongue diagnosis is a non-invasive, simple and valuable diagnostic tool. TCM treats the tongue coating on a very sensitive scale that reflects physiological and pathological changes in the organs, especially the spleen and stomach. Tongue coating can diagnose disease severity and determine the TCM syndrome (“Zheng” in Chinese). The biological bases of different tongue coating appearances are still poorly understood and lack systematic investigation at the molecular level.


Tongue coating samples were collected from 70 chronic gastritis patients and 20 normal controls. 16S rRNA denatured gradient gel electrophoresis (16S rRNA–DGGE) and liquid chromatography and mass spectrometry (LC–MS) were designed to profile tongue coatings. The statistical techniques used were principal component analysis and partial least squares–discriminate analysis.


Ten potential metabolites or markers were found in chronic gastritis patients, including UDP-D-galactose, 3-ketolactose, and vitamin D2, based on LC–MS. Eight significantly different strips were observed in samples from chronic gastritis patients based on 16S rRNA–DGGE. Two strips, Strips 8 and 10, were selected for gene sequencing. Strip 10 sequencing showed a 100% similarity to Rothia mucilaginosa. Strip 8 sequencing showed a 96.2% similarity to Moraxella catarrhalis.


Changes in glucose metabolism could possibly form the basis of tongue coating conformation in chronic gastritis patients. The study revealed important connections between metabolic components, microecological components and tongue coating in chronic gastritis patients. Compared with other diagnostic regimens, such as blood tests or tissue biopsies, tongue coating is more amenable to, and more convenient for, both patients and doctors.

Chronic gastritis; Tongue coating; 16S rRNA denatured gradient gel electrophoresis; Liquid chromatography and mass spectrometry