首页|315例冠心病患者舌象特征客观化研究

315例冠心病患者舌象特征客观化研究

Research on Objective Characteristics of Tongue Manifestation in 315 Patients with Coronary Heart Disease

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目的 探究冠心病患者的舌象客观化特征.方法 纳入冠心病患者315例设为冠心病组,健康体检受试者211例设为健康对照组.另根据315例冠心病患者常见合并病(原发性高血压、颈动脉粥样硬化、2型糖尿病、脂肪肝、高脂血症、心力衰竭、脑梗死)情况,按照其是否存在分为合并该疾病组和非合并该疾病组.采用TFDA-1型舌诊仪采集舌象图像,对舌质(TB)、舌苔(TC)特征进行描述,比较色度指标中RGB、HIS、Lab颜色空间(R,红色;G,绿色;B,蓝色;H,色度;I,亮度;S,饱和度;L,明度;a,红色-绿色轴;b,黄色-蓝色轴),舌苔厚薄指标(per-All),纹理指标中对比度(CON)、角度方向二阶矩(ASM)、熵值(ENT)、均值(MEAN).结果 与健康对照组比较,冠心病组舌质特征指标TB-R、TB-G、TB-B、TB-I、TB-L偏低,TB-H、TB-b偏高;舌苔特征指标TC-R、TC-B偏低,TC-CON、TC-MEAN、TC-H、TC-b偏高(P<0.05或P<0.01).冠心病合并原发性高血压组较非合并原发性高血压组,per-All、TB-G、TB-L偏高,TB-a、TC-a偏低(P<0.05);合并颈动脉粥样硬化组较非合并颈动脉粥样硬化组,TB-CON、TB-ENT、TB-MEAN偏高,TB-ASM偏低(P<0.05或P<0.01);合并2型糖尿病组较非合并2型糖尿病组,per-All偏低,TB-H偏高(P<0.05或P<0.01);合并脂肪肝组较非合并脂肪肝组,TB-CON、TB-MEAN、TB-ENT偏高,TB-ASM、TC-S偏低(P<0.05或P<0.01);合并高脂血症组较非合并高脂血症组,TB-S、TB-a偏低(P<0.05);合并心力衰竭组较非合并心力衰竭组,TB-R、TB-G、TB-I、TB-L偏低,TB-a偏高(P<0.05或P<0.01);合并脑梗死组较非合并脑梗死组,TC-CON、TC-ENT、TC-MEAN偏高,TC-ASM偏低(P<0.05或P<0.01).结论 冠心病患者比健康人舌色更暗,舌苔纹理粗糙.相较冠心病非合并相关疾病者,冠心病合并原发性高血压者舌色更淡、舌苔更厚,合并颈动脉粥样硬化者舌质纹理更粗糙,合并2型糖尿病者舌苔更薄,合并脂肪肝者舌质纹理更粗糙、苔色更白,合并高脂血症时和心力衰竭者舌色更淡,合并脑梗死者舌苔纹理更粗糙.
Objective To investigate the objective characteristics of tongue manifestations in patients with coro-nary heart disease(CHD).Methods A total of 315 participants with CHD were recruited in the CHD group,and 211 healthy participants who underwent physical examination were recruited as the healthy control group.In addition,according to the common comorbidities(primary hypertension,carotid atherosclerosis,type 2 diabetes mellitus,fatty liver,hyperlipidaemia,heart failure,and cerebral infarction)in 315 participants with CHD,each comorbidity was classified into a group of comorbidities with that disease and a group of non-comorbidities.Tongue images were cap-tured using a TFDA-1 tongue diagnostic instrument to characterise the tongue body(TB)and tongue coating(TC),comparing the RGB,HIS,and Lab colour spaces in the chromaticity index(R,red;G,green;B,blue;H,hue;I,intensity;S,saturation;L,lightness;a,red-green axis;b,yellow-blue axis),the tongue coating thickness index(per-All),contrast(CON),angular second moment(ASM),entropy(ENT),and mean(MEAN)in texture metrics.Results Compared with the healthy control group,the characteristic indexes of tongue body in CHD group showed lower TB-R,TB-G,TB-B,TB-I,TB-L and higher TB-H,TB-b;and the characteristic indexes of tongue coating in CHD group showed lower TC-R,TC-B and higher TC-CON,TC-MEAN,TC-H,TC-b(P<0.05 or P<0.01).Compared with non-combined primary hypertension group,CHD combined primary hypertension group showed higher per-All,TB-G,TB-L,and lower TB-a,TC-a(P<0.05);compared with the non-combined carotid atherosclerosis group,CHD combined carotid atherosclerosis group showed higher TB-CON,TB-ENT,TB-MEAN,and lower TB-ASM(P<0.05 or P<0.01);compared with the non-combined type 2 diabetes mellitus group,CHD combined type 2 diabetes mellitus group showed lower per-All and higher TB-H(P<0.05 or P<0.01);compared with the non-combined fatty liver group,CHD combined fatty liver group showed higher TB-CON,TB-MEAN,TB-ENT,and lower TB-ASM and TC-S(P<0.05 or P<0.01);compared with the non-combined hyperlipidaemia group,CHD combined hyperlipidaemia group showed lower TB-S and TB-a(P<0.05);compared with non-combined heart failure group,CHD combined heart failure group showed lower TB-R,TB-G,TB-I,TB-L,and higher TB-a(P<0.05 or P<0.01);compared with non-combined cerebral infarction group,CHD combined cerebral infarction group showed higher TC-CON,TC-ENT,TC-MEAN,and lower TC-ASM(P<0.05 or P<0.01).Conclusion Compared to healthy individuals,patients with CHD tend to have darker tongue colours and rougher TC textures.Compared with non-comorbidity participants,those with primary hypertension tended to be lighter tongue colour and thicker tongue coating,those with carotid atherosclerosis had paler tongue body,those with type 2 diabetes mellitus had thinner tongue coating,those with fatty liver disease had paler tongue body and whiter tongue colour,those with hyperlipidaemia and heart failure had paler tongue colour,and those with cerebral infarction had rougher tongue texture.

coronary heart diseaseobjectification of tongue manifestationtongue diagnosis

段梦遥、王楚皓、谈宇权、廉坤、寿鑫甜、姜泱、毛伯䶮、胡志希

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湖南中医药大学中医学院,湖南省长沙市岳麓区学士路300号,410208

北京中医药大学中医学院

北京中医药大学生命科学学院

中国中医科学院西苑医院

湖南省中西医结合医院

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冠心病 舌象客观化 舌诊

国家自然科学基金国家自然科学基金国家资助博士后研究人员计划湖南省自然科学基金

8227441212102064GZC202303232023JJ40399

2024

中医杂志
中华中医药学会 中国中医科学院

中医杂志

CSTPCD北大核心
影响因子:1.464
ISSN:1001-1668
年,卷(期):2024.65(9)
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