103例原发性肝癌患者围手术期舌象变化规律  

Tongue Changes in 103 Perioperative Patients with Primary Liver Cancer

作　　者：叶艳[1,2] 秦丽萍[1] 岳小强[1] 翟笑枫[1] 徐静[3] 肖开银[3] 黄枫[1] 李柏[1] 

机构地区：[1]第二军医大学附属长海医院,上海市杨浦区翔殷路800号200433 [2]上海中医药大学 [3]广西医科大学第一附属医院

出　　处：《中医杂志》2014年第1期48-52,共5页Journal of Traditional Chinese Medicine

基　　金：上海市科学技术委员会科研计划资助项目(12401907600;12401907800);上海市中医药事业发展三年行动计划第二批重大研究资助项目(ZYSNXD-CC-ZDYJ032)

摘　　要：目的观察原发性肝癌患者手术前后舌象特征变化,探讨肝癌围手术期患者证候特征。方法收集103例拟行手术的原发性肝癌患者,于术前1天及术后1、3、5天上午6:30—8:00观察患者舌象,填写中医舌象调查表,用数码照相机留取舌体图片,采用中医舌诊综合信息处理系统分析舌质及舌苔颜色平均RGB各分量值。结果定性及定量结果均提示,术前患者以青紫舌为主,术后1天以红舌为主,术后3、5天青紫舌占居首位(P<0.05);术后舌质颜色R分量值升高,以术后第1天最明显,术后3、5天舌质颜色R分量值逐渐下降(P<0.05)。术后3、5天较术前1天舌苔R、G、B各分量值逐渐下降(P<0.05)。术后舌形胖大、齿痕、点刺舌有增多趋势(P<0.05)。手术前后皆以厚腻苔为主,且术后较术前比例逐渐上升(P<0.05)。术后1、3、5天较术前1天舌下络脉宽度明显降低(P<0.05)。结论血瘀、水湿、气虚证舌象贯穿原发性肝癌患者围手术期,术后5天内阴虚内热舌象比例有所增加。Objective To observe changes of the tongue and research the pattern characteristics in perioperative patients with primary liver cancer （PLC）. Methods Totally 103 PLC patients scheduled for surgery were collected. The tongue was observed from 6： 30am to 8： 00am one day before surgery and on the 1st, 3rd and 5th day after surgery. The TCM Tongue questionnaire was filled. The tongue pictures were taken with digital camera. The average RGB （red, green and blue ） component values of tongue and tongue fur were analyzed with TCM Tongue Examination Comprehensive Information Processing System. Results The purple tongue was common before surgery and on the 3rd and 5th day after surgery and red tongue was common on the 1st day after surgery （P 〈0. 05）. The R value of tongue was increased after surgery especially on the 1 st day after surgery but the R value of tongue was gradually decreased on the 3rd and 5th day after surgery （P 〈 0. 05）. Comparing with one day before surgery, the R, G and B values of tongue fur were gradually decreased on the 3rd and 5th day after surgery （P 〈 0. 05 ）. The enlarged tongue, tongue bearing dental impressions and prickly tongue was increased after surgery （P 〈 0. 05）. The thick and slimy tongue fur was common before and after surgery, especially after surgery （p 〈 0. 05）. Comparing with one day before surgery, the width of sublingual veins was significantly decreased on the 1st, 3rd and 5th day after surgery （P 〈0. 05）. Conclusion The tongues of blood stasis pattern, water-damp pattern and qi deficiency pattern are common during the perioperative period of PLC but the tongues of yin deficiency internal heat pattern are increased within 5 days after surgery.

关 键 词：原发性肝癌 舌象 围手术期 

分 类 号：R241[医药卫生—中医诊断学] R273[医药卫生—中医临床基础]