120例肝纤维化患者舌面象特征分析  

Analysis of Tongue and Facial Complexions in 120 Patients with Hepatic Fibrosis Based on the Parameter Characteristics

作　　者：宫爱民[1] 曹玉[1] 董秀娟[1] 蒋芳玉 杨世忠[1] 王忆勤[2] 

机构地区：[1]海南医学院中医学院,海口571101 [2]上海中医药大学科技实验中心,上海201203

出　　处：《世界科学技术-中医药现代化》2016年第10期1646-1651,共6页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：海南省卫生厅卫生计生行业科研项目(13A200034):扶正化瘀胶囊对肝炎肝纤维化临床疗效观察;负责人:宫爱民;国家自然科学基金委地区科学基金项目(81460692):基于随机森林法的MG中医证候学规律研究;负责人:董秀娟;上海市科委择优委托项目(14D0500400):中医四诊信息采集与分析标准体系研发;负责人:王忆勤;上海市健康与评估重点实验室(13DZ2261000);负责人:王忆勤

摘　　要：目的:本文主要探讨肝纤维化患者舌象、面象等参数临床特征,为肝纤维化患者中医临床辨证提供量化的客观依据。方法:由具有丰富经验的1-2名临床医生进行舌、面判读,记录观察结果;同时应用中医四诊仪器检测120例肝纤维化患者舌、面参数,统计分析各证型的舌面象特征。结果:120例肝纤维化患者的舌象以淡红舌、淡紫舌、白厚苔为多见,面象以青黄、萎黄和目眶暗为多见;舌象参数中舌色、肝纤维化各证型苔色指数显著性差异;面部RGB、Lab指数提示:肝纤维化各证型中湿热中阻证面色偏于黄色、肝肾阴虚证面色以红色为主、肝郁脾虚证面色偏青、气虚血瘀证面色较暗,面色偏于青黑色。结论:应用数字化中医四诊仪器为望诊信息采集及分析建立客观指标,通过舌质参数、舌象指数、面部RGB、Lab指数等数据对肝纤维化患者舌面等望诊信息进行量化处理,有利于提高疾病信息采集的准确性,规范中医师收集病情资料的操作,更好地发挥中医望诊的临床应用价值,有效提高中医药防治疾病的科学性、客观性、稳定性。This study aimed to discuss the tongue and facial complexional norm of clinical diagnosis, which was of great significance in the syndrome differentiation of liver fibrosis. One or two clinicians were engaged in observing and differentiating the tongues and facial complexions and noted observations. Meanwhile, tongues and facial complexions of 120 patients with liver fibrosis were tested using four diagnostic methods in traditional Chinese medicine（TCM）, and their parameter characteristics were analyzed. It was found that the 120 patients mostly featured reddish tongues, maven pale tongues with white heavy tongue coatings, and bluish and yellow facial complexions or withered face with darkened periocular complexions. The parameter characteristics of tongues, such as the color hues of tongue and tongue coating, were differentiated in various syndromes in the patients. The facial RGB and Lab values showed that patients of the syndrome of humid heat locked in the middle enegizer proned to present withered facial complexion, while the patients with liver- and kidney-yin deficiency syndrome presented reddish facial complexions, patients with the syndrome of spleen weakness caused by liver stagnation greenish facial complexions and patients with the syndrome of qi deficiency caused by blood stasis darkened or black facial complexions. In conclusion, objective indexes were established with the adoption of the digital TCM diagnostic equipment to glean and analyze the information from patients＇ facial complexions which were quantified based on the parameters of tongue bodies, tongue related indexes, facial RGB values and Lab indexes of the patients. It was beneficial for TCM physicians to provide with precise information of diseases and standardize the process of collecting basic information to make it worthwhile to apply TCM observation of patients＇ facial complexions to clinic and prevent and cure diseases scientificaly, objectively and firmly.

关 键 词：肝纤维化 数字化中医四诊仪 舌象 面象 

分 类 号：R241[医药卫生—中医诊断学]