化生型慢性萎缩性胃炎患者的舌象特点分析  

Analysis of tongue features in patients with metaplastic chronic atrophic gastritis

作　　者：杨洋[1] 杨敏[2] 瞿先侯 赵鹏程[2] 王欣[1] 孟曼[1] 苏晓兰[1] 魏玮[1] YANG Yang;YANG Min;QU Xian-hou;ZHAO Peng-cheng;WANG Xin;MENG Man;SU Xiao-lan;WEI Wei(Department of Gastroenterology,Wangjing Hospital,Beijing 100102,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院望京医院功能性胃肠病北京市重点实验室,北京100102 [2]北京中医药大学,北京100029

出　　处：《中国中西医结合消化杂志》2019年第9期684-688,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：中医药行业科研专项项目(No:201507001-09);中国中医科学院自主选题研究项目(No:ZZ11-035)

摘　　要：[目的]探讨化生型慢性萎缩性胃炎(CAG)患者中医舌苔舌形的分布特点。[方法]选取2017年12月~2018年12月就诊于我院脾胃病科经电子内镜加病理组织学检查确诊的化生型CAG患者,并记录患者基本信息、生活方式(是否吸烟、是否饮酒),比较轻、中、重度不同病变程度患者生活方式及中医舌苔舌形特点。[结果]共纳入107例患者,不同程度肠上皮化生在性别、是否吸烟、是否饮酒方面分布差异无统计学意义,不同程度肠上皮化生患者舌苔舌形有明显的差异性。舌苔主要集中在黄腻苔、白腻苔,舌形主要集中在胖大伴齿痕舌、胖大舌。舌苔舌形方面,薄白苔占8.48%,薄黄苔占7.48%,白腻苔占29.91%,黄腻苔占51.40%,少苔占2.80%。薄苔主要常见于轻度肠上皮化生,腻苔主要存在于中重度肠上皮化生,而且随着肠上皮化生程度的加重,腻苔所占的比例逐渐增大,各组之间差异有统计学意义(P<0.05)。舌形中胖大舌有占22.43%,胖大伴齿痕占55.14%,瘦舌有占10.28%,裂纹舌占6.54%,正常舌5.61%。随着肠上皮化生程度的加重,胖大伴齿痕舌与裂纹舌比例逐渐增大,各组之间分布差异存在明显(P<0.05)。[结论]化生型CAG病理病变程度与舌象有一定的内在联系,提示脾胃虚弱与湿邪与本病的发生加重存在一定联系,舌诊在诊治化生型萎缩性胃炎病变中有重要的价值。[Objective]To investigate the distribution characteristics of tongue coating and tongue shape in TCM patients with chronic atrophic gastritis of metaplastic type.[Methods]The patients diagnosed as intestinal metaplasia by electronic endoscopy and histopathological examination in Wangjing hospital of traditional Chinese medicine of Chinese Academy of sciences between December 2017 and December 2018 was selected.The patients’ basic information and life style(whether smoking or drinking)were recorded and compare the life style and tongue shape characteristics of the patients with mild,moderate and severe intestinal metaplasia lesions.[Results]A total of 107 patients were included.There was no significant difference in the distribution of intestinal metaplasia of different degrees in terms of gender,smoking and drinking.Tongue coating and tongue shape of patients with intestinal metaplasia of different degrees were significantly different.Tongue coating is mainly concentrated in yellow and white greasy coating and tongue shape is mainly concentrated in fat tongue and fat tongue with teeth marks.As for the shape of tongue coating,thin white coating accounts for 8.48%,thin yellow coating for 7.48%,white greasy coating for 29.91%,yellow greasy coating for 51.40% and less coating for 2.80%.With significant difference(P<0.05),Thin coating is mainly found in mild intestinal metaplasia while greasy coating mainly exists in moderate to severe intestinal metaplasia.And with intestinal metaplasia aggravating,the proportion of greasy coating gradually increased.Among the tongue shapes,fat tongue accounted for 22.43%,fat tongue with tooth marks for 55.14%,thin tongue for 10.28%,cracked tongue for 6.54% and normal tongue for 5.61% with significant difference in the distribution(P<0.05).And with intestinal metaplasia aggravating,the proportion of fat tongue with teeth mark and tongue crack gradually increased.[Conclusion]The degree of pathological lesion of metaplasia chronic atrophic gastritis has certain internal relation with

关 键 词：慢性萎缩性胃炎 肠上皮化生 舌苔 舌形 脾胃虚弱 

分 类 号：R573.3[医药卫生—消化系统]