病毒性肺炎患者不同时期胸部CT影像及中医舌象特征分析  

Analysis of Characteristics of Chest CT Image and Traditional Chinese Medicine Tongue Image in Patients with Viral Pneumonia at Different Stages

作　　者：宋连英[1] 张耀圣[1] 付超[1] 王文华 王宏伟 程灵芝 张立苹[1] SONG Lianying;ZHANG Yaosheng;FU Chao;WANG Wenhua;WANG Hongwei;CHENG Lingzhi;ZHANG Liping(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,100700;Beijing Longfu Hospital)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京隆福医院

出　　处：《中医杂志》2023年第14期1444-1447,共4页Journal of Traditional Chinese Medicine

基　　金：北京市中医管理局北京中医药“薪火传承3+3工程”室站分站建设项目。

摘　　要：胸部计算机体层摄影(CT)是呼吸系统疾病的常用检查方法。通过观察病毒性肺炎不同分期患者胸部CT的影像表现及其相应的舌象,探索病毒性肺炎的影像分期与舌象可能存在的内在联系,发现早期患者CT示肺纹理清晰,未见明显异常或肺纹理增粗、紊乱,舌象表现为舌体正常、舌质淡红、舌苔薄白。轻型患者CT示肺内有磨玻璃样密度结节状影,病灶数量少,范围小,可见支气管充气征,舌质多呈淡红、淡紫、红色,舌苔多呈薄白苔或薄黄苔。进展期患者CT示肺内病灶数量增多,密度增高,范围扩大,肺实质内广泛渗出、实变,可见小叶间隔增厚呈“铺路石征”,舌体多肥大、或边有齿痕,舌质多为红舌、绛舌、红紫舌,舌苔多白腻苔。重症期患者CT出现广泛的弥漫性间质性病变,以实变为主,呈典型“白肺”,舌紫暗、苔黄厚腻。恢复期患者胸部CT示病灶数量减少、范围缩小、密度减低,部分病灶可完全吸收、消失,舌质暗红、苔薄白少。病毒性肺炎患者舌象变化与胸部CT变化具有一定规律,可通过中医观察舌象变化评估肺内病变情况,同时更好地指导临床用药,也为该病的病情变化及预后转归等提供依据。Chest computed tomography(CT)is a necessary examination for respiratory diseases.This paper ex-plored the possible relationship between the CT image and the tongue image of the viral pneumonia(VP)by observing the viral pneumonia chest CT findings and the corresponding tongue image at different stages.It was found that early VP patients showed clear lung texture,no obvious abnormality or thickened and disordered lung texture through CT,as well as normal tongue body,light red tongue and thin white coating.In mild patients,CT showed nodular shad-ows with ground-glass density in the lungs,small number of lesions and small-size area,while the tongue body was mainly light red,light purple,or red,and the coating was mostly thin white or thin yellow.For patients at the ad-vanced stage,CT showed that the number of lesions and the density in the lungs increased,while the scope was en-larged,and there was extensive exudation and consolidation in the lung parenchyma,with thickened interlobular sep-ta like a"paving stone sign";the tongue was hypertrophied or had tooth marks on the edge,with red,crimson,or red-purple tongue,and greasy coating mostly.Patients at the severe stage showed extensive diffuse interstitial lesions on CT,mainly consolidation like a typical"white lung",with purple,dusky tongue and yellow,thick and greasy coat-ing.At the recovery stage,the chest CT of the patients showed a decrease in the number,scope,and density of lesions,and completely absorption or disappearance of some lesions;the tongue was dusky and red with thin and white coating.The tongue image could be observed to infer the condition of the lung diseases,which can better guide clinical medication and provide evidence for the disease changes and prognosis.

关 键 词：病毒性肺炎 计算机体层摄影 舌象 

分 类 号：R259[医药卫生—中西医结合]