慢性心力衰竭患者舌象特征与NYHA心功能分级相关性临床研究  

Clinical Study on Correlation Between Characteristics of Tongue Manifestation and NYHA Cardiac Function Classification in Patients with Chronic Heart Failure

作　　者：张蕾[1,2] 李小茜[3] 何建成[3] ZHANG Lei;LI Xiaoqian;HE Jiancheng(School of Clinical Medicine,He'nan University of Science and Technology,Luoyang He'nan 471003,China;Department of Integrated Chinese and Western Medicine,The First Affliated Hospital of He'nan University of Science and Tec oyang He'nan 471003,China;Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]河南科技大学临床医学院,河南洛阳471003 [2]河南科技大学第一附属医院中西医结合科,河南洛阳471003 [3]上海中医药大学基础医学院,上海201203

出　　处：《新中医》2023年第16期75-80,共6页New Chinese Medicine

基　　金：国家自然科学基金青年项目(81803996)。

摘　　要：目的:观察181例慢性心力衰竭患者的舌象特征,并探讨其与纽约心脏病协会(NYHA)心功能分级的关系。方法:应用中医传统望舌方法,采集181例慢性心力衰竭住院患者的舌诊资料,包括舌色、舌形、苔色、苔质。比较不同心功能分级患者的舌质、舌苔特征。结果:①舌色分布频率由高到低依次为青紫舌、绛舌、红舌、淡红舌、淡白舌。NYHA心功能Ⅱ级患者主要为淡红舌,心功能Ⅲ、Ⅳ级患者主要为青紫舌。不同NYHA心功能分级之间舌色分布差异有统计学意义(P<0.05)。两两比较,心功能Ⅱ、Ⅲ级淡白舌比率低于心功能Ⅳ级者(P<0.05);心功能Ⅲ、Ⅳ级淡红舌比率低于心功能Ⅱ级者(P<0.05),青紫舌比率高于心功能Ⅱ级者(P<0.05)。②舌形分布频率由高到低依次为裂纹舌、瘦薄舌、胖大舌、正常舌。NYHA心功能Ⅱ级患者主要为瘦薄舌,心功能Ⅲ、Ⅳ级患者以裂纹舌多见。不同NYHA心功能分级之间舌形分布差异有统计学意义(P<0.05)。两两比较,心功能Ⅲ、Ⅳ级正常舌比率低于心功能Ⅱ级患者(P<0.05),裂纹舌比率高于心功能Ⅱ级者(P<0.05)。③苔色分布频率由高到低依次为黄苔、灰黑苔、白苔。心功能Ⅱ级患者主要为白苔,心功能Ⅲ级患者中黄苔、灰黑苔较常见,心功能Ⅳ级患者以灰黑苔多见。不同NYHA心功能分级之间苔色分布差异有统计学意义(P<0.05)。两两比较,心功能Ⅲ、Ⅳ级白苔比率低于心功能Ⅱ级者(P<0.05),灰黑苔比率高于心功能Ⅱ级者(P<0.05)。④苔质厚薄程度分布频率由高到低依次为少/无苔、腻苔、厚苔、薄苔。NYHA心功能Ⅱ级患者主要为薄苔,心功能Ⅲ、Ⅳ级患者以少/无苔多见。不同NYHA心功能分级之间舌苔质厚薄程度分布差异有统计学意义(P<0.05)。两两比较,心功能Ⅲ、Ⅳ级薄苔比率低于心功能Ⅱ级者(P<0.05),少/无苔比率高于心功能Ⅱ级者(P<0.05);心功能Ⅳ级腻苔比率高于心�Objective:To observe the characteristics of tongue manifestation in 181 cases of patients with chronic heart failure(CHF),and to explore its relationship with New York Heavy Artillery(NYHA)cardiac function classification.Methods:Traditional inspection of the tongue of Chinese medicine was applied to collect the tongue diagnosis data of 181 patients with CHF,including tongue color,form of the tongue,coating color,and texture of coating.The characteristics of tongue body and tongue coating in patients with different cardiac function grades were compared.Results:①According to the distribution frequency from high to low,the tongue color included bluish purple tongue,crimson tongue,red tongue,pale red tongue,and pale tongue.Patients with NYHA cardiac function gradeⅡmainly had pale red tongue,and patients with cardiac function gradeⅢandⅣmainly had bluish purple tongue.There were significant differences in the distribution of tongue color among patients with different NYHA cardiac function grades(P<0.05).Pairwise comparison showed that the rate of pale tongue in patients with cardiac function gradeⅡandⅢwas lower than that in patients with cardiac function gradeⅣ(P<0.05),the rate of pale red tongue in patients with cardiac function gradeⅢandⅣwas lower than that in patients with cardiac function gradeⅡ(P<0.05),and the rate of bluish purple tongue was higher than that in patients with cardiac function gradeⅡ(P<0.05).②According to the distribution frequency from high to low,the form of the tongue included fissured tongue,thin tongue,enlarged tongue,and normal tongue.Patients with NYHA cardiac function gradeⅡmainly had thin tongue,and patients with cardiac function gradeⅢandⅣmainly had fissured tongue.There were significant differences in the distribution of the form of the tongue among patients with different NYHA cardiac function grades(P<0.05).Pairwise comparison showed that the rate of normal tongue in patients with cardiac function gradeⅢandⅣwas lower than that in patients with cardiac

关 键 词：慢性心力衰竭 舌诊 舌色 舌形 苔色 苔质 NYHA心功能分级 

分 类 号：R541.61[医药卫生—心血管疾病]