不同病程2型糖尿病患者舌象的相关因素研究  

Study on the related factors of tongue image in patients with different courses of type 2 diabetes mellitus

作　　者：杨睿博 张艳 罗文轩 陈宇[1] 姜碧瑶 叶晨 王宇琦 蔡卢琪 肖永华[1] YANG Ruibo;ZHANG Yan;LUO Wenxuan;CHEN Yu;JIANG Biyao;YE Chen;WANG Yuqi;CAI Luqi;XIAO Yonghua(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院肾病内分泌科,100700

出　　处：《环球中医药》2023年第11期2232-2239,共8页Global Traditional Chinese Medicine

基　　金：国家重点研发计划“中医药现代化研究”重点专项(2017YFC1703302);第五批全国中医临床优秀才研修项(国中医药教函[2022]1号)。

摘　　要：目的分析不同病程2型糖尿病(type 2 diabetes mellitus,T2DM)患者的舌象特征及其与实验室指标的相关性。方法使用TDF-1型舌象仪采集300例T2DM患者舌象图片,由2位高年资中医内科专家对舌神、舌质老嫩、舌体厚薄、舌体大小、齿痕、点刺、裂纹、瘀斑、剥苔、津液、苔厚、苔腻等舌质、苔质特征分别进行程度量化评分,同时使用色度学RGB色彩模式对舌暗、舌紫、苔黄等舌色、苔色特征进行测定。按照病程长短将所有患者分3组,应用SPSS软件分析3组患者舌象特征与静脉血糖、空腹血糖、餐后2小时血糖、糖化血红蛋白(haemoglobin A1c,HbA1C)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白(low density lipoprotein cholesterol,LDL-C)、肾小球滤过率(glomerular filtration rate,GFR)、尿素(Urea)、肌酐(creatinine,Cr)、尿酸(uric acid,UA)、视黄醇结合蛋白(retinol-binding protein,RBP)、同型半胱氨酸(homocysteine,HCY)等实验室指标的相关性。结果(1)T2DM长病程组较短病程组舌神减少,舌点刺减少,舌紫暗降低,且舌质更老、舌苔更趋黄、厚、腻;(2)T2DM短病程组的舌神与GFR呈正相关,中病程组的舌神与HCY呈负相关;(3)T2DM短病程组的瘀斑与体质指数呈正相关,中病程组的舌紫暗程度与体质指数呈正相关,长病程组的舌紫暗程度与血糖水平呈正相关。结论不同病程T2DM患者舌象与实验室指标存在一定的相关性,可为T2DM的病情轻重提供一定的参考。Objective To analyze the tongue image characteristics and its correlation with laboratory indicators in patients with T2DM of different courses.Methods The TDF-1 tongue picture acquisition instrument was used to collect 300 tongue picture pictures of type 2 diabetes patients.Two senior medical experts of traditional Chinese medicine scored the degree of tongue spirit,old and tender tongue,thick and thin tongue body,size of tongue body,tooth marks,pricks,cracks,ecchymosis,coating peeling,body fluid,thick and greasy coating,and measured the tongue color and coating color characteristics such as dark tongue,purple tongue,yellow tongue coating,etc.with RGB color mode of colorimetry.All patients were divided into 3 groups according to the duration of the disease.SPSS software was used to analyze the correlation between tongue features and laboratory indicators of the 3 groups of patients.Laboratory indicators included Venous blood glucose,fasting blood glucose,2h postprandial blood glucose,glycosylated hemoglobin(HbA1C),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),glomerular filtration rate(GFR),Urea,creatinine(Cr),uric acid(UA),retinol binding protein(RBP),homocysteine(HCY),etc.Results(1)Compared with the T2DM duration equal or less than 5 years group,the T2DM duration more than 15 years group had less tongue spirit,less tongue prickling,less dark purple tongue,and older tongue texture,thicker and greasy tongue coating.(2)When the duration of T2DM was equal or less than years,tongue strength was positively correlated with GFR;when the course of disease was more than 5 years and equal or less than 15 years,tongue strength was negatively correlated with HCY.(3)When the duration of T2DM was equal or less than 5 years,ecchymosis was positively correlated with BMI score in T2DM patients.When the course of disease was more than 5 years and less than 15 years,the degree of tongue dark in T2DM patients was positively correlated with BMI.When the duration of T2DM is mor

关 键 词：2型糖尿病 病程 舌象 专家赋值法 RGB色彩模式 实验室指标 相关性 

分 类 号：R259[医药卫生—中西医结合]