315例冠心病患者舌象特征客观化研究  

Research on Objective Characteristics of Tongue Manifestation in 315 Patients with Coronary Heart Disease

作　　者：段梦遥 王楚皓 谈宇权 廉坤 寿鑫甜 姜泱 毛伯 胡志希 DUAN Mengyao;WANG Chuhao;TAN Yuquan;LIAN Kun;SHOU Xintian;JIANG Yang;MAO Boyan;HU Zhixi(School of Chinese Medicine,Hunan University of Chinese Medicine,Changsha,410208;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine;School of Life Sciences,Beijing University of Chinese Medicine;Xiyuan Hospital,China Academy of Chinese Medical Sciences;Hunan Provineial Hospital of Integrated Traditional Chinese and Western Medicine)

机构地区：[1]湖南中医药大学中医学院,湖南省长沙市410208 [2]北京中医药大学中医学院 [3]北京中医药大学生命科学学院 [4]中国中医科学院西苑医院 [5]湖南省中西医结合医院

出　　处：《中医杂志》2024年第9期921-927,共7页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82274412,12102064);国家资助博士后研究人员计划(GZC20230323);湖南省自然科学基金(2023JJ40399)。

摘　　要：目的探究冠心病患者的舌象客观化特征。方法纳入冠心病患者315例设为冠心病组,健康体检受试者211例设为健康对照组。另根据315例冠心病患者常见合并病(原发性高血压、颈动脉粥样硬化、2型糖尿病、脂肪肝、高脂血症、心力衰竭、脑梗死)情况,按照其是否存在分为合并该疾病组和非合并该疾病组。采用TFDA-1型舌诊仪采集舌象图像,对舌质(TB)、舌苔(TC)特征进行描述,比较色度指标中RGB、HIS、Lab颜色空间(R,红色;G,绿色;B,蓝色;H,色度;I,亮度;S,饱和度;L,明度;a,红色-绿色轴;b,黄色-蓝色轴),舌苔厚薄指标(per-All),纹理指标中对比度(CON)、角度方向二阶矩(ASM)、熵值(ENT)、均值(MEAN)。结果与健康对照组比较,冠心病组舌质特征指标TB-R、TB-G、TB-B、TB-I、TB-L偏低,TB-H、TB-b偏高;舌苔特征指标TC-R、TC-B偏低,TC-CON、TC-MEAN、TC-H、TC-b偏高(P<0.05或P<0.01)。冠心病合并原发性高血压组较非合并原发性高血压组,per-All、TB-G、TB-L偏高,TB-a、TC-a偏低(P<0.05);合并颈动脉粥样硬化组较非合并颈动脉粥样硬化组,TB-CON、TB-ENT、TB-MEAN偏高,TB-ASM偏低(P<0.05或P<0.01);合并2型糖尿病组较非合并2型糖尿病组,per-All偏低,TB-H偏高(P<0.05或P<0.01);合并脂肪肝组较非合并脂肪肝组,TB-CON、TB-MEAN、TB-ENT偏高,TB-ASM、TC-S偏低(P<0.05或P<0.01);合并高脂血症组较非合并高脂血症组,TB-S、TB-a偏低(P<0.05);合并心力衰竭组较非合并心力衰竭组,TB-R、TB-G、TB-I、TB-L偏低,TB-a偏高(P<0.05或P<0.01);合并脑梗死组较非合并脑梗死组,TC-CON、TC-ENT、TC-MEAN偏高,TC-ASM偏低(P<0.05或P<0.01)。结论冠心病患者比健康人舌色更暗,舌苔纹理粗糙。相较冠心病非合并相关疾病者,冠心病合并原发性高血压者舌色更淡、舌苔更厚,合并颈动脉粥样硬化者舌质纹理更粗糙,合并2型糖尿病者舌苔更薄,合并脂肪肝者舌质纹理更粗糙、苔色更白,合并高脂血症时Objective To investigate the objective characteristics of tongue manifestations in patients with coronary heart disease(CHD).Methods A total of 315 participants with CHD were recruited in the CHD group,and 211 healthy participants who underwent physical examination were recruited as the healthy control group.In addition,according to the common comorbidities(primary hypertension,carotid atherosclerosis,type 2 diabetes mellitus,fatty liver,hyperlipidaemia,heart failure,and cerebral infarction)in 315 participants with CHD,each comorbidity was classified into a group of comorbidities with that disease and a group of non-comorbidities.Tongue images were captured using a TFDA-1 tongue diagnostic instrument to characterise the tongue body(TB)and tongue coating(TC),comparing the RGB,HIS,and Lab colour spaces in the chromaticity index(R,red;G,green;B,blue;H,hue;I,intensity;S,saturation;L,lightness;a,red-green axis;b,yellow-blue axis),the tongue coating thickness index(per-All),contrast(CON),angular second moment(ASM),entropy(ENT),and mean(MEAN)in texture metrics.Results Compared with the healthy control group,the characteristic indexes of tongue body in CHD group showed lower TB-R,TB-G,TB-B,TB-I,TB-L and higher TB-H,TB-b;and the characteristic indexes of tongue coating in CHD group showed lower TC-R,TC-B and higher TC-CON,TC-MEAN,TC-H,TC-b(P<0.05 or P<0.01).Compared with non-combined primary hypertension group,CHD combined primary hypertension group showed higher per-All,TB-G,TB-L,and lower TB-a,TC-a(P<0.05);compared with the non-combined carotid atherosclerosis group,CHD combined carotid atherosclerosis group showed higher TB-CON,TB-ENT,TB-MEAN,and lower TB-ASM(P<0.05 or P<0.01);compared with the non-combined type 2 diabetes mellitus group,CHD combined type 2 diabetes mellitus group showed lower per-All and higher TB-H(P<0.05 or P<0.01);compared with the non-combined fatty liver group,CHD combined fatty liver group showed higher TB-CON,TB-MEAN,TB-ENT,and lower TB-ASM and TC-S(P<0.05 or P<0.01);compared with the non-combi

关 键 词：冠心病 舌象客观化 舌诊 

分 类 号：R259[医药卫生—中西医结合]