结直肠癌术后患者舌象特征参数与中医证型分布研究  

Study on tongue characteristic parameters and traditional Chinese medicine syndrome type distribution in patients with colorectal cancer after operation

作　　者：袁晨越 焦文 刘湘君 刘怡[1] 吴杏黎 任建琳[1] YUAN Chenyue;JIAO Wen;LIU Xiangjun;LIU Yi;WU Xingli;REN Jianlin(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071

出　　处：《中华中医药杂志》2024年第8期4443-4449,共7页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.82004255,No.82174452,No.81873279);上海市科学技术委员会科研计划项目(No.19401935200);上海申康医院临床三年行动计划(No.SHDC2020CR2047B);上海市科技创新行动计划生物医药科技支撑专项(No.22S21901000)。

摘　　要：目的:观察结直肠癌(CRC)术后患者与正常人间及CRC术后不同中医证候间舌象客观化特征参数变化特点。方法:选取83例上海中医药大学附属中医医院肿瘤科门诊CRC术后患者及20名上海中医药大学附属市中医医院体检中心健康体检者,使用手机及标准24色色卡(美国X-Rite公司)采集舌象信息,通过舌象分析系统,比较CRC术后患者与正常人间及CRC术后不同中医证候间舌象客观化特征参数变化。结果:①与正常人比较,CRC术后患者舌色、苔色明度(V)参数下降,饱和度(S)参数上升(P<0.05),与正常人舌、苔相比色调(H)值具有统计学差异(P<0.05)。在舌象特征参数比较中,CRC术后患者润燥指数、剥苔指数、裂纹指数、点刺指数均有所上升(P<0.05),厚薄指数有所下降(P<0.05)。②CRC术后患者各中医证候舌色比较中,湿热蕴结证患者腐腻指数较高、厚薄指数较低;脾肾阳虚证患者舌、苔根部S值明显下降,润燥指数、胖瘦指数较高;气血两虚证患者舌左侧S值较低,V值较高;瘀毒内结证患者苔色S值升高、V值下降,厚薄指数较低;肝肾阴虚证患者剥苔指数、裂纹指数、点刺指数较高,胖瘦指数较低。结论:CRC术后患者舌象客观化特征参数与CRC中医诊断与辨证理论基本一致,上述指标为CRC诊断及其各中医证型辨证提供重要参考,有望为后续建立更明确的CRC诊断模型提供依据。Objective:To observe the changes of tongue objective characteristic parameters between patients with colorectal cancer(CRC)and normal people and between different traditional Chinese medicine(TCM)syndromes after CRC.Methods:A total of 83 cases of post CRC patients in Oncology Department of Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,and 20 cases of health checkups in Physical Examination Center,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine were selected.Tongue image information was collected using mobile phones and standard 24 color color cards(X-Rite Company of the United States).Through tongue image analysis system,the changes of tongue image objective characteristic parameters between patients after CRC and normal people as well as between different TCM syndromes after CRC were compared.Results:①Compared with the normal people,the V parameter of tongue color and fur color of patients after CRC decreased,and the S parameter increased(P<0.05).There was a statistical difference between the H value of tongue color and fur color of patients after CRC(P<0.05).In the comparison of tongue characteristic parameters,the moistening dryness index,coating peeling index,crack index and prick index of patients after CRC increased(P<0.05),and the thickness index decreased(P<0.05).②In the comparison of tongue color of different TCM syndromes in patients after CRC operation,the patients with damp heat accumulation syndrome have higher greasy index and lower thickness index;The S value of tongue and moss root in patients with spleen kidney yang deficiency syndrome decreased significantly,and the moistening dryness index and fat thin index were higher;The S value of the left side of the tongue in patients with deficiency of both qi and blood is low,and the V value is high;The S value of fur color increased,the V value decreased,and the thickness index was lower in patients with the syndrome of

关 键 词：结直肠癌 中医证候 辨证论治 舌诊 客观化 

分 类 号：R273[医药卫生—中西医结合]