增龄相关的冠心病痰瘀互结证患者舌象特征客观化研究  

Objective Study on Characteristics of Tongue Image in Patients with Age-Related Coronary Heart Disease and Phlegm-Blood Stasis Syndrome

作　　者：杨珺涵 咸楠星 张世祺 高诗岳 王基实 马新宇 李相泽 李腾 刘悦[1] 杨关林[5,6] 张哲 YANG Junhan;XIAN Nanxing;ZHANG Shiqi;GAO Shiyue;WANG Jishi;MA Xinyu;LI Xiangze;LI Teng;LIU Yue;YANG Guanlin;ZHANG Zhe(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Medical Experiment Center,China Academy of Chinese Medical Sciences,Beijing 100700,China;Shenyang Vocational Technical Institute,Shenyang 110045,China;Lanpu Jinkeen(Beijing)Technology Co.,Ltd.,Beijing 100000,China;National-Local Joint Engineering Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Control of Cardiovascular Diseases in Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Key Laboratory of Traditional Chinese Medicine,Ministry of Education,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,National Key Research Laboratory for the Management of Cardiovascular Diseases with Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳100847 [2]中国中医科学院医学实验中心,北京100700 [3]沈阳职业技术学院,辽宁沈阳110045 [4]蓝普金睛(北京)科技有限公司,北京100000 [5]辽宁中医药大学心脑合病中西医结合防治技术国家地方联合工程实验室,辽宁沈阳110847 [6]中医脏象理论及应用教育部重点实验室,辽宁沈阳110847 [7]辽宁中医药大学附属医院,痰瘀论治血脉病国家中医药管理局重点研究室,辽宁沈阳110032

出　　处：《中华中医药学刊》2025年第3期56-62,I0010,共8页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(81703970);国家中医药管理局首批青年岐黄学者支持项目(国中医药人教函[2020]218号)。

摘　　要：目的探讨冠心病痰瘀互结证患者的舌象特点,分析其舌象变化的规律。方法采用整群抽样法,纳入2020年11月—2021年11月就诊于辽宁中医药大学附属医院心内科的冠心病稳定型心绞痛(也称劳力性心绞痛)210例患者的舌象临床资料,将纳入病例分为痰瘀互结证组与非痰瘀互结证组。按照世界卫生组织(World Health Organization,WHO)年龄分段标准将痰瘀互结证组分为中年组(27例)、低龄老年组(40例)、高龄老年组(17例)。对不同年龄组的痰瘀互结证患者HSV(Hue,Saturation,Value)、RGB(Red,Green,Blue)参数等舌象特征进行分析,探究与增龄相关的舌象变化规律。结果冠心病·痰瘀互结证患者不同年龄组间舌质、舌苔分布差异具有统计学意义。舌色特征:中年组多红舌,低龄老年组多淡紫舌,高龄老年组多绛舌和紫舌(P<0.05);中年组舌质尖部H值小于低龄老年组、高龄老年组(P<0.05),中年组舌质尖部V值大于其他两组(P<0.05)。高龄老年组舌质左部、右部、中部S值大于中年组和低龄老年组(P<0.05),V值小于中年组和低龄老年组(P<0.05),高龄老年组舌质左部、右部、中部的R+B/R+G+B值大于其他两组;舌形特征:中年组多胖大、齿痕舌,高龄老年组多瘦薄舌,且高龄老年组多裂纹舌、老舌、嫩舌(P<0.05);舌苔特征:中年组舌苔多白腻如豆腐脑铺舌,高龄老年组患者舌苔淡黄黏糊状如鸡子黄覆盖,腻苔比例逐渐减少,以高龄老年组腻苔比例最低(P<0.05)。中年组舌苔左部、右部、中部V值大于低龄老年组、高龄老年组(P<0.05),高龄老年组舌苔左部、右部、中部的S值大于中年组和低龄老年组(P<0.05),高龄老年组舌苔根部的V值小于其他两组(P<0.05),高龄老年组舌苔中部、根部的R+G/R+G+B值大于其他两组。结论(1)中年组易痰瘀热化。(2)伴随增龄瘀血程度逐渐加重。(3)高龄老年组痰瘀之邪易伤及营阴。(4)高龄老年组易虚实夹杂。Objective To explore the characteristics of tongue in patients with coronary heart disease(CHD)and phlegm-blood stasis syndrome,and to analyze the changes in the tongue image.Methods A total of 210 patients with stable angina pecto-ris(also known as effort angina)in the Cardiology Department of Liaoning Provincial Hospital of Traditional Chinese Medicine from November 2020 to November 2021 were included in this study.The patients were divided into phlegm-blood stasis syn-drome group and non-phlegm-blood stasis syndrome group.According to the WHO(World Health Organization)age classifica-tion standard,the phlegm-blood stasis syndrome group was divided into middle age group(27 cases),young elderly group(40 cases)and old elderly group(17 cases).The tongue features such as HSV(Hue,Saturation,Value)and RGB(Red,Green,Blue)parameters were analyzed in patients with phlegm-blood stasis syndrome in different age groups to explore the age-related changes in the tongue image.Results There were significant differences in the distribution of tongue color,texture and shape be-tween the phlegm-blood stasis syndrome group and non-phlegm-blood stasis syndrome group.In terms of tongue color,the middle age group had more red tongues,while the young elderly group had more light purple tongues,and the old elderly group had more dark red and purple tongues(P<0.05).In terms of texture features,the middle age group had a smaller H value in the tip of the tongue compared to the young elderly group and old elderly group(P<0.05),while the middle age group had a higher V value in the tip of the tongue compared to the other two groups(P<0.05).The old elderly group had a higher S value in the left,right and middle parts of the tongue compared to the middle age group and young elderly group(P<0.05),while the old eld-erly group had a lower V value in the left,right and middle parts of the tongue compared to the middle age group and young elder-ly group(P<0.05).The old elderly group had a higher R+B/R+G+B value in the left,right and middle parts o

关 键 词：冠心病 痰瘀互结证 年龄 舌象 客观化 

分 类 号：R256.2[医药卫生—中医内科学]