1.上海中医药大学基础医学院,上海市浦东新区蔡伦路1200号,201203
2.上海中医药大学附属曙光医院生殖医学中心
3.厦门大学
xjt@fudan.edu.cn;(021)51322124
收稿:2021-09-01,
修回:2021-11-25,
纸质出版:2022-02-17
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郭志玲,梁梦晨,郭晓静等.281例月经不调患者舌象特征研究[J].中医杂志,2022,63(04):356-361.
GUO Zhiling,LIANG Mengchen,GUO Xiaojing,et al.Tongue Manifestations of 281 Patients with Menstrual Irregularities[J].Journal of Traditional Chinese Medicine,2022,63(04):356-361.
郭志玲,梁梦晨,郭晓静等.281例月经不调患者舌象特征研究[J].中医杂志,2022,63(04):356-361. DOI: 10.13288/j.11-2166/r.2022.04.011.
GUO Zhiling,LIANG Mengchen,GUO Xiaojing,et al.Tongue Manifestations of 281 Patients with Menstrual Irregularities[J].Journal of Traditional Chinese Medicine,2022,63(04):356-361. DOI: 10.13288/j.11-2166/r.2022.04.011.
目的
2
探讨月经不调患者舌象特征及规律。
方法
2
纳入就诊于上海中医药大学附属曙光医院生殖中心的月经不调患者(月经不调组)281例及体检中心的健康人(健康对照组)213例,使用TFDA-1型数字舌面诊仪采集两组受试者的舌象图像数据。颜色指标包括HSI、Lab、YCrCb颜色空间(TB,舌质;TC,舌苔;H,色调;I,亮度;S,饱和度;L,明度;a,红色-绿色轴;b,黄色-蓝色轴;Y,亮度;Cr,红色信号与亮度值之间的差异;Cb,蓝色信号与亮度值之间的差异),纹理指标包括对比度(CON)、角度方向二阶矩(ASM)、熵值(ENT)、平均值(MEAN),舌苔指数(perAll)。再对281例月经不调患者辨证分为气(血)虚证63例、肾虚证40例、血热证40例、血瘀证41例、肝郁证48例、痰湿证49例,对不同证型的舌象特征进行分析。
结果
2
月经不调组舌色图像指标TB-S、TB-Cb、TC-S、TC-Cb高于健康对照组,TB-H、TB-I、TB-L、TB-b、TB-Y、TC-I、TC-L、TC-Y低于健康对照组(
P
<0.05);月经不调组舌象纹理指标的TB-ASM、TC-ASM高于健康对照组,TB-CON、TB-ENT、TB-MEAN、TC-CON、TC-ENT、TC-MEAN低于健康对照组(
P
<0.05)。不同证型月经不调患者舌象颜色指标除TB-H、TC-H、TC-b、TC-Cb外,其余各指标差异均有统计学意义(
P
<0.05)。不同证型月经不调患者在舌象纹理指标及舌苔指数TB-CON、perAll上差异有统计学意义(
P
<0.05)。
结论
2
月经不调患者舌象颜色更暗、饱和度高,舌质纹理更细腻。其中血热证的舌质红色色度分量最高,血瘀证的舌象较血热证和肝郁证蓝色色度成分高,痰湿证的舌质较气(血)虚更为粗糙,血瘀证和痰湿证的舌苔面积较大。
Objective
2
To study the characteristics of tongue manifestations of female patients with menstrual irregularities (MI).
Methods
2
The patients were recruited from Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and 281 MI patients admitted to the reproductive medicine center (MI group) and 213 healthy subjects (control group) were included. The tongue manifestations data were collected by using the TFDA-1 digital tongue inspection instrument. The color indicators included HSI, Lab and YCrCb color spaces such as tongue body (TB), tongue coating (TC), hue (H), brightness (I), saturation (S), lightness (L), red-green axis (a), yellow-blue axis (b), luminance (Y), difference of red signal with brightness value (Cr) and difference of blue signal with brightness value (Cb) values, and the texture indicators were contrast (CON), angular second moment (ASM), entropy (ENT), mean value (MEAN), and tongue coating index (perAll). The 281 MI patients were categorized into
qi
(blood) deficiency pattern (63 cases), kidney deficiency pattern (40 cases), blood heat pattern (40 cases), blood stasis pattern (41 cases), liver constraint pattern (48 cases), and phlegm damp pattern (49 cases), and the tongue manifestations of different patterns were analyzed.
Results
2
The tongue color indicators TB-S, TB-Cb, TC-S, and TC-Cb were higher in the MI patients, and TB-H,TB-I,TB-L,TB-b, TB-Y, TC-I,TC-L,and TC-Y were significantly lower than those in the healthy subjects (
P
<0.05). The tongue texture indicators TB-ASM and TC-ASM were higher in the MI patients, while the TB-CON, TB-ENT, TB-MEAN, TC-CON, TC-ENT and TC-MEAN were lower than those in the healthy subjects (
P
<0.05). There were statistical differences between different TCM patterns in tongue color indicators except for TB-H, TC-H, TC-b and TC-Cb (
P
<0.05). Tongue texture indicators and tongue coating index TB-CON and perAll were significantly different among patients with different TCM patterns (
P
<0.05).
Conclusion
2
The tongue color of MI patients are more dusky with higher saturation and more delicate texture. The Cr value is highest in patients with blood heat pattern, and the Cb value in patients with blood stasis pattern was higher than that of blood heat pattern and liver constraint pattern. The texture is rougher in phlegm damp pattern patients than that in
qi
(blood) deficiency pattern patients. The coating area in patients with blood stasis pattern and phlegm damp pattern is larger.
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