1.湖南中医药大学中医学院,湖南省长沙市岳麓区学士路300号,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
515800272@qq.com,(0731)88458217
收稿:2023-09-26,
修回:2024-02-17,
纸质出版:2024-05-02
移动端阅览
段梦遥,王楚皓,谈宇权等.315例冠心病患者舌象特征客观化研究[J].中医杂志,2024,65(09):921-927.
DUAN Mengyao,WANG Chuhao,TAN Yuquan,et al.Research on Objective Characteristics of Tongue Manifestation in 315 Patients with Coronary Heart Disease[J].Journal of Traditional Chinese Medicine,2024,65(09):921-927.
段梦遥,王楚皓,谈宇权等.315例冠心病患者舌象特征客观化研究[J].中医杂志,2024,65(09):921-927. DOI: 10.13288/j.11-2166/r.2024.09.009.
DUAN Mengyao,WANG Chuhao,TAN Yuquan,et al.Research on Objective Characteristics of Tongue Manifestation in 315 Patients with Coronary Heart Disease[J].Journal of Traditional Chinese Medicine,2024,65(09):921-927. DOI: 10.13288/j.11-2166/r.2024.09.009.
目的
2
探究冠心病患者的舌象客观化特征。
方法
2
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
2
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
2
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,合并高脂血症时和心力衰竭者舌色更淡,合并脑梗死者舌苔纹理更粗糙。
Objective
2
To investigate the objective characteristics of tongue manifestations in patients with coronary heart disease (CHD).
Methods
2
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
2
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-combined hyperlipidaemia group, CHD combined hyperlipidaemia group showed lower TB-S and TB-a (
P
<0.05); compared with non-combined heart failure group, CHD combined heart failure group showed lower TB-R, TB-G, TB-I, TB-L, and higher TB-a (
P
<0.05 or
P
<0.01); compared with non-combined cerebral infarction group, CHD combined cerebral infarction group showed higher TC-CON, TC-ENT, TC-MEAN, and lower TC-ASM (
P
<0.05 or
P
<0.01).
Conclusion
2
Compared to healthy individuals, patients with CHD tend to have darker tongue colours and rougher TC textures. Compared with non-comorbidity participants, those with primary hypertension tended to be lighter tongue colour and thicker tongue coating, those with carotid atherosclerosis had paler tongue body, those with type 2 diabetes mellitus had thinner tongue coating, those with fatty liver disease had paler tongue body and whiter tongue colour, those with hyperlipidaemia and heart failure had paler tongue colour, and those with cerebral infarction had rougher tongue texture.
《中国心血管健康与疾病报告2021》编写组 . 《中国心血管健康与疾病报告2021》要点解读 [J]. 中国心血管杂志 , 2022 , 27 ( 4 ): 305 - 318 .
张梦雪 , 陈伶利 , 周德生 , 等 . 冠心病舌诊的现代研究 [J]. 中西医结合心脑血管病杂志 , 2020 , 18 ( 18 ): 3002 - 3005 .
田琪 , 吕琴 , 任健 , 等 . 舌象采集及其特征分析的客观化研究进展 [J]. 中医药导报 , 2023 , 29 ( 3 ): 119 - 123 .
蔡轶珩 , 胡绍斌 , 关静 , 等 . 中医舌诊客观化技术发展分析及应用探讨 [J]. 世界科学技术-中医药现代化 , 2021 , 23 ( 7 ): 2447 - 2453 .
唐智贤 , 李萍 , 曾雅楠 , 等 . 计算机辅助舌象分析诊断研究进展 [J]. 医学信息学杂志 , 2022 , 43 ( 6 ): 36 - 39,71 .
宋连英 , 张耀圣 , 付超 , 等 . 病毒性肺炎患者不同时期胸部CT影像及中医舌象特征分析 [J]. 中医杂志 , 2023 , 64 ( 14 ): 1444 - 1447 .
羊琪琪 , 彭云花 , 裴艳妮 , 等 . 224例实证功能性便秘患者舌象特征参数分析 [J]. 中医杂志 , 2020 , 61 ( 20 ): 1817 - 1820 .
徐艺峰 , 王忆勤 , 郝一鸣 . 2型糖尿病及其合并高血压高血脂患者四诊客观参数分析 [J]. 世界科学技术-中医药现代化 , 2022 , 24 ( 2 ): 591 - 596 .
国家卫生计生委合理用药专家委员会 , 中国药师协会 . 冠心病合理用药指南(第2版) [J]. 中国医学前沿杂志 (电子版), 2018 , 10 ( 6 ): 1 - 130 .
FUNES DSH , BRIDGE C . Analysis of hair color and texture for forensic examinations [J]. J Forensic Sci , 2021 , 66 ( 2 ): 520 - 533 .
JIANG T , GRADUS JL , ROSELLINI AJ . Supervised machine learning:a brief primer [J]. Behav Ther , 2020 , 51 ( 5 ): 675 - 687 .
许家佗 . 舌象客观化识别方法的研究进展 [J]. 上海中医药杂志 , 2002 , 48 ( 2 ): 42 - 45 .
周明瀚 , 刘旺华 , 李花 , 等 . 原发性高血压阴虚阳亢证舌象客观化研究 [J]. 中华中医药杂志 , 2022 , 37 ( 6 ): 3401 - 3404 .
李灿东 . 中医诊断学 [M]. 北京 : 中国中医药出版社 , 2016 : 43 - 48 .
岳美中 . 心痛、胸痹的探讨 [J]. 新中医 , 1974 ( 4 ): 10 - 15 .
曹磊 , 于睿 . 胸痹110例舌象分析 [J]. 实用中医内科杂志 , 2008 , 22 ( 4 ): 69 - 70 .
何彦虎 , 金华 , 张俊鹏 , 等 . 高血压病合并冠心病从湿瘀论治 [J]. 辽宁中医药大学学报 , 2021 , 23 ( 7 ): 67 - 70 .
吴瑜 , 李新梅 , 卓剑丰 , 等 . 191例颈动脉粥样硬化患者中医辨证分型与医学相关因素分析 [J]. 中医药导报 , 2017 , 23 ( 14 ): 83 - 85 .
魏佳华 , 方心怡 , 苗润宇 , 等 . 中医药防治糖尿病研究进展 [J]. 辽宁中医杂志 , 2023 , 50 ( 5 ): 240 - 245 .
陆俊红 , 徐艺峰 , 王忆勤 , 等 . 2型糖尿病患者中医主证脉诊客观参数分析 [J]. 世界科学技术-中医药现代化 , 2023 , 25 ( 2 ): 813 - 819 .
李晓静 , 赵瑜 , 冯琴 , 等 . 基于文献分析的非酒精性脂肪肝中医证型分布特点 [J]. 世界中医药 , 2023 , 18 ( 2 ): 263 - 268 .
谷鑫 , 吴承玉 . 高脂血症诊治思路探析 [J]. 中医杂志 , 2014 , 55 ( 2 ): 166 - 167 .
付婧婷 , 张明雪 . 冠心病合并慢性心衰的中医证候探析 [J]. 中医药信息 , 2019 , 36 ( 6 ): 49 - 51 .
李贝贝 , 常诚 . 舌诊在中风病中的应用研究概述 [J]. 中医药通报 , 2021 , 20 ( 5 ): 68 - 72 .
0
浏览量
0
下载量
4
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号