探讨117例海南地区冠心病患者不同证型的 舌象特征

Investigation of Tongue Manifestation across Different Traditional Chinese Medicine Syndromes in 117 Cases of Coronary Heart Disease Patients in Hainan Region

摘要: 目的：观察冠心病人群中医证型、以及合并不同疾病下的舌象特征规律。方法：通过MT-BS-01型舌诊仪采集冠心病患者的舌象图像并通过舌诊分析系统得到舌象图像数据，结合《冠心病患者信息采集表》量表采集冠心病患者症状资料用以辨证分型，观察不同证型下舌质、舌苔的数据分析。结果：不同证型的冠心病患者舌象数据有着显著差异，如气虚血瘀、气滞血瘀以及血瘀证的TB-a值较高、TB-V值均低，表明其舌色以暗红为主；痰浊闭阻TB-a值最低、TB-b、TC-S、TC-b值高，表明其舌色偏淡，舌苔偏黄。此外舌象数据TB-R、TB-B、TC-G、TC-B、TB-H、TB-S、TB-V、TC-H、TC-S、TC-V、TB-L、TB-a、TB-b、TC-L、TC-a、TC-b的值差异具有统计学意义(P < 0.05)，TB-G、TC-R差异无统计学意义(P > 0.05)。而合并不同疾病后的冠心病患者舌象数据值无统计学意义(P < 0.05)。结论：在冠心病人群中，客观化的中医舌象特征指标能指示一定的病理状态，也可以作为中医辨证分型诊断的依据和参考，但合并不同疾病状态下的冠心病患者舌象特征指标鉴别意义不大。

Abstract: Objective: To observe the regularity of tongue image characteristics of patients with coronary heart disease in different TCM syndrome types and those with different comorbidities. Methods: Tongue images of patients with coronary heart disease were collected by MT-BS-01 tongue diagnosis instrument and tongue image data were obtained through tongue diagnosis analysis system. Symptom data of patients with coronary heart disease were collected by “Coronary Heart Disease Patient Information Collection Form” scale for syndrome differentiation and typing. The tongue body and tongue coating data of different syndrome types were analyzed. Results: There were significant differences in tongue image data among patients with coronary heart disease in different syndrome types. For example, the TB-a value was higher and the TB-V value was lower in Qi deficiency and blood stasis, Qi stagnation and blood stasis, and blood stasis syndrome, indicating that the tongue color was mainly dark red. In phlegm turbidity and blood stasis syndrome, the TB-a value was the lowest, and the TB-b, TC-S, and TC-b values were high, indicating that the tongue color was pale and the tongue coating was yellow. In addition, the values of tongue image data such as TB-R, TB-B, TC-G, TC-B, TB-H, TB-S, TB-V, TC-H, TC-S, TC-V, TB-L, TB-a, TB-b, TC-L, TC-a, and TC-b were statistically significant (P < 0.05), while the values of TB-G and TC-R were not statistically significant (P > 0.05). However, there was no statistical significance in tongue image data values of patients with coronary heart disease with different comorbidities (P < 0.05). Conclusion: In the population of patients with coronary heart disease, objective tongue image characteristic indicators of TCM can indicate certain pathological states and can be used as the basis and reference for TCM syndrome differentiation and diagnosis. However, the tongue image characteristic indicators of patients with coronary heart disease with different comorbidities have little discriminatory significance.