716例广东地区原发性高血压病患者的中医舌象特征及病机探讨

Investigation of Tongue Feature and Chinese Medicine Pathogenesis of 716 Patients with Essential Hypertension in Guangdong

目的:探索广东地区原发性高血压病(Essential Hypertension,EH)的中医病机及舌象变化特点。方法:通过临床流行病学调查,收集716例原发性高血压病患者的舌象资料,并进行描述性统计分析和逐步Logistic回归分析。结果:舌质以绛舌(40.8%)、胖大舌(87.6%)出现的频率最高,其次是黯红舌(33.3%)、紫舌(23.2%)、红舌(16.2%)、裂纹舌(71.8%)、齿痕舌(59.6%)、点刺舌(40.8%),兼有瘀斑瘀点20例;舌苔以黄苔(90.5%)、薄苔(67.6%)出现的频率最高,其次为腻苔(52.5%)、厚苔(29.1%);92%以上的患者舌下络脉特征发生改变。舌体与舌苔的综合分析得出绛舌与点刺舌、瘀斑瘀点、颤动舌、痿软舌、苔少、剥苔、燥苔相关;黯红舌与胖大舌、腻苔相关;红舌与瘦小舌、点刺舌、黄苔相关,紫舌与厚苔、白苔、黄苔相关;淡黯舌与润苔、白苔相关;淡红舌与齿痕舌相关。结论:广东地区EH病属本虚标实,血液壅滞贯穿始终。本虚常表现为阴虚和气虚,标实常表现为火热和痰浊。

Objective：To investigate the characteristics of Chinese medicine pathogenesis and tongue feature of essen- tial hypertension in Guangdong. Methods ：Via the clinical -epidemiological investigation, the data of tongues of 716 pa- tients with essential hypertension was collected. Then the related data was analyzed through descriptive statistical analysis and stepwise logistic regression analysis. Results ：The findings showed that about the body of tongue, the amount of deep red tongue（40. 8% ） and plump tongue{87.6% ） were the largest,followed by dark red tongue{33.3% ） ,purplish tongue （23.2%）, red tongue （ 16. 2% ）, fissured tongue （71. 8% ）, teeth - printed tongue （59. 6% ） and prickly tongue （40. 8% ）. While ecchymosis on tongue could be seen in 20 cases. The yellow fur（90.5% ） and the thin moss（67.6% ） had the highest share of the tongue coating, followed by sticky greasy fur（52.5% ）, thick fur（29.1% ）. Besides, the sub- lingual vessels of more than 92% patients were abnormal. According to the comprehensive analysis of the tongue body and tongue fur, deep red tongue was related to prickly tongue, ecchymosis on tongue, trembling tongue, flaccid tongue,less fur, eroded fur and dry fur. Dark red tongue was related to plump tongue and sticky greasy fur. Red tongue was related to thin tongue, prickly tongue and yellow fur. Purplish tongue was related to thick fur, white fur and yellow fur. Pale tongue was related to moist fur and white fur. Pink tongue was related to teeth - printed tongue. Conclusion ： EH disease in Guang- dong region is the syndrome of the root（Ben） deficiency and the branch（Biao） sthenia,in this case,the root is deficiency of Qi deficiency and Yin deficiency while the branch is mostly fire syndrome and phlegm syndrome. As well as, blood stagnation is through to the end.