1003例慢性乙型肝炎(ALT≥2×ULN)患者中医舌诊特点的临床研究

Clinical Study on Tongue Diagnosis Feature of 1003 Patients of Chronic Hepatitis B(ALT2ULN)

目的:开展全国范围内多中心慢性乙型肝炎(ALT≥2×ULN)患者舌象的采集与分析,归纳慢性乙型肝炎(ALT≥2×ULN)舌象分布特点。方法:通过调查全国共计1 003例慢性乙型肝炎(ALT≥2×ULN)患者的舌象并进行图像记录,应用清华大学研发的《舌象采集及分析系统》进行数据处理,运用统计学方法,对1 003例慢性乙型肝炎(ALT≥2×ULN)患者舌象进行分析。结果:从1 003例临床资料中,慢性乙型肝炎(ALT≥2×ULN)患者常见舌色分布依次为:红、淡红、暗、淡白;常见的舌形分布依次为:齿痕、荣润、胖大、舌有瘀斑及舌下脉络发绀等;常见的舌苔色分布依次为:白、黄;常见的苔质分布依次为:薄苔、腻苔、厚苔。属"肝胆湿热证"的舌象分布特点为:苔色黄,舌质色红,苔腻,舌荣润,苔色白,苔薄,苔厚。属"肝郁脾虚证"的舌象分布特点为:苔色白,苔薄,舌质淡红,舌质色红,苔腻,舌胖大有齿痕,舌荣润,苔色黄。结论:慢性乙型肝炎(ALT≥2×ULN)患者舌象涉及的病理因素主要有气虚、湿盛、血瘀等。肝胆湿热、肝郁脾虚两种证型患者的舌象分布特点与学会颁布的标准较为一致,能够为后续研究提供较好的参考。

Objective：To explore the distribution regularities of tongue picture by collecting and analyzing muti^center nationwide tongue picture of chronic hepatitis B（ALT≥2ULN） patients.Methods：A total of 1 003 chronic hepatitis B（ALT≥2×ULN）patients were recruited.Collecting the clinical manifestations of tongue by image recording and using the ＂Tongue Picture Acquisition and Analysis System＂ which developed by Tsinghua University for data processing to analyze the Tongue Picture Feature of 1003 chronic hepatitis B（ALT≥2×ULN） patients.Results：By analyzing the clinical data of 1 003 patients,the main tongue color of chronic hepatitis B（ALT≥2ULN） were：red,pale red,dark,and light white.The main tongue shape were：teeth prints,nourishing and moistening,swollen,tongue with ecchymosis,and blue and purple collaterals under tongue.The main coating color were：white and yellow.The main tongue coating were：thin fur,greasy fur,and thick fur.The tongue diagnosis feature of dampness-heat in the liver and gallbladder syndrome were：coating yellow,tongue red,tongue coating greasy fur,tongue shape nourishing and moistening,coating white,tongue coating thin fur,tongue coating thick fur.The tongue diagnosis feature of liver stagnation and spleen deficiency syndrome were：coating white,coating thin fur,tongue pale red,tongue red,tongue coating greasy fur tongue shape swollen and teeth prints,tongue shape nourishing and moistening,and coating yellow.Conclusion：The pathological factors of tongue diagnosis feature of Chronic hepatitis B（ALT≥2×ULN） are mainly involved in qi deficiency,wetness hyperactivity type,and blood stasis.The tongue diagnosis feature of dampness-heat in the liver and gallbladder syndrome and liver stagnation and spleen deficiency syndrome were more consistent with the standard issued by academy,which can provide a good reference for future study.