体质指数与舌象特征的相关性研究

A correlation study between body mass index and features of tongue manifestation

目的探讨BMI与舌象特征的相关性。方法以1655名体检者为对象，测量身高和体重，计算BMI，并进行中医舌诊，数码相机拍摄舌象图。结果在1655名体检者中，体重正常、超重／肥胖和体重过低者分别为843人（50．94％）、724人（43．74％）和88人（5．32％）。超重／肥胖组黯红舌（37．98％比24．56％；χ^2=40．883，P〈0．001）、紫舌（5．94％比3．44％；χ^2=8．133，P=0．017）、紫黯舌（2．35％比0．59％；χ^2=10．398，P=0．006）、黄苔（63．95％比58．84％；χ^2=9．570，P=0．008）、厚腻苔（24．86％比17．20％；χ^2=18．698，P〈0．001）出现率显著高于体重正常组，剥脱／少苔／无苔出现率显著低于体重正常组（1．93％比3．91％；χ^2=6．454，P=0．040）。体重过低组红／绛舌（48．86％比24．72％；χ^2=24．608，P〈0．001）、红点舌（7．95％比1．93％；χ^2=12．254，P=0．002）、薄白苔（22．73％比9．53％；χ^2=14．030，P=0．001）出现率显著高于体重正常组。二元logistic回归分析显示，黯红舌（OR1．830，95％CI1．515-2．211；P〈0．001）、紫舌（OR1．874，95％CI1．211～2．901；P=0．005）、紫黯舌（OR4．259，95％CI1．610～11．266；P=0．003）、黄苔（OR1．294，95％CI1．093-1．531；P=0．003）、灰黑苔（OR6．147，95％CI1．816-20．811；P=0．004）、厚腻苔（OR1．597，95％CI1．289～1．978；P〈0．001）与BMI呈正相关，淡红舌（OR0．766，95％CI0．637～0．920；P=0．004）、红／绛舌（OR0．659，95％CI0．549-0．789；P〈0．001）、红点舌（OR0．548，95％CI0．326-0．921；P=0．023）、薄白苔（OR0．695，95％CI0．536-0．900；P=0．006）、白苔（OR0．821，95％CI0．6830．986；P=0．035）与BMI呈负相关。结论BMI与舌象特征具有一定相关性，超重／肥胖人群的异常舌色以黯红舌为主；体重过低组异常舌色以红／绛舌为主。舌苔异常者均以黄厚苔为主。不同体重者的舌形均基本正常。

Objective To investigate the correlation between body mass index （BMI） and features of tongue manifestation. Methods A total of 1 655 physical examination individuals were selected, and height and body weight were measured to calculate BMI. Traditional Chinese Medicine tongue inspection was performed, and map of tongue manifestation was photographed by a digital camera. Results Among the 1 655 physical examination individuals, prevalences of normal weight, overweight/obesity and low weight were 50.94%, 43.74% and 5.32%, respectively. The prevalences of individuals had dark red tongue （37.98% vs. 24.56%; χ^2=40.883, P〈0.001）, purplish tongue （5.94% vs. 3.44%;χ^2=8.133, P=0.017）, dark purplish tongue （2.35% vs. 0.59%; χ^2=10.398, P=0.006）, yellow fur （63.95% vs. 58.84%; χ^2=9.570, P=0.008）, thick greasy fur （24.86% vs. 17.20%;χ^2=18.698, P〈0.001） in the overweight/obesity group were significantly higher than those in the normal weight group, and the prevalence of individuals had exfoliative fur/little fur/less fur in theoverweight/obesity group was significantly higher than that in the normal weight group （1.93% vs. 3.91%; χ^2=6.454, P=0.040）. The prevalences of individuals had red or deep red tongue （48.86% vs. 24.72%; χ^2=24.608, P〈0.001）, red dot tongue （7.95% vs. 1.93%; χ^2=12.254, P=0.002）, thin whitish fur （22.73% vs. 9.53%; χ^2=14.030, P=0.001） in the low weight group were significantly higher than those in the normal weight group. Binary logistic regression analysis showed positive correlation between dark red tongue （OR 1.830, 95% CI 1.515-2.211; P〈0.001）, purplish tongue （OR 1.874, 95% CI 1.211-2.901; P=0.005）, dark purplish tongue （OR 4.259, 95% CI 1.610-11.266; P=-0.003）, yellow fur （OR 1.294, 95% CI 1.093-1.531; P=0.003）, gray-black fur （OR 6.147, 95% CI 1.816-20.811; P=0.004）, thick greasy fur （OR 1.597, 95% CI 1.289-1.978; P〈0.001） and BMI, and negative correlation between pink tongue （OR 0.766, 95% CI 0.637-0.920; P=0.004）, red or deep red tongue （OR 0.659, 95% CI 0.549-0.789; P〈0.001）, red dot tongue （OR 0.548, 95% CI 0.326-0.921; P=0.023）, thin whitish fur （OR 0.695, 95% CI 0.536-0.900; P=0.006）, whitish fur （OR 0.821, 95% CI 0.683-0.986; P=0.035） and BMI. Conclusions There is some correlation between BMI and features of tongue manifestation. Abnormal tongue color is mainly dark red tongue in the overweight/obesity individuals, and red or deep red tongue in low weight individuals. Abnormal tongue fur is mainly thick yellow fur. The tongue shape is normal in different body weight groups.