舌象与原发性痛风炎症活动度关系的临床研究

The Clinical Research on the Relationship between Tongue Image and Inflammatory Activity of Primary Gout

目的探讨舌象与痛风炎症活动度的关系,为中医药防治痛风提供新思路。方法采用前瞻性研究方法,共纳入原发性痛风患者120例,其中急性期80例,缓解期40例。对舌象资料量化积分,对比急性期与缓解期舌象特征,并探讨舌象积分与炎症指标的相关性。结果急性期组红舌、黄苔、腻苔和滑苔的出现率高于缓解期组,缓解期组淡白舌、白苔的出现率高于急性期组(P <0.05)。Logistic回归模型提示黄苔、腐腻苔、胖舌均是痛风急性发作的正相关影响因素,黄苔时痛风急性发作的概率是白苔时的117.047倍。急性期的舌象特征如红舌、黄苔、腻苔积分与血沉、超敏C反应蛋白、NLRP3炎症体、白细胞介素-1β呈正相关。结论舌诊在判断痛风的炎症活动度,及预测痛风急性发作方面有一定的诊断价值和规律性。

Objective:To investigate the relationship between the tongue characteristics and inflammatory activity of gout,so as to provide new ideas for the prevention and treatment of gout by traditional Chinese medicine.Methods:The prospective study method was applied. A total of 120 patients were included for clinical observation,among which 80 were in the acute phase of gout and 40 were in the remission phase of gout. Tongue image data was collected for analysis by means of quantized scores. The tongue images of patients in the acute phase of gout and the remission phase were compared. Furthermore,we investigated the correlation of tongue image with inflammation markers of gout. Results:The comparison of the distribution of tongue images in the acute and remission of gout showed that the occurrence rate of red tongue,yellow fur,greasy fur and slippery fur in the acute phase of gout was higher than that in the remission stage group,and the occurrence rate of pale tongue and white fur in the remission stage group was higher than that in the acute phase of gout,with statistical significances(P <0.05). The results of logistic regression analysis showed that yellow fur,greasy fur and bulgy tongue were all positive correlated influencing factors of acute gout attack. According to odds ratio,the probability of acute gout attack with yellow fur was 117.047 times higher than white fur. The correlation analysis showed that the quantitative score of red tongue,yellow fur and greasy fur were positively correlated with ESR,CRP,NLRP3 and IL-1β. Conclusion:Tongue diagnosis is valuable for evaluating the inflammation activity of gout and predicting acute attack of gout.