系统性红斑狼疮患者的舌质颜色与疾病活动度相关性的临床研究

Clinical study on the correlation between tongue color and disease activity in patients with systemic lupus erythematosus

目的:探讨基于红绿蓝(RGB)色度学量化后的系统性红斑狼疮(SLE)患者舌质颜色在不同疾病活动度的差异,为临床评估SLE患者的疾病活动度提供新依据。方法:收集SLE患者的基本信息、临床症状及舌象图片等临床资料,参照SLEDAI-2000对患者进行疾病活动度的评估,运用中医四诊合参对患者进行辨证分型,后将临床数据信息统计分析。结果:招募的120例SLE患者轻度活动组以阴虚内热证为主,中度活动组以阴虚内热证、脾肾阳虚证、热毒炽盛证为主,重度活动组以热毒炽盛证为主;舌质RGB值提示R%在轻中重三组中差异具有统计学意义(P<0.01);G%、R%+G%+B%中度与轻度差异具有统计学意义(P<0.05)。提示轻度活动组患者以舌质偏暗红为主,中度活动组以舌质偏暗红或淡白或红为主,重度活动时以舌质偏红、绛红为主。SLE患者舌质R%与血沉有一定的正相关(r=0.254,P<0.05),与白蛋白存在负相关(r=-0.309,P<0.05),舌质G%嗜酸性粒细胞(r=-0.254,P<0.05)与血红蛋白(r=-0.238,P<0.05)及白蛋白(r=-0.266,P<0.05)呈负相关。结论:舌质颜色的改变能在一定程度上评估SLE患者的疾病活动度,其中阴虚内热、热毒炽盛等以热证为主的患者舌象,随着疾病活动性的增加,从暗红逐渐转为红,并进一步转变为红绛。

Objective:To explore the differences of tongue color of systemic lupus erythematosus(SLE)patients based on RGB colorimetric quantification and related laboratory physical and chemical indicators in different disease activity.It provides new ideas for evaluating the disease activity of SLE patients in clinical practice.Methods:Collecting the basic information,clinical symptoms,tongue pictures and other clinical data of patients with SLE,and the disease activity of the patient was evaluated with reference to SLEDAI-2000,and the four diagnostic methods of traditional Chinese medicine were used to distinguish and classify the patient,and then the data information was statistically analyzed.Results:The mildly active group of 120 SLE patients recruited was mainly yin deficiency and internal heat,the moderately active group was dominated by yin deficiency and internal heat,spleen and kidney yang deficiency,and heat toxicity,and the severely active group was dominated by heat toxicity.The RGB value of tongue showed that R%was statistically different in the light,medium and heavy groups(P<0.01),G%and R%+G%+B%were statistically different in the midly and moderately active groups(P<0.05).It was suggested that the light activity group mainly had dark red tongue,the moderate activity group was mainly dark red or light white or red,and the tongue was red and crimson during heavy activity.In SLE patients,tongue R%had a positive correlation with ESR(r=0.254,P<0.05),and negatively correlated with serum albumin(r=-0.309,P<0.05),and tongue G%had a positive correlation with of Hb(r=-0.238,P<0.05)and serum albumin(r=-0.266,P<0.05).Conclusion:The change of tongue color can evaluate the disease activity of SLE patients to a certain extent.Among them,the tongue image of patients with heat evidence,such as yin deficiency and internal heat,heat toxicity,etc.,gradually changed from dark red to red with the increase of disease activity,and further changed to red.