中医舌象特征与胸部CT在病毒性肺炎中的相关性研究

Correlation between TCM Tongue Features and Chest CT-based Staging of Viral Pneumonia

目的:探索病毒性肺炎患者胸部CT影像学分期与中医舌象特征的相关性。方法:选取2020年1月至2022年2月北京中医药大学东方医院和黄石中医院收治的病毒性肺炎患者的舌象和胸部CT影像117例作为研究对象,采用单因素分析舌质、舌体、舌苔在不同CT分期的分布情况,对有意义的自变量进行多因素Logistic回归分析探讨胸部CT分期与舌象特征的相关性。结果:117例病毒性肺炎患者CT所示早期17例(14.53%)、进展期85例(72.65%)、消散期15例(12.82%)。患者舌质淡色舌者20例(17.09%)、红舌者29例(24.79%)、紫舌者68例(58.12%);舌苔少无苔者31例(26.5%)、薄苔者19例(16.24%)、腻苔者67例(57.26%);舌体瘦小者12例(10.3%)、正常者49例(41.9%)、肥大者56例(47.9%)。单因素分析结果显示舌质、舌体、舌苔与胸部CT影像不同分期间的差异有统计学意义(P<0.05),纳入舌质、舌体、舌苔等因素进行多因素logistic回归分析。多因素分析结果显示胸部CT早期比进展期红舌、少无苔、薄苔多,瘦小舌少;消散期比进展期红舌、少无苔、瘦小舌多。结论:病毒性肺炎患者的舌质在胸部CT早期多为淡舌,在进展期多为紫舌和消散期多为红舌;舌苔在胸部CT早期多为薄苔,在进展期多为腻苔,消散期多为少无苔;舌体在胸部CT早期多为正常、肥大(正常偏多),在进展期多为正常、肥大(肥大偏多),消散期多为正常、瘦小(瘦小偏多)。

Objective:To investigate the correlations between the chest computed tomography(CT)-based staging of viral pneumonia and TCM tongue features.Methods:A total of 117 patients with viral pneumonia treated in Dongfang Hospital affiliated to Beijing University of Chinese Medicine and Huangshi Central Hospital from January 2020 to February 2022 were enrolled in this study.The univariate analysis was performed to reveal the distribution of tongue colors,tongue sizes,and tongue coatings in different stages determined by chest CT images.The features were compared among CT imaging stages.The significant tongue features were selected for multivariate logistic regression analysis.Results:According to the CT images,the 117 patients with viral pneumonia included 17(14.53%)patients in the early stage,85(72.65%)patients in the advanced stage,and 15(12.82%)patients in the lesion-dissipating stage.The patients showed pale tongue(17.09%),red tongue(24.79%),or purple tongue(58.12%).The tongue coating was absent or little in 31(26.5%)patients,thin in 19(16.24%)patients,and greasy in 67(57.26%)patients.The tongue was thin in 12(10.3%)patients,in normal size in 49(41.9%)patients,and enlarged in 56(47.9%)patients.The results of univariate analysis showed that the tongue color,tongue size,and tongue coating had significant differences among the three stages determined by chest CT images(P<0.05).The multivariate logistic regression analysis showed that the early stage had more patients with red tongue,little or absent coating,and thin coating and fewer patients with thin tongue than the advanced stage.The lesion-dissipating stage showed more patients with red tongue,little or absent coating,and thin tongue than the advanced stage.Conclusion:The patients with viral pneumonia mainly show pale tongue in the early stage,purple tongue in the advanced stage,and red tongue in the lesion-dissipating stage.The tongue coating is thin in the early stage,greasy in the advanced stage,and little or absent in the lesion-dissipating stage.Most patients show normal tongue size in the early stage,enlarged tongue in the advanced stage,and thin tongue in the lesion-dissipating stage.