不同证型慢性肾功能衰竭患者舌象的定量分析

Quantitative Analysis of Tongue Phenomena in Patients with Different Patterns of Chronic Renal Failure

为探讨舌象定量分析的方法,采用细胞化学、图象分析技术检测慢性肾功能衰竭脾肾气虚(A)、脾肾阳虚(B)、肝肾阴虚(C)、阴阳两虚(D)四个不同证型患者舌上皮细胞化学成分,并对检测指标进行判别分析。结果:(1)A型患者舌象多为舌淡或谈胖苔簿白;B型多舌质淡自、淡胖或暗而苔白滑或白厚腻;C型多见舌红苔少或苔薄黄;D型舌象变化不一。(2)与正常组(N)相比,各型患者舌上皮细胞琥珀酸脱氢酶(SDH)、葡萄糖-6-磷酸脱氢酶(G-6-PDH)均降低,C型最低;糖原(PAS)含量C型低于N,而A、B型高于N;酸性磷酸酶(ACP)各证型之间差异无显著性意义;在此基础上建立了各证型函数判别式。将所测数据进行组内回代检验,A、B、C出型和N的符合率分别为70.4％、75％、84.2％、64.3及100％。结论:本项目所采用的细胞化学、图象分析技术及函数判别式临床符合率较高,可作为CRF四型判别舌诊的客观指标之一。

In order to explore the method of quantitative analysis of the tongue phenomena, the chemical composition of the epithelial cells of the tongue in the patients sick with chronic renal failure in four patterns of qi deficiency in the spleen and kidney (A), yang deficiency in the spleen and kidney (B) , yin deficiency in the liver and kidney (C) and deficiency in both yin and yang (D) was determined by the techniques of cytochemistry and image pattern analysis. Simultaneously, the determined indexes were judged and analyzed. The results showed that (1) the tongue was mostly pale or pale and flabby with thin and white tongue coating in the patients of Pattern A, pale and white, pale and flabby or dim with white and slippery or white, thick and sticky tongue coating in the patients of Pattern B, red tongue with scanty tongue coating or thin and yellow tongue coating in the patients of Pattern C, and different phenomena in the patients of Pattern D. (2) In comparison with the normal group (N), succinate dehydrogenase (SDH) and glucose - 6 -phosphate dehydrogenase (G - 6 - PDH) of the epithelial cells of the tongue all declined in the patients of various patterns, lowest in Pattern C, and glycogen (PAS) content was lower in Pattern C than in Pattern N and higher in Pattern A and B than in Pattern N. But, there was no significant difference in acid phosphatase (ACP) in various patterns. Based on this, function judge mode was established for various patterns. By back substitution test of the determined indexes among the groups, the coincidence rate in Pattern A, B, C, D and N was respectively 70.4% , 75% , 84.2% , 64.3% and 100%. The conclusion is that the clinical coincidence rate in the techniques of cytochemistry, image pattern analysis and function judge mode adopted in this subject is higher and can be used as one of the objective indexes for identification of tongue phenomena in four patterns of CRF.