摘要
目的分析代谢综合征(Metabolic Syndrome,MS)患者的舌象特征,为研究中医舌象辨证与人体生物学基础的联系提供证据与支撑。方法通过MS临床流行病学调查数据库提取患者舌象资料及理化数据,SPSS17.0软件对数据进行描述性统计分析以及Logistic回归分析。结果共纳入3211例MS患者,男女构成比1.06:1,其中血脂、血压、血糖均异常者最多,占32.70%(1050例);其次为血脂伴血压不伴血糖异常者,占31.45%(1010例);血糖伴血压不伴血脂异常者占22.39%(719例);多在40~69岁,平均年龄(53.86±10.33)岁,男性年龄分布较女性前移;异常舌形以胖大舌(32.4%)、裂纹舌(14.2%)、齿痕舌(11.0%)出现的频率最高;舌色以红舌(38.2%)出现的频率最高,其次是淡白舌(17.0%)、淡紫舌(15.1%),舌下络脉青紫曲张出现频率亦较高(14.4%);苔色以黄苔和白苔为主,分别占53.9%和46.0%;苔质以薄苔(37.6%)和腻苔(36.8%)出现频率最高,其次是厚苔(25.4%)。Logistic回归分析发现血压升高与舌形胖大、舌色红绛、舌有瘀斑/点、舌下络脉青紫曲张、舌苔薄等具有显著相关性;血脂异常与舌色淡紫、舌下络脉青紫曲张、舌苔腻、舌苔厚、舌苔水滑有显著相关性;空腹血糖升高与舌色淡白正相关,与舌下络脉青紫曲张、舌苔润、舌苔水滑负相关。同时,舌象变化与理化指标间存在密切联系,舌色加深、舌有瘀斑及舌下络脉青紫曲张与血液黏稠度显著增高有关。结论不同类型MS患者的舌象各有特点,以实证多见,均存在着不同程度舌色加深、瘀斑及舌下络脉青紫曲张等血瘀表现。MS患者舌象与疾病因子、理化指标及血流变之间存在一致性与相关性,是MS多种因素联合作用的反映,可为MS的临床诊疗提供客观化依据。
Objective To analyze the characteristics of tongue in patients with metabolic syndrome(MS)and provide evidence and support for the correlation between TCM pattern differentiation based on tongue characteristic and basis of human biology.Methods Data of MS patients’tongue images and their physical and chemical examination results were extracted from MS clinical epidemiological investigation database.SPSS17.0 software was used for descriptive statistical analysis and stepwise logistic regression of the data.Results 3,211 MS patients were included in the study with a male-to-female ratio of 1.06:1.The number of patients with abnormal levels of blood lipids,blood pressure(BP)and fasting plasma glucose(FPG)was the largest(1,050),accounting for 32.70%.The number of those with abnormal levels of blood lipids and BP and normal levels of FPG came next(1,010),accounting for 31.45%,followed by the number of cases with abnormal levels of FPG and BP and normal levels of blood lipids(719),accounting for 22.39%.The average age of the patients was 53.86±10.33 with the majority aged from 40 to 69.The age distribution of men is younger than that of women.The most frequently observed abnormal tongue shapes were enlarged tongue(32.4%),cracked tongue(14.2%)and teethmarked tongue(11.0%).In terms of tongue color,red tongue(38.2%)was the most frequently encountered,followed by pale tongue(17.0%)and light purple tongue(15.1%).Varicose sublingual vein cyanosis(14.4%)was also seen at a high frequency.The colors of tongue coatings were mainly yellow and white,accounting for 53.9%and 46.0%respectively.Most of the tongue coatings were thin(37.6%),greasy(36.8%)or thick(25.4%).Logistic regression showed that increase in blood pressure was significantly related to enlarged tongue,red and crimson tongue,stasis macules and spots on the tongue,varicose sublingual vein cyanosis and thin tongue coating,etc.Abnormal levels of blood lipids were significantly correlated with light purple tongue,varicose sublingual vein cyanosis,greasy tongue coating,thick tongue coating and glossy tongue coating.Increase in fasting blood glucose was positively related to pale tongue.However,there was a negative correlation between blood glucose and varicose sublingual vein cyanosis,moist tongue coating and glossy tongue coating.Meanwhile,there was a close relationship between changes in tongue image and patients’physical and chemical examination results.Deep tongue color,stasis macules and spots on the tongue and varicose sublingual vein cyanosis were related to significant increase in blood viscosity.Conclusion Tongue images of MS patients of different types demonstrate different characteristics.Most of them present excess pattern with blood stasis featuring deep tongue color,stasis macules and spots on the tongue and varicose sublingual vein cyanosis.There is consistency and correlation between tongue image and pathogenic factors,physical and chemical examination results and hemorheological parameters of patients with MS,which reflects the influence of multiple factors on MS.The present findings can provide objective basis for clinical diagnosis and treatment of MS.
作者
朱晓云
汤阳
朱莉莉
冯磊
刘喜明
Zhu Xiaoyun;Tang Yang;Zhu Lili;Feng Lei;Liu Ximing(Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing University of Chinese Medicine,Bejing 100029,China,;China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《北京中医药大学学报》
CAS
CSCD
北大核心
2020年第10期849-858,共10页
Journal of Beijing University of Traditional Chinese Medicine
基金
国家科技重大专项项目(No.2011ZX09102-011-08)
国家科技支撑计划项目(No.2009BAI80B04)
国家自然科学基金项目(No.81804085)
关键词
代谢综合征
流行病学
舌象特征
中医病机
metabolic syndrome
epidemiology
tongue characteristics
TCM pathogenesis
