节点文献
平和质与三种偏颇体质的舌象研究
【作者】 张莹；
【导师】 梁嵘；
【作者基本信息】 北京中医药大学 ， 中医诊断学， 2012， 硕士
【摘要】 1目的本研究采用对照研究的方法,探讨中医体质辨识中的平和质与三种偏颇体质(痰湿质、湿热质、阴虚质)的舌象特征；采用颜色科学的方法,对四种体质的舌色色度值进行了比较；研究了四种体质的舌象与问卷条目的关系,以期为体质辨识提供舌诊的参考依据。2方法以体检人群为对象,应用王琦的《中医体质分类与判定表》进行体质辨识,确定研究对象的体质类型；同时由中医师进行舌象观察并拍摄数字舌图,应用舌象分析仪及相关颜色分析软件提取和分析色度值,得出数字舌图的舌色信息,对平和质组、痰湿质组、湿热质组和阴虚质组进行对比研究。根据数据类型选择适当的统计学方法,运用SAS8.0进行分析(包括卡方检验、非参数检验等)。3结果3.1体质类型的分布情况：3467例研究对象中,平和质占28.44%,基本平和质占13.27%,8种偏颇体质占58.29%,作为研究对象的痰湿质、湿热质、阴虚质,分别占6.84%、7.87%和4.73%。3.2平和质组和三种偏颇体质组的舌象特征：平和质组中,属于正常范围的舌质(淡红舌、正常舌形)与舌苔(薄白苔)的出现率均不到50%。与平和质组比较,痰湿质组的暗红舌、厚腻苔的发生率增高,差异有统计学意义(P<0.05)；湿热质组的红/绛舌、厚腻苔的发生率增高,差异有统计学意义(P<0.05)；阴虚质组的红/绛舌、瘦薄舌、少苔的发生率增高,差异有统计学意义(P<0.05)。3.3平和质组、痰湿质组、湿热质组和阴虚质组的数字舌图的舌象信息：痰湿质组L值明显高于其他三种体质,a值大体相当,阴虚质组、湿热质组、平和质组的b值稍高于痰湿质组,差异有统计学意义(P<0.05)；四种体质组不同舌色间的色度值比较差异有统计学意义(P<0.05)。3.4痰湿质组的典型条目中的上眼睑比别人肿出现率偏低,阴虚质组的典型条目中的口唇颜色比一般人红、两颧部偏红出现率偏低,均未达到50%,其他典型条目随得分的增高而增高。3.5三种体质中有个别条目与临床研究一得到的典型舌象是吻合的,其中痰湿质组中嘴里有黏黏的感觉、舌苔厚腻或有厚厚的感觉均与暗红舌、厚腻苔有对应关系；湿热质组中口苦或嘴里有异味与淡黄苔、厚腻苔存在对应关系,额面部油脂分泌多与红/绛舌存在对应关系；阴虚质组中口干咽燥、总想喝水与暗红舌、红/绛舌存在对应关系,皮肤或口唇干与少苔存在对应关系。4结论4.1不同体质的典型舌象具有规律性,但典型舌象的出现率不足一半,虽然发生率不高,但在辨识体质的过程中加入舌象的观察,可以更明确的辨明体质。4.2不同体质的典型舌色的色度值存在差别,运用色度学的方法可以对舌色的细微差异进行量化比较。4.3体质测评问卷中各个条目的权重是不同的,应对不同体质的条目进行定量分配,在体质辨识过程中区别对待。
【Abstract】 1ObjectiveUsing control study method to discuss the Tongue characteristics between gentleness in the identification of TCM constitution with three biased constitution(Phlegm-wetness type, Wet-heat type, Yin-deficiency type). And using the color of the scientific method to analysis tongue color of the four kinds of physical and further study the tongue and symptoms of the four physical. The purpose is to provide for the physical identification of tongue diagnosis reference.2MethodsSelected medical population as the object, Application of Wang Qi TCM constitution classification and decision tables for physical identification to determine the physical type of the object of study. Tongue by Chinese medicine practitioners and take digital tongue map application Tongue analyzer and color analysis software to extract and analyze the obtained digital tongue tongue color map information. To comparative analysis of gentleness, phlegm-wetness type, wet-heat type, yin-deficiency type, four groups of the Tongue by Chinese medicine practitioners.3Results3.1The distribution of the physical type:In the3467cases sdudied Gentleness accounted for28.44%, Basic gentleness accounted for13.27%,8kinds of biased constitution accounted for58.29%. As a study of Phlegm-wetness type, Wet-heat type, Yin-deficiency type, respectively accounted for6.84%,7.87%and4.73%respectively.3.2The gentleness group and three biased physical group characteristics of the Tongue:In the gentleness group, the normal range of the tongue color and fur of the tongue rate are less than50%.Compared with gentleness group,in the Phlegm-wetness group,the incidence of dark red tongue,thick and greasy fur and yellow moss increased, the difference was statistically significant (P<0.05); in the Wet-heat group scarlet tongue, the incidence of thick and greasy tongue coating increased.the difference was statistically significant (P<0.05); in the Yin-deficiency group, the incidence of scarlet tongue, thin tongue, little coating increased, the difference was statistically significant (P<0.05).3.3digital tongue Figure of the gentleness group, Phlegm-wetness group, Wet-heat group, Yin-deficiency group:The Phlegm-wetness Group L was significantly higher than the other three physical, a value roughly equivalent, Yin-deficiency group, the Wet-heat group, the gentleness group b value slightly higher than the Phlegm-wetness group, the difference was statistically significant (P<0.05); Four physical group color values between the different tongue color difference was statistically significant(P<0.05). 3.4In the Phlegm-wetness group, the entry of eyelid than others swollen is lower than others, In the yin-deficiency group, the entry of the two zygomatic reddish and Lips the color red than the average person is lower than others, and did not reach50%,other typical entries with the higher score increased.3.5Three kinds of physical fitness in a typical Tongue individual entry and clinical research is consistent, in the Phlegm-wetness group, Mouth sticky feeling and thick and greasy tongue coating or thick tongue have correspondence with dark, thick and greasy fur; in the wet-heat group, Mouth pain or mouth odor have correspondence with yellow moss, thick and greasy fur; in the yin-deficiency group, Dry mouth and throat, and always want to drink have correspondence with the dark red tongue, red/purple tongue and little coating.4conclution4.1The typical physical Tongue is regularity, but the typical tongue like a rate of less than50%, although the incidence is not high, but to join in the process of identification of physical observation of the Tongue, can more clearly identify the physical.4.2Different physique of the typical tongue color has differences, with the use of colorimetry method can quantify and compare the nuances of the tongue color.4.3The weight of each entry is different in the Physical evaluation questionnaire, we should respond to different physical entry rationing, and treated differently in the physical identification process.