CAJ | 학술논문

目的：开展全国范围内多中心慢性乙型肝炎（ALT≥2×ULN）患者舌象的采集与分析，归纳慢性乙型肝炎（ALT≥2×ULN）舌象分布特点。方法：通过调查全国共计1003例慢性乙型肝炎（ALT≥2×ULN）患者的舌象并进行图像记录，应用清华大学研发的《舌象采集及分析系统》进行数据处理，运用统计学方法，对1003例慢性乙型肝炎（ALT≥2×ULN）患者舌象进行分析。结果：从1003例临床资料中，慢性乙型肝炎（ALT≥2×ULN）患者常见舌色分布依次为：红、淡红、暗、淡白；常见的舌形分布依次为：齿痕、荣润、胖大、舌有瘀斑及舌下脉络发绀等；常见的舌苔色分布依次为：白、黄；常见的苔质分布依次为：薄苔、腻苔、厚苔。属“肝胆湿热证”的舌象分布特点为：苔色黄，舌质色红，苔腻，舌荣润，苔色白，苔薄，苔厚。属“肝郁脾虚证”的舌象分布特点为：苔色白，苔薄，舌质淡红，舌质色红，苔腻，舌胖大有齿痕，舌荣润，苔色黄。结论：慢性乙型肝炎（ALT≥2×ULN）患者舌象涉及的病理因素主要有气虚、湿盛、血瘀等。肝胆湿热、肝郁脾虚两种证型患者的舌象分布特点与学会颁布的标准较为一致，能够为后续研究提供较好的参考。
목적：개전전국범위내다중심만성을형간염（ALT≥2×ULN）환자설상적채집여분석，귀납만성을형간염（ALT≥2×ULN）설상분포특점。방법：통과조사전국공계1003례만성을형간염（ALT≥2×ULN）환자적설상병진행도상기록，응용청화대학연발적《설상채집급분석계통》진행수거처리，운용통계학방법，대1003례만성을형간염（ALT≥2×ULN）환자설상진행분석。결과：종1003례림상자료중，만성을형간염（ALT≥2×ULN）환자상견설색분포의차위：홍、담홍、암、담백；상견적설형분포의차위：치흔、영윤、반대、설유어반급설하맥락발감등；상견적설태색분포의차위：백、황；상견적태질분포의차위：박태、니태、후태。속“간담습열증”적설상분포특점위：태색황，설질색홍，태니，설영윤，태색백，태박，태후。속“간욱비허증”적설상분포특점위：태색백，태박，설질담홍，설질색홍，태니，설반대유치흔，설영윤，태색황。결론：만성을형간염（ALT≥2×ULN）환자설상섭급적병리인소주요유기허、습성、혈어등。간담습열、간욱비허량충증형환자적설상분포특점여학회반포적표준교위일치，능구위후속연구제공교호적삼고。
Objective:To explore the distribution regularities of tongue picture by collecting and analyzing muti-center nationwide tongue picture of chronic hepatitis B (ALT≥2ULN)patients.Methods:A total of 1 003 chronic hepatitis B(ALT≥2 ×ULN) patients were recruited.Collecting the clinical manifestations of tongue by image recording and using the“Tongue Picture Acquisi-tion and Analysis System”which developed by Tsinghua University for data processing to analyze the Tongue Picture Feature of 1 003 chronic hepatitis B(ALT≥2 ×ULN)patients.Results:By analyzing the clinical data of 1 003 patients,the main tongue col-or of chronic hepatitis B (ALT≥2ULN)were:red,pale red,dark,and light white.The main tongue shape were:teeth prints, nourishing and moistening,swollen,tongue with ecchymosis,and blue and purple collaterals under tongue.The main coating color were:white and yellow.The main tongue coating were:thin fur,greasy fur,and thick fur.The tongue diagnosis feature of damp-ness-heat in the liver and gallbladder syndrome were:coating yellow,tongue red,tongue coating greasy fur,tongue shape nouris-hing and moistening,coating white,tongue coating thin fur,tongue coating thick fur.The tongue diagnosis feature of liver stagna-tion and spleen deficiency syndrome were:coating white,coating thin fur,tongue pale red,tongue red,tongue coating greasy fur, tongue shape swollen and teeth prints,tongue shape nourishing and moistening,and coating yellow.Conclusion:The pathological factors of tongue diagnosis feature of Chronic hepatitis B (ALT≥2 ×ULN)are mainly involved in qi deficiency,wetness hyperac-tivity type,and blood stasis.The tongue diagnosis feature of dampness-heat in the liver and gallbladder syndrome and liver stagna-tion and spleen deficiency syndrome were more consistent with the standard issued by academy,which can provide a good reference for future study.