Study on the Tongue Manifestations for the Blood-Stasis and Toxin Syndrome in the Stable Patients of Coronary Heart Disease
Study on the Tongue Manifestations for the Blood-Stasis and Toxin Syndrome in the Stable Patients of Coronary Heart Disease
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冠心病稳定期患者血瘀毒证舌象研究
DOI：
10.1007/s11655-011-0615-4
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发表时间：
2011-05-01
影响因子：
2.9
通讯作者：
Chen Ke-ji
中科院分区：
文献类型：
--
作者：
Feng Yan;Xu Hao;Chen Ke-ji
目的基于“瘀毒成灾”病机假说，根据一年随访中急性心血管事件（ACEs）情况，探讨稳定型冠心病（CHD）患者血瘀毒证的舌象表现。方法：纳入254例经冠状动脉造影确诊的稳定型冠心病患者，观察其临床表现。 采用统一型数码相机记录舌象，随访一年期间出现ACEs的29例被分为ACEs组。根据非ACEs组的性别、年龄（±2.5岁）、糖尿病史及既往急性冠脉综合征住院史，将non-ACEs按2:1的比例进行匹配，纳入54例。比较ACEs组和非ACEs组舌外观的差异。结果15例表现为青色舌（包括蓝底舌或蓝紫色舌），其中ACEs组11例（37.9%），非ACEs组4例（7.4%），差异有统计学意义（P<0.002）。非ACEs组舌苔黄黄者26例，显着高于ACEs组（48.1% vs. 10.3%，P=0.001）。非ACEs组舌苔粘腻的发生率高于ACEs组（66.7% vs. 41.4%，P=0.026）。 ACEs组紫红色舌下血管比例高于非ACEs组（41.4% vs. 20.4%，P=0.041）。比值比（OR）分析显示，舌青、舌下血管紫红色、舌苔干腻或脏油腻的患者在一年随访期间更容易发生ACE（OR：11.67，95％CI：3.34年3.34-40.81，P<0.001；OR：2.76，95％CI：1.02 1.02~7.44,P<0.05; OR: 3.12, 95%, CI: 0.89 0.89~10.92,P=0.066）。结论 舌青（包括青底舌或青紫舌）、舌下血管紫红是潜在的瘀毒舌象。舌苔由粘腻变为干腻或脏腻也可能是“化毒”的舌象表现，有待进一步研究证实。
ObjectiveTo explore the tongue manifestations for the blood-stasis and toxin syndrome in the stable patients of coronary heart disease (CHD) according to the acute cardiovascular events (ACEs) in one-year follow-up which based on the pathogenesis hypothesis of “blood-stasis and toxin causing catastrophe”.MethodsTotally 254 stable CHD cases were enrolled after diagnosed by coronary angiography, their tongue appearances were recorded by the digital camera of uniform type, 29 cases with ACEs during one-year follow-up were assigned in ACEs group. The non-ACEs were matched in proportion of 2:1 according to the gender, age (±2.5 years), diabetes mellitus history and previous acute coronary syndrome hospitalization history in the non-ACEs group, and 54 cases were eligibly included. The differences of tongue appearance between the ACEs and non-ACEs group were compared.ResultsFifteen cases manifested with bluish tongue (including bluish-grounding or bluish purple tongue), among which 11 cases (37.9%) in the ACEs group and four cases (7.4%) in the non-ACEs group, and there was significant difference (P<0.002). Twenty six cases showed yellow tongue coating in the non-ACEs group, which was significantly higher than that in the ACEs group (48.1 vs. 10.3%,P=0.001). The tongue of sticky greasy coating was more frequently occurred in the non-ACEs group than that in the ACEs group (66.7% vs. 41.4%,P=0.026). The proportion of purplish-red sublingual vessel was higher in the ACEs group than that in the non-ACEs group (41.4% vs. 20.4%,P=0.041). Odd ratio (OR) analysis showed that the patients with bluish tongue, purplish-red sublingual vessel, dry-greasy or dirty greasy coating were more likely to experience ACEs during oneoneyear follow-up (OR: 11.67, 95%CI: 3.34 year 3.34–40.81,P<0.001; OR: 2.76, 95%CI: 1.02 1.02–7.44,P<0.05; OR: 3.12, 95%, CI: 0.89 0.89–10.92,P=0.066).ConclusionsThe bluish tongue (including bluish-grounding or bluish purple tongue) and purplish-red sublingual vessel were potential tongue manifestations of blood-stasis and toxin. The tongue coating changing from sticky greasy to dry greasy or dirty greasy was also probably a tongue manifestation of “transforming toxin”, which need demonstration by further study.