刘洪宇 张长连 陆小左

[摘要] 目的 为更准确地诊断高尿酸血症及提高临床疗效，拟对高尿酸血症患者舌象进行初步分析。 方法 2017年1～7月利用舌象仪在天津武清泉达医院随机收集50例高尿酸血症患者舌象作为高尿酸组，同时采集50名健康体检者的舌象作为健康组，分析高尿酸血症舌色RGB值和苔色RGB值，并对高尿酸血症舌色和苔色特点进行初步探讨。 结果 两组舌尖颜色R1、舌尖颜色G1、舌尖颜色B1、舌左边颜色R2、舌左边颜色G2、舌右边颜色R3、舌右边颜色B3比较，差异均有统计学意义（均P < 0.05）;两组舌根苔色R4、舌尖苔色G6、舌尖苔色R6、舌中苔色B5、舌尖苔色B6比较，差异均有统计学意义（均P < 0.05）。舌色淡紫、红绛，苔色黄、苔色白为高尿酸血症的舌象特点。结论 高尿酸血症舌色、苔色具有与正常舌色、苔色不同的特点，为高尿酸血症的中医防治与疗效评估提供了基础数据。

[关键词] 高尿酸血症;舌色;苔色;RGB值

[中图分类号] R589          [文献标识码] A          [文章编号] 1673-7210（2019）03（a）-0113-04

[Abstract] Objective To diagnose hyperuricemia more accurately and improve the clinical effect， the tongue manifestation of patients with hyperuricemia was analyzed preliminarily. Methods The tongue manifestation of 50 patients with hyperuricemia in Tianjin Wuqing Quanda Hospital by tongue manifestation analyzer from January to July 2017 was randomly collected as hyperuricemia group. At the same time， the tongue manifestation of 50 healthy persons was collected as healthy group. The RGB values of tongue color and RGB values of moss color of hyperuricemia were analyzed， and the characteristics of tongue color and moss color of hyperuricemia were analyzed preliminarily. Results There were all statistically significant differences of the tongue tip color R1， the tongue tip color G1， the tongue tip color B1， the left tongue color R2， the right tongue color R3 and the right tongue color B3 between the two groups （all P < 0.05）. There were all statistically significant differences of the moss color of tongue root R4， the moss color of tongue tip R6， the moss color of tongue tip G6， the moss color of central tongue B5 and the moss color of tongue tip B6 between the two groups （all P < 0.05）. Lilac or purple-red tongue， yellow or white moss seems to be the characteristics of tongue manifestation of hyperuricemia. Conclusion The tongue color and moss color of hyperuricemia have different characteristics compared with those of normal tongue color and moss color， which provides essential data for TCM prevention and treatment and efficacy evaluation of hyperuricemia.

[Key words] Hyperuricemia; Tongue color; Moss color; RGB value

高尿酸血癥是一种由于嘌呤代谢异常而引起的代谢性疾病，尿酸生成过多或排泄减少都可以导致人血尿酸的升高，进而导致高尿酸血症。由于大多数患者临床症状不典型，甚至可终身不出现症状，高尿酸血症没有得到人们应有的重视，但无症状高尿酸血症对健康的影响不容忽视，研究表明高尿酸血症与高血压病、高血脂、冠心病、脑血管意外、糖尿病、肾病等具有显著的相关性，对人类健康造成威胁。目前，由于中药有降低尿酸作用持久、副作用小的优点，受到越来越多患者的认可。舌诊法在我国具有悠久的历史，是中医辨证的重要依据，舌象能客观地反映人体正气的盛衰、病邪的深浅、病情的进退，因此根据舌象的变化可以预测疾病转归[1]。随着中医学的发展，舌诊已成为诊察疾病的一种常用手段，并且广泛地应用于临床。中医舌诊在高尿酸血症的辨证分型和辨证用药的过程中具有重要的作用。为了提高高尿酸血症的中医辨证分型、疗效评估和临床用药的准确率，笔者对高尿酸血症舌色和苔色RGB值进行研究，并对高尿酸血症舌色和苔色的特点进行分析。