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摘要: 目的 探讨结直肠息肉患者不同舌诊特征，以研究结直肠息肉与舌诊之间的相应关系及临床意义。方法 收集符合纳入标准的83例门诊及住院的结直肠息肉患者(息肉组)和16例健康者(对照组)的舌象，并进行临床辨证分析。结果 息肉组粪便隐血占比明显高于对照组，差异有统计学意义(P< 0.05)。息肉组舌色以淡红(58%)和淡白(24%)为主，舌苔多见白薄(25%)、白厚腻(52%)、黄腻(23%)，舌形多见正常舌(64%)、齿痕舌(12%)、肥大舌(12%)。舌苔苔质与息肉数量、大小之间差异有统计学意义(P< 0.05)。单发或 < 10 mm息肉多以白薄和白厚腻舌苔为主，多发或≥10 mm息肉则以白厚腻和黄腻舌苔为主。舌色和舌形在息肉数量和大小中差异无统计学意义(P>0.05)。结论 息肉患者舌象存在特异性表现，舌色和粪便隐血与息肉患病存在密切相关性。不同舌苔与结直肠息肉数量和大小有关，但不影响腺瘤类型和息肉表面形态。通过对舌色和舌苔的诊断，可用于辅助诊治结直肠息肉。Abstract: Objective To study the relationship between colorectal polyp and tongue diagnosis and its clinical significance.Methods A total of 83 outpatients and inpatients with colorectal polyps and 16 healthy subjects who met the inclusion criteria were collected. The tongue images of the subjects were collected and analyzed by clinical syndrome differentiation.Results The percentage of fecal occult blood in the polyp group was significantly higher than that in the healthy control group(P< 0.05). In the polyp group, tongue color was mainly light red(58%) and light white(24%), and tongue coating was mainly white thin(25%), white thick greasy(52%), yellow greasy(23%), and tongue shape was mostly normal tongue(64%), toothed tongue(12%), hypertrophy tongue(12%). There were statistically significant differences in the number and size of polyps on tongue coating(P< 0.05). Single or < 10 mm polyps were mostly white thin and white thick greasy tongue coating, multiple or =10 mm polyps were mainly white thick greasy and yellow greasy tongue coating. Tongue color and tongue shape had no statistical significance in the number and size of polyps(P>0.05).Conclusion There are specific manifestations of tongue image in patients with polyp, and there is a close correlation between tongue color and fecal occult blood and polyp. The number and size of polyps are correlated with different tongue coating, but the adenoma type and polyp surface morphology are not affected. The diagnosis of tongue color and tongue coating can be used to assist the diagnosis and treatment of colorectal polyps.
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Key words:
- colorectal polyp /
- tongue diagnosis /
- tongue color /
- tongue coating /
- correlation
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表 1 2组基线资料比较
例(%) 基线资料 对照组
(16例)息肉组
(83例)t或χ2 P 性别 男 9(56) 51(61) 1.731 0.188 女 7(44) 32(39) 年龄/岁 49.50±15.61 56.58± 12.72 1.476 0.714 身高/cm 162.20±9.07 164.77± 8.19 0.671 0.504 体重/kg 60.01±14.57 63.88± 12.13 0.680 0.499 BMI 21.54±4.25 23.45± 3.36 1.415 0.161 吸烟/(次·周-1) 无 13(81) 62(75) 1~2 2(13) 2(2) 4.928 0.085 ≥3 1(6) 19(23) 饮酒/(次·周-1) 无 14(88) 66(80) 1~2 1(6) 6(7) 0.761 0.683 ≥3 1(6) 11(13) 
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表 2 2组实验室数据和舌象比较
例(%) 实验室数据和舌象 对照组
(16例)息肉组
(83例)t或χ2 P 粪便隐血 阴性 14(88) 28(52) 5.135 0.023 阳性 2(12) 26(48) Hp感染 阴性 14(88) 33(66) 1.785 0.182 阳性 2(12) 17(34) 粪便钙卫蛋白/(mg·L-1) 34.10±
34.0859.86± 68.68 0.506 0.623 CA199/(U·L-1) 4.37±
5.4511.03± 25.21 0.454 0.652 CEA/(ng·mL-1) 1.91±
0.382.43± 2.27 0.508 0.613 CA724/(U·mL-1) 0.60±
0.422.16± 2.72 1.271 0.209 AFP/(ng·mL-1) 3.75±
3.002.88± 1.36 1.228 0.224 舌色 淡红 7(44) 48(58) 淡白 1(6) 20(24) 7.917 0.048 红 4(25) 8(10) 青紫 4(25) 7(8) 舌苔苔质 白薄 3(19) 21(25) 白厚腻 9(56) 43(52) 4.057 0.255 黄腻 3(19) 19(23) 无苔 1(6) 0 舌形 点刺 0 2(2) 瘀斑 0 3(4) 齿痕 3(19) 10(12) 5.950 0.311 肥大 0 10(12) 裂痕 1(6) 5(6) 正常 12(75) 53(64)
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表 3 息肉数量与舌象相关性分析
例(%) 舌象 单个组
(33例)2~4个组
(40例)>4个组
(10例)χ2 P 舌色 淡红 22(67) 18(45) 8(80) 淡白 7(21) 12(30) 1(10) 7.562 0.272 红 2(6) 5(12) 1(10) 青紫 2(6) 5(12) 0 舌苔苔质 白薄 10(30) 11(28) 0 白厚腻 19(58) 20(50) 4(40) 12.129 0.016 黄腻 4(12) 9(22) 6(60) 舌形 点刺 1(3) 1(2) 0 瘀斑 1(3) 2(5) 0 齿痕 5(15) 4(10) 1(10) 7.003 0.725 肥大 2(6) 6(15) 2(20) 裂痕 1(3) 2(5) 2(20) 正常 23(70) 25(63) 5(50)
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表 4 息肉大小与舌象相关分析
例(%) 舌象 < 10 mm
组(59例)10~20 mm
组(17例)>20 mm
组(7例)χ2 P 舌色 淡红 32(54) 11(65) 5(72) 淡白 16(27) 3(17) 1(14) 3.165 0.788 红 5(9) 2(12) 1(14) 青紫 6(10) 1(6) 0 舌苔苔质 白薄 20(34) 1(6) 0 白厚腻 29(49) 10(59) 4(57) 12.003 0.017 黄腻 10(17) 6(35) 3(43) 舌形 点刺 1(2) 1(6) 0 瘀斑 3(5) 0 0 齿痕 8(14) 1(6) 1(14) 9.817 0.457 肥大 6(10) 4(24) 0 裂痕 3(5) 2(12) 0 正常 38(64) 9(52) 6(86)
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