糖尿病患者的舌象脉象客观化分析及相关性研究

Objective analysis of tongue and pulse manifestations and correlation study in diabetic patients

关键词:  糖尿病  舌象客观化  脉象客观化

Key words:  diabetes mellitus  objective tongue manifestation  objective pulse manifestation

摘要:

目的 比较糖尿病患者与健康人群的舌象脉象客观化特点，探索舌象脉象参数与糖尿病发生的内在关系，为该病的中西医治疗提供参考依据。方法 纳入2025年4月24日——2025年10月24日就诊于北京中医药大学房山医院良乡分院的糖尿病患者和健康人群，使用DS01-A型舌面脉信息体质辨识系统，采集了包括舌质、舌苔的定性结论，舌质、舌苔在Lab、RGB、HSV色彩空间的定量参数，脉象的定性结论，和包括波幅（H1-H5）、时间（T1-T5）、面积（AS，AD）等在内的脉搏波定量参数。采用卡方检验、Mann-Whitney U检验、二元logistic回归模型分析糖尿病患者的舌象脉象客观化特征。结果 共收入糖尿病患者和健康人群各257例，两组患者在舌色、舌边尖红、脉位、脉力和脉势等方面的分布差异，具有统计学意义（P＜0.05）。糖尿病患者的舌Lab-a、舌RGB-G、舌RGB-B均高于健康受试者，舌Lab-L、舌HSV-S均低于健康受试者（P＜0.05）。糖尿病患者的苔Lab-a、苔Lab-b、苔RGB-R、苔RGB-G、苔RGB-B、苔HSV-H均高于健康受试者，苔Lab-L、苔HSV-S、苔HSV-V均低于健康受试者（P＜0.05）。糖尿病患者的脉象指标，脉率、H2、H3、H5、W1、W2均高于健康受试者，H1、H4、AS、AD均低于健康受试者（P＜0.05）。二元logistic回归分析显示，脉势异常（OR=3.035）、H2值升高（OR=1.251）、H3值升高（OR=1.066）为是否发生糖尿病的独立危险因素。结论 舌象脉象客观化分析能够捕捉细微差异并提供良好的特征解释，糖尿病患者以H2值和H3值升高、脉势异常为主要表现，临床可将三者的变化作为糖尿病诊断及防治效果评估的参考指标，为糖尿病的中西医治疗提供依据。

Abstract:

Objective To compare the objective characteristics of tongue and pulse manifestations between diabetic patients and healthy populations, explore the intrinsic relationships between tongue/pulse parameters and diabetes occurrence, and provide reference evidence for integrated Chinese and Western medicine treatment of this disease. Methods Diabetic patients and healthy individuals who visited Liangxiang Branch of Fangshan Hospital, Beijing University of Chinese Medicine from April 24, 2025 to October 24, 2025 were enrolled. The DS01-A tongue-pulse-body constitution identification system was used to collect qualitative conclusions including tongue color and coating color, quantitative parameters of tongue body and coating in Lab, RGB, and HSV color spaces, qualitative pulse conclusions, and pulse wave quantitative parameters including amplitude (H1-H5), time (T1-T5), and area (AS, AD). Chi-square test, Mann-Whitney U test, and Binary logistic regression models were used to analyze the objective characteristics of tongue and pulse manifestations in diabetic patients. Results A total of 257 diabetic patients and 257 healthy subjects were enrolled in this study. Significant differences were found between the two groups in the distribution of tongue color, redness of tongue edges and tip, pulse position, pulse force, and pulse tendency (P < 0.05). Diabetic patients showed higher values in tongue Lab-a, tongue RGB-G, and tongue RGB-B, but lower values in tongue Lab-L and tongue HSV-S compared to healthy subjects (P < 0.05). Diabetic patients exhibited higher values in coating Lab-a, coating Lab-b, coating RGB-R, coating RGB-G, coating RGB-B, and coating HSV-H, but lower values in coating Lab-L, coating HSV-S, and coating HSV-V compared to healthy subjects (P < 0.05). For pulse parameters, diabetic patients showed higher pulse rate, H2, H3, H5, W1, and W2, but lower H1, H4, AS, and AD compared to healthy subjects (P < 0.05). Binary logistic regression analysis revealed that abnormal pulse tendency (OR=3.035), elevated H2 value (OR= 1.251), and elevated H3 value (OR=1.066) were independent risk factors for diabetes occurrence. Conclusion Objective analysis of tongue and pulse manifestations can capture subtle differences and provide good characteristic interpretation. Diabetic patients are mainly characterized by elevated H2 and H3 values and abnormal pulse tendency. Clinically, changes in these three parameters can be used as reference indicators for diabetes diagnosis and treatment efficacy evaluation, providing evidence for integrated Chinese and Western medicine treatment of diabetes.