消化性溃疡病胃镜下溃疡分期和舌象色度关系研究
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摘要
目的:观察和探讨消化性溃疡病电子胃镜下溃疡分期和舌色、苔色色度的关系。
方法:75例消化性溃疡病患者经电子胃镜检查确诊后,根据胃镜下溃疡的分期分为活动期和非活动期(包括愈合期和瘢痕期)两组,以数码相机摄取患者舌象并在图像处理软件中测定舌色和苔色在RGB、HSL和Lab三种不同的色彩模式下的数据,用以分析舌色、苔色和消化性溃疡胃镜下分期的关系。
结果:在RGB、HSL、Lab三种色彩模式下,消化性溃疡病活动期的舌色的R/(R+G+B)、S、a值高于非活动期(P<0.05),L值小于非活动期(P<0.05),非活动期苔色的R+G+B值大于活动期(P<0.05)。以上具有显著差异性结果提示消化性溃疡病活动期患者的舌色的深浅程度要比非活动期患者要深,而苔色则是非活动期患者的更接近白色。
结论:在一定的研究范围内以客观量化的方法得到和在人眼观察相一致的结果,即消化性溃疡病活动期红舌较非活动期常见,非活动期白苔的比例相对活动期要高。
Objective:To observe the relationship between the gastroscopic stage classification of peptic ulcer and the chromaticity of tongue body as well as its coating.Methods:75 peptic ulcer patients, who underwent gastroscopy, were divided into active-stage group and inactive-stage group. The former one included the cases in healing stage and scaring stage. The tongue images of were taken by digital camera and the chromaticity of the tongue and coating were analyzed in three different color space systems (RGB, HSL, Lab) with image processing software.Results:The analysis of the chromaticity in the three color space system suggested that value R/(R+G+B)、 value S、 value a of the tongue color in the active-stage patients were distinctively higher than those in inactive-stage patients (P<0.05), the value L in the former is lower than that in the later. The value R+G+B of the coating color in inactive-stage
patients were significantly higher than its counterpart in active-stage patients. The data with the significant, difference suggested that the redness of tongue body in the active-stage cases exceed the tongue body color of the inactive-stage cases, while the coating color of the later group was whiter than the counterpart.Conclusion:To some extend, this research result is equivalent with macroscopic result that the red tongues in active stage can be found much more than those in inactive stage and the white coatings can be found less in the former.
方法:75例消化性溃疡病患者经电子胃镜检查确诊后,根据胃镜下溃疡的分期分为活动期和非活动期(包括愈合期和瘢痕期)两组,以数码相机摄取患者舌象并在图像处理软件中测定舌色和苔色在RGB、HSL和Lab三种不同的色彩模式下的数据,用以分析舌色、苔色和消化性溃疡胃镜下分期的关系。
结果:在RGB、HSL、Lab三种色彩模式下,消化性溃疡病活动期的舌色的R/(R+G+B)、S、a值高于非活动期(P<0.05),L值小于非活动期(P<0.05),非活动期苔色的R+G+B值大于活动期(P<0.05)。以上具有显著差异性结果提示消化性溃疡病活动期患者的舌色的深浅程度要比非活动期患者要深,而苔色则是非活动期患者的更接近白色。
结论:在一定的研究范围内以客观量化的方法得到和在人眼观察相一致的结果,即消化性溃疡病活动期红舌较非活动期常见,非活动期白苔的比例相对活动期要高。
Objective:To observe the relationship between the gastroscopic stage classification of peptic ulcer and the chromaticity of tongue body as well as its coating.Methods:75 peptic ulcer patients, who underwent gastroscopy, were divided into active-stage group and inactive-stage group. The former one included the cases in healing stage and scaring stage. The tongue images of were taken by digital camera and the chromaticity of the tongue and coating were analyzed in three different color space systems (RGB, HSL, Lab) with image processing software.Results:The analysis of the chromaticity in the three color space system suggested that value R/(R+G+B)、 value S、 value a of the tongue color in the active-stage patients were distinctively higher than those in inactive-stage patients (P<0.05), the value L in the former is lower than that in the later. The value R+G+B of the coating color in inactive-stage
patients were significantly higher than its counterpart in active-stage patients. The data with the significant, difference suggested that the redness of tongue body in the active-stage cases exceed the tongue body color of the inactive-stage cases, while the coating color of the later group was whiter than the counterpart.Conclusion:To some extend, this research result is equivalent with macroscopic result that the red tongues in active stage can be found much more than those in inactive stage and the white coatings can be found less in the former.
引文
[1] 郑芝田.胃肠病学(第三版)[M].北京:人民卫生出版社,2000.334～335.
[2] 王烈全,等.消化性溃疡[M].北京:中国医药科技出版社,2005.15～16.
[3] Wei-Guo Dong, Chun-Sheng Cheng, Shao-Ping Liu, et al. Epidemiology of peptic ulcer disease in Wuhan area. of China from 1997 to 2002 [J]. World J Gastroenterol 2004, 10(22): 3377～3379.
[4] 田德禄.中医内科学[M].北京:人民卫生出版社,2002,177～183.
[5] 朱文锋,等.中医诊断学[M].上海:上海科学技术出版社,2000,35～50.
[6] 李任先,徐志伟,陈群.古今舌诊研究与图谱[M].广州:广东科技出版社,2000,27～28.
[7] 曹炳章原著:张成博,欧阳兵,唐迎雪点校.辨舌指南.天津:天津科学技术出版社,2003:23～24.
[8] 姚保泰.中医舌象与胃镜像对照图谱[M].山东:山东科学技术出版社,1996:4～5.
[9] 王克建,张佳兰,王素芬,等.慢性胃炎与溃疡病的舌苔观察——附111例纤维胃镜检查资料分析[J].新医学,1977,8(3):110.
[10] 沈家足,陈泽霖,徐梨花,等.胃部疾病的舌象观察[J].上海中医药杂志,1979(5):33.
[11] 庞宁海,马文香.226例慢性胃十二指肠病的舌象与胃镜象观察[J].中医杂志,1985,26(12):53.
[12] 伍仕琨,谭伯强.311例胃十二指肠病变内镜象与舌象临床观察[J].广州中医学院学报,1990,13(1):1.
[13] 方晓华.消化性溃疡的分期与舌苔的关系[J].实用中西医结合杂志,1997,10(13):1297.
[14] 俞亚琴,石喜之.消化性溃疡的临床分期与舌象关系探讨[J].浙江中医杂志,2001,36(12):524.
[15] 朱国曙,张闽光,李劲亮.十二指肠球部溃疡三期舌象特点及意义[J].福建中医学院学报,2003,13(5):10.
[16] 潘奔前,周俊亮.消化性溃疡胃镜表现与中医证型的相关性研究[J].新中医,2005,12(37):34.
[17] 王传家.胃及十二指肠疾病(第一版)[M].甘肃:甘肃人民出版社,1975.
[18] 徐景藩.中医药治疗胃十二指肠溃疡88例分析[M].中医杂志,1986,27(12):37.
[19] 刘圣杰,陈宝清.舌诊及幽门弯曲菌与胃脘痛发病关系探讨[J].中西医结合杂志.1990,10(11),677.
[20] 韩文,赵成忠.高寒地区常见胃病的舌象与胃镜资料的比较分析[J],中医杂志, 1992,33(6):46.
[21] 陈泽霖,陈梅芳.舌诊研究(第二版)[M].上海:上海科学技术出版社,1982.
[22] 许家佗.舌象客观化识别方法的研究进展[J].上海中医药杂志,2002(2):42.
[23] 赵荣莱,危北海,丁瑞,等.舌质和舌苔的计算机定量描述和分类[J].1989,30(2):47.
[24] 隗继武,任永安,张启明,等。脾胃病舌质变化规律的计算机分析[J].山东中医药大学学报,1997,21(6):434.
[25] 余兴龙,谭耀麟,竺子民,等.中医舌诊自动识别方法的研究[J].中国生物医学工程学报,1994,13(4):336.
[26] 许秀森,翁维良.血瘀证舌质定量诊断研究[J].中国中医药科技,1994,1(1):10.
[27] 翁维良,黄世敬,洪尚杓,等.运用“中医舌诊专家系统”对血瘀证舌质的研究[J].中国中医基础医学杂志,2000,6(10):58.
[28] 翁维良,黄世敬.中医舌诊客观化研究[J].中国工程科学,2001,3(1):78.
[29] 徐志伟,陈群,张书河.青紫类舌色的色度量化特征研究新探[J].中医药学刊,2004,8(22):1374.
[30] 张书河,郭爱银,刘梅.中医舌诊中舌色的色度学特征研究[J].广州中医药大学学报,2005,22(4):323.
[31] 邹金盘,汪卫东,李光熙,等.224例SARS患者舌象定量与病情相关性研究[J].中国中西医结合杂志,2003,23(10):740.
[32] 张志枫,顾超,王志国,等.WZX舌色分析系统在胃病患者舌像信息处理中的应用[J].上海中医药大学学报,2004,18(3):52.
[33] 张志枫,周昌乐,许家佗,等.舌色视觉计算方法在中成药疗效评估中的应用[J].上海中医药大学学报,2005,19(3):45.
[34] 陈建仲,夏德椿,李燊铭,等.不同肺功能状态之舌诊研究[J].中国医药大学学报,1998,7(3):137.
[35] 丁明,张建正.基于L*a*b*彩色模式的舌苔定量描述和分类[J].仪器仪表学报,2002,23(3):328.
[36] 张永涛,梁嵘,王召平,等.884例体检人群舌色数字图像应用不同颜色模型的比较[J].中国中医基础医学杂志,2005,11(3):207.
[37] 畸田隆夫.胃溃疡诊断.吉利和编.内科.No.2胃十二指.柬京:南江堂,1971:197.
[38] 许家佗,周昌乐,方肇勤,等.舌像颜色特征的计算机分析与识别研究[J].上海中医药大学学报,2004,18(3):43.
[39] 李俊,罗翌,邹旭,等.消化性溃疡活动期证型探讨[J].辽宁中医杂志,2000,27(7):297～298.
[2] 王烈全,等.消化性溃疡[M].北京:中国医药科技出版社,2005.15～16.
[3] Wei-Guo Dong, Chun-Sheng Cheng, Shao-Ping Liu, et al. Epidemiology of peptic ulcer disease in Wuhan area. of China from 1997 to 2002 [J]. World J Gastroenterol 2004, 10(22): 3377～3379.
[4] 田德禄.中医内科学[M].北京:人民卫生出版社,2002,177～183.
[5] 朱文锋,等.中医诊断学[M].上海:上海科学技术出版社,2000,35～50.
[6] 李任先,徐志伟,陈群.古今舌诊研究与图谱[M].广州:广东科技出版社,2000,27～28.
[7] 曹炳章原著:张成博,欧阳兵,唐迎雪点校.辨舌指南.天津:天津科学技术出版社,2003:23～24.
[8] 姚保泰.中医舌象与胃镜像对照图谱[M].山东:山东科学技术出版社,1996:4～5.
[9] 王克建,张佳兰,王素芬,等.慢性胃炎与溃疡病的舌苔观察——附111例纤维胃镜检查资料分析[J].新医学,1977,8(3):110.
[10] 沈家足,陈泽霖,徐梨花,等.胃部疾病的舌象观察[J].上海中医药杂志,1979(5):33.
[11] 庞宁海,马文香.226例慢性胃十二指肠病的舌象与胃镜象观察[J].中医杂志,1985,26(12):53.
[12] 伍仕琨,谭伯强.311例胃十二指肠病变内镜象与舌象临床观察[J].广州中医学院学报,1990,13(1):1.
[13] 方晓华.消化性溃疡的分期与舌苔的关系[J].实用中西医结合杂志,1997,10(13):1297.
[14] 俞亚琴,石喜之.消化性溃疡的临床分期与舌象关系探讨[J].浙江中医杂志,2001,36(12):524.
[15] 朱国曙,张闽光,李劲亮.十二指肠球部溃疡三期舌象特点及意义[J].福建中医学院学报,2003,13(5):10.
[16] 潘奔前,周俊亮.消化性溃疡胃镜表现与中医证型的相关性研究[J].新中医,2005,12(37):34.
[17] 王传家.胃及十二指肠疾病(第一版)[M].甘肃:甘肃人民出版社,1975.
[18] 徐景藩.中医药治疗胃十二指肠溃疡88例分析[M].中医杂志,1986,27(12):37.
[19] 刘圣杰,陈宝清.舌诊及幽门弯曲菌与胃脘痛发病关系探讨[J].中西医结合杂志.1990,10(11),677.
[20] 韩文,赵成忠.高寒地区常见胃病的舌象与胃镜资料的比较分析[J],中医杂志, 1992,33(6):46.
[21] 陈泽霖,陈梅芳.舌诊研究(第二版)[M].上海:上海科学技术出版社,1982.
[22] 许家佗.舌象客观化识别方法的研究进展[J].上海中医药杂志,2002(2):42.
[23] 赵荣莱,危北海,丁瑞,等.舌质和舌苔的计算机定量描述和分类[J].1989,30(2):47.
[24] 隗继武,任永安,张启明,等。脾胃病舌质变化规律的计算机分析[J].山东中医药大学学报,1997,21(6):434.
[25] 余兴龙,谭耀麟,竺子民,等.中医舌诊自动识别方法的研究[J].中国生物医学工程学报,1994,13(4):336.
[26] 许秀森,翁维良.血瘀证舌质定量诊断研究[J].中国中医药科技,1994,1(1):10.
[27] 翁维良,黄世敬,洪尚杓,等.运用“中医舌诊专家系统”对血瘀证舌质的研究[J].中国中医基础医学杂志,2000,6(10):58.
[28] 翁维良,黄世敬.中医舌诊客观化研究[J].中国工程科学,2001,3(1):78.
[29] 徐志伟,陈群,张书河.青紫类舌色的色度量化特征研究新探[J].中医药学刊,2004,8(22):1374.
[30] 张书河,郭爱银,刘梅.中医舌诊中舌色的色度学特征研究[J].广州中医药大学学报,2005,22(4):323.
[31] 邹金盘,汪卫东,李光熙,等.224例SARS患者舌象定量与病情相关性研究[J].中国中西医结合杂志,2003,23(10):740.
[32] 张志枫,顾超,王志国,等.WZX舌色分析系统在胃病患者舌像信息处理中的应用[J].上海中医药大学学报,2004,18(3):52.
[33] 张志枫,周昌乐,许家佗,等.舌色视觉计算方法在中成药疗效评估中的应用[J].上海中医药大学学报,2005,19(3):45.
[34] 陈建仲,夏德椿,李燊铭,等.不同肺功能状态之舌诊研究[J].中国医药大学学报,1998,7(3):137.
[35] 丁明,张建正.基于L*a*b*彩色模式的舌苔定量描述和分类[J].仪器仪表学报,2002,23(3):328.
[36] 张永涛,梁嵘,王召平,等.884例体检人群舌色数字图像应用不同颜色模型的比较[J].中国中医基础医学杂志,2005,11(3):207.
[37] 畸田隆夫.胃溃疡诊断.吉利和编.内科.No.2胃十二指.柬京:南江堂,1971:197.
[38] 许家佗,周昌乐,方肇勤,等.舌像颜色特征的计算机分析与识别研究[J].上海中医药大学学报,2004,18(3):43.
[39] 李俊,罗翌,邹旭,等.消化性溃疡活动期证型探讨[J].辽宁中医杂志,2000,27(7):297～298.