不同病情慢性肝炎患者面部各区位点色度值的比较研究.docVIP

不同病情慢性肝炎患者面部各区位点色度值的比较研究 　　[摘要] 目的 探?不同病情慢性肝炎患者面部各区位点色度值的差异。 方法 收集2009年3月～2015年12月在首都医科大学附属北京佑安医院就诊的慢性肝炎患者388例作为观察组，以招募的325名高校学生和教师为基础的健康人群作为对照组。采用王鸿谟教授创立的三级色部定位法进行面部分区，采用Lab颜色法测定面部五脏区位点的Lab值。通过单因素方差分析，比较两组人群及不同病情（轻、中、重度）慢性肝炎患者的Lab值。 结果 观察组患者心、脾、肾、肝、肺各区位点L值均低于对照组，且随病情加重逐渐降低，组间比较差异均有统计学意义（P 0.05），其中尤以肝区位点降低较为显著并持续；a值在不同病情慢性肝炎心、脾、肾、肝、肺各区位点差异有统计学意义（P 0.05），而且在一定病变程度范围内，观察组患者面部的心、脾、肾、肝、肺各区位点色度a值高于对照组。而心、肝、肺各区位点色度b值在一定病变程度范围内会有改变，但数值变化未表现出明显规律。 结论 随着病变程度的加深，慢性肝炎患者面部色度值会随之发生相应的病态改变，尤其是反映于面部色泽明度及红色或绿色感觉的数值变化。 　　[关键词] 中医诊断学；慢性肝炎；色度值 　　[中图分类号] R259 [文献标识码] A [文章编号] 1673-7210（2017）09（a）-0085-04 　　[Abstract] Objective To explore the differences of chromatic values of all facial regional sites in different disease conditions of patients with chronic hepatitis. Methods Three hundred and eighty-eight cases of patients with chronic hepatitis treated in Beijing Youan Hospital， Capital Medical University from March 2009 to December 2015 were collected as observation group， while 325 cases of healthy people composed of college students and teachers were recruited as control group. The three-level color positioning method set up by professor Wang Hongmo was used to take facial distribution， the Lab color method was used to detect the Lab values of facial regional sites of five zang viscera. Through one-way analysis of variance， the Lab values of patients with chronic hepatitis in two groups and different disease conditions （light， medium， heavy） were compared. Results The L values of heart， spleen， kidney， liver， lung of all regional sites in the observation group were all lower than those of control group， which were decreased gradually as the disease got worse， the differences were all statistically significant （P 　　[Key words] Diagnostics of Chinese medicine； Chronic hepatitis； Chromatic value 　　中医临床诊断强调望诊，将望诊作为中医四诊之首，而有“望而知之谓之神”（《难经?六十一难》）之说。其中望色是通过观察人体皮肤（主要是面部皮肤）色泽变化以诊察病情的方法。望色诊病的方法作为中医独特的诊病方法之一，具有悠久的历史[1-3]，早在两千多年前的《黄帝内经》中就十分强调望色对于临床诊断的重要性，指出诊病必当察色，如《素问?阴阳应象大论》中提及“善诊者，