类风湿关节炎舌象研究-中西医结合临床专业论文.docxVIP

成都中医药大学硕士学位论文 成都中医药大学硕士学位论文 PAGE PAGE 1 中文摘要 舌诊是中医辨证指标的核心之一。中医用其判断病人的证侯类型 和病机属性，从而明确诊断，通过舌象能客观地反映出人体气血的盛 衰、证侯的虚实、疾病的寒热、病邪的深浅、病性的转归变化。具有 关资料显示，近年来风湿免疫性疾病发病率有上升趋势。一些研究表 明舌诊对风湿性疾病的辨证分型，指导遣方，判断病情轻重及预后都 具有十分重要的意义。然而目前对舌象的研究大多局限于肉眼观察或 侧重局部病理变化的讨论，易受主观因素的影响，并也缺乏定量性。 为了使类风湿关节炎的病情判定能有更明确客观的量化指标，本研究 根据中医舌诊专家系统，设计统一的舌诊观察方案，固定采光环境、 患者体位及伸舌姿势，采用日本 SONY 数码相机以约 10°的俯角对 准舌体，近距离（40cm）强制闪光拍摄，编号录入计算机，将舌相 切割处理后，应用计算机彩色图像处理技术对选定典型的舌质舌苔区 域进行舌质、舌苔 RGB(三基色，R 为红色，G 为绿色,B 为蓝色)值测 定，并及时录入相应临床资料，以数据库形式储存，将数据库资料导 入 SPSS 系统进行统计分析。严格按照选择病例标准，通过对 326 例 类风湿关节炎患者舌象舌质、舌苔、舌形及舌脉观察研究，初步确定 了舌色、舌苔的 RGB 数值特征，舌象与类风湿关节炎证型关系，舌 象与关节功能关系，舌象与病程进展关系。为类风湿关节炎的中医辨 证、治疗提供良好的参考依据。 关键词：中医舌诊 类风湿关节炎 计算机 ABSTRACT Tongue diagnosis is one of core elements of differentiation standards of Chinese medicine , through which patients types and pathogenesis can be judged , so it is clear that the Deficiency-Excess of Qi and Blood、Deficiency-Excess of pattern、Cold and Heat of disease、location of the evil、 development of diseases nature can be objectively reflected from tongue manifestation. In recent years, rheumatism immunity disease keeps an upward tendency in the rate of incidence according to some studies data . Some studies indicate that tongue diagnosis is very significant for the differentiation and type-dividing of rheumatic disease 、 formular-choosing、clinic result-judging , However ,nowadays , great attention is put to the visual observation and discussion of partial pathological changes in the study of tongue manifestation , so it is easy to be affected by subjective factors, and it also lacks quantitative assessment . In order to get specific and objective quantification target for the judgment of conditions of rheumatism arthritis , unified observation method for tongue diagnosis was designed in this research based on the Chinese medicine tongue diagnosis expert system , for example , to PAGE PAGE 3 成都中医药大学硕士学位论文select the lighting environment, to regulate the body posture 成都中医药大学硕士学位论