北京中医药大学学报2025，Vol.48Issue(3)：398-411,14.DOI:10.3969/j.issn.1006-2157.2025.03.014
糖尿病肾脏病湿热证不同分期的舌象客观化特征研究
Objective characteristics of tongue manifestation in different stages of damp-heat syndrome in diabetic kidney disease
摘要
Abstract
Objective To investigate the objective characteristics of tongue manifestation in different stages of damp-heat syndrome in diabetic kidney disease(DKD).Methods A cross-sectional study enrolled 134 patients with DKD G3-5 stages who met the diagnostic criteria for damp-heat syndrome in DKD.The patients were treated at Dongzhimen Hospital,Beijing University of Chinese Medicine,from May 2023 to January 2024.The patients were divided into three groups:DKD G3,DKD G4,and DKD G5 stage,with 53,33,and 48 patients in each group,respectively.Clinical general data(gender,age,and body mass index)and damp-heat syndrome scores were collected from the patients.The YZAI-02 traditional Chinese medicine(TCM)AI Tongue Image Acquisition Device was used to capture tongue images from these patients.The accompanying AI Open Platform for TCM Tongue Diagnosis of the device was used to analyze and extract tongue manifestation features,including objective data on tongue color,tongue quality,coating color,and coating texture.Clinical data and objective tongue manifestation characteristics were compared among patients with DKD G3-5 based on their DKD damp-heat syndrome status.Results No statistically significant difference in gender or body mass index was observed among the three patient groups.The DKD G3 stage group had the highest age(P<0.05).The DKD G3 stage group had a lower score for symptoms of poor appetite and anorexia(P<0.05)than the DKD G5 group.No statistically significant difference was observed in damp-heat syndrome scores among the three groups.Compared with the DKD G5 stage group,the DKD G3 stage group showed a decreased proportion of pale color at the tip and edges of the tongue(P<0.05).The DKD G4 stage group exhibited an increased proportion of crimson at the root of the tongue,a decreased proportion of thick white tongue coating at the root,a decreased proportion of pale color at the tip and edges of the tongue,an increased hue value(indicating color tone)of the tongue color in the middle,an increased brightness value(indicating color lightness)of the tongue coating color in the middle,and an increased thickness of the tongue coating(P<0.05).No statistically significant difference was observed in other tongue color proportions,color chroma values,body characteristics,coating color proportions,coating color chroma values,and coating texture characteristics among the three groups.Conclusion Tongue features differ in different stages of DKD damp-heat syndrome in multiple dimensions,enabling the inference that during the DKD G5 stage,the degree of qi and blood deficiency in the kidneys,heart,lungs,liver,gallbladder,spleen,and stomach is prominent.Dampness is more likely to accumulate in the lower jiao,particularly in the kidneys,whereas heat evil in the spleen and stomach is the most severe.These insights provide novel ideas for the clinical treatment of DKD.关键词
糖尿病肾脏病/湿热证/舌象客观化/分期论治/同证异治Key words
diabetic kidney disease/damp-heat syndrome/objective tongue manifestation/staged treatment/same syndrome with different treatments分类
中医学引用本文复制引用
董昭熙,郭燕,彭成东,柳红芳,史扬,宿家铭,温雅轩,徐哲宇,于欣卉,梅洁,蔡丰翼,臧欣悦..糖尿病肾脏病湿热证不同分期的舌象客观化特征研究[J].北京中医药大学学报,2025,48(3):398-411,14.基金项目
国家自然科学基金项目(No.81774273) （No.81774273）
中央高水平中医医院临床科研业务费资助项目(No.DZMG-XZYY-23005) （No.DZMG-XZYY-23005）
首都卫生发展科研专项项目(No.2024-1-4192) （No.2024-1-4192）
中华中医药学会联合攻关项目(No.2023DYPLHGG-06) （No.2023DYPLHGG-06）
北京中医药大学东直门医院领军人才项目(No.DZMG-LJRC0015) （No.DZMG-LJRC0015）
北京中医药大学"揭榜挂帅"项目(No.2023-JYB-JBZD-023) National Natural Science Foundation of China(No.81774273) （No.2023-JYB-JBZD-023）
