本文選題：高血壓 + 辨證分型��； 參考：《廣州中醫(yī)藥大學》2013年碩士論文

【摘要】：目的： 本研究認為高血壓病的證型互相之間的鑒別在舌象上有特定的著手點,而反映在光譜學上有特定的量化指標范圍。研究中,我們突出舌診臨床需要,立足中醫(yī)根本,我們將高血壓病證型分為四種,包括痰濕壅盛、陰虛陽亢、肝火亢盛、陰陽兩虛,探求他們在光譜上量化的不同,促進中醫(yī)現(xiàn)代化研究。 方法： 選取高血壓病人213名,中醫(yī)證型分為痰濕壅盛、肝火亢盛、陰虛陽亢、陰陽兩虛四型,采集屬于舌尖部位的舌色信息,對不同的證型所采集得到的數(shù)據(jù)予以計算制圖,最后進行統(tǒng)計。采集儀器使用USB4000型VIS/NIR可見近紅外光譜儀,Matlab7.0軟件(美國MathWorks公司)編程從而進行數(shù)據(jù)計算,Origin8.0軟件(美國Origin Lab公司)制圖,均數(shù)比較統(tǒng)計分析方面使用的是軟件SPSS19.0for Windows。 結果： 將研究對象舌色的x10與y10值導入到CIE1964標準色度坐標圖中,可見各型舌色散點在色度坐標中的分布存在著各自的特點。不同證型的高血壓病患者舌色的CIE LAB色空間三維分布區(qū)域存在差異。比較高血壓病不同證型患者舌色的L值：痰濕壅盛型的舌色的L*值比其余3個證型略高,且與陰虛陽亢型的L*差異有統(tǒng)計學意義(P0.01)；與肝火亢盛型的L*差異有統(tǒng)計學意義(P0.05)；其他證型互相之間差異無統(tǒng)計學意義(P0.05)。通過高血壓病不同證型患者舌色a*b*色坐標的分布結果,不同證型的舌色分布差異明顯,如痰濕壅盛型主要分布于左方,陰虛陽亢型主要集中在右下方；而肝火亢盛型和陰陽兩虛型在圖中均分布于圖的中上方,其中肝火亢盛型分布偏右,陰陽兩虛型分布偏左。不同證型患者舌色色度角存在差異：痰濕壅盛組色度角值最大,陰虛陽亢組色度角值最小,其中陰虛陽亢與痰濕雍盛型之間、陰虛陽亢與陰陽兩虛型之間、肝火亢盛與陰陽兩虛之間的色度角比較差異有統(tǒng)計學意義(P0.05)；而肝火亢盛與陰虛陽亢型之間、痰濕壅盛與陰陽兩虛之間、肝火亢盛與痰濕壅盛之間的色度角比較差異無明顯統(tǒng)計學意義(P0.05)。不同證型患者舌色的彩度值差異明顯：痰濕壅盛組彩度值最小,陰虛陽亢組彩度值最大,其中陰虛陽亢與痰濕雍盛型之間、陰虛陽亢與陰陽兩虛型之間、肝火亢盛與陰陽兩虛之間、痰濕壅盛與陰陽兩虛之間、肝火亢盛與痰濕壅盛之間的彩度值比較差異有統(tǒng)計學意義(P0.05),而肝火亢盛與陰虛陽亢型之間的彩度值比較差異無明顯統(tǒng)計學意義(P0.05)。 結論： 高血壓病四種證型(痰濕壅盛、肝火亢盛、陰虛陽亢、陰陽兩虛型)互相之間鑒別時舌色上有差異,而這些差異可以量化反映在光譜數(shù)據(jù)上面。那么在臨床鑒別不同證型時,這些標準量化的光譜數(shù)據(jù)確可指導辨證。
[Abstract]:Objective:This study suggests that the identification of syndromes of hypertension has a specific starting point in tongue image and a specific quantitative index range in spectroscopy.To promote the study of modernization of traditional Chinese medicine.Methods:Finally, statistics are carried out.Results:By importing the tongue color x10 and y10 values into the CIE1964 standard chromaticity coordinate map, we can see that the distribution of various tongue dispersion points in the chrominance coordinate has its own characteristics.The spatial distribution of CIE LAB color in different syndromes of hypertension patients was different.The L value of tongue color in patients with different syndrome types of hypertension was compared: the L * value of tongue color of phlegm dampness accumulation type was slightly higher than that of the other three syndrome types.There was significant difference between L* and Yin-deficiency and Yang hyperactivity type (P0.01A), and there was significant difference between L* and liver-fire hyperactivity type (P0.05N), and there was no significant difference between other syndrome types (P0.05G).According to the distribution results of the color of tongue in different syndrome types of hypertension, the distribution of tongue color of different syndromes is obvious, such as phlegm and dampness accumulation type mainly distributed on the left side, Yin deficiency and Yang hyperactivity type mainly concentrated in the lower right part;The type of hyperactivity of liver-fire and the deficiency of both yin and yang were distributed in the middle and upper part of the graph, in which the distribution of the hyperactive type of liver-fire was on the right side, and the distribution of the type of deficiency of both yin and yang was on the left.There were differences in tongue color angle between different syndromes: phlegm dampness accumulation group had the largest color angle value, Yin deficiency yang hyperactivity group had the lowest color angle value, among them, Yin deficiency yang hyperactivity and phlegm dampness Yongsheng type, yin deficiency yang hyperactivity and yin yang deficiency type,The difference of color angle between hyperactivity of liver-fire and deficiency of yin and yang was statistically significant (P 0.05), while between hyperactivity of liver fire and hyperactivity of yin and yang, phlegm dampness and deficiency of both yin and yang, there was a significant difference between phlegm and dampness and deficiency of yin and yang.There was no significant difference in chromaticity angle between hyperactivity of liver fire and phlegm dampness.The color values of tongue color of different syndrome types were significantly different: phlegm dampness accumulation group had the smallest color value, and Yin deficiency yang hyperactivity group had the largest color value, in which Yin deficiency yang hyperactivity and phlegm dampness Yongsheng type, yin deficiency yang hyperactivity and yin and yang deficiency type,Between liver-fire hyperactivity and yin and yang deficiency, between phlegm dampness and yin and yang deficiency,There was significant difference in color value between hyperactivity of liver fire and phlegm dampness accumulation, but there was no significant difference in color value between hyperactivity of liver fire and hyperactivity of yin deficiency and yang hyperactivity.Conclusion:There are differences in tongue color between the four syndrome types of hypertension (phlegm dampness hyperactivity, liver fire hyperactivity, yin deficiency and yang hyperactivity, yin and yang deficiency), and these differences can be quantitatively reflected in the spectral data.In clinical identification of different types of syndrome, these standard quantitative spectral data can guide syndrome differentiation.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R241.25;R259

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