原发性肝癌不同中医证型患者舌色的光谱测色及其色度学比较研究

目的：应用光谱测色法检测原发性肝癌不同证型患者的舌色资料，并进行其舌色的色度学比较研究，探讨原发性肝癌不同辨证分型的舌色特点以及舌色和证型之间的关系。方法：应用光谱测色法采集133名原发性肝癌患者的舌色数据资料，根据临床特点辨证为肝郁脾虚、湿热蕴结、肝肾阴虚、气滞血瘀4类证型，观察各证型色度坐标、主波长分布、兴奋纯度的变化特点和CIELAB均匀色彩空间分布特点，比较各型色度角、彩度的区别，并分析不同证型之间总色差、明度差、色度差、饱和度差、色相差等参数的区别。结果：原发性肝癌患者不同证型舌色的色度坐标分布不同；气滞血瘀型的主波长分布明显不同于其他3个证型；兴奋纯度值在肝郁脾虚、湿热蕴结、肝肾阴虚型肝癌患者呈现为逐渐增加的特点（P〈0．01）；不同证型舌色于CIELAB三维色空间分布区域不同；色度角结果提示气滞血瘀型为负值，与其他3型明显不同（P〈0．01）；肝郁脾虚、湿热蕴结、肝肾阴虚型的彩度值呈现为逐渐增加的特点（P〈0．01），与兴奋纯度的结果一致；色差比较中，以人眼观察能力为衡量方式的结果量化了不同证型舌色的各矢量差别。结论：原发性肝癌不同证型患者的舌色存在着明显色差，与临床舌色的特点相符，这将为原发性肝癌中医辨证分型标准的统一提供客观参考，有利于舌诊度量的标准化与规范化。

Chromaticity and optical spectrum colorimetry of the tongue color in different syndromes of primary hepatic carcinoma

OBJECTIVE： In this study, the optical data of tongue color of different syndromes in primary hepatic carcinoma （PHC） were detected by optical spectrum colorimetry, and the chromaticity of tongue color was compared and analyzed. The tongue color characteristics of different syndromes in PHC and the relationship between different syndromes and tongue color were also investigated. METHODS： Tongue color data from 133 eligible PHC patients were collected by optical spectrum colorimetry and the patients were divided into 4 syndrome groups according to their clinical features. The syndrome groups were liver depression and spleen deficiency （LDSD）, accumulation of damp-heat （ADH）, deficiency of liver and kidney yin （DLKY）, and qi stagnation and blood stasis （QSBS）. The variation characteristics of chromaticity coordinates, dominant wavelength, excitation purity and the distribution in the International Commission on Illumination （CIE） LAB uniform color space were measured. At the same time, the differences of overall chromatism, clarity, chroma, saturation and hue were also calculated and analyzed. RESULTS： PHC patients in different syndrome groups exhibited differences in chromaticity coordinates. The dominant wavelength of QSBS was distinctly different from that of the other 3 syndromes. Excitation purity in the syndromes of LDSD, ADH and DLKY showed gradual increases （P~0.01）. Different syndromes in the CIE LAB color three-dimensional space showed differences in tongue color distribution areas. The CIE hue-angle value of QSBS was negative, and different from that of the other3 syndromes （P~0.0]）. CIEchromain the syndromes of LDSD, ADH and DLKY showed gradual increases （P~0.01）, the same as excitation purity. In the comparison of chromatism, tongue color variations in different syndromes were quantified by human observation. CONCLUSION： This study shows that tongue color diagnosis according to the syndrome classifications of traditional Chinese medicine can be quantified with optical spectrum colorimetry technology. Different syndromes in PHC exhibit distinct chromatisms of tongue color through the calculation and analysis of chromaticity parameters of CIE, combined with colorimetric system and CIE LAB color space, and these are consistent with the characteristics of clinical tongue color. Applying optical spectrum colorimetry technology to tongue color differentiation has the potential to serve as a reference point in standardizing traditional Chinese medicine syndrome classification in PHC.