2型糖尿病足舌诊客观化特征研究＊

目的 探讨舌象与2型糖尿病足的关系,为中医药防治2型糖尿病足提供新思路。方法 采用前瞻性研究方法,共纳入2糖尿病患者180例,其中2型糖尿病患者60例,2型糖尿病足患者120例。对舌象资料进行客观化判定,对比2型糖尿病与2型糖尿病足的舌象特征,建立预报糖尿病足发生舌象的回归模型。结果 2型糖尿病足患者红舌、青紫舌的出现率比糖尿病患者组高,但红舌、白苔和滑苔的出现率比糖尿病组低（P < 0.05）。Logistic回归模型提示青紫舌、黄苔、腻苔、裂痕舌、齿痕舌均是2型糖尿病足发生的正相关影响因素,紫舌出现时2型糖尿病足的概率是红舌的12.53倍;黄苔和腻苔时糖尿病足的概率分别是正常舌苔时的4.069和4.617倍;裂纹舌和齿痕舌时2型糖尿病足发生的概率是正常舌的5.723和3.776倍。结论 舌诊客观化在判断2型糖尿病足及预测2型糖尿病足方面有一定的诊断价值和规律性。

Objective Characteristics of Foot and Tongue Diagnosis in Type 2 Diabetes Mellitus

Objective To explore the relationship between tongue image and type 2 diabetic foot, and to provide a new idea for the prevention and treatment of type 2 diabetic foot with traditional Chinese medicine.Method Prospective research method was adopted. A total of 180 patients with type 2 diabetes were included, including 60 patients with type 2 diabetes and 120 patients with type 2 diabetic foot. Objective Judgment was made on the tongue image data, and a regression model was established to predict the tongue image of diabetic foot by comparing the tongue image characteristics of type 2 diabetes mellitus and type 2 diabetic foot.Result The occurrence rate of red tongue and purple tongue in type 2 diabetic foot patients was higher than that in diabetic group, but the occurrence rate of red tongue, white moss and smooth moss was lower than that in diabetic group (P < 0.05). The Logistic regression model suggested that purple tongue, yellow moss, greasy moss, split tongue and tooth mark tongue were all positively correlated to the occurrence of type 2 diabetic foot. Type 2 diabetic foot is 12.53 times more likely to occur with purple tongue than with the red tongue. The probability of diabetic foot in yellow moss and greasy moss was 4.069 and 4.617 times higher than that in the normal tongue, respectively. The probability of type 2 diabetic foot with split tongue and tooth mark tongue is 5.723 and 3.776 times that of normal tongue.Conclusion The objectification of tongue diagnosis has certain diagnostic value and regularity in judging and predicting type 2 diabetic foot.