The Clinical Observation Of The Tongue In Rheumatoid Arthritis

Objective:The study is on inspection of the tongue through observation of 160 cases of rheumatoid arthritis to generalize and analyze the tongue presentations's distruction feature, probe into and summarize the law of inspection of the tongue with rheumatoid arthritis so as to make sure the concrete clinical meaning and application value of tongue inspection in rheumatoid arthritis. Thus, It gives an accordance in inspecting the pathogenic factor and discriminating the pathogenesis. What' s more, it is a basis for zheng differentiation-classification and prescription.Method:We select 160 patients who measure up to the Chinese and Western medicine standard of rheumatoid arthritis to be study subjects. When they visit doctors or admit the hospital within one day, we will observe their tongue presentations. The main point is to observe the tongue presentation from three angles, tongue color, tongue coating and arteries and veins under the tongue. Besides, we gather and record the typical tongue presentation by using digital camera. Meanwhile, we use comprehensive analysis by the four examination methods to carry out Chinese zheng differentiation-classification, and collect common condition including age, sex, pathogenesis and index which can estimate Pathogenetic condition. The clinical observing index consists of arthrocele number, joints pain number and time of early morning stiffness. We adopt normal method to inspect Blood Sedimentation(ESR) and C-reactive protein(CRP). Then we summarize the information, analyze the data and generalize the tongue presentations' s distruction feature.Result:(1)In this investigation of 160 cases, the ratio of men to women is three to one. Female' s incidence rate of RA is obviously higher than male' s. There are five kinds of colors of the tongue of the patients with rheumatoid arthritis, which is the red, dard red, pink, pale and dark pale in proportion. From the observation, we find out that female patients with rheumatoid arthritis are more than male in general or in various tongue colors. Moreover, it makes no sense in statistic if we get the outcome by comparing the five tongue colors (P>0. 05) .(2)The five tongue colors' average age arranges in order from the small to large is: red, pink, dark red, pale and dark pale. It has big difference when making comparision(P<0.05);The average pathogenesis arranges in order from short to long is: red, pink, pale, dark red and dark pale. It has no difference when making comparision(P>0. 05) .(3)The average age of the group which sublingual collateral vessels is bend has obvious difference with that of the normal group(P<0.05); The comparision of the average pathogenesis has no difference(P>0. 05).(4)In the five indexes to estimate the Pathogenetic condition,the difference of pale coating and yellow coating in the same index as well as the differece in the five kinds of texture of fur make no sense in statistic(P>0.05) .(5)RA' s zheng hou is distributed as follow: 54 cases dampness-heat Stagnation pattern (33.7%), 31cases cold-dampness Stagnation pattern (19.4%), 19cases yang deficiency cold of kidney qi pattern(11. 9%), 29 cases deficiency of Yin of both Liver and Kidney(18.1%), and 27 cases stagnant blood stagnation pattern(16. 9%).(6)The red tongue is mostly distributed in dampness-heat Stagnation pattern and deficiency of Yin of both Liver and Kidney, which accounts for 60. 3% and 32.8% respectively; the dark red tongue is more distributed in stagnant blood stagnation pattern(48.7%); the pink tongue is mostly distributed in cold-dampness Stagnation pattern(54. 3%); the dark pale tongue is both distributed in yang deficiency cold of kidney qi pattern and stagnant blood stagnation pattern for 38. 5%; nevertheless, the pale tongue is mostly shown in yang deficiency cold of kidney qi pattern(58. 8%). The tongue is always with yellow, thick and greasy tongue fur is the sign of dampness-heat stagnation pattern, the white and thick tongue fur is of cold-dampness Stagnation pattern, the thin and white tongue fur is the sign of yang deficiency cold of kidney qi pattern, little tongue fur is the sign of deficiency of Yin of both Liver and Kidney, while the patient with stagnant blood stagnation pattern shows no obvious concentrated distribution trend of tongue fur. Conclusion:Rheumatoid arthritis' tongue color does not make much difference in disribution in sex; The change of RA's tongue color and its relationship with age conforms to the Pathology reflection of the nature development law of human beings; whether the sublingual collateral vessels is bend or not has close relatioship with age, while the pathogenesis is short or long does not affect the sublingual collateral vessels too much; What the tongue coating shows has no correlative relationship with the pathogenetic condition. In clinical application, the moral treatment of tongue color and tongue coating plays an important role in zheng differentiation-classification of this disease; From the obsevation of tongue, it helps to judge the amount of asthenia and sthenia as well as the degree of cold and heat, so as to decide the degree of reinforcement and expulsion.