目的：观察157 例慢性肾病（CKD）不同肾功能分期的舌象特征。方法：采用上海中医药大学研制的舌面一体仪记录分析157 例（CKD）患者和30例正常人的舌象图，比较其不同肾功能分期下舌象的客观化参数有无差异。结果：①肾病各期和对照组比较R、L值均有明显降低（P<0.05）；肾病CKD1、2、3、4期和对照组比较G和B值均有明显降低（P<0.05）；不同肾病分期间R、G、B、L值CKD1期、CKD2期较CKD4期有明显降低（P<0.05）；CKD1、2、3期较CKD5期明显降低（P<0.05）。②肾病5组和对照组比较裂纹参数均有明显增高（P<0.05）；CKD5期和对照组比较腐腻参数差异明显（P<0.05）；CKD3、4和5期和对照组比较剥脱参数差异明显（P<0.05）；随着肾功能下降，不同肾病分期组间CKD1期、CKD2期较CKD5期的腐腻指数、剥脱指数明显降低（P<0.05）。结论：中医舌面诊仪能为临床CKD 的临床诊断提供一定的客观依据。

This study was aimed to observe the tongue image characteristics at different renal function stages among 157 chronic kidney disease (CKD) patients. Tongue images of 157 CKD cases and 30 healthy people were recorded with the instrument designed by Shanghai University of Traditional Chinese Medicine. Parameters of the tongue image were compared among different renal function stages. The results showed that compared with the control group, there were obvious decreasing on the R and L indexes in groups of different renal function stages(P < 0.05). Compared with the control group, there were obvious decreasing on the G and B indexes in groups of CKD1, CKD2, CKD3 and CKD4 stages(P < 0.05). Compared to CKD4 stage, there were obvious decreasing on the R, G, B, L indexes from group of CKD1 and CKD2 stage(P < 0.05). Compared with the group of CKD5 stage, there were obvious decreasing in the group of CKD1, CKD2, and CKD3 (P < 0.05). Compared with the control group, the cracking index was obvious increased in 5 stages(P < 0.05). There was obvious difference in the greasy index between the group of CKD5 stage and the control group (P < 0.05). Compared with the control group, there was obvious difference in the peeling index from the group of CKD3, CKD 4, CKD5 stage(P < 0.05). Along the decreasing of renal function, compared with the group of CKD5 stage, there was obvious decreasing on the greasy index and peeling index in the group of CKD1 and CKD2 (P < 0.05). It was concluded that Chinese medicine tongue and face diagnosis instrument can provide certain objective evidence for the clinical diagnosis of CKD.

国家自然科学基金委面上项目（81173199）：基于中医四诊信息融合的常见中医证候诊断模型研究，负责人：王忆勤；上海市卫生局中医药事业发展三年行动计划（重大研究）项目（ZYSNXD-CC-ZDYJ012）：“中医临床四诊技能训练与考核系统”研制，负责人：王忆勤；上海市卫生局中医药国际标准培育项目（ZYSNXD-CC-BZH）：中医舌象图像、参数国际标准的前期研究，负责人：王忆勤；国家中医药管理局开发提升改造项目（ZYZLSB-2012[022]）：面向健康监测的物联网系统的开发，负责人：王忆勤；国家中医药管理局重点学科：中医诊断学科，负责人：王忆勤。