本研究計畫之目的，在於建立中醫診斷學中舌診的客觀指標，藉由病毒性肝炎病患者來探討不同肝功能狀態下的舌診表現，並經由清熱利濕滋陰法治療後病情和體質的改變，對舌診之影響，以觀察中醫證型的改變與舌診之關係。 本研究共收案86名樣本，其中4名中途退出，共完成82名樣本，如表一。其中男性共55例，女性27例；B型肝炎共37例，C型肝炎43例，合併B和C型肝炎2例。於四診的條件下所判定的濕熱組共57例，非濕熱組共25例，而於單純用舌診的條件下所判定的濕熱組共65例，非濕熱組共17例。藉由清熱利濕滋陰之藥物治療後觀察並記錄舌診所表現的變化。患者服用藥物時間為兩個月，分別在服用藥物前和二個月後各做一次問卷、抽血及舌診攝影。 結果在評估療效上發現原先是溼熱證型的患者經清熱利濕滋陰法的藥物治療後會轉變成非溼熱證型。其生化值在服藥前溼熱證型與非溼熱證型兩組並無明顯的差異；而服藥前後溼熱體質中服藥前後GOT、GPT、γ-GT其值有顯著的下降趨勢。而清熱利濕滋陰法的藥物治療後看不出來對於慢性B型肝炎或者是慢性C型肝炎有任何轉成陰性或者看到抗體的形成。在服藥前發現患者舌苔呈黃色，苔質較膩，舌苔較厚者，舌質是質裂較多，舌色較偏紅色系，朱點較多，證明了傳統醫學上所認定的溼熱舌苔。 但用藥前後苔色反偏黃，朱點及苔厚程度用藥後皆較多，表示在非溼熱證型用清熱利濕滋陰法的藥物是無效的。而溼熱證型中用藥的結果: 舌苔上苔裂及苔的厚度反而增加，舌質上朱點亦增加，表示服用清熱利濕滋陰法的藥物是無效的。 判定紅色系列舌最重要的變數，也就是可藉由舌診圖片中紅色(R)的多少來判定此舌診相片是否屬於紅舌系列，而舌苔的判別方程式中發現其變數項目與藍色(B)及亮度(L)有關。; By observing different types of tongue diagnosis in relation to different stages of viral hepatitis patients, and changes of heath status and tongue diagnosis after the treatment of Chin-Lar-Li-She-Si-In-Fa, current study aimed to establish objective standards for tongue diagnosis in traditional Chinese medicine. There were 86 hepatitis patients agreed to participate in the study while 4 of them withdrew earlier, ending with 82 remained in the analyses including 55 male and 27 female. Among these 82 patients, 37 were infected with hepatitis B, 43 with hepatitis C and 2 with both. Under the condition of Si-Chn, there were 57 determined to be She-Lar (hot and damp) and 25 not She-Lar, while under simple tongue diagnosis, there were 65 She-Lar and 17 non-She-Lar. The treatment period was two months and questionnaire interviews were conducted before and after the treatment. Blood samples were collected and tongue photograph were performed during the study period. We found that those who were originally She-Lar turned non-She-Lar after the treatment and there was no significant difference between She-Lar and non-She-Lar in biochemical exams before treatment. Among those with She-Lar condition, their GOT, GPT and γ-GT decreased significantly after treatment. There were no virus conversion occurred for hepatitis B and C carriers with this treatment. It showed that before treatment, most of the tongue-coating was yellow and thicker and tongue tended to be red with spots which were traditionally considered She-Lar tongue-coating. But after use of the medicine, tongue coating is thicker and turned yellow for both She-Lar and non-She-Lar types of patients, showing that the treatment was not effective. The most important factor to determine whether the tongue was red was the numbers of red spots and the color of the tongue in tongue photograph. The way to determine tongue-coating depended on the blue and lightness.
