病理性齿痕舌的特点及其与证候相关性临床研究
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摘要
目的:探讨病理性齿痕舌出现的特点及其与证候的相关性,为进一步研究病理性齿痕舌的临床意义提供思路和方法,并为其与疾病的回归提供客观依据和基础性工作。
方法:临床研究:用流行病学横断面研究方法对800例大内科患者进行观察,将患者分为齿痕舌阳性组和阴性组。采用Optimas 6.5数字彩色图像显微分析软件对数码相机拍摄的齿痕舌照片进行图像分析,观察性别、年龄,舌体胖瘦、舌色苔色以及舌苔厚薄与病理性齿痕舌的关系;同时根据临床中医诊断,结合病理性齿痕舌患者的症状、体征及舌脉等进行评定,观察病理性齿痕舌患者的中医证候特征,总结出病理性齿痕舌患者常见证型及相互关系。
结果:病理性齿痕舌的出现率为38.13%,其中男性患者与女性患者的出现率分别为35.52%、40.69%。病理性齿痕舌常伴见胖大舌、薄白苔,而且其齿痕程度与舌苔的厚度几乎成正比,但却与舌色的关系不大。
病理性齿痕舌患者常见证候为:肝胆湿热＞脾肾阳虚＞肺脾气虚＞肝肾阴虚＞肝脾血瘀＞肾虚水泛＞脾虚湿盛＞脾胃虚寒＞肝气郁结＞痰湿阻肺。其致病因素涉及到湿、痰、瘀、郁、寒、热等,脏腑基础与肝、脾、肾、胃、肺、心及胆相关,其中肝脏病证与病理性齿痕舌的密切关系仅次于脾。
结论:虽然淡白舌、胖大舌和齿痕舌三种舌象之间存在着一定的联系,但并不是必然的联系。瘦小舌也可出现齿痕,其原因可能是与气血不足或阴虚,舌体瘦薄松软失养有关。
对于病理性齿痕舌患者,在辨证的基础上,可以参考上述证候特征,有重点的进行辨证治疗。同时不可忽视肝脏及心理因素与病理性齿痕舌的相关性。
Objective: To investigate the pathological teeth-print characteristic and sum up the Traditional Chinese Medicine (TCM) syndrome characteristic of the pathological teeth-print, in order to offer reference to TCM treatment and provide scientific bases for further study.
Methods: Clinical observation: during the cross-sectional investigation, 800 patients were collected as subjects. The patients were separated into two groups, the teeth-print group and non-teeth-print group. Photos of the teeth-print were taken by numeral camera named Canon DIGITAL IXUS I. At the same time, we evaluated their TCM syndrome such as symptom, physical sign, tongue, fur of the tongue, pulse which collected through observation, auscultation, interrogation and palpation.
Results: The results showed that the prevalence of the pathological teeth-print was found to be 38.13%. The number of female patients with pathological teeth-print was 49.06%, higher than that in male. The age factor had significant effect on the pathological teeth-print.
Teeth-print is often seen with swollen tongue (51,48%). In addition, it is divergent with the prevenient investigation that teeth-print was seen with dark red tongue (26,58%), compared with other abnormal tongue color. Along with the severity of teeth-print, there is also an increase of the thick fur and yellow fur. We found that tongue coating is closely related with the extent of teeth-print.
The pathological teeth-print group presented 37 kinds of syndrome and they come down to liver、spleen、heart、kidney、lung、stomach and gallbladder. The causes of the pathological teeth-print have striking correlation with dampness.
Conclusion: The results of the research hint that, the incidence of patientsin female was higher than in male, and there were two ages peak of incidences. The pathological teeth-print tongue has closely but not inevitable relation with swollen and pale tongue. Not all the pathological teeth-print stands for deficiency of syndrome. In the process of treating all kinds of patients with pathological teeth-print, under guiding of identifying the syndrome to cure, which using supplying deficiency of spleen and kidney or eliminating dampness and phlegm or activating blood to eliminate stasis or nourishing Yin. At the same time, enough attention should be paid to the relation between the psychological factor and the pathological teeth-print tongue.
方法:临床研究:用流行病学横断面研究方法对800例大内科患者进行观察,将患者分为齿痕舌阳性组和阴性组。采用Optimas 6.5数字彩色图像显微分析软件对数码相机拍摄的齿痕舌照片进行图像分析,观察性别、年龄,舌体胖瘦、舌色苔色以及舌苔厚薄与病理性齿痕舌的关系;同时根据临床中医诊断,结合病理性齿痕舌患者的症状、体征及舌脉等进行评定,观察病理性齿痕舌患者的中医证候特征,总结出病理性齿痕舌患者常见证型及相互关系。
结果:病理性齿痕舌的出现率为38.13%,其中男性患者与女性患者的出现率分别为35.52%、40.69%。病理性齿痕舌常伴见胖大舌、薄白苔,而且其齿痕程度与舌苔的厚度几乎成正比,但却与舌色的关系不大。
病理性齿痕舌患者常见证候为:肝胆湿热＞脾肾阳虚＞肺脾气虚＞肝肾阴虚＞肝脾血瘀＞肾虚水泛＞脾虚湿盛＞脾胃虚寒＞肝气郁结＞痰湿阻肺。其致病因素涉及到湿、痰、瘀、郁、寒、热等,脏腑基础与肝、脾、肾、胃、肺、心及胆相关,其中肝脏病证与病理性齿痕舌的密切关系仅次于脾。
结论:虽然淡白舌、胖大舌和齿痕舌三种舌象之间存在着一定的联系,但并不是必然的联系。瘦小舌也可出现齿痕,其原因可能是与气血不足或阴虚,舌体瘦薄松软失养有关。
对于病理性齿痕舌患者,在辨证的基础上,可以参考上述证候特征,有重点的进行辨证治疗。同时不可忽视肝脏及心理因素与病理性齿痕舌的相关性。
Objective: To investigate the pathological teeth-print characteristic and sum up the Traditional Chinese Medicine (TCM) syndrome characteristic of the pathological teeth-print, in order to offer reference to TCM treatment and provide scientific bases for further study.
Methods: Clinical observation: during the cross-sectional investigation, 800 patients were collected as subjects. The patients were separated into two groups, the teeth-print group and non-teeth-print group. Photos of the teeth-print were taken by numeral camera named Canon DIGITAL IXUS I. At the same time, we evaluated their TCM syndrome such as symptom, physical sign, tongue, fur of the tongue, pulse which collected through observation, auscultation, interrogation and palpation.
Results: The results showed that the prevalence of the pathological teeth-print was found to be 38.13%. The number of female patients with pathological teeth-print was 49.06%, higher than that in male. The age factor had significant effect on the pathological teeth-print.
Teeth-print is often seen with swollen tongue (51,48%). In addition, it is divergent with the prevenient investigation that teeth-print was seen with dark red tongue (26,58%), compared with other abnormal tongue color. Along with the severity of teeth-print, there is also an increase of the thick fur and yellow fur. We found that tongue coating is closely related with the extent of teeth-print.
The pathological teeth-print group presented 37 kinds of syndrome and they come down to liver、spleen、heart、kidney、lung、stomach and gallbladder. The causes of the pathological teeth-print have striking correlation with dampness.
Conclusion: The results of the research hint that, the incidence of patientsin female was higher than in male, and there were two ages peak of incidences. The pathological teeth-print tongue has closely but not inevitable relation with swollen and pale tongue. Not all the pathological teeth-print stands for deficiency of syndrome. In the process of treating all kinds of patients with pathological teeth-print, under guiding of identifying the syndrome to cure, which using supplying deficiency of spleen and kidney or eliminating dampness and phlegm or activating blood to eliminate stasis or nourishing Yin. At the same time, enough attention should be paid to the relation between the psychological factor and the pathological teeth-print tongue.
引文
[1]陶杏芬.中医舌象在血液透析中的应用[J].河北中西结合杂志,1999,8(2):251-252
[2]尚瑞梅,王济民,赵聚宾,等.舌体测量器与计算方法的研究及应用[J].河北中医,1991,13(1):48-50
[3]钱心如,陈依萍,陈洋霖.齿印舌临床调查分析[J].中医杂志,1991,32(1):33-35
[4]灰本元.Journal of Phytotherapy[J].2000,2(1):12-15
[5]和过直(日).胖嫩舌、齿痕舌与虚证的关系[J].东方医学,2002,18(1):11-13
[6]梁嵘,王召平编译.腻苔与齿痕舌的流行病学调查[J].国外医学中医中药分册,2002,24(1):10
[7]村松睦(日).齿痕舌的临床意义[J].国外医学.中医中药分册,1992,12(3):1-3
[8]张远炎,陈红珍,黄才华等.新疆喀什1499名中小学生舌象调查分析[J].中医杂志,1998,39(3):175-176
[9]钱心如,陈泽霖,戴豪良,等.齿印舌的病理形态学研究[J].中西医结合杂志,1990,10(6):337-339
[10]赵亚丽,西广成,刘艳骄.用相关系数方法探讨齿痕舌出现的特点[J].中国中医基础医学杂志,2003,9(9):77-79
[11]王新奉,刘济跃.462例老年前期者与老年人舌边齿痕观蔡[J]. 山东中医杂志,1991,10(6):17
[12]张远炎,陈红珍,郁书亮,等.气虚证舌象的临床观察[J].成都中医药大学学报,1999,22(1):21-22
[13]中国抗癌协会.癌症患者胖大舌、瘦小舌、齿印舌的研究[J].肿瘤,1995,15(1):39-40
[14]金芬芳.齿痕舌的现代研究概况[J].北京中医药大学学报,2002,25(1):57-59
[15]朱文锋.中医诊断学[M].北京:中国中医药出版社,2002.78-219
[16]李乃民.望舌诊病[M].北京:人民出版社.1987.29
[17]康亚国,宋晓群.活血化瘀法在老年病治疗中的应用[J].现代中医药杂志,2006,26(1):50-51
[18]岛田丰.舌苔与气血水及脾胃失调的关系[J].国外医学.中医中药分册,1996,18(6):27
[19]郭振球.老年亚健康状态评析[J].河南中医学院学报,2003,18(5):11-12
[20]杨世忠,孙龙,王春妍.亚健康状态责之于肝失疏泄[J].长春中医学院学报,2003,19(1):3-4
[21]陈文姬,陈文垲.200例抑郁症患者舌象研究[J].南京中医药大学学报,2006,22(1):16-17
[22]彭贵军.抑郁症肝郁脾虚、心脾两虚证证候标准第二轮专家问卷分析[J].湖南中医学院学报,2003,23(5):37
[23]陈泽霖.舌诊研究[M].上海:上海科技出版社,1982,56
[2]尚瑞梅,王济民,赵聚宾,等.舌体测量器与计算方法的研究及应用[J].河北中医,1991,13(1):48-50
[3]钱心如,陈依萍,陈洋霖.齿印舌临床调查分析[J].中医杂志,1991,32(1):33-35
[4]灰本元.Journal of Phytotherapy[J].2000,2(1):12-15
[5]和过直(日).胖嫩舌、齿痕舌与虚证的关系[J].东方医学,2002,18(1):11-13
[6]梁嵘,王召平编译.腻苔与齿痕舌的流行病学调查[J].国外医学中医中药分册,2002,24(1):10
[7]村松睦(日).齿痕舌的临床意义[J].国外医学.中医中药分册,1992,12(3):1-3
[8]张远炎,陈红珍,黄才华等.新疆喀什1499名中小学生舌象调查分析[J].中医杂志,1998,39(3):175-176
[9]钱心如,陈泽霖,戴豪良,等.齿印舌的病理形态学研究[J].中西医结合杂志,1990,10(6):337-339
[10]赵亚丽,西广成,刘艳骄.用相关系数方法探讨齿痕舌出现的特点[J].中国中医基础医学杂志,2003,9(9):77-79
[11]王新奉,刘济跃.462例老年前期者与老年人舌边齿痕观蔡[J]. 山东中医杂志,1991,10(6):17
[12]张远炎,陈红珍,郁书亮,等.气虚证舌象的临床观察[J].成都中医药大学学报,1999,22(1):21-22
[13]中国抗癌协会.癌症患者胖大舌、瘦小舌、齿印舌的研究[J].肿瘤,1995,15(1):39-40
[14]金芬芳.齿痕舌的现代研究概况[J].北京中医药大学学报,2002,25(1):57-59
[15]朱文锋.中医诊断学[M].北京:中国中医药出版社,2002.78-219
[16]李乃民.望舌诊病[M].北京:人民出版社.1987.29
[17]康亚国,宋晓群.活血化瘀法在老年病治疗中的应用[J].现代中医药杂志,2006,26(1):50-51
[18]岛田丰.舌苔与气血水及脾胃失调的关系[J].国外医学.中医中药分册,1996,18(6):27
[19]郭振球.老年亚健康状态评析[J].河南中医学院学报,2003,18(5):11-12
[20]杨世忠,孙龙,王春妍.亚健康状态责之于肝失疏泄[J].长春中医学院学报,2003,19(1):3-4
[21]陈文姬,陈文垲.200例抑郁症患者舌象研究[J].南京中医药大学学报,2006,22(1):16-17
[22]彭贵军.抑郁症肝郁脾虚、心脾两虚证证候标准第二轮专家问卷分析[J].湖南中医学院学报,2003,23(5):37
[23]陈泽霖.舌诊研究[M].上海:上海科技出版社,1982,56