阴虚光剥舌形成机理的研究

Study on the Mechanism of Denuded Tongue Coating Due to Yin Deficiency

从舌脱落细胞学、病理学、微循环、微量元素代谢等方面综合探讨了阴虚光剥舌的形成机理。结果表明,阴虚光剥舌上皮细胞剥脱速率增快;丝状乳头消失,舌粘膜次级乳头缺如,舌上皮角质化过程障碍;微循环观察见蕈状乳头内微血管构形异常,血管内红细胞聚集,流速缓慢。微血管扩张瘀血,微循环呈瘀滞状态。患者唾液锌含量明显高于健康人(P<0.01),提示体内锌含量变化也可能是光剥舌形成的一个病理因素。

Denuded tongue coating is an important sign of serious Yin deficiency.The total number of exfoliated cells increased in the imprint of a Yin-deficient tongue.Not only the cells of the superficial layer but those of the middle layer appeared.Many necrotic cells could also be seen.This picture ahowed that the cell exfoliation rate of a Yin-deficient tongue was faster than in a normal tongue, caused chiefly by the degeneration and necrosis of the epithelial cells.It is believed that cell necrosis is the principal feature of the Yin-deficient tongue.This is in accordance with the TCM theory that denuded tongue coating is due to exhaustion of Yin fluid.Study on lingual morphology:The filiform papillae disappeared in slices of Yin-deficient tongue.The fungiform papillae had atrophied,the number of strata of epithelial cells reduced,and there were no complete keratinocytes or granules, tonofilaments and membrane coating granules in the cytoplasm. Observation of the microcirculation of fungiform papillae of a Yin-deficient tongue showed:the structure of vessels was abnormal,blood flowed slowly,red blood cells aggregated and the vessels dilated.Microcirculation of the blood was stagnant.The disturbance of microcirculation could accelerate the abnormal metabolism of lingual epithelial cells and cell necrosis,resulting in denuded tongue coating.Analysis of salivary zinc level.The salivary zinc level(0.232 μg/ml)of the patients with Yin-deficient tongue was significantly higher than that of healthy subjects(0.099 μg/ml).Zinc can affect the formation and function of nuclear spindle in cellular mitosis.The change of zinc level may be a pathogenic factor in Yin-deficient tongue.