胆管结石患者胆道外引流前后舌象变化

The Clinical Observation of Tongue Picture Changes Before and After External Biliary Drainage in Patients with Bile Duct Stones

目的:观察胆管结石患者胆道外引流前后舌象的变化规律。方法:选取2013年5月至2015年12月在本院住院的胆管结石接受胆道外引流手术的患者60例,所有患者入院后给予禁食、积极抗感染、护肝、补液等处理,腹痛严重者予解痉、止痛等对症治疗,完善入院相关检查,分别给予经皮肝穿刺胆道外引流术或内窥镜下鼻胆管引流术,记录患者胆道外引流前与引流结束后第3天清晨的舌象,将分类后的舌诊内容归纳为数据表,录入EXCEL表格。结果:胆道外引流前,舌色以淡红色、红舌、绛舌多见,淡白舌及紫舌较少,舌苔主要表现为不同程度的黄苔、厚腻苔;引流后,舌色多演变为淡红色,与引流前相比较有明显差异,具有统计学意义(P<0.05)。引流后,大部分深黄苔、焦黄苔多向淡黄苔及白苔转化,但苔质由原来的腻苔、润苔,大多转化为燥苔,与引流前相比较,差异有统计学意义(P<0.05)。结论:胆道外引流前后需观察患者舌象变化,胆道引流后患者舌象多呈现阴亏津耗之象,在治疗过程中,需固护津液。

Objective： To observe the rule of tongue picture changes before and after external biliary drainage in patients with bile duct stones. Methods： Sixty patients who were hospitalized in our hospital from May 2013 to December 2015 were treated with external biliary drainage. All patients were treated with fasting,active anti infection,liver protection and rehydration. Patients with severe abdominal pain were treated with antispasmodic and analgesic treatment. The tongue picture changes of patients before and after the third day of drainage were classified into data tables and EXCEL tables. Results： Before drainage of the biliary tract,the color of the tongue was common in light red,red tongue and crimson tongue,and the pale tongue and purple tongue were less.The tongue coating was mainly yellow moss and thick greasy fur. After drainage,the tongue color changed to light red,which was significantly different from that before drainage,with statistical significance(P〈0. 05）. After the drainage,most of the deep yellow tongue coating and brown tongue coating were converted to the pale yellow and white,but the coating were mostly transformed from the greasy and moistening into dry,and the difference was statistically significant(P〈0. 05） compared with before the drainage. Conclusion： Before and after biliary drainage,we need to observe the changes of tongue picture. After the biliary drainage,the tongue appearance of the patients shows more yin deficiency and fluid consumption. In the process of treatment,we need to protect and strengthen body fluid.