剥苔之中西医辨析

An Analysis of Exfoliation Treated with Integrated Traditional Chinese and Western Medicine

观察舌苔变化是中医诊病的一种传统手段,然而舌苔又受到许多因素的影响,如药物因素等干预可以使舌苔发生变化,若通过表面所看到的现象(舌苔)就去判断疾病的病性会严重影响疾病诊断的准确性。本文以剥苔为例,从中西医角度对其病机及治疗进行阐述,西医认为肺胀病患者出现剥苔是由于口腔内环境紊乱所致,激素可引起口腔内环境紊乱,应重视口腔护理,防止口腔菌群紊乱,从局部治疗;中医认为剥苔病机多属气阴亏虚,然临证发现肺胀病阳虚证患者也可见剥苔,阳虚寒湿困脾,津液代谢失常,精微不能输布于舌面所致。剥苔只是一种体征,是疾病在舌面上的反映,不必单一治疗剥苔,而以治疗原发病为主,从整体进行辨证论治,若辨证论治准确,整体得以调理,剥苔也会随之改善。

Observing the change of tongue coating is a traditional means of diagnosis of Chinese medicine. However,the tongue coating is influenced by many factors,for example,the intervention of drug factors can change the tongue coating. At this time,only depending on the appearance of the phenomenon（ tongue coating） to judge the disease will affect the accuracy of the disease diagnosis seriously. Taking exfoliation as an example,this paper expounds the pathogenesis and treatment from the perspective of Chinese and Western medicine,so the treatment of exfoliation should take into consideration from the perspective of Chinese and Western medicine together. The patients with lung distention appear to be exfoliated from the point of view of the Western medicine as a result of the internal disturbance in the oral cavity. The hormone can cause a disturbance in the oral cavity,which is related to the patient＇s long-term inhalation of hormones. Western medicine focuses on oral care to prevent oral flora disorders for local treatment. Traditional Chinese medicine holds that the disease is mostly caused by deficiency of qi and yin. However,it is found that exfoliation can also be seen in patients with lung swelling and yang deficiency syndrome. Yang deficiency and cold dampness obstructing the spleen,and body fluid metabolism is abnormal. The essence can not be spread on the tongue surface,so the treatment should focus on syndrome differentiation. Exfoliation is only a sign,and a reflection of disease on the tongue surface. It does not need to be treated by single treatment. The treatment should focus on primary diseases based on syndrome differentiation. If syndrome differentiation is correct and the whole body can be adjusted,the exfoliation will also be improved.