三种新发疫病的舌象特征分析及临床指导意义

Analysis of Tongue Characteristics of Three New Epidemic Diseases and Its Clinical Guiding Significance

分析三种新发疫病:严重急性呼吸综合征(SARS)、甲型H1N1流感、新型冠状病毒肺炎(COVID-19)的舌象特征,发现SARS与甲型H1N1流感舌色特征均以红舌为主,SARS病程后期多见绛舌、青紫舌,甲型H1N1流感初期多见舌尖红,危重型则多见青紫舌、胖大舌,COVID-19舌色则以淡红舌为主,重型多见青紫舌。在舌苔方面,SARS、甲型H1N1流感及COVID-19舌苔均多见腻苔特征,但SARS、甲型H1N1流感病程初期尚多见薄白苔、薄黄苔、薄腻苔,而COVID-19病程初期舌苔即以白厚苔、厚腻苔为主。不同的舌象表现反映了不同的病因病机,同时舌象的阶段性变化也体现了温病过程中卫气营血的传变规律。三者都有不同程度的腻苔表现,且患者多有胖大舌或齿痕舌,说明平素脾虚湿盛之人更易感受疫邪,对疫病临床辨证论治具有指导意义。

To analyze the tongue characteristics of three new epidemic diseases:severe acute respiratory syndrome(SARS),influenza A(H1N1) and coronavirus disease 2019(COVID-19). It is found that the tongue color characteristics of SARS and influenza A(H1N1) are mainly red,crimson tongue and purplish tongue are more common in the late stage of SARS disease,red tongue tip is more common in the early stage of influenza A(H1N1),purplish tongue and fat tongue are more common in critical cases. The color of COVID-19 tongue is mainly light red tongue,and severe cases are more common with purplish tongue. In the aspect of tongue coating,SARS,influenza A(H1N1)and COVID-19 all show greasy fur,but in the early stage of SARS and influenza A(H1N1),thin white fur,thin yellow fur and thin greasy fur are often seen,while in the early stage of COVID-19,tongue coating is mainly white thick fur and thick greasy fur. Different tongue manifestations reflect different etiology and pathogenesis. At the same time,the phased changes of tongue also reflect the regularity of transmission of wei-qi-ying-xue in the process of febrile disease. Three diseases have different degrees of greasy fur,and most of the patients have fat tongue or tooth-marked tongue,indicating that people with spleen deficiency and dampness are more vulnerable to the evil of epidemic disease. It has guiding significance for clinical diagnosis and treatment of epidemic diseases.