因虚致郁论治灼口综合征

Treatment of burning mouth syndrome due to the theory of deficiency causing depression

灼口综合征的病位在口窍,通过经脉与脾胃紧密关联;且其常与情绪障碍相互为病,“七情内伤,脾胃先病”,脾胃亦有调节转化情志之功。笔者认为“因虚致郁”是灼口综合征发病、病程进展以及预后的重要病机。脾胃虚损则诸窍不利,继而内生痰浊、气滞等多种病邪,形成郁滞之象,导致疾病进展,迁延难愈,故在灼口综合征的防治中应重视顾护脾胃。提出治疗灼口综合征应重以补益脾胃,令中焦不虚,气血通调,同时兼施化痰清火以安疾病之变,调肝脾畅气机以防疾病迁延。临证当从病机入手,共施“补、疏、通”之法,遣方用药则根据病机演变和偏盛程度灵活配伍加减,晓治病之则,扶正祛邪,攻补兼施,提高临床思辨能力,为中医防治灼口综合征提供临床新思路。

Burning mouth syndrome is located in the orifices of the mouth and is closely related to the spleen and stomach through the meridians;and it is often associated with mood disorders,which are often associated with burning mouth syndrome.“When seven emotions are injured internally,the spleen and stomach will be sick first”,and the spleen and stomach have the function of regulating and transforming the emotions.The author believes that “depression due to deficiency” is an important pathogenetic mechanism for the onset,progression and prognosis of burning mouth syndrome.If the spleen and stomach are deficient,the orifices will be unfavorable,and then phlegm and qi stagnation will be generated,resulting in stagnation,which will lead to disease progression and prolonged healing,therefore,the prevention and treatment of burning mouth syndrome should pay attention to the care of the spleen and stomach.It is proposed that the treatment of burning mouth syndrome should focus on tonifying the spleen and stomach,so that the middle jiao is not deficient,and the qi and blood are well regulated,while at the same time applying phlegm and clearing the fire in order to secure the change of the disease,and regulating the liver and spleen to smooth the qi to prevent the disease from being prolonged.The clinical evidence should start from the disease mechanism and apply the method of “tonic,dredge and pass”,and the prescription and medication should be based on the evolution of the disease mechanism and the degree of prevalence of the disease with flexible matching and addition and subtraction,so as to know the rules of treating the disease,supporting the positive and eliminating the evil,attacking and tonifying the disease at the same time,to improve the ability of clinical discernment,and to provide a new clinical thinking for the prevention and treatment of burning mouth syndrome in traditional Chinese medicine.