基于古今文献的痰瘀互结证舌象解析

Analysis of tongue manifestations with intermingled phlegm-blood stasis syndrome based on ancient and modern literature

根据历代文献及现代学者的认识,痰瘀互结证舌象可兼见痰与瘀的舌象特征,大体可从舌质及舌下络脉诊瘀,从舌苔诊痰。由于存在瘀与痰轻重各异、寒化热化不同,兼挟的不同以及伤津与否,舌象有所不同。痰瘀互结证也可出现特殊的舌象,如舌质为蓝紫色,舌苔为灰黑苔、紫黑苔、霉酱色苔等。总体而言,痰瘀互结证舌质特点为舌色青、紫、暗,舌苔特点为腻而晦暗、厚而有根,舌下络脉特点为粗胀、迂曲。舌苔厚而有根是痰瘀之“结”的表现。痰瘀互结证的舌象既有两证素组合兼见的表现,又有“结”的特征表现,可以给痰瘀互结证作为一个整体证的研究以启示。

According to the literature of previous dynasties and the understanding of modern scholars,the tongue manifestations of intermingled phlegm-blood stasis syndrome could show both the tongue manifestations of phlegm and that of blood stasis.The tongue diagnosis of blood stasis can be generally diagnosed by tongue body and sublingual veins,and phlegm can be diagnosed from tongue coating.Because the main part in intermingled phlegm-blood stasis syndrome could be phlegm or blood stasis,and they can affect each other,it would show different tongue manifestations.The dry condition of tongue is related to the phlegm and blood stasis which is heavy,and whether body fluid is injured.There are special tongue manifestations with intermingled phlegm-blood stasis syndrome,such as the tongue is blue purple,the tongue coating is gray black,purple black,mildew sauce color,and so on.In general,the tongue body with intermingled phlegm-blood stasis syndrome is characterized by blue,purple and dark tongue color,the tongue coating is characterized by greasy and dark,thick and rooted,and the sublingual veins are characterized by swelling and tortuosity.The intermingling'of phlegm and blood stasis could show thick and rooted tongue coating.The founding that the tongue manifestations of intermingled phlegm-blood stasis syndrome shows that of both the two syndrome elements and the'intermingling'can give enlightenment to the study of intermingled phlegm-blood stasis syndrome as a whole syndrome besides a combination of two syndrome elements.