郁证发微(三十二)——郁证味觉、舌觉异常论

Series of discussion on depression syndrome( 32) : Allotriogeusia and abnormal tongue perception due to depression syndrome

探讨郁证性味觉、舌觉异常的因机证治。味觉异常包括口苦、口甘、口酸、口咸、口辛等,舌觉异常包括舌痛、舌麻、舌干燥、舌强、舌肿满、舌灼热等。郁证性味觉、舌觉异常均为情志病因所致,除了情志类表现外,尚可伴随一系列纷繁复杂的躯体症状;病位多在肝胆、心肾、脾胃;病机、证候以少阳枢机不利、肝郁肝火、肝胆湿热、心虚胆怯、心神不宁、心火、阴虚火旺、心肾不交以及脾胃蕴热为多见;治疗需要各随其证从郁论治,必要时化痰祛瘀。郁证性味觉、舌觉异常可见于现代医学之精神创伤、强迫症、抑郁症、焦虑症、癔病、神经衰弱及与精神因素相关的更年期综合征、灼口综合征等疾病。

This paper mainly discusses the causes,mechanism,syndromes and treatments of allotriogeusia and abnormal tongue perception due to depression syndrome. Allotriogeusia includes bitter taste,sweet taste,sour taste,salty taste,pungent taste in the mouth. Abnormal tongue perception includes glossalgia,numb tongue,dry tongue,stiff tongue,swollen tongue and burning sensation of tongue. Allotriogeusia and abnormal tongue perception due to depression syndrome are caused by emotional factors. In addition to emotional manifestations,a series of complicated somatic symptoms can be observed simultaneously. The disease location mainly involves the liver-gallbladder,heart-kidney and spleen-stomach. And the pathogenesis and syndromes mainly involve depressed lesser yang,liver qi depression,liver fire,dampness-heat of liver-gallbladder,deficiency of heart-gallbladder,disturbance of heart spirit,heart fire,hyperactivity of fire due to yin deficiency,disharmony between heart and kidney and accumulated heat in spleen and stomach. As for the treatment,relieving depression according to different syndromes should be flexibly used. If necessary,it also should resolve phlegm and remove blood stasis. In modern medicine,psychological trauma,obsessive compulsive disorder,depression,anxiety disorder,hysteria,neurasthenia,and menopausal syndrome,burning mouth syndrome and other diseases related to emotional factors may result in allotriogeusia and abnormal tongue perception due to depression syndrome.