136例胸痹(气阴两虚兼血瘀证)患者舌象观察  

Tongue Observation on 136 Cases of Chest Stuffiness and Pains Patients with Qi and Yin Deficiency and Blood Stasis Syndrom

作　　者：陈岩[1] 杨关林[1] 张会永[1] 罗智博[1] 张哲[1] 

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《中华中医药学刊》2009年第3期478-480,共3页Chinese Archives of Traditional Chinese Medicine

摘　　要：目的:通过观察胸痹心痛(气阴两虚兼血瘀证)患者经治疗症状缓解前后的舌象,探讨胸痹心痛(气阴两虚兼血瘀证)患者舌象的特征性表现,及其临床演变规律。方法:选取中医诊断符合胸痹心痛气阴两虚兼血瘀证,西医诊断符合冠心病不稳定型心绞痛的住院患者共计136例。观察经治疗症状缓解前后的主症、次症、舌象等,分别给予赋值记录,进行符号秩和检验。结果:胸痹心痛气阴两虚兼血瘀证(不稳定性心绞痛)以红舌、绛舌为主,在病情发作期间,以绛舌为主;经治疗缓解后,舌色逐渐变淡,以红色为主。舌苔在病情发作期间,以黄厚燥苔为主,少苔所占比重不足30%;经治疗缓解后,厚苔逐渐变薄,颜色变白,燥苔也有不同程度改善,少苔患者舌苔也逐渐生长。此外,此类患者舌体胖大者居多,少数为瘦小舌,40%以上患者舌体伴有齿痕,30%以上伴有裂纹。治疗后,齿痕、裂纹未见明显减少。结论:胸痹心痛(气阴两虚兼血瘀证)舌象:舌体胖大、舌质红绛、苔黄厚燥,可见齿痕或裂纹。病情缓解后,舌质变淡,舌苔变白变薄变润,呈现一定的规律。Objective： By observing tongue pictures of patients with Chest Stuffiness and Pains before and after improvement of symptoms after therapy, in order to investigate the characteristic features, finally to explore the specific rule of characteristic changes of tongue pictures before and after improvement of symptoms after therapy. Methods ： Cases according with Chest Stuffiness and Pains of deficiency of both qi and yin with Blood stasis from TCM diagnose and unstable angina pectoris from Diagnostic Criteria, strictly corresponding to inclusion criteria and inclusion criteria, totally coming to 136 incidents. Main symptoms,secondary symptoms, tongue pictures of included patients before and after improvement of symptoms after therapy were recorded in detail, then the main symptoms and secondary symptoms were given value assignment and marks ,finally the database of the patients symptoms was established. The database got introduced into statistical software SPSS 15.0, and carried out Wilcoxon Matched-pairs Signed-ranks Test. Results ： Chest Stuffiness and Pains of deficiency of both qi and yin with Blood stasis（ unstable angina） mainly red tongue and crimson tongue, at the onset of the disease mainly crimson tongue;after therapy the symptoms gradually improved and the tongue color also gradually became light,mainly red tongue. At the onset of the disease tongue coating mainly yellow thick and dry fur,the proportion of the less fur less than 30% ;after therapy with the improvement of the symptoms, thick fur gradually thinned out, the color of tongue coating gradually turned white, dry fur also had improvement in various degrees ,tongue coating of patients with less fur also gradually grew out. In addition, in such patients the large fat tongues were primary, a few were little thin tongues, more than 40% tongue body accompanied with indentation, more than 30% accompanied with crack. After therapy, indentation and crack were seen no evidently reduced. Conclusion ： The tongue pictures of Chest Stuffiness and

关 键 词：胸痹 心痛 舌诊 舌象 气阴两虚兼血瘀 冠心病 不稳定型心绞痛 

分 类 号：R256.22[医药卫生—中医内科学]