中医舌象联合听力学检查对中医耳鸣辨证的初步研究  

Tongue Observation Combined with Audiogram in the Differential Diagnosis of Tinnitus

作　　者：张庆平 宋大桥 楼正才[3] 

机构地区：[1]浙江省义乌市中医医院药剂科,322000 [2]义乌市中医院中医科 [3]义乌市中心医院耳鼻咽喉科

出　　处：《中国全科医学》2012年第30期3548-3550,共3页Chinese General Practice

基　　金：义乌市科技计划资助项目(2010-3-10)

摘　　要：目的探讨中医舌象联合听力学检查对中医耳鸣辨证的作用。方法选择传统中医辨证为风热侵袭、肝火上扰、痰火郁结、脾胃虚弱、肾精亏损5个证型的53例主观性耳鸣患者,分别由西医医师进行舌象观察及纯音测听和声导抗检查。结果各证型中风热侵袭型均表现为舌淡、苔薄白或薄黄;肝火上扰型中有12例表现为舌深红、苔黄,1例表现为舌淡、苔薄白或薄黄;痰火郁结型均表现为舌深红、苔黄;肾精亏损型均表现为舌淡红、苔薄白;脾胃虚弱型中有14例表现为舌淡红、无苔。不同证型鼓室导抗图差异无统计学意义(P>0.05)。听力图显示风热侵袭型突出表现为全频听阈升高,平坦型曲线占7/9;肝火上扰型表现为高频听阈升高,陡降型曲线占9/13;肾精亏损型表现为低、高频听阈升高,显降型和山型曲线各占4/9、3/9;痰火郁结型表现为中、高频听阈升高,缓降型和陡降型曲线各占2/7、3/7,脾胃虚弱型表现为中、高频听阈升高,陡降型和切迹型曲线各占5/15、4/15。结论中医舌象联合听力图可能对西医医师进行中医耳鸣辨证具有一定的指导意义。Objective To evaluate the role of tongue observation combined with audiogram in the differential diagnosis of tinnitus. Methods Totally 53 patients （53 ears） with tinnitus were differentiated into five syndrome patterns based on traditional Chinese medicine （TCM） theory ： invasion of wind - heat, up - stirring of liver fire, stagnation of phlegm - fire, weak- ness of spleen - stomach, and kidney - essence deficiency. Tongue observation and audiogram were performed in all cases. Re- suits The patients with different syndrome patterns showed characteristic tongue pictures. Audiogram types were significantly different in these five groups （ P 〈 0. 05 ）. Conclusion Tongue observation combined with audiogram can provide valuable information for the differential diagnosis of tinnitus.

关 键 词：耳鸣 舌象 鼓室图 听力图 

分 类 号：R241.2[医药卫生—中医诊断学]