对主诉“上火”者中“已病”舌象的观察与思考  

Observation and Thinking of Diseased Tongue among Shanghuo(Heatiness) People

作　　者：梁嵘[1] 陈冬宁[2] 王召平[2] 李丹溪[1] 姚叙莹[1] 田丁[1] 王盛花[2] 

机构地区：[1]北京中医药大学中医诊断系,北京100029 [2]首都医科大学附属北京同仁医院体检中心,北京100730

出　　处：《世界科学技术-中医药现代化》2015年第10期2020-2023,共4页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家科学技术部973计划项目(2011CB505402):中医思维认知科学研究;负责人:王志良;国家科学技术部973计划项目(2011CB505404):中医健康状态自我报告-脏腑经络辨识法研究;负责人:杨志敏

摘　　要：目的:探讨主诉为"上火"时出现"已病"舌象的诊断意义。方法:以303例主诉"上火"的案例为基础,分析"已病"舌象与问诊资料的关联性。结果:1所有案例中,53.14%的"上火"者具有2个以上的"上火"诱因。复合诱因以不内外因(饮食因素、劳累)与内因(压力大、情绪不好)的组合为多见。当多个"上火"诱因同时存在时,舌象表现为"已病"的机率明显增加;2 29.95%"上火"者为经常上火,其舌象表现为"已病"的机率明显增加。结论:当舌象表现为"已病"时,多已不是"欲病"的上火,而属"已病"的中医热证。在中医体检中,有效地区分"欲病"与"已病"十分重要,而"已病"舌象是区分两者的重要依据。This study was aimed to discuss the diagnosis significance of the diseased tongue demonstration in Shanghuo（heatiness） people. Based on 303 Shanghuo cases, the relevance of diseased tongue demonstration and inquiry data were analyzed. The results showed that 53.14% Shanghuo cases had at least more than 2 Shanghuoinducing causes. The most common inducing cause combinations were pathogenic factors neither endogenous nor exogenous（unbalanced diet, overworked） and internal factors（over stressed, emotional）. When there were several Shanghuo causes occurred at the same time, the probability of appearing diseased tongue demonstration increased significantly. There were 29.95% Shanghuo cases occurred Shanghuo experience frequently. And in these cases, the probability of appearing diseased tongue demonstration increased significantly. It was concluded that when Shanghuo people had diseased tongue demonstration appeared, it was not merely just ＂is going to get ill＂, but was already suffering from heat syndrome. In traditional Chinese medicine（TCM） physical examination, to effectively differentiate ＂is going to get ill＂ and ＂being ill＂ was initially important. And the diseased tongue demonstration was a crucial diagnostic basis.

关 键 词：治未病 上火 舌诊 已病 病因 

分 类 号：R441[医药卫生—诊断学]