厚腻苔内涵阐释及临床应用  

Connotation Interpretation and Clinical Application of Thick Greasy Tongue Coating

作　　者：杨光[1] 陈光[1,2] 王阶[1] YANG Guang;CHEN Guang;WANG Jie(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053;Beijing University of Chinese Medicine)

机构地区：[1]中国中医科学院广安门医院 [2]北京中医药大学

出　　处：《中医杂志》2019年第6期472-476,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81673847);中央级公益性科研院所基本科研业务费专项(Z210-013)

摘　　要：厚腻苔是一种复合舌象,是目前人群中较常见的舌苔类型。通过考证其历史沿革,明确其内涵为腻中较厚的舌苔,并总结出舌的自洁作用减弱、舌上细菌增加、吸烟饮酒、发热感染、肿瘤五个厚腻苔形成原因。理论上厚腻苔主痰、饮、水、湿、食积,临床上辨明厚腻苔有助于病邪和病证性质的辨别,疾病病机演变的推测及邪正消亡和胃气存亡的判断。厚腻苔的治疗,不仅可从除湿化痰、消食化滞、泻热解毒等正治之法入手,而且可从补阳退苔、养阴退苔等反治角度论治,临证有大柴胡汤、甘露消毒丹等针对厚腻苔的专方。Thick greasy tongue coating,a combined type of tongue coating,has been an important sort of coating in the contemporary population.By clarifying its evolution in the history,this paper figured out its connotation,which is the thick ones of the greasy coating,and pointed out 5 reasons for its arising such as weakening of self-cleaning effect of tongue,increased bacteria on the tongue,smoking and drinking,fever and infection and tumor.Theoretically,this tongue coating is one of the manifestations of phlegm,fluid,pathological water,dampness,and food accumulation.Identifying thick greasy coating in clinic is helpful for differentiation of pathogenic factors and of disease features,inference of evolution of pathogenesis of disease,and determination of the result of the fight between vital qi and pathogenic qi,survival or downfall of stomach qi.Besides,thick greasy coating could be not only normally treated by dissolving phlegm and eliminating dampness,promoting digestion and resolving stagnation,clearing heat and resolving toxins,but also artfully treated by supplementing yang and enriching yin.Moreover,there are specific prescriptions targeting dropping thick greasy tongue coating,like Dachaihu Decoction(大柴胡汤)and Ganlu Xiaodu Pills(甘露消毒丹).

关 键 词：厚腻苔 舌诊 中医诊断学 正治 反治 

分 类 号：R241.25[医药卫生—中医诊断学]