肾虚所致口苦论治  

Treatment of Bitterness in Mouth Due to Kidney Deficiency

作　　者：陈沛霖 孟冬 吴圣贤[1] 杨惠民[1] CHEN Peilin;MENG Dong;WU Shengxian;YANG Huimin(Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《山东中医药大学学报》2022年第6期694-697,共4页Journal of Shandong University of Traditional Chinese Medicine

基　　金：国家科技重大专项课题(编号:2017ZX09304019);国家科技重大专项子课题(编号:2017ZX09304019001)。

摘　　要：口苦常见于肝胆、脾胃及心系疾病,传统中医理论对于口苦多从肝胆、脾胃论治,病机多为湿热弥漫三焦,热邪犯脾胃、肝胆,心火上炎引起口中泛苦。通过分析口苦的病因病机、处方用药规律、现代实验研究,发现部分患者的口苦可由肾气亏虚所致,肾气亏虚则唾液分泌减少,致口干、口苦。肾阴虚口苦治以补益肾阴,可选用既济汤、醴泉饮等方;肾阳虚口苦,当以温补肾阳为主,可选用天雄散、附子理中汤。临床不能凡见口苦即断热证,需四诊合参,辨清其本质,方能获得良效。Bitterness in mouth is common in diseases of liver and gallbladder,spleen and stomach,as well as heart system disease.In the theoretical research of traditional Chinese medicine,bitterness in mouth is mostly treated from liver and gallbladder,spleen and stomach.The pathogenesis is mostly dampness-heat permeating triple energizer,heat pathogen invading spleen and stomach,liver and gallbladder,and up-flaming of heart fire causing bitterness in mouth.In this paper,by analyzing the etiology and pathogenesis,prescription and medication regularities and modern experimental study,it is found that bitterness in mouth in some patients can also be caused by kidney qi deficiency,which decreases the saliva secretion resulting in dryness and bitterness in mouth.Bitterness in mouth due to kidney yin deficiency should be treated with nourishing kidney yin,Jiji Decoction(既济汤),Liquan Fluid(醴泉饮)and other formulas might be used.Bitterness in mouth due to kidney yang deficiency should be treated with warming and tonifying kidney yang,Tianxiong Powder(天雄散)and Fuzi Lizhong Decoction(附子理中汤)might be used.Clinically,bitterness in mouth couldn’t be diagnosed as the heat syndrome directly,which should be compre-hensively analyzed with four examinations to diffe-rentiate the essence so as to achieve good effects.

关 键 词：口苦 口干 肾虚 肾阴虚 肾阳虚 唾液减少 肝胆实火 脾胃湿热 

分 类 号：R241.4[医药卫生—中医诊断学]