口臭中医证治相应关系的研究

目的探寻基于临床研究证据的口臭中医证治相应关系,为中医治疗口臭和规范化治疗提供借鉴。方法借鉴流行病学和循证医学的思路方法,开展口臭的中医文献研究,梳理口臭证型分布特点及每一证型的用药规律。结果入选的42篇文献中共涉及规范后中医证型28种,前6位的依次是脾胃湿热证、湿热内蕴证、胃火炽盛证、胃肠食积证、肝火犯胃证、肺热证。脾胃湿热证、湿热内蕴证用药中有6味是相同的,即藿香、佩兰、茵陈、黄芩、半夏、甘草;胃火炽盛证、肝火犯胃证用药以黄连、黄芩、陈皮、甘草为共性药物;胃肠食积证以焦三仙、茯苓,肺热证以桑白皮、地骨皮为针对性用药。结论口臭发病实证以湿热为主,虚证以阴虚为主,主要责之于脾胃;在今后口臭的辨证论治中可考虑以用药集中的中药为该证的基础方,在此基础上随证加减,以治病求本为原则。

Correlative Study on Halitosis Treated with Pattern Differentiation of Traditional Chinese Medicine

Objective To explore the correlation of pattern differentiation of TCM in treatment of halitosis based on clinical study evidence so as to provide the reference for the standardized treatment. Meth- ods In reference to the ideas on epidemiology and evidence -based medicine,the Chinese medicine litera- ture study on halitosis was conducted. The pattern distribution characters and the medicinal law for each pat- tern of halitosis were collected and analyzed. Results Forty - two literatures were selected and found that 28 standard patterns of Chinese medicine were involved. The top 6 patterns were spleen and stomach damp heat, internal accumulation of damp heat, excessive stomach fire, gastrointestinal food accumulation, liver fire attac- king stomach and lung heat. The six same herbs were used in the treatment of spleen and stomach damp heat, internal accumulation of damp heat, named, agastache rugosus, eupatorium, herba artemisiae capillariae, scutellaria baicalensis, pinellia ternata and liquorice. Rhizoma coptidis, radix scutellariae, pericarpium citri re- ticulatae and liquorice were the common herbs in the treatment of excessive stomach fire and liver fire attac- king stomach. The scorched malt, hawthorn fruit and mediccated leaven, and poria cocos were used for gastro- intestinal food accumulation. Cortex mori and cortex lycii radicis were for lung heat specifically. Conclusion Excess damp heat and yin deficiency are differentiated in halitosis ,with the spleen and stomach involved. The related herbs can be used and the basic formulas be modified in accordance with pattern differentiation and focus on the treatment of the root cause of disease.