舌形诊法在冠心病辨证中的应用

五脏六腑通过经络与舌相联,其中心与舌的关系最为密切。舌象的改变首先反映心的功能状态。望舌形是舌诊的主要内容之一,与舌色和舌苔相比,舌形诊法的客观性更强,更能充分体现机体的生理病理状态。冠心病的基本病机以气、血、阴、阳亏虚为本,以血瘀、寒凝、痰浊痹阻心脉为标。舌体的老嫩可反映冠心病虚实的变化;舌体胖瘦、是否有裂纹能够反映冠心病患者气血津液的盈亏;舌形苍老,舌面有点刺,多提示冠心病痰瘀日久,郁而化热,热毒充斥血分;舌体胖大而滑嫩,舌色淡白,多与冠心病患者命门火衰、水湿阴寒邪气蓄积有关,为阳虚寒凝之证;舌下脉络形状的改变侧重反映血液运行情况,对冠心病瘀血证的诊断具有重要价值。

Application of Tongue Shape Diagnosis in Syndrome Differentiation of Coronary Heart Disease

Internal organs are connected with the tongue through the meridians,and the condition of cardiac function can be reflected by the change of tongue manifestation,as the tongue and heart are quite intimate.Tongue shape inspection is one of the main methods of tongue diagnosis.Compared with tongue color and tongue coating,tongue shape inspection is more objective and fully reflects the physiological and pathological state of the body.In the pathogenesis of coronary heart disease(CHD),Qi,Blood,Yin,and Yang insufficiency are the root causes,and Blood stasis,cold coagulation,turbid phlegm obstructing the heart are the manifestation.The tenderness of the tongue can reflect the excess and deficiency changes of CHD.The figure of the tongue and the existence of cracks can reflect the capacity of Qi,Blood,and Fluid of CHD patients.Tough tongue with prick surface often indicates CHD with long-term Phlegm and Blood stasis,which transformed into heat and flooded into Blood;Smooth and tender plump tongue with pale color mostly related to the decline of vital gate fire and the accumulation of dampness,cold,and pathogenic qi in CHD patients,which is a symptom of Yang deficiency and cold congelation.The change of the sublingual vein shape,however,reflecting the blood circulation,which is of great value in the diagnosis of Blood stasis combined CHD.