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探討《溫病條辨》中口腔各部位乾燥之診斷分析

A Literature Review of Investigation the Dryness of the Oral Cavity from the Wen-Bing-Tiao-Bian

摘要


口乾之症狀影響全球約四分之一人口,其症狀可大大影響患者生活品質,在西醫中以口乾症作命名,在中醫典籍中最早從今本《黃帝內經》起即有對於口乾症狀描述,於唐《千金翼方》中更分類出消渴篇章對於此症狀及用藥有更多了解,於明清時期口乾論述廣泛出現於典籍中,其中在《溫病條辨》中口乾、渴的症狀開始大量出現於書中,《溫病條辨》為清代醫家吳鞠通撰寫,其著作以三焦辨證為綱領,系統化統整出多種溫熱病類型,敘述溫病的病因、分類、傳變及預後。本文針對《溫病條辨》文中針對口、唇、舌、咽等口腔各解剖部位的乾燥,作三焦、衛氣營血及方劑分析與探討,內容包含各條文中三焦歸類、症狀與方劑衛氣營血及其他層次歸納分析、探討上、中、下三焦病位及病程如何辨別,及口渴、渴不欲飲水層次區別,特殊邪氣影響層次範圍,最後歸納出面對溫邪造成口乾時其臨床診斷路徑如何著手,提供未來醫者在溫熱病範疇中口乾的臨床診斷的想法與參考。

關鍵字

吳鞠通 溫病條辨 口乾 文獻探討

並列摘要


Dryness in the mouth affects about a quarter of the world's population, and the symptom significantly affect the quality of life of patients. Dryness in the mouth also called xerostomia in western medicine, and the symptom significantly influenced patient's quality of life. The symptom of dry mouth has been mentioned in Huangdi Neijing first. There were some section which described emaciationthirst disease in Supplement to Thousand Ducat Formulas written in Tang dynsaty. The description of dry mouth and thirsty widely used in Ming and Qing dynasties, especially in the Wen-Bing-Tiao-Bian. Wen-Bing-Tiao-Bian, written by Wu Ju Tong at Qing dynasty, systemically integrates various kinds of warm-heat evils and describes the cause, classification, transmission and prognosis of the warm diseases. This article analyzes the dryness of the mouth, lips, tongue, pharynx, and discusses the relation of triple burner and Wei-Qi-Ying-Xue level of warm diseases at different oral parts. The content inherits the tradition of Wen-Bing-Tiao-Bian and also concludes the clinic thinking process of how to approach and diagnosis oral dryness by triple burner and Wei-Qi-Ying-Xue theory and we expect to provide different idea for clinical use.

參考文獻


Millsop JW, Wang EA, Fazel N. Etiology, evaluation, and management of xerostomia. Clinics in dermatology. 2017; 35(5): 468-76.
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Agostini BA, Cericato GO, Silveira ERd, Nascimento GG, Costa FdS, Thomson WM, et al. How common is dry mouth? Systematic review and meta-regression analysis of prevalence estimates. Brazilian dental journal. 2018; 29(6): 606-18.
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