舌下絡脈在現代醫學的臨床意義：文獻回顧

舌診是中醫四診及辨證論治的重要指標之一。舌下絡脈出現怒張、分支、瘀點都是血瘀證的徵候，但舌下絡脈的分級方式多元尚未有定論，臨床意義也尚未有完整的探討。本文藉由搜尋PubMed、華藝線上圖書館、中國期刊全文數據庫、臺灣期刊論文索引系統、臺灣博碩士論文知識加值系統等中英資料庫，從1980至2020年11月共1143篇文獻，從中篩選出28篇文獻，以文獻回顧的方式探討舌下絡脈之定義，觀察特徵，脈變化之病理及臨床應用。研究顯示舌下絡脈曲張與心血管疾病有顯著相關，其中對高血壓有較高的特異性。舌下絡脈的嚴重程度與肝纖維化程度成正比，亦能篩檢罹患肝癌的高風險族群，而舌下絡脈的嚴重度分級、寬度、顏色都與肝癌臨床分級呈現正相關，因此也可作為肝癌患者追蹤病情變化的指標。舌下絡脈亦和癌症、自體免疫疾病、婦科疾病有相關性，但仍須更多研究文獻佐證。舌下絡脈可以作為中醫臨床辨證的客觀指標及血瘀證的診斷依據。

關鍵字

舌診；舌下絡脈；舌下靜脈曲張；血瘀證

並列摘要

Tongue diagnosis is one of the most important indicators among the four examinations and pattern identification and treatments of Traditional Chinese Medicine (TCM). Abnormal sublingual vein with petechiae, branches or engorged blood vessels are characteristics of blood stasis pattern. However, no agreement has been established on the grading methods and clinical significance of the sublingual vein. The aim of this study was to review the clinical literatures published in PubMed, Airiti Library, Chinese Academic Journals Full-text Database, PerioPath Index to Taiwan Periodical Literature System, National Digital Library of Theses and Dissertations in Taiwan and other Chinese and English electronic databases, between 1980 and November 2020. Overall, 28 clinical literatures were selected to explore the definition, pathological mechanism, characteristics and applications of sublingual vein in modern medicine from 1140 articles. The results showed that sublingual vein is significantly related to cardiovascular disease and are highly specific to hypertension. The severity of the sublingual vein is also positively correlated with the degree of liver fibrosis and is used to screen the high-risk patients and serves as a prognostic indicator of hepatoma. Few studies have also reported that sublingual vein is related to cancer, autoimmune disorders and gynecological diseases. The sublingual vein can be used as objective indicators of blood stasis syndrome in TCM. Further investigation to explore different populations and clinical diseases are suggested in the future.