Dry mouth is a common clinical symptom, which refers to the state or feeling of dry mouth caused by decreased saliva secretion. Relevant statistics show that the prevalence of dry mouth is about 5.5% to 46%, and it increases with age. In the elderly population over 65 years old, the proportion of dry mouth patients can rise to 30% to 40%. Xerostomia seriously affects the quality of life of patients.
In western medicine, "dry mouth" is a symptom of a certain disease, which is more common in the elderly and women, and is common in Sjogren's syndrome, diabetes, hyperthyroidism, radiation dry mouth and other diseases. Its treatment is mainly etiological treatment and artificial saliva. However, many people do not have these diseases after examination, but they still have symptoms of dry mouth, which cannot be alleviated after treatment.
Dry mouth belongs to the category of "Sjogren's syndrome" in the name of traditional Chinese medicine. Different from modern medicine, Chinese medicine believes that as long as there are lesions in the large intestine, spleen, stomach, heart, kidney meridian or viscera, it will affect the oral cavity or tongue, lips, pharynx and other related organs. Le Qisheng's team of Chinese medicine believes that dry mouth is a manifestation of imbalance between qi and blood and yin and yang in the oral cavity, including yang deficiency, yin deficiency, qi deficiency and blood stasis.
Treating xerostomia from Yang Deficiency
Distinguishing dry mouth from yang deficiency, on the one hand, kidney yang deficiency, poor qi movement and persistent qi movement; On the other hand, spleen-yang deficiency leads to exhaustion, dysfunction of body fluid, stagnant water and dampness, and dry mouth.
We know that water on the ground becomes gas and clouds through transpiration and gasification of the sun. Gas condenses into water in the air, and after reaching a certain weight, it will fall again under the action of gravity and other factors. The running process of water and liquid in human body is very similar to the natural water cycle.
Body fluid is transported from the spleen to the lung, and then injected into the bladder through the water channel of the lung. When the sky is cold, water falls to the ground, just like the spleen in the human body transports water to the lungs and then transports the gas cooled by lung gold to the bladder. Water from spleen to lung depends not only on the transport function of spleen, but also on the transpiration of kidney yang, both of which are indispensable.
Clinically, people with yang deficiency and dry mouth often have too much phlegm and thick and greasy fur. Although they are thirsty, they don't want to drink water or even hot water. Treatment: the method of warming yang and transforming qi, transforming drinking and benefiting water.
Treating xerostomia from Yin Deficiency
The spleen opens in the mouth, and its flowers are in the lips. The spleen yin is insufficient, the stomach is rotten, the Shui Gu function is limited, and the body fluid is insufficient, so dry mouth occurs; Le Qisheng's Chinese medicine team believes that with the increase of age, kidney qi gradually weakens, while liver and kidney are homologous, kidney deficiency will naturally affect the liver, and the liver will also affect the transport and transformation function of the spleen.
Therefore, dry mouth due to yin deficiency is mainly caused by yin deficiency of liver and kidney, inflammation of deficiency fire and burning body fluid by fire. Dry mouth due to yin deficiency is more common in the elderly. In addition to dry mouth, there will be symptoms such as waist and knee pain, mental fatigue and constipation. Treatment: nourishing yin and clearing heat.
Treating xerostomia from Qi Deficiency
Deficiency of spleen-qi leads to fluid failure, which is the basic pathogenesis of dry mouth in modern people. The transport and excretion of body fluid depend on the rise and fall of qi. Spleen and stomach are the source of qi and blood biochemistry, and the source of body fluid depends on the diet ingested by human body and the good metabolism of spleen and stomach. If the spleen and stomach are deficient in qi and body fluid, it will lead to insufficient saliva secretion and dry mouth.
It is said in the theory of pathogenic stages of dry mouth caused by fatigue that "this is caused by qi and blood failure, separation of yin and yang, insufficient cold and heat, heat generated by upper energizer, and dry mouth". It can be seen that the occurrence of dry mouth is closely related to qi deficiency, which leads to dereliction of duty in transportation and transformation and loss of body fluid, so dry mouth is seen. Treatment: invigorating spleen and benefiting qi
Treating xerostomia from blood stasis
The Theory of Blood Syndrome also puts forward that "if there is blood stasis, qi is blocked by blood, and body fluid can't rise with it", "if there is blood stasis, qi can't flow and can't rise with body fluid" and "if there is blood stasis, there is no thirst", which reveals the pathogenesis of dry mouth caused by blood stasis.
Blood stasis is not only an important cause of dry mouth, but also a pathological product produced in the process of disease, which is accompanied by the occurrence, development and prognosis of dry mouth. Treatment: promoting blood circulation and removing blood stasis.
Traditional Chinese medicine has great advantages in treating xerostomia. The most important thing in clinic is to treat xerostomia based on syndrome differentiation, which is not limited to thinking and conventional methods, and truly achieve "syndrome differentiation and treatment" and finally recover the disease. However, it should be noted that the pathogenesis of some patients in clinic is complex, with excess and deficiency mixed, deficiency and blood stasis combined, and multiple disease sites coexist. At this time, if we only treat it from the above pathological factors, we often can't achieve its effect; We should examine the syndrome, seek the cause, treat the disease before it happens, and adjust the triple energizer.
Case study:
Patient Mr. Li Lao, 68 years old, was first diagnosed in June 19. 1 year ago, the patient complained that there was no obvious inducement and his mouth was sticky, especially at night. I went to other hospitals for many times to rule out diseases such as diabetes, hyperthyroidism, Sjogren's syndrome and tumor, but the symptoms did not improve significantly after treatment, so I came to see a doctor.
Preliminary diagnosis: dry mouth is obvious at night, accompanied by light mouth, sometimes dizziness, cough, cough with white phlegm, and sleep is ok. The tongue is red and the coating is white and thick. Pulse strings are all wet, which is heavier than heat, indicating that phlegm-dampness is internal resistance and qi does not transform body fluid. The treatment is to strengthen the spleen and promote qi circulation, eliminate dampness and resolve phlegm. Prescription: Pericarpium Citri Tangerinae, Rhizoma Pinelliae Preparata, Poria, Rhizoma Atractylodis, Rhizoma Atractylodis Macrocephalae, Rhizoma Coptidis, Trichosanthis Radix, Herba Pogostemonis, Radix Scrophulariae, Fructus Canarii Albi, Scorpio, Scutellariae Radix, Hypericum perforatum and Glycyrrhrizae Radix, 15, 1 daily, and decocted.
After the second diagnosis, the patient complained that the dry mouth was less than before, and instead it was aphtha, swelling and pain of lower limbs, short and red urine, loss of appetite, pale mouth, restless night sleep, dry stool, red tongue, thick greasy yellow fur and thready pulse. Considering that after taking the medicine, the dampness gradually becomes turbid, and internal heat begins to appear, and the damp heat is steamed together, which becomes a disease. Therefore, the treatment is to eliminate dampness and clear heat and promote triple energizer. Prescription: Semen Armeniacae Amarum, Semen Amomi Rotundus, Coicis Semen, Rhizoma Pinelliae Preparata, Cortex Magnolia Officinalis, medulla Tetrapanacis, Talcum, Rhizoma Coptidis, Trichosanthis Radix, Herba Agastaches, Fructus Canarii Albi, Semen Ziziphi Spinosae, and Glycyrrhrizae Radix, 14 dose, 1 dose/day, decocted in water.
Three diagnosis: After taking the medicine, the patients' lower limb pain was relieved, and the symptoms of dry mouth were further alleviated. Mulberry leaves 1, Rhizoma Phragmitis and Eupatorium adenophorum were added to the original prescription. Activating spleen and eliminating dampness, clearing away heat and promoting fluid production. Follow-up treatment with methods of invigorating spleen and eliminating dampness and invigorating spleen and benefiting qi has eliminated the symptoms of dry mouth.
Although dry mouth will not endanger life and health, it will also bring great trouble to life. However, it should be noted that many diseases will also be accompanied by dry mouth symptoms, such as diabetes and hyperthyroidism. Therefore, when treating dry mouth, you should not take medicine at will. It is necessary for doctors to treat dry mouth based on syndrome differentiation, clarify the cause, prescribe the right medicine, and improve the symptoms of dry mouth from the root.
I hope that the above related expressions can benefit more friends, and friends who need dialectical guidance can also click on my avatar to send private messages.