How to see health from the tongue
1, mirror tongue
That is, the tongue is not coated and smooth as a mirror. Mild malnutrition, or lack of iron or vitamin B2; If it is serious, it means that the body fluid is insufficient and the condition is serious.
If the mirror tongue of a patient with a long illness is crimson, it is also necessary to prevent sepsis. If the old man's tongue is as smooth as a mirror, the two veins at the base of the tongue become thicker and longer, indicating that he has cor pulmonale.
2. Cow tongue
It is that the tongue is dark red and the tongue coating is peeling off like beef. Cow tongue is common in patients with pernicious anemia.
People who eat corn and sorghum for a long time are prone to lack nicotinic acid, leading to memory loss and Alzheimer's disease.
Step 3 hit your tongue
It means that there are many red prickles on the tongue surface, like the fruit of grass mold. Puncture holes appear on the tip of the tongue or the edge of the tongue, indicating that the heat is abundant, which can be seen in patients with various febrile infectious diseases or large-area burns; Puncture in the tongue is mostly due to more toxic heat or heat entering the blood, which is easy to shock and coma.
People who suffer from insomnia, constipation or high pressure at night, as well as vitamin deficiency, malnutrition and cerebral cortex dysfunction, will also have red thorns on their tongues.
4. cracked tongue
Lingual cracks include deep cracks, shallow cracks and cracks and wrinkles in different directions. Shallow fissure of tongue surface is mainly due to atrophy of tongue mucosa, while deep fissure is a more serious atrophic lesion of tongue.
5. Express with your heart and words
That is, there is a small blank in the middle of the tongue coating, and the tongue coating has fallen off, which often indicates the lack of nutrition in the body.
A trembling tongue
Involuntary tremor occurs when the tongue is extended, which can be seen in high fever, hyperthyroidism, hypertension and some nervous system diseases.
Nongshe
Repeatedly sticking your tongue out of your mouth and licking your lips is called wiping your tongue. Heat in the heart and spleen, premonition of moving wind or mental retardation in children. The difference between tongue extension and tongue manipulation is that the former is difficult to extend and retract, while the latter can extend and retract, but repeatedly retract and spit out the tongue.
6. Stiff tongue
The tongue is neither swollen nor contracted, but tough, losing its usual softness and elasticity, also known as "strong tongue". "Strong tongue" is common in some serious diseases, such as coma and convulsion.
A few local factors on the tongue, such as severe tongue ulcer or the accumulation of hard and thick fur on the tongue, make the tongue rotation inflexible, but it is easy to distinguish it from tongue stiffness caused by central nervous system diseases.
Teach you how to read your tongue to know your health.
Tongue vibration: stick out your tongue in front of the mirror. If your tongue vibrates slightly, it is probably a sign of mental stress and physical decline.
Suggestion: adjust the schedule as soon as possible and eat reasonably, otherwise you will soon face the danger of neurasthenia!
Purple tongue: when the blood contains a lot of waste and the water supply in the body is insufficient, the oxygen-deficient blood and oxygen-containing blood will be mixed together, making the blood vessels turn purple. If you feel stiff shoulders and backache besides purple tongue, it means that too much toxin has been deposited in your body!
Suggestion: stick to a light diet for a week, keep regular light aerobic exercise, and the toxins will be discharged quickly.
Too thick tongue coating: the tongue coating is as easy to be scraped off as tofu residue, which may be caused by gastrointestinal dysfunction or overeating.
Suggestion: It's best to go to the gastroenterology department and let the doctor help you reduce stomach fire.
The tongue coating is too thin: the tongue coating falls off inexplicably and the color of the tongue surface is mottled and uneven, which is called "map tongue" in medicine. Korean medical experts pointed out that people with allergies are most likely to have this situation, especially in spring and autumn. The appearance of "map tongue" shows that your resistance is declining.
Suggestion: stay away from allergens such as pollen and small insects during this time.
Yellowing of tongue coating: Yellowing of tongue coating is probably a signal of cold virus invasion.
Suggestion: eat more pumpkin isothermal food to prevent bacterial invasion.
Black tongue coating: the tongue coating is light black, which may be the reason for the increase of body temperature.
Suggestion: Taking a hot bath and doing some relaxation exercises can effectively lower the body temperature.
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abstract
Anatomical organs of the same name. Also known as spirit root and obsession. Located in the mouth. Should be in the heart, taste. It is closely related to swallowing and pronunciation. "Lingshu Pulse Degree": "The heart and qi pass through the tongue, and the heart and the tongue can know five flavors." Soul pivot: "the opportunity of tongue and sound." The root of the tongue is called a tongue book; The tip of the tongue is called the tip of the tongue; The sides of the tongue are called the sides of the tongue; The tendon of the tongue root is called the tongue system; The middle of the tongue is called the middle of the tongue. Observing the color, quality, shape and coating of tongue is one of the important contents of TCM inspection.
Tongue diagnosis: diagnostic terminology. It is one of the key contents of the visit. Important objective indicators of TCM disease diagnosis. The tongue is the seedling of the heart, waiting outside the spleen, and the coating is born of stomach qi. Zang-fu organs are connected with tongue through meridians. The difference between the hand and the tongue is the root of the tongue, the foot pulse of Shaoyin is the root of the tongue, the foot pulse of Jueyin is the root of the tongue, and the foot pulse of Taiyin is connected with the root of the tongue, so the pathological changes of viscera can be reflected in the tongue quality and tongue coating. Tongue diagnosis is mainly to investigate the shape, color and dryness of tongue quality and tongue coating, so as to judge the nature, depth and rise and fall of qi and blood of the disease. Cao Zhangbing's Guide to Distinguishing Tongue: "Distinguishing the quality of tongue can distinguish the deficiency and excess of viscera, and depending on the coating of tongue, we can observe the depth of six evils." Tongue diagnosis should combine tongue quality, tongue coating and syndrome differentiation. Generally speaking, the pathological changes reflected by the two are the same, but there are also inconsistencies, which need comprehensive analysis and measurement, and refer to other syndromes to make a correct judgment.
anatomical structure
Tongue is an organ composed of skeletal muscle, with mucous membrane on the surface of the bottom of the mouth, which is covered with mucus. The muscles inside are arranged in three different directions, so it can move flexibly.
Muscle organs in the mouth are covered with mucous membranes, and the protrusions on them are called the back of the tongue. Tongue can be divided into three parts: root, body and tip. There are many small nodular protrusions on the mucosa of the tongue root surface, which are called lingual tonsils. There are many protrusions with different thicknesses on the surface of the tongue, which are called lingual papillae. Some of them contain taste buds in the tongue papilla epithelium, which can feel the taste. Under normal circumstances, the epithelium is slightly keratinized and exfoliated. Keratinized epithelium, exfoliated epithelium filled in the nipple space, saliva, food crumbs, white blood cells, etc. Form a normal thin and white tongue coating. Traditional Chinese medicine often observes tongue coating as a reference for diagnosis. The sublingual mucosa is thin and smooth, and there is a mucosal fold in the center connected with the floor of the mouth, which is called lingual frenulum. Tongue muscle is a kind of skeletal muscle, which is very flexible and participates in chewing, swallowing and assisting language activities.
Tongue-related diseases and their clinical treatment
Tongue cancer: The tongue is prone to malignant tumors, so lymphatic drainage of the tongue is particularly important. Malignant tumor on the back of tongue metastasized to bilateral superior cervical deep lymph nodes; However, the malignant tumor in the front of the tongue did not metastasize to the deep cervical lymph nodes until the late stage. Because these lymph nodes are close to the internal jugular vein, tongue metastases can spread widely along the internal jugular vein in the submental triangle and mandibular triangle. It is a malignant tumor that occurs in the mucosa of the tongue. Most of them are squamous cell carcinoma. Most of the lesions occurring at the base of tongue are related to precancerous lesions of poorly differentiated squamous cells. Most of them occurred at the edge of tongue 1/3, and most of them were ulcer type and infiltration type. There is infiltration around, which can cause tongue movement disorder and affect language, chewing, swallowing and eating. There is a smell of cancer. Regional lymph node metastasis is early and the metastasis rate is high. Biopsy can make a definite diagnosis. The comprehensive treatment effect is good, and radiotherapy, chemotherapy and surgery can be used. Surgical treatment includes partial glossectomy, hemiglossectomy, subtotal glossectomy, total glossectomy and combined radical operation of tongue, jaw and neck. Tissue defect can be repaired with pedicled flap or free flap.
Diagnostic points
(1) generally occurs at the lateral margin of the tongue 1/3, with local ulcer or infiltration and spontaneous pain.
(2) Generally, it has a high degree of malignancy, rapid growth and strong infiltration, and often involves the lingual muscles and hypoglossal nerves, resulting in limited tongue movement and difficulty in speaking, eating and swallowing.
(3) Late invasion of the floor of the mouth is difficult to distinguish from primary invasion of the tongue by cancer of the floor of the mouth.
(4) Chronic stimuli often exist in the corresponding parts of tumors, such as the residual roots of teeth or sharp marginal ridges; Precancerous lesions such as leukoplakia may also occur.
(5) Early cervical lymph node metastasis often occurs in tongue cancer, especially in the upper and middle cervical lymph nodes; You can also transfer by leaps and bounds. Metastasis to the lungs further away.
(6) Tumor biopsy can confirm the pathological nature.
treat cordially
(1) Primary focus with limited tumor range, superficial appearance, good differentiation and small invasion. Local surgical resection or cryotherapy and laser therapy can be performed; If the infiltration is large, radiotherapy can be used to control the primary focus first, and then neck lymph node dissection can be performed; Advanced tongue cancer or tongue root lesions should be treated mainly by surgery, supplemented by radiotherapy and chemotherapy.
(2) Cervical lymph nodes should be treated or selectively cleaned.
(3) If the tongue defect is greater than 1/2, tissue transplantation should be performed for glossoplasty.
(4) Chinese medicine treatment:
1. stagnation of fire and upward attack: the tongue becomes thicker or harder, such as beans resembling bacteria; Or erosion, sudden lotus. Unbearable pain, salivation and foul smell, anxiety and insomnia, yellow urine, yellow fur and rapid pulse. Treatment: clear heart and reduce fire, detoxify and remove blood stasis. Prescription: Daochi Powder is added with Coptidis Rhizoma, Gardenia, Taraxacum, Radix Curcumae, Radix Sophorae Tonkinensis, Herba Hedyotidis Diffusae and grape branches.
2. Fire injures Yin: purple and red tongue, swelling and pain, ulceration and foul smell, inconvenient rotation, food obstruction, body heat and thirst, emaciation, yellow and thick fur, and slippery pulse. Treatment: clearing away heat and toxic materials, purging fire and nourishing yin. Prescription: Cool Ganlu Drink with Radix Sophorae Tonkinensis, Shā rotto Katakuri and Radix Gentianae.
3. Deficiency of both qi and blood: short tongue, inability to rotate, difficulty in eating, difficulty in language, emaciation, palpitation and shortness of breath, mental fatigue or fatigue, insomnia, thin and white fur and weak pulse. Treatment: invigorating the heart and spleen, benefiting qi and nourishing blood. Prescription: Guipi Decoction. Seaweed and kelp are added for swollen neck; Radix Rehmanniae, Radix Scrophulariae and Herba Dendrobii are added for patients with yin deficiency and heat excess; Add yam, lentils or use Liujunzi decoction for people with loose stools.
Excision of tongue root tumor
Applied anatomy: partial resection of the same tongue.
Surgical indication
1. Benign tumor or tumor-like lesion of tongue root, such as mixed tumor, lymphangioma, ectopic thyroid, etc.
2. Malignant tumor of tongue root, which is a certain distance from epiglottis, will not affect epiglottis function after resection.
Preoperative preparation: ipsilateral glossectomy. Prepare a tracheotomy kit.
Anesthesia: general anesthesia with nasal intubation.
Posture: supine position, shoulder pads, slightly upward.
Surgical procedure
If it is squamous cell carcinoma, adenocarcinoma and other malignant tumors, unilateral or bilateral neck lymph node dissection should be carried out according to the specific situation. If the patient can open his mouth wide and it is a benign tumor, the tumor can be exposed by pulling his tongue out of his mouth, and the diamond-shaped tumor can be cut and sutured by splitting his tongue from the midline.
If the tongue can't be pulled out, or it is a malignant tumor, it is necessary to cut it longitudinally in the middle of the lower lip, or even saw off the mandible in the middle; Before the mandible was cut in the middle, the mark was fixed on the mandible with a miniature titanium plate, and the bottom of the opening and the tongue body were cut in the middle line. After exposure, the tumor was completely removed, the tongue was repaired and sutured in layers. Rigid internal fixation for reduction and fixation of median mandibular fracture; Finally, suture the lower lip incision in layers.
Accident treatment: timely and properly suture to stop bleeding during operation to avoid postoperative respiratory tract obstruction, and preventive tracheotomy when necessary.
Polizel's therapy
1. Inserting a nasogastric feeding tube after operation, generally maintaining a liquid diet for 6-8 days after operation, and extubating after swallowing and eating. It takes 65,438+0.5 ~ 30 days for patients with epiglottitis of the tongue to be fed with nasal liquid, and extubation can only be carried out after swallowing the liquid.
2. Keep your mouth clean and do oral care twice a day. If there is pharyngeal fistula, nasal feeding with liquid diet should be delayed until the fistula is closed.
3. Systemic use of antibiotics to prevent infection.
4. 6 ~ 7 days after operation, the suture of skin and lower lip mucosa was removed. /kloc-Take off the tongue suture on 0/0 day, and let the tongue suture fall off by itself.
5. If tracheotomy is performed, it will be treated with tracheotomy after operation.
clinical experience
1. If the tumor is located in the lateral part of the base of the tongue, after sawing the midline of the mandible, cut the inner mucosa of the opening along the lower part of the internal alveolar ridge, and pull the tongue to the healthy side to expose the tumor and remove it. If the resection area of tongue root is large, it can be repaired with pedicled flap or free flap.
2. If the tumor on one side of the tongue root is large and involves the pharyngeal side wall, the affected mandible can also be removed at the mandibular angle, and the mandibular muscles can be pulled back and forth to completely remove the tongue root and pharyngeal side lesions. Mandibular osteotomy with reduction at both ends and firm internal fixation.