In real life, it is not uncommon for people to experience symptoms of dry mouth, bitter mouth, and bad breath. Epidemiological surveys show that the prevalence of bad breath is quite high around the world. In China, people aged 15-64 years old Among the population, the prevalence rate of bad breath is about 27.5%, and most of these people are also accompanied by symptoms of bitter mouth and dry mouth.

Recently, a friend asked whether dry mouth, bitter mouth, and bad breath are due to excessive liver qi and whether it is caused by internal heat. In fact, this is not necessarily the case. For many patients who experience symptoms of dry mouth, bitter mouth and bad breath, the problem lies in the spleen. Studies have also found that a high proportion of patients are caused by spleen deficiency and dampness resistance.

"Suwen·Liujie Zangxiang Lun" says: "The five flavors enter the mouth and are hidden in the intestines and stomach. The flavors are stored in order to nourish the five qi. The qi is harmonious and generated. The body fluids form each other, and the spirit is generated by itself. "Traditional Chinese medicine believes that the spleen opens into the mouth, its flower is in the lips, and the fluid in it is saliva. The spleen leads to the mouth, and saliva is the mouth fluid, which can moisten the mouth. Therefore, the occurrence of dry mouth is closely related to the spleen. The moistening effect mainly reflected in the oral cavity depends on the Qingqing function of spleen. The spleen and stomach are the foundation of acquired diseases, the source of biochemistry of qi, blood and body fluids, and also the driving force for the upward transmission of body fluids. If the spleen is strong, the source of body fluids will be sufficient, and the body fluids will be continuously transported up to the mouth. Therefore, the body fluids in the mouth will be harmonious and dry mouth will not occur.

However, in modern society, people’s lifestyles and diets have undergone great changes. More and more people are addicted to rich, sweet and rich foods, or have irregular diets, or have liver qi stagnation due to poor emotions. Stagnation, liver wood restrains spleen earth, resulting in spleen deficiency and dry mouth and bitter mouth. Just as Li Dongyuan's "Spleen and Stomach Theory: Lung and Spleen and Stomach Deficiency Theory" said: "A deficiency of the spleen and stomach results in laziness and a tendency to lie down, and the limbs are not able to close up. It is the season of autumn dryness. Dampness and heat are less likely to subside, and there is pain in the weight and joints, a bitter mouth, a dry tongue, and a lack of appetite. , irregular bowel movements, frequent urination, no craving for food, and inability to digest food... When Yang is raised to benefit the stomach, it is called Shengyang Yiwei Decoction."

In addition, the spleen is located in the middle burner and is responsible for transportation and transformation. If the spleen is deficient. It will be unable to transport water, grains and fluids. On the one hand, it will cause food stagnation. On the other hand, it will cause the internal growth of dampness, blocking Yang Qi, and the body fluids will not be able to carry up, resulting in dry mouth, sticky mouth, and bad breath. "Jingyue Quanshu" also records: "Although bad breath is caused by stomach fire, it also has differences other than fire. The odor caused by stomach fire and the turbid qi will also be accompanied by hot mouth and dry mouth, and those with Yangming fire syndrome. That's right. If there is no fire syndrome and the odor is like rancid or sour, soreness in the mouth, belching after eating, etc., it is also like the odor caused by dampness and dirt, which is different from the odor caused by heat, and it is a cause of failure. , and those with weak spleen that cannot transform food are more common. This is a yang syndrome, which should be used to clear the stomach fire, and a yin syndrome, which should be used to regulate the heart and spleen. It cannot be said that odor will cause other diseases. It is pointed out that spleen deficiency and dampness resistance is also one of the important reasons for bad breath.

In the actual treatment, Zhang Shaocai, a doctor from the Longnan Traditional Chinese Medicine team, combined with his clinical practice experience, shared: The treatment principle for spleen deficiency and dampness resistance is usually to strengthen the spleen and remove dampness. Clinically, Shenling Atractylodes Powder can be used to strengthen the spleen. It can promote qi, diuresis and turbidity, and add or subtract according to the actual situation of the patient. If the patient has severe bad breath, add Patchouli, Peilan, and lotus leaves. If there is both qi stagnation and abdominal pain, add Corydalis chinensis and Soupelandia too. Citrus aurantium and Magnolia officinalis. For those with heavy dampness and heat, add Si Miao Powder. For those with stagnant diet, add Jiao Sanxian and Gallus gallus gallinae. For those with poor bowel movements, add Qinpi, betel nut, and Citrus aurantium husk. For those with insufficient Qi, add small doses of Bupleurum and Cimicifuga. To enhance Yang Qi, add Psoralen and Morinda officinalis for spleen and kidney deficiency, and add Acorus and Polygala for those with poor sleep.

For example, a previous patient, 26 years old, reported that he had bad breath symptoms for 1 week and was prone to oral ulcers. He took long-term self-medication of heat-clearing and detoxifying Chinese patent medicines, but the effect was not obvious. He had phlegm in his mouth and dry mouth when he woke up in the morning. , the stool is about once every 2-3 days and is dry. Observing the tongue, it can be seen that the tongue is fat and enlarged, the edges of the tongue are red, and the coating is white and greasy. The syndrome is weak in the spleen and stomach and endogenous dampness and heat. The treatment is to use aroma to dissolve turbidity, clear away heat and purge fire, and strengthen the spleen. Prescriptions include Peilan, Patchouli, Acorus, Coptis, Dandelion, Chrysanthemum, Honeysuckle, Radix Pseudostellariae, Poria, Atractylodes, Amomum villosum, Coix Seed, Chinese Yam, Gallus gallus gallus L. and Licorice. ***5 doses, 1 dose per day, taken warm in the morning and evening. The patient was also instructed to eat a light and nutritious diet and gargle with green tea water. During the follow-up visit, he reported that the bad breath was significantly reduced and the oral ulcers were reduced. After continuing to take 7 doses, all the symptoms disappeared, and there was no recurrence in 1 year.

The patient reported that he had been taking heat-clearing and detoxifying drugs for a long time, because most of the heat-clearing and detoxifying products were bitter and cold. Taking them for a long time would easily damage the spleen yang, cause the spleen to lose its transportation and transformation, and accumulate dampness into phlegm, which would turn into heat over time. However, The root cause is spleen and stomach yang deficiency, and treatment should be based on spleen and stomach strengthening products as appropriate. In this prescription, Peilan and Patchouli are used to dissolve turbidity. If the patient complains of phlegm in the mouth in the morning, add Acorus to remove phlegm and turbidity. The amount of heat-clearing drugs such as coptis and dandelion should be small to avoid further damage to the spleen yang. Chrysanthemum, a refreshing product, can be used instead. Of. Adding Gallus gallus gallinae not only strengthens the spleen, transports and transforms, but also is a good medicine for treating aphthous ulcers; add Shenling Baizhu powder to strengthen the spleen and stomach. This case can be described as a combination of virtual and actual symptoms, so the actual treatment should be modified or subtracted according to the syndrome to achieve the effect of taking into account both the symptoms and the symptoms, and effectively improve the effect of dry mouth and bad breath.

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