凌桂华 肖静 周舒雯 张会择 赖宇

【摘 要】 多涎症以唾液分泌过多，频繁吞吐，不分昼夜为主症。多责于脾阳虚衰，日久及肾，脾肾两虚，水湿不化，上泛为涎。现举验案1则，从脾肾同治入手，治以温脾化饮、益肾摄唾，方以理中汤加减，疗效显著。

【关键词】 脾肾同治;多涎症;验案

【中图分类号】R249.2/.7   【文献标志码】 A    【文章编号】1007-8517（2021）05-0101-03

Exemplification of Clinical Cases of Treatment for Hypersalivation Syndrome Through Common Therapy on Spleen and Kidney

LING Guihua1 XIAO Jing1 ZHOU Shuwen1 ZHANG Huize1 LAI Yu2*

1.School of Clinical Medical Sciences，Chengdu University of Traditional Chinese Medicine，Chengdu 610075，China;

2.School of Basic Medical Sciences，Chengdu University of Traditional Chinese Medicine，Chengdu 610075，China

Abstract：Hypersalivation Syndrome is characterized by excessive saliva secretion， frequent huff and puff， regardless of day and night.It is mainly responsible for the deficiency of Spleen Yang， gradually affecting kidney.Then leading to the deficiency of spleen and kidney，which results in the dampness of waterand the excess of saliva.There is a clinical case of Treatment for Hypersalivation Syndrome Through Common Therapy on Spleen and Kidney illustrated in this article.Warming spleen yang and resolving dampness，reinforcing kidney and intaking the saliva should be the treatment.？Lizhong Decoction was the basic prescriptions，with obvious efficacy.

Keywords：Common Therapy On Spleen And Kidney; Hypersalivation Syndrome; Clinical Case

多涎癥是指唾液分泌过多，分泌与进食不一致，频繁吞咽或吐出，甚至流出口外之症，也称“喜唾”[1-4]。涎唾是口腔中的粘液与唾液，其中清稀水样的称为涎，粘稠泡沫状的称为唾，二者常相兼而见[5]。该症归属中医学“痰饮”“肺痿”范畴，常见中焦湿热、脾胃虚寒、肾阳虚衰、肺气虚寒、胃热虫动等证型，治疗上分别予以清泻脾胃湿热、温补中阳和胃、补足少阴肾经、温肺益气、清热驱虫等治法[1-2]。其发病多与脾肾两脏相关，常因脾阳虚衰，运化失职，迁延失治或久治不愈，日久及肾，气化失司，脾肾两虚，水湿不化，上泛为涎。笔者临床从脾肾两脏同治，取得确切疗效，现浅析如下，以供参考。

1 治法理论

《素问·宣明五气》篇曰：“五气所病，脾为吞……五藏化液，脾为涎”[6]。脾为太阴湿土，为胃行其津液，其津液源于水谷，而布散全身，津液随脾脉上行，泌于口者为涎，脾为涎之生化之源。《张氏医通·卷四》说：“盖脾为涎，脾虚不能约束津液，故涎沫自出”[7]，又《素问·至真大要论》曰：“诸病水液，澄澈清冷，皆属于寒”[6]。脾为水之中州，主运化水湿，主升清，开窍于口，在液为涎。涎为脾所制，生理状态下，脾气的固摄与调节功能正常，涎源源不断分泌于口腔，进食时较多，但不至溢于口外，非进食时减少，涎分泌有度。